A popular assumption about people who engage in BDSM is that there must be some kind of psychological pathology underlying their kink. After all, the DSM-V lists some paraphilias, though it now distinguishes between a paraphilia and paraphilic disorder. But, is BDSM healthy?

More on Paraphilia versus Paraphilic Disorder

A paraphilia refers to a specific sexual interest that deviates from the culturally normative. It involves intense and recurrent sexual fantasies, urges, or behaviors that revolve around non-human objects, non-consenting individuals, or activities causing suffering or humiliation. Examples of paraphilias include exhibitionism, voyeurism, fetishism, sadism, masochism, and pedophilia.

A paraphilic disorder, as defined in the DSM-V, is characterized by distress, impairment, or harm to oneself or others due to the presence of a paraphilia. While the presence of a paraphilia alone does not necessarily indicate a disorder, when it causes significant distress or harm or interferes with a person’s ability to function in daily life, it may be classified as a paraphilic disorder.

The distinction between a paraphilia and a paraphilic disorder lies in the impact of the condition on an individual’s well-being and functioning. A paraphilia becomes a paraphilic disorder when it causes distress, impairs interpersonal relationships, creates a risk of harm to oneself or others, or results in an inability to control or limit the behavior associated with the paraphilia.

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Check out the latest research on fetishes and criminality:

• Criminal Histories and Recidivism Rates for Juveniles Convicted of Child Pornography Possession

Read more articles about BDSM.

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The Study

A 2006 study by Connolly sought to address psychological functioning in BDSM practitioners in a rather thorough manner. The author recruited 132 BDSM practitioners from southern California to participate in the study.

The study asked them to answer a rather in depth battery of psychological assessments including the MMPI-2, MCMI, Beck Depression Inventory and many others. It assessed all manner of psychological issues, including trauma. The participants were also asked questions about their BDSM activities and preferred behaviors.

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.

Did the study answer the question: Is BDSM Healthy?

The study found that across most psychological categories tested, BDSM participants scored similarly to the normative samples.

• Depression
  • The participants in this sample scored lower in depression than the normative sample
• Anxiety
  • The participants scored overall lower in anxiety than comparative groups
• PTSD & Trauma
  • PTSD scores on the MMPI-2 and MCMI – III were lower than the general population
• Dissociation
  • The participants scores were higher than the normative sample on the MDI scale
• Sadism & Masochism
  • The participants scored low on psychological sadism.
• Personality
  • The participants scored higher on narcissism than the norm and did not score higher than the norm on any other personality profiles.

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.

So, Is BDSM Healthy?

The results indicated that the people in the study sample, BDSM practitioners from Southern California, were no different than the normative samples used on all of the assessment measures.

There was evidence for higher levels narcissism in the study population. There was also some evidence to suggest that this group had higher levels of narcissism than the normative sample as well. Additionally, the study participants did not have higher levels of trauma than the normative sample.

The authors conclude that there is “little support for the view that psychopathology underlies the behavior.”

Reference: Connolly, P. (2006). Psychological Functioning of Bondage/Domination/Sado-Masochism (BDSM) Practitioners. Journal of Psychology and Human Sexuality, DOI: 10.1300/JO56v18n01_05

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

Do you feel your sexual behavior, or that of someone you love, is out of control? Then you should 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.

The post Is BDSM Healthy or a Deviant Fetish? first appeared on Dr. Jen's Recovery Readings.

There are many articles in the news and troves of internet articles relating to the pornography epidemic. But there are relatively few scientific studies to back up those assertions. And fewer still about pornography and BDSM.

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The Study

In an article published in 2020 in the Journal of Sexual Medicine, Herhenick and colleagues shared their findings from the 2016 National Survey of Pornography Use, Relationships and Sexual Socialization (NSPRSS). 

This survey, taken by 2533 individuals, looked at sexual behaviors such as:

• Dominant or submissive (target) sexual behavior
• Age of 1^st pornography use
• Prevalence of pornography use
• The types of pornography content that was viewed

The subjects were nearly equally men and women varying in age from 18 to 60. The subjects were predominantly white, straight and married.  

For instance, if children are accessing pornography in their early teens, it would be helpful if their sexual education involved some discussion of pornography.

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.

Age of First Exposure to Pornography and BDSM

94% of the men in this study reported some use of pornography with an average age of first exposure to pornography of 13.8 years old. 87% of women in the survey reported pornography use with an average age of first exposure of 17.8 years old.  

There were some differences based on gender as related to dominant and target behaviors. Women were more likely to report they experienced target behaviors, such as being called a slut, having a partner choke or spank them, than men. Women also reported being three times more likely to experience sexual pressure than men. 

