Sexual Sadism and Sexual Masochism

Sexual sadism denotes sexual arousal and excitement in response to the psychological or physical suffering of another, whereas sexual masochism denotes a preferred fantasy of selfsuffering. The term sexual sadism derives from the name of the 18th century French aristocrat and pornographic author, Marquis de Sade, who reportedly lived a disreputable adult life abusing young prostitutes. The term sexual masochism was coined by the 19th century psychiatrist Richard von Krafft-Ebing, who derived the term from the name of the well-known German novelist Leopold von Sacher-Masoch, who was reported to have high interest in images of brutality, and in fantasies of being enslaved by a beautiful and torturing woman. Freud was the first to combine both terms—sadism and masochism—into the expression sadomasochism.

The term sadomasochism suggests a fundamental link between sexual sadism and sexual masochism. Although not all masochists also practice sadism and vice versa, factors distinguishing sadism from masochism in any one individual may be subtle and paradoxes may be inherent to both the maso-chist's and the sadist's positions. The supposedly submissive masochist holds control and defines the limits of activity, whereas the sadist suffers a dependence on control (34). For example, the man who erotically enjoys being beaten appears at first glance to be a masochist. Thorough assessment, however, may reveal that he is most aroused by the sadistic experience of controlling his partner by pushing her as far as he can, against her will, to inflict pain on him. The more she resists, the more aroused he is. Only a keen understanding of these subtleties and a detailed investigation of the partners' overt behaviors and internal experiences elucidate an accurate diagnostic formulation.

The incidence of either sexual sadism or sexual masochism is unknown but both appear to be more common in individuals of middle and upper socioeconomic groups. Some utilize prostitutes to act out their fantasies (37). Baumeister estimates that between 5% and 10% of the population engage in some form of recreational sadomasochistic activity, where light discomfort, but not severe pain or injury, is commonly inflicted (38). Far fewer have engaged in sex play where sadomasochistic fantasies are acted out on a regular and preferred basis. Nevertheless, the prevalence of sadomasochistic social clubs suggests that these preferences are not rare. Surveys of sadomasochistic magazine readers and club members suggest that masochistic interests are more common than sadistic interests.

The actual behaviors, as well as their intensity, associated with sadomasochistic preferences vary greatly (39). Spanking or being spanked is common, often using implements such as whips, canes, or hairbrushes. Also common are tying, blindfolding, or handcuffing, or the masochistic reciprocal of being tied, blindfolded, or handcuffed. More rarely, acute pain is inflicted, such as by applying burning candles to bare skin or piercing the skin with sharp objects. Although it is commonly asserted that sadomasochistic partners maintain tightly controlled parameters to avoid serious injury, activities can get out of control and occasionally do lead to injury. In S&M clubs, individuals may be suspended from ceilings or confined in cages. Such behaviors underscore, in the eyes of some theorists, both control and hostility as core elements in sadomasochism. Among the most dangerous of activities are those that involve choking and strangling. Even the most liberal advocates of recreational S&M warn against "breath control play" or asphyxiophilia, asserting that no amount of care can reliably prevent death (40).

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