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A previous study found a variety of unusual sexual interests to cluster in a five-factor structure, namely submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism (Schippers et al., 2021). The current study was an empirical replication to examine whether these findings generalized to a representative population sample. An online, anonymous sample ( N = 256) representative of the Dutch adult male population rated 32 unusual sexual interests on a scale from 1 (very unappealing) to 7 (very appealing). An exploratory factor analysis assessed whether similar factors would emerge as in the original study. A subsequent confirmatory factor analysis served to confirm the factor structure. Four slightly different factors of sexual interest were found: extreme, illegal and mysophilic sexual activities; light BDSM without real pain or suffering; heavy BDSM that may include pain or suffering; and illegal but lower-sentenced and fetishistic sexual activities. The model fit was acceptable. The representative replication sample was more sexually conservative and showed less sexual engagement than the original convenience sample. On a fundamental level, sexual interest in light BDSM activities and extreme, forbidden, and mysophilic activities seem to be relatively separate constructs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: The purpose of this study was to obtain information about the sexual behaviors, sexual functioning of "bondage-discipline, dominance-submission, sadism, masochism" (BDSM) practitioners., Methods: The study group (n=141) consisted of 65 women and 76 men who defined themselves as BDSM practitioners included in the study with the snowball technique through websites that are accessible on online BDSM groups. A control group (n=167) who stated that they were not BDSM practitioners was also recruited through websites. Sociodemographic and Sexual Behavior Evaluation Form and Arizona Sexual Experience Scale (ASEX) were used online to gather data., Results: No significant difference was found between BDSM practitioners and controls with regard to ASEX scores. Yet, in women, the mean ASEX score was lower in BDSM practitioners than in the control group whereas in men, the mean ASEX score was higher in the BDSM practitioners., Conclusion: Gender might be an important factor in terms of sexual functioning in cisgender BDSM practitioners. Awareness on problems of this sexual minority should be increased., Competing Interests: Conflict of Interest: The authors declared that there is no conflict of interest., (Copyright: © 2024 Turkish Neuropsychiatric Society.)

Sexual consent has received increased attention in mainstream media, educational, and political settings since the rise of the #MeToo movement in 2017. However, long before #MeToo, sexual consent has been a core practice among people who engage in Bondage and Discipline, Dominance and Submission, Sadism, and Masochism (BDSM). This study examined sexual consent norms among a sexually diverse sample, including people who practice BDSM (n = 116), people who identify with another sexual minority group, such as swingers and sex workers (n = 114), and people who did not identify with a sexual minority group, termed sexual majority group members (n = 158). Explicit consent for both BDSM- and non-BDSM-related activities was rated as more common (descriptively normative) among people who were a member of the BDSM community compared to majority participants. Further, BDSM participants rated consent discussions as less sexually disruptive compared to majority participants. We found no significant group differences in the extent to which people thought sexual consent should be discussed. We also discuss findings from an open-ended question asking participants to recall a recent sexual experience with a new partner. This study demonstrates variability in consent norms between groups and points to the potential to shift sexual consent behaviors among majority participants., (© 2023. Crown.)

This article examines the development of male bondage in Britain during the 1970s and 1980s through an examination of products designed by Jim Stewart, who founded the company Fetters in 1976. Through research using primary written sources, interviews with early customers, users and business partners, and the objects themselves, this paper situates Fetters designs within the broader infrastructures that were essential for the development of the material culture of male BDSM. The research finds that the primary contacts and inspiration came from outside of the emergent gay leather scene, in particular the cult of Houdini and publications that facilitated collecting of esoteric objects. Furthermore, military culture is shown to have influenced the design and mediation of bondage objects in a way that was fundamental to their design and functioning. This analysis therefore highlights some tensions surrounding cultural aspects of sexual identity that were negotiated through the design and development of objects produced at Fetters.