Do you believe you have an online pornography addiction? Then take this free Cyber Pornography Addiction Test (CYPAT) and have the results to speak with your therapist.

Pornography Preference by Gender

The survey also assessed gender differences in the types of pornography being viewed.

Men were significantly more likely than women to view pornography that included:

• Facials
• Gang bangs
• Double penetration
• Face fucking
• BDSM
• Simulated rape/pressure to engage in unwanted sexual acts

Interestingly, the more pornography a person had viewed both in the year prior to the survey and in their lifetime was significantly associated with engaging in dominant and target behaviors in all survey participants.

Another Interesting Finding Relates to Consent

Both women (27%) and men who have sex with men (31%) reported they have had a male sexual partner attempt to have anal sex with them without prior discussion or permission. 

This study, post the popularity of 50 Shades of Grey, shows that pornography use and some sexual behaviors considered to be in the realm of BDSM by some are relatively common in a population representative of white, heterosexual Americans.  

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Check out the latest research on fetishes and criminality:

• Criminal Histories and Recidivism Rates for Juveniles Convicted of Child Pornography Possession

Read more articles about BDSM.

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Discussing “Real Sex” Versus Pornography and BDSM

This study has implications both for education and the concept of deviance. For instance, if children are accessing pornography in their early teens, it is important to discuss pornography during their sexual education. Particularly if a young person views the acts in pornography to be what non-porn sex actually looks like. 

In the past, many sexual behaviors have been considered deviant that do not fit into the mainstream, heteronormative idea of acceptable sexual practices. Therefore, obtaining prevalence data about these behaviors can help to decrease the stigma around them. 

It is difficult to call something, like spanking, deviant, because 45 to 76% of this study’s participants have done it.

Reference: Herbenick, D., Fu, T-C., Wright, P., Paul, B., Grados, R., Bauer, J. & Jones, R. (2020).  Diverse sexual behaviors and pornography use:  Findings from a nationally representative survey of Americans aged 18 to 60 years.  Doi.org/10.1016/j.jsxm2020.01.013

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

For an in-depth guide on talking to your adolescents about cybersex and pornography, check out Dr. Jen’s book. Amazon | BookBaby

The post Pornography and BDSM: What Americans are Really Doing first appeared on Dr. Jen's Recovery Readings.

I read Overcoming Unwanted Intrusive Thoughts for several reasons: 

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The first is that we sometimes have individuals referred to us for potential sexual addiction who have intrusive sexual thoughts. Frequently these individuals are not dealing with a problematic sexual behavior, but intrusive sexual thoughts and we refer them out to a great area clinician who specializes in treating Obsessive Compulsive Disorder. 

Second, we do have a lot of clients who have some version of intrusive thoughts. So, I thought: the more I could learn about it, the better.

The subtitle of the book is A CBT based guide to getting over frightening, obsessive or disturbing thoughts. 

My initial assumption was that the book was going to more traditionally CBT focused, but I did not find it so. It reads more like a book that is advocating some level of mindfulness-based practice. 

This is perfect for me as we often use this in our practice. 

One helpful part of this book is how much it normalizes intrusive thoughts. Many people have thoughts that pop into their heads that are about violence, sexualized content or doing or engaging in what the author calls “disgusting” acts. 

Anytime we can work to reduce shame it is a great thing! 

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.

The Six Steps to Overcoming Unwanted Intrusive Thoughts

I want to focus this review on the authors six steps to reduce distress over a thought. They are very mindfulness based and are also extremely applicable to dealing with urges and cravings in any type of addiction. 

The steps are: 

Recognize

The first step is to just recognize that an intrusive thought is just a thought. To adapt this to addiction recovery, a craving is just a craving. We can recognize it for what it is. That means we pause and label it. Thought. Craving, etc.

Just Thoughts

The next step is to remind oneself that it is just a thought or craving. 

Accept and Allow

From there we Accept and Allow the thought or craving. The author says that this means we actively allow the thoughts to be there. We don’t act on it, but we also do not need to give the thoughts or cravings attention. For example, someone in recovery might say to themselves, this is just a craving.

Float and Feel

The Float and Feel step requires perhaps a bit more explanation. The author says to float above the fray and allow the feelings to just stay there. This is described as an attitude of “non-active, non-urgent, non-effortful observation.” This is also called the Wise Mind. Float and Feel is to passively allow the thought or craving to be and not engage with it. 

Let Time Pass

Perhaps one of the hardest steps is to just let time pass. This is to learn to sit with the feelings that come up and not try to immediately do something to get rid of them. Recognize that a thought or a craving is just a false message from our brain. 

Proceed

The last step is to Proceed or just keep going. Continue with whatever it was that you were doing. 

