It’s not all sex addiction: A clinical look at BDSM fetish
When I started working nearly exclusively in the sex addiction field, it was not very widely known and even less widely accepted.
Update: Pornography and BDSM: What Americans are Really Doing
Those 7 years have brought a great deal of recognition to the addiction. The increased attention to sex addiction is, in part, a great thing.
However, there is a down side as well.
The moniker sex addict now seems to be tossed around rather lightly. It’s used as an excuse for sexual behavior when celebrities are caught engaging in behind someone’s back. In my opinion, this is a detrimental development.
First, it minimizes the pain and suffering experienced by someone who truly has a sex addiction.
Secondly, it has the potential to demonize aspects of sexuality because they are “outside the box.”
Why we don’t just say “It’s Sex Addiction”
As a clinician, supervisor, and trainer, I try to emphasize the importance of correctly diagnosing a client’s behavior.
I do not throw the label sex addict around lightly.
I also understand there are things people do that are outside of the comfort zone of societal norms. This does not necessarily make a person a sex addict. I struggle with the idea that one can sometimes hear espoused that anything that is outside the norm of traditional heterosexual sex stereotypes is addiction. In this, and a series of writings to follow, I will take a look at behaviors that are often labeled addictive even when they may not be so.
Just because it may make someone uncomfortable, does not make it addictive.
Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?
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Fetish and Kink Play versus Sex Addiction
The inspiration for this first article comes from my brother, Christopher Weeks, who is a professional photographer (http://black-cat-studios.tumblr.com/) in Tampa, Florida.
He recently posted photography work he had done at an event called Fetish Divine (www.fetishdivine.com). Fetish Divine is an organization that hosts pan-sexual play parties at a club in Tampa.
When my brother photographs these events (as an invited professional) he often gets complaints from others about the photographs being lewd or pornographic.
The famous Supreme Court opinion by Justice Potter Stewart on obscene material has been quoted by the masses for years:
“I know it when I see it.”
However, isn’t that dependent on the viewer?
This discussion with my brother started me thinking about how we view S&M in the sex addiction treatment community. There are some that would always categorize this type of behavior as addictive. The DSM-V (the diagnostic bible for mental health practitioners) places sadomasochism in the paraphilia section of disorders.
Sexual Masochism disorder is defined by a person:
- For at least 6 months, obtaining recurrent and intense sexual arousal from the act of being humiliated, beaten, bound or otherwise made to suffer, as manifested by fantasies, urges or behaviors.
Sexual Sadism Disorder is defined by a person:
- For at least 6 months, obtaining recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges or behaviors.
The key to both of these diagnoses is the B section.
For Sexual Masochism, the fantasies, urges or behaviors must cause significant distress or impairment in social, occupational, or other important areas of functioning.
For Sexual Sadism, the individual has to have acted on these urges with a non-consenting person, or the sexual urges or fantasies must cause clinically significant distress or impairment in the same categories listed above.
From a purely clinical point of view, engaging in BDSM only becomes an issue if it impairs a person’s functioning or if it is with a non-consensual partner.
Are you a Licensed Professional Counselor in need of continuing education? Learn more about Sex Addiction, Erotic Conflict, and Moral Incongruence from Dr. Weeks and Sexual Addiction Treatment Services, an NBCC ACEP™ approved provider!
Sexual Addiction Treatment Services has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7250. Programs that do not qualify for NBCC credit are clearly identified. Sexual Addiction Treatment Services is solely responsible for all aspects of the programs.
Do you have a problem or just an interest?
From the perspective of Sexual Addiction (a diagnosis that does not exist in the DSM-V), we look at BDSM as behavioral categories or scales according to one instrument (the Sexual Dependency Inventory). This means that someone who is a sex addict may engage in behaviors involving pain exchange or humiliation and/or domination. In addiction treatment, as in the DSM criteria for SMD or SSD, we look at the effects of engaging in this behavior on the person:
- Does it cause distress on any level?
- Has the person ever tried to stop engaging in the behavior?
- Do we see an escalation of the behavior in order to get the same feeling or high?
If the answer to these and similar questions is no, then we cannot unequivocally say that the person who is engaging in the BSDM is a sex addict.
Does everyone consent?
When discussing any fetish with a client, I don’t approach it as right or wrong, or addictive or not. We try to frame the fetish with the question “is it healthy or not.” Is the engagement in the fetish consensual for all parties?
Consent is critical. Consent is different from coercion or compliance.
Learn more about consent, compliance, and coercion from Dr. Weeks.
If a person is consenting, they fully wish to participate in the behavior. They are not doing so because they are pressured by a partner or feel they are obligated to do so for some reason. If I engage in the behavior because I fear my partner will leave me, then this is not true consent.