In this paper, I set out to describe the different viewpoints, conceptualisations and defence mechanisms of the state of passivity; the categorisation by Freud; how the perspective of his thinking was altered by later insights and clinical observations; the close connection between the superego, passivity and masochism; the significance of the internal object world for Melanie Klein; countertransference as a means of access to masochism and destructiveness, with the aid of a short case illustration; and, finally, Betty Joseph's clinical experiences in work with her patients.

This study examined the relationship between narcissism, masochism, and violent criminal justice involvement. Current interventions used with offender populations target traits such as antisocial personality but typically ignore narcissism and masochism. Understanding the connection between violent crime, narcissism, and masochism can help us develop a more indepth understanding of which personality features contribute to an increased proclivity towards criminal action. The participants (N = 494) were post-incarcerated individuals. To assess individuals' degree of narcissistic and masochistic thinking, the Narcissistic Personality Inventory and the underserving self-image subscale of the Self-Defeating Interpersonal Style Scale were administered via a Qualtrics survey. Basic demographic information, psychopathy, intelligence, and personality were also measured and controlled for in the analyses. A logistic regression indicated that high levels masochistic thinking were associated with violent criminal justice involvement, even when relevant covariates were controlled for. High levels of narcissism were not found to exhibit a statically significant relationship with violent criminal justice involvement when psychopathy was controlled for. These findings suggest that masochistic characteristics may be a potential target for treatment in rehabilitating offenders., (Copyright © 2023 National Medical Association. Published by Elsevier Inc. All rights reserved.)

Adult baby/diaper lovers (AB/DLs) enjoy role-playing as babies and/or wearing diapers. They also engage in other related activities, such as urinating or defecating themselves and having an adult care for them. Previous surveys have revealed that AB/DLs commonly report sexual motivation, a finding that is corroborated by case reports in the psychiatric literature and some media interviews. The fact that AB/DLs change their appearance and behavior to become more like babies raises the possibility that they have an erotic target identity inversion (ETII). In ETIIs, a person's external erotic target is inverted into the self, resulting in sexual arousal by the fantasy of being a member of the target class or by imitating one. If AB/DLs are sexually motivated by an ETII, they should experience both sexual attraction to babies and sexual arousal by the fantasy of being a baby. We surveyed 207 male AB/DLs recruited from the Internet about their sexual orientation, sexual motivation, and sexual interests for a primarily quantitative analysis. Consistent with past research, a substantial minority of participants reported non-heterosexual identities (42%), and a large majority reported some degree of sexual motivation for being AB/DLs (93%). Wearing diapers and urinating or defecating oneself were rated as especially sexual. Even though 40% of participants reported sexual arousal by the fantasy of being a baby, only 4% reported sexual attraction to babies. This pattern of results is contrary to predictions from the concept of ETIIs. Instead, participants indicated that physical or mental pain, humiliation, and an adult woman were important to their sexual fantasies of being a baby. Masochism appears to be a promising alternative to an ETII for explaining the sexual motivation of AB/DLs., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Dominant/submissive role-play (D/s) is associated with specialized roles including Mistress, Master, Slave, Switch, Sadist, and Masochist. The current study uses cluster analysis to provide empirical evidence that no binary opposition or single spectrum constitutes a workable typology of individuals based on their affinities for these roles. The optimality of a particular choice of clustering scheme, including the number of clusters, is established using a replication technique which is presented in detail. A large number ( n = 236,353) of individualized results (profiles) generated by the BDSM Test, a popular anonymous web survey, were analyzed. We hypothesize a two-dimensional typology of D/s profiles as the inferential result of our cluster analyses.

