Friday, June 14, 2013

Two Texts on BDSM and Psychiatry

I am hard pressed for time this week and did not know whether I would be able to write a post. But as luck would have it, I found two interesting texts I can reference.

I was reading an online discussion about ethics that started out completely unrelated to BDSM, but then had someone bringing in BDSM as a topic of ethics. Some people propagated the usual ignorance, equating BDSM to violence and claiming that anyone who is into "such crap" must have had a traumatic experience during childhood. One participant in the debate, who was apparently kinky himself, kindly pointed out that this is utter nonsense. I did not get involved myself. The discussion was several years old already, and even if it had been current, I tend to not waste my time with such matters anymore.

However, in reading through that discussion, I found two interesting texsts on BDSM and psychiatry. One is Psychology & BDSM: Pathology or Individual Difference? by Margaret Nichols, a psychologist and fellow kinkster, who delves into the history of psychotherapy and sexual minorities:

In the area of sexuality, psychology has been particularly harsh and justified particularly brutal treatments for those considered "sexual deviants." Through the first half of the twentieth century, girls who had "excessive sex drive", e.g. masturbated regularly, were considered abnormal and might be subjected to clitoridectomies; until the 1970s gay people could be committed to mental institutions by parents; and even today electro-shock aversion therapy and so-called "chemical castration" are considered acceptable psychiatric interventions for sexual paraphilias - among which are included Fetishism, Sexual Masochism, Sexual Sadism, Transvestic Fetishism, and other practices near and dear to some of us.

Why does psychiatry even concern itself with sexual behavior that is consensual and adult? Why label any such behavior "sick"? Urban anthropologist and founding LSM member Dr. Gayle Rubin has described the way society views sex by classifying sexual behavior as part of the "Charmed Circle of Sex" versus the "Outer Limits". Basically, society likes sex to be straight, married, monogamous, private, not-forhire, procreative, and vanilla. Some BDSMers manage to violate each and every one of those proscriptions - sometimes all at once! According to Rubin, society does its best to eradicate or suppress behavior on the "outer limits". We do this in several ways, including social and religious disapproval, legislation around sexuality, and classifying behavior as psychologically "sick" versus "healthy". Enter the role of psychiatry.

Mental health theories have changed. Masturbation is okay; women can be sexual; even homosexuality is no longer a mental illness. But psychiatry still pathologizes BDSM, and I maintain that this contributes to shame, secrecy, isolation, and selfloathing within the BDSM community. More concretely, it justifies laws criminalizing S/M behavior, legal decisions to deny child custody to kinky people, and discrimination in job and housing areas. So it’s more important than you think to fight the psychiatric classification of kinky behavior.


Nichols goes on to make a case for why it is unwarranted and harmful to classify an inclination for BDSM and assorted fetishes as "paraphilias", argues that traditional psychological theories of sexuality from Krafft-Ebing to Freud have been "pretty dismal", but still exert influence today, and proposes an alternate view labelled "the paradoxical view of sex", which holds that "there is no reason to consider sexual behavior pathological unless concrete evidence of lifethreatening or similar horrendous harm exists, or unless it is nonconsensual (by definition including children as nonconsensual)".

The other text I wanted to bring to your attention is Bias in Psychotherapy with BDSM Clients and BDSM in Psychotherapy: A Culturally Aware Curriculum by Heather Powers:

Bondage, Discipline, and Sadomasochism (BDSM) is a sexual orientation and behavior often misunderstood by both the psychological community and the public. Although extreme and obsessive BDSM activities may point to a paraphilic diagnosis, the majority of people involved in BDSM are well adjusted, successful and productive members of society. It is important that the mental health community have proper tools for differentiating between paraphilic disorders and healthy sexual diversity. Paper one examines the historical and present experiences of BDSM participants as a stigmatized sexual minority. Paper two addresses twelve clinical guidelines for providing culturally sensitive care to BDSM clients. These guidelines may be used as a three segment class for mental health providers interested in working with BDSM oriented clients.

In Powers' thesis, I found the various surveys and studies she cites of particular interest, and the insight they provide into the variety of people's motivations for BDSM, the variety of BDSM practices and lifestyles, and the fact that an inclination for BDSM does not point towards mental illness, past abuse or difficulty with "normal" sex, as is sometimes assumed. All of which is in accordance with my own experiences and impressions of both my own kink and the kinks of others I have met in the BDSM community.

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Lea said...

Very interesting writings. Thanks for sharing.