Psychological Distress
Another aspect we look at when discussing fetishes is psychological distress.
- Does engaging in the behavior cause any type of psychological distress to the person?
- Is it creating strain on relationships?
- Is it interrupting normal life functioning?
- Does the person feel ashamed of the behavior they are engaging in or aroused by?
Again, if the answer to these questions is no, then it is not my place as a therapist to label the behavior as dysfunctional, addictive, or wrong.
Struggling with excessive sexual thoughts, urges, or activities that are causing you distress? Take the free, online Sexual Symptom Assessment Scale (SSAS) and get a link to share with your therapist.
Take Aways
As I move into my 8thth year of working nearly exclusively with sexual addiction, I fear that our community, as well as the public, has a tendency to pathologize non-traditional sexuality. I also have a fear that well-meaning therapists will impose their own sexual beliefs and views onto others, particularly clients, and end up doing more harm to a person than good.
As therapists who deal with sex on a daily basis, it behooves us to know our own boundaries with sex but also be open to other forms of sexuality that others enjoy. Can we work to re-frame sexuality, sexual addiction, and “deviance,” moving away from right and wrong, good and bad to “is it healthy for you?”
If it is, then perhaps we don’t need to pathologize it. If it is not, then we can help our client to work through their issue.
Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.
Are you looking for more reputable, data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.
Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.
Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?
Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!
July 31, 2014 @ 4:21 pm
I think your ‘summary’ question is fair, but it must be hard to determine in different individuals, and how they ‘raise the bar’ on pain levels, degredation, etc..? I wonder what percentage of ‘addicts’ are more dependent on the imagined ‘affirmation’ that comes with sex. Please excuse the way i’ve expressed myself, I’m ignorant of, but extremely interested in this subject!
July 31, 2014 @ 4:51 pm
John
This is a very valid question. The name Sex Addiction is a bit of a misnomer when you look at the root of addiction. In my opinion, Sex Addiction truly has nothing to do with sex. It is about a search for connection that often comes from ruptured attachments. One of the core beliefs about sex that many sex addicts have is that sex is love. Sex and love get fused somewhere along the line. Therefore, your thought about an addict becoming dependent on the affirmation from sex is dead on. A downward spiral often ensues. I need sex for validation/love but perhaps feel shameful about my sexual behavior. That fuels my negative self beliefs about being bad and unlovable. Those feelings are intolerable so I try to fill the emotional hole and use sex to do so. The spiral ensues. If I only feel validated or affirmed through sex but feel bad about my behavior, I am bound to escalate both the behaviors and bad feelings. Thanks for your comment. Jennifer
October 19, 2021 @ 11:17 pm
My boyfriend and I broke up 3 weeks ago due to his fettish activity. He was engaging in online porn and chat rooms while I was away. He seems to have a duo personality and was very loving and caring on one hand, but needs genital mutilation and BDSM stimulation to enjoy sex. I have experimented with him when we first began dating and he could tell I was not that into it.
I didn’t find out until 1 1/2 years into our relationship that his 17 year marriage was ruined by this behavior, not only from porn but reaching out to online prostitutes that he felt he had relationships with and flying to see them in person.
He started reconnecting with one that was also a con artist. When I found out and confronted him, he yelled at me and left the relationship without any discussion. He was embarrassed to be caught in a lie and ashamed. We reconnected after a month apart. He promised he cut all contact with her. She ruined his life once and he would let it lose me too.
2 years later, I started noticing some warning signs again- too much information on what he did in a day while I was traveling, getting his second nipple pierced, and sending selfies to someone else when we traveled together.
I caught him in a tiny lie one evening that opened to more…again he yelled and me and deflected to make it my problem that I do not trust him. He ended our relationship immediately, again, without discussion.
One of my points to him is that this prostitute (who is married) did not have a relationship with him and is using him for money. I felt he was reaching out to her again.
One hand I feel relieved to be out, but I don’t understand the duo personality that is he is in denial over this behavior. He was a great partner to me to me most of the time, but was addicted to this behavior and had to get it from somewhere if I am not engaging.
I guess my question is how to process this – sometimes I feel that I brought this on. I tried to open conversation about it on numerous occasions, but he would always shut down, maybe out of shame or embarrassment. Is this addictive behavior? …how can I encourage him to get help?
January 1, 2022 @ 3:55 pm
Sorry for taking months to reply. The post was lost in mountains of spam. It is hard to tell without meeting someone if the behavior is addictive. Fair to say it is problematic as two relationships were lost due to it. He can find qualified help either with http://www.iitap.com or http://www.sash.net. Both organizations certify therapists in this area. Always best to get assessed by a professional. And…not something you brought on.