Little is known about distinct factors linked with acting on paraphilic interests or refraining from engaging in paraphilic behaviors. Participants from Canada and the United States ( N = 744), aged 19-42 years ( M = 29.2; SD = 3.18), were recruited through Amazon's Mechanical Turk. Participants completed questionnaires about their paraphilic interests and behaviors, as well as potential key factors linked to behavioral engagement (i.e., perceptions of consent, sexual excitation/inhibition, impulsivity, moral disengagement, empathy). Results indicated that higher moral disengagement and impulsivity, lower sexual control (i.e., high sexual excitation, low sexual inhibition), and maladaptive understandings of consent were best able to differentiate individuals who reported highly stigmatized (e.g., hebephilia, pedophilia, coprophilia) or Bondage and Dicipline, Dominance and Submission, Sadism and Masochism(BDSM)/Fetish paraphilic interests and engagement in the paraphilic behaviours associated with these interests relative to individuals who did not report such paraphilic interests or behaviors. Moreover, higher moral disengagement, impulsivity, and maladaptive perceptions of consent were best able to differentiate non-consensual paraphilic interests and behaviours (e.g., voyeurism, exhibitionism) compared to individuals who did not report these paraphilic interests or behaviours. These results provide future directions for the exploration of mechanisms that may contribute to engagement in paraphilic behaviors and may be targets for intervention aimed at preventing engagement in potentially harmful paraphilias.

Powerplay, or the consensual power exchange between "Dominant" and "submissive" (D/s) role partners, is common practice within BDSM culture. To many BDSM practitioners, their D/s role is an integral part of their sexual identity, informing not only their sexual scripts but also their non-sexual social interactions. Linguistic Inquiry and Word Count (LIWC) text analysis software was used to process 261 participants' responses to prompts asking them to write erotic and relationship-themed narratives. Using a data-driven approach to model selection, we regressed participants' engagement in BDSM and D/s powerplay role identification on standardized language frequencies. Stories from more active BDSM practitioners' narratives used more perceptual words, suggesting potentially mindful, intimate, and detailed storytelling, whereas non-practitioners used more tentativeness and death in their writings. Moreover, language reflected D/s role attributes, with Dominants exhibiting ownership, responsibility, and other-focus, and submissives referencing power dynamics and self-focus in their responses. Findings are consistent with existing literature on BDSM power relationships and relate to psychosexual well-being.

Previous studies have shown that individual differences in adult playfulness are important in interpersonal relationships. However, there is a lack of research on the role of playfulness in human sexuality. Using three studies with four independently collected samples ( N total  = 1,124) we tested the differential relations between global playfulness and four facets of playfulness ( O ther-directed, L ighthearted, I ntellectual, W himsical; OLIW) with broad ("Sexy Seven") and narrow (sociosexuality, sexual sensation seeking, and sexual compulsivity) sexuality-related personality traits and sadomasochistic sexual practices (BDSM). Our main findings were: (1) Each of the Sexy Seven traits was related to global playfulness or at least one playfulness facet while only Whimsical playfulness (liking odd and/or unusual things, persons, or activities) was related to each Sexy Seven trait; (2) Sexual sensation seeking related to playfulness with small effect sizes ( f 2  ≤ 0.11), Whimsical playfulness positively related to narrow traits of sexuality; and (3) those engaging in BDSM were more playful than non-practitioners. The findings support the notion that playfulness (particularly Whimsical playfulness) relates to sexuality-related personality traits and sadomasochistic practices may be one way of expressing adult playfulness.

According to previous research, interest in BDSM (Bondage-Discipline, Dominance-Submission and Sadomasochism) activities is high in several European countries and various BDSM practices are not uncommon. There is a limited amount of research on the personalities of BDSM practitioners, but in previous research practitioners have been found to have better overall well-being and to be more educated than the general population. The current study explored the prevalence of BDSM interest and practice in a Finnish sample ( n = 8,137, age range 18-60, M = 30.14, SD  = 8.08) and investigated the association between BDSM interest and personality measured with the six-factor personality measure HEXACO. A total of 38% of the sample was interested in BDSM sex and non-heterosexual individuals displayed almost twice as much interest and at most 83% more participation in BDSM than heterosexual individuals. Younger participants (18-28 years old) displayed almost three times as much interest than older participants. There were some associations between BDSM interest and personality factors, but the effect sizes of these associations were modest. The study shows that BDSM interest is quite common among the Finnish population.