Of course, as with most difficult things we need to change, this process is much easier said than done.  These steps take time to learn and even more time to master.  A good first step is to just be able to recognize a thought or a craving and label it for what it is. I am having a craving.  I am just going to try to sit with it as long as I can without judging it.  Thoughts and cravings pass.

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!

Conclusion

Overcoming Unwanted Intrusive Thoughts is a nice primer to help individuals start to understand their intrusive thoughts. 

It also helps them come to understand if the thoughts are simply intrusive thoughts or indicative of something else, such as OCD, that might require professional help to master.

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

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.

The post Book Review: Overcoming Unwanted Intrusive Thoughts first appeared on Dr. Jen's Recovery Readings.

Earlier this year, Dr. Justin Lehmiller published his book Tell Me What You Want:  The Science of Sexual Desire and How It Can Help You Improve Your Sex Life.  Dr. Lehmiller is a researcher and writer about human sexuality. I became familiar with his work from his blog, Sex and Psychology and use his textbook in my graduate Human Sexuality Course.  I was excited to see him write something for the general public as his previous writings have been more academic.

Dr. Lehmiller wrote this book based on the results of a survey he conducted in which he asked more than 4,000 Americans over 350 questions about sexual fantasies.  He also obtained information about sexual histories, psychological profiles and demographics.  What emerged from the data is that Americans fantasize about sex a lot and many things that might not seem “normal” are quite normal after all.

When people come in to treatment for anything relating to sex, I always get questions about what is normal.  How often do people have sex? How much porn viewing is normal?  I have a fetish, does that mean I am not normal?  For some reason, we are worried about our sexual appetites and arousal templates not being normal.  I always answer that there is no such thing as normal but after reading this book, the “normal” that so many people assume about American sexuality is not terribly normal at all.

So, what are the top seven things Americans fantasize about?  The number one sexual fantasy is about multi-partner sex.  Coming in at number two is power, control and rough sex.  Third is novelty, adventure and variety.  Fourth is taboo or forbidden sex.  Rounding out the bottom three are partner sharing and non-monogamous relationships, passion and romance and erotic flexibility (homoeroticisim and gender bending).

Instead of summarizing the entire book (go read it for all the juicy details), I’ll give you some fun facts.  Men and women are different in how they fantasize.  Interestingly, Dr. Lehmiller found that when women fantasize, they don’t really fantasize about a particular person but in their fantasies, women frequently see themselves as the object of desire.  They are the focus of the fantasy, not the other person.  Men, on the other hand, tend to be the actors in a fantasy, acting on an object of desire.

What do your politics say about your sexual fantasies?  Well, if you are a Democrat, you are more likely to fantasize about things like intimacy, bonding and BDSM.  The Republicans, on the other hand, were much more likely to fantasize about things that are a bit more taboo such as orgies, infidelity and swinging.  Republicans were also more likely to fantasize about things like exhibitionism and voyeurism.  Why you ask?  Dr. Lehmiller suggest that we tend to want what those in positions of authority tell us we can’t have!!!

Dr. Lehmiller’s book is a helpful resource for both therapists and non-therapists alike.  Many Americans deal with a great deal of sexual shame.  They either have been told or believe that their sexual fantasies, desires or behavior are wrong, sinful, perverted etc.  The fact is, the opposite is quite true.  When we hold sexual shame, we tend to repress our true sexual feelings.  This can cause problems in relationships but also in our own mental health.

I will end this short review with the following quote from the book:

“What all this tells us is that we need to stop judging whether sexual desires are healthy or unhealthy based only on how many people in the population have them.  Instead, what we really need to do is look at sexual interests on a case by case basis and ask ourselves two questions that have nothing to do with how many people have them: (1) is this sexual activity consensual or non consensual? (2) does it pose an unacceptable risk of harm to one or more people that goes well beyond the usual risks of having sex?” p181

Dr. Lehmiller has a slightly different take on what I say frequently to my clients and students about sexual desires.  I don’t care what it is as long as it is consensual and legal!

I encourage you to read Tell Me What You Want:  The Science of Sexual Desire and How It Can Help You Improve Your Sex Life.  If nothing else, maybe it helps erase some sexual shame, which is something our culture needs more of!

The post Book Review: Tell Me What You Want first appeared on Dr. Jen's Recovery Readings.

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?

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

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.

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Check out the latest research on fetishes and criminality:

• Criminal Histories and Recidivism Rates for Juveniles Convicted of Child Pornography Possession

Read more articles about BDSM.

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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 8th^th 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!

The post It’s not all sex addiction: A clinical look at BDSM fetish first appeared on Dr. Jen's Recovery Readings.