In this article, we report research participants' experiences providing professional bondage, discipline, sadism, masochism (BDSM), and other fetish services in Canada. Like many sexual service providers, professional dominatrices often argue that their work challenges patriarchal and oppressive systems of sexual and gender conformity. These women assert that Canadians misunderstand the range of activities that fall under "BDSM" and the dynamics of power within the provider/client relationship. As a result, misrepresentations and inaccuracies form the basis of Canadian laws, which open professional BDSM practitioners to criminalization and remove provider and client autonomy to consent. The 35 professional dominatrices who participated in our mixed-method study challenge this narrow interpretation of their work, suggesting that Canadian law denying bodily autonomy in this context fails to reflect the realities of professional BDSM. Rather than protection from violence, the mischaracterization of the services as criminal in nature serves to perpetuate marginalization, increase vulnerability to exploitation, and maintain stigmatization of non-normative sexualities., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Sexual assault in higher education is a continuing concern. At the same time, college students are engaging in a range of consensual sexual behaviors that could appear to be sexual violence. Sexuality education on college campuses should address the spectrum of sexual behaviors and college health professionals and administrators need to be able to distinguish consensual rough sex from sexual violence. Common consent negotiations in BDSM (bondage and discipline, dominance and submission, sadism and masochism) contexts may serve as an appropriate model for acquiring consent. This viewpoint article aims to (1) review the increased participation of college students in diverse sexual behaviors, and (2) introduce the consent process of BDSM as a framework for college health professionals to discuss consent for other sexual behaviors.

Masochism is central to all pathologies and its relevance in clinical practise cannot be underestimated. The initial connection made by Freud was that masochism was a component or partial instinct, still operating within the pleasure principle. The relationship between masochism and the theory of drives marks a main theoretical difference in the different authors' explorations of this subject. The understanding of what is meant by 'masochism' gained complexity following Freud's postulation of a life and death drive (which is more or less contemporary with his 1924 paper on masochism) and the differences made by him between 'primary' and 'secondary' masochism. This introduction to the papers presented in this section will address some of these differences, as well as exploring the notions of primary erotogenic masochism, feminine and moral masochism. It will also look at the notion of binding /unbinding of the life/death drives, and the role of the superego. It will introduce the different papers by Novick and Novick, Bourdin, Frank and Persano on developmental perspectives, primary masochism, views on French analysts such as Benno Rosenberg and on Kleinian ideas on the subject as well as on the role of the body, pain and self harm.

Background: As behaviors, alternative sexual (alt-sex) (i.e., kink, bondage, discipline, dominance, submission, sadism, and masochism , consensual non-monogamy, swinging, leather, and fetish practices) practitioners often emphasize that consent and boundaries are key elements of alt-sex activities. Despite these emphases, individuals experience consent violations and sexual assault both prior to engaging and during their involvement in alt-sex activities., Purpose: This study examines alt-sex practitioners' sexual assault and nonconsensual experiences in order to highlight potential means of intervention and prevention, as well as inform clinical and legal professionals., Methods: In collaboration with the National Coalition for Sexual Freedom, this study uses an international survey of adults in alt-sex communities ( N = 2996) to examine sexual assault and nonconsensual experiences both within and outside of alt-sex contexts., Results: We found a lower rate of consent violations in the alt-sex community (26%) compared to sexual assault as an adult outside of alt-sex contexts (34%) and sexual assault as a minor (40%). We found significant differences by groups in sexual assault as a minor (gender, sexual orientation, age, and live in the US or not), sexual assault outside of alt-sex contexts (gender, sexual orientation, and age), nonconsensual experiences in alt-sex contexts (gender, sexual orientation, age, and race), receiving nonconsensual touch in alt-sex contexts (gender, sexual orientation, and age), giving nonconsensual touch in alt-sex contexts (sexual orientation, age, living in the US or not, and race), and being falsely accused of nonconsensual touching in alt-sex contexts (gender, age, and living in the US or not). Within the most recent consent violation, the most common behaviors were non-kink related, except for lack of aftercare. Nearly 40% of participants reported the reasons for their most recent consent violation in alt-sex contexts were being selfish or caught up in the moment., Implications: Focused interventions are needed to address how different populations are experiencing assault and violations in alt-sex contexts.

Masochistic elements are puzzling entanglements for most of us in the beginning. Taking Melanie Klein's attempts to think about them thus show one way how to make sense of them. Starting from her struggles with masochistic symptoms in child analyses in the early 1920ies Melanie Klein tried to conceptualize those experiences in a way that could help to fact them in the analytic process. In this article the development is outlined, the move from thinking about them in libidinal terms to gradually grasping in greater depth their destructive quality. She speaks of an "evil principle" and then finds a conclusive solution in conceptualizing masochism as a representation of the death drive. In the next decades her followers would further work on the complexities of the countertransference issues and superego organizations in masochism in more detail as will be shown. Finally, a look in a piece of present analytic work will exemplify the clinical usefulness of the Kleinian conceptualization.

This paper attempts to address self-harm from a psychoanalytic perspective in contemporary clinical practice and their relationship with aggression, impulsiveness, violence, and masochism. Self-harm is frequent in adolescents and young people, predominantly in feminine gender. The author describes the different manifestations of self-injurious behaviors in the contemporary clinic, its manifestation in adolescents and its relationship with psychopathology. Self-harm is a way of communication, through actions, to deal with psychic pain and with the self-vulnerability. Self-harm behaviors are a manifestation of psychic tension that results overwhelming, intolerable and its discharge relieves the subject suffering, although this way is ephemeral. Suffering is linked to childhood traumatic experiences, where the self of the infant was cathected with a greater amount of aggression than erotic libido. The author states that affective aggression is triggered by emotions like anger, sadness, and emptiness. Archaic masochism is a form of identification with the aggressor and a turn against oneself aggression commonly associated with episodes of child abuse. Also, it argues that the violence linked to self-injury is intersubjective fabric in nature and requires an interdisciplinary approach.

Benno Rosenberg's work has been little translated into English. Yet, his work on masochism is a landmark in France. He set himself the goal of deploying all the richness and implications of the second Freudian drive theory and the introduction of the death drive. He therefore returns to "the Economic Problem of Masochism" to give all its value to the drive fusion that it achieves internally and which is therefore for it "guardian of life", even if it is can also be fatal. He draws consequences on the psychic construction of the ego, the superego and on that of temporality. He also describes a "work of melancholy" which is different from mourning. Thinking it necessary to push the consequences of the new theorizing further than Freud was able to do, he revisits "Inhibition, Symptom and Anxiety" to articulate the triggering of anxiety by a libidinal demand and the threat to the unity of the ego who comes from the death drive due to conflict. Starting from the psychosomatic descriptions of Pierre Marty, whose options are specified, he also proposed a metapsychology of somatization during the overflow of the psyche by the destructiveness which will then threaten the body.

This text presents how Freud thinks about the masochism. In 1915, it is the return of active sadism in a passive drive which is characteristic of masochism, always secondary. In 1919, he sees in masochism the genesis of perversions. And the article of 1924 knows a primary masochism and distinguishes erotogenic masochism, feminine masochism and moral masochism. After Freud, many studies of clinical forms of masochism can be noted, and in France there is a thesis about the masochism as a first psychic link (Benno Rosenberg, Marilia Aisenstein).

Recent research has shown that a tendency to harm others goes hand in hand with a tendency to harm oneself. The present two studies further supported the notion that the joy of harming others and oneself has a common core by showing positive relationships between dark personality traits (particularly psychopathy) and sexual masochistic preferences and between general masochistic tendencies and sexual sadistic preferences. Despite the overlap between dark personality traits and general masochistic tendencies, they independently predicted the engagement in sexual sadomasochism. These relationships statistically held when controlling for the impact of basic personality (Study 1). Study 2 found that self-enhancement, openness to change, and low conservation values serve as motivators for a person's attraction to sexual sadomasochism and shed some light on the differences between sexual sadomasochism and the Dark Tetrad. Overall, people who score relatively high on dark personalities and masochism are particularly predisposed to engage in sexual sadomasochism, in both the dominant and the submissive roles., Competing Interests: Declaration of competing interest The author has no declarations of interest., (Copyright © 2022 The Author. Published by Elsevier B.V. All rights reserved.)

Over the last 102 years, a lot of discussion was being held about the psychoanalytic conception of the "death drive," but still with inconclusive results. In this paper, we start with a brief review of Freud's conception, followed by a comprised overview of its subsequent support or criticisms. The core of our argument is a systematic review of current biochemical research about two proposed manifestations of the "death drive," which could hopefully move the discussion to the realm of science. It was already established that drive satisfaction leads to the secretion of beta-endorphins, and research evidence also shows that the same biochemical mechanisms get activated in the case of masochism and the gambling disorder but only if they are preceded by chronic frustration of the essential drives. We conclude that the actual situation is more complex than Freud hypothesized, and that a fundamental revision of the psychoanalytic drive theory is necessary., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kirsch, Dimitrijevic and Buchholz.)

Bondage/discipline, dominance/submission, and sadism/masochism (BDSM) proclivity among college students is poorly characterized, in part because existing measures of BDSM proclivity highlight the consensual nature of BDSM and are appropriate for use with non-community members (e.g., those who may not understand BDSM jargon). The current study introduces such a measure, the BDSM Proclivity Scale, which characterizes BDSM proclivity among college students and evaluates relations of BDSM proclivity with other sexual attitudes and behaviors. College students (n = 552) completed measures of BDSM proclivity, sociosexual attitudes and behaviors, rape-supportive attitudes, lifetime sexual partners, and consent-seeking behavior. Two factors mapping onto attitudes and experiences related to BDSM were identified and cross-validated. Average endorsements of BDSM attitudes and experiences on a 7-point Likert scale (1 = strong disagreement, 7 = strong agreement) were 5.61 and 4.44, respectively. Structural models revealed that lifetime sexual contact and gender significantly positively correlated with BDSM attitudes and experiences, sociosexual attitudes positively correlated with BDSM attitudes, and rape-supportive attitudes positively correlated with BDSM experiences. Consent-seeking was unrelated to BDSM experiences or attitudes. College student BDSM proclivity was evident for both attitudes and experiences, highlighting the need to characterize the development of BDSM proclivity and its correlates, the sources of students' knowledge, and the nature of students' experiences. The observed associations between BDSM proclivity and relevant sexual attitudes and behaviors support its construct validity and suggest that BDSM proclivity may prove to be an important addition to the broader constructs assessed in sexual attitudinal and behavioral domains., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Empirical research on the origins of kinky erotic desires (e.g., sadomasochism, bondage, domination/submission, roleplaying, sexual fetishism, etc.) has been limited and rarely rooted in the narratives of kinky people themselves. Among a sample of 260 self-identified kinky users of a kink-oriented social networking website living in 21 countries, we examined self-reported narratives of the origins of kink desires. An inductive coding process by four independent coders yielded 20 categories of responses, organized into five broad discourses about the origins of kinky desires: identity (e.g., personality, personal taste, and role exploration; 72.7% of responses), nurture (e.g., both traumatic and non-traumatic life experiences; 38.1% of responses), negation (e.g., disavowing or doubting a particular idea about the origins of their kink interests; 24.6% of responses), nature (e.g., biology and genetics; 22.7% of responses), and uncertainty (e.g., not being able to identify an origin of kinky desires; 10.4% of responses). Fewer than 19% of participants mentioned any kind of trauma in their responses. We discuss implications for scientific understandings of kinky sexual desire within the umbrella of sexual diversity.

This national web-population study from Norway ( N = 4,148) assessed 1) the prevalence of BDSM and role-play interests and behaviors, 2) the socio-demographic characteristics of the BDSM-oriented participants, and 3) the associations between a) BDSM and b) role-play interests and behaviors, and sexual satisfaction, relationship satisfaction, and relationship closeness. Over one in three study participants endorsed at least one BDSM interest or behavior variable. There were no gender nor educational level differences between the BDSM-oriented participants and their traditional "vanilla" (non-BDSM-oriented) counterparts, though BDSM and interests were more common among younger and self-identified LGBQ+ participants. Sexual satisfaction was positively associated with role-play and BDSM behaviors while interest in role-play (but not having previously engaged in it) was negatively associated with this outcome. Lower relationship closeness was associated with an interest in role-play (but not having tried it). No BDSM-related variables were significantly associated with relationship closeness. The findings suggest that BDSM interests and behaviors are relatively common and are linked with sexual and relationship satisfaction.

Prior limited research on entrance into BDSM divided paths of entry into external or internal factors (Yosta & Hunter, 2012), while research on age at entry into BDSM has not considered variation by BDSM role identity, gender, sexual orientation, and other demographic differences. In this mixed-methods exploratory study, we contribute to this literature by collecting and analyzing qualitative interviews with 96 self-described practitioners of BDSM to more fully describe distinct pathways into BDSM, adding nuance to prior descriptions of entry. We also collected and analyzed surveys with 2,017 self-described practitioners of BDSM to examine patterns of age at entry into BDSM practices and fantasies, and selection into older or younger age at practice and age at fantasy by BDSM role identity, gender, sexual orientation, and other demographic characteristics. Interview respondents told "constructionist sexual stories" describing introductions to BDSM via popular culture including pornography and other media, the Internet, or a sexual partner that awaked an inherent interest, along with "essentialist sexual stories" which described self-discovery solely attributed to an inherent personality characteristic. Survey data revealed that age at fantasy and onset of behavior varied by social-environmental factors. Pathways and patterns into BDSM behavior and fantasies therefore reflect a combination of idiosyncratic interests, exposure to ideas via the media or partners, and stratified social norms and opportunities related to sexual behavior., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The purpose of this study was to examine Norwegians' reports of seven varied sexual acts. Data were obtained from a questionnaire survey of a probability-based web sample of 2,181 men and 1,967 women aged 18-89 years. Among seven acts of sexual variety, the most common sexual experiences were trying to watch pornography with a partner, engaging in sex in unusual places, and using sex toys. Older age was negatively associated with all sexual behaviors. Regarding more unorthodox acts of sexual variety, heterosexual men's sexual preferences involved having and desiring group sex, whereas heterosexual women's sexual experiences and desires involved having sex in unusual places. Lesbian, gay, bisexual (LGB) individuals generally showed greater curiosity or experience of having group sex and engaging in BDSM (bondage, discipline, dominance and submission, and sadomasochism) activities than heterosexual adults. However, while LGB men had a high preference for group sex activities, LGB women had more positive attitudes toward BDSM activity. Individuals appear to accumulate more acts of sexual variety over time, thus making the incorporation of sexual variety a function of age. This study supports the idea that sexual variety has expanded among those born from 1960 onwards.

Memorializes Paula J. Caplan (1947-2021). Caplan was a leading scholar in feminist psychology, and an early contributor to the feminist critique and re-visioning of psychology. In her now-classic books The Myth of Women's Masochism ; Don't Blame Mother: Mending the Mother-Daughter Relationship ; and Between Women: Lowering the Barriers she took particular aim at psychoanalytic theories that women are inherently masochistic and unable to form loving bonds with their mothers and female friends. She was concerned throughout her career with the ways that medicalized views of people's suffering framed them as mentally ill without considering how society's structures and social behaviors (including sex and race discrimination) forced people into difficult situations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The bondage-discipline, dominance-submission, and sadism-masochism (BDSM) community has achieved diversity with respect to gender identity and sexual orientation yet does so to a lesser extent with respect to race and ethnicity. A total of 398 BDSM practitioners recruited in 2018 and 2019 from BDSM conferences located within the Southern, Midwestern, and Western regions of the U.S., as well as online, completed surveys asking about racial and ethnic discrimination, fetishization, and inclusivity. People of color were 16 times more likely than non-people of color to feel discriminated against at BDSM events and 17 times more likely to feel fetishized. Qualitative results included troubling stories of overt racism and offensive racial slurs, and examples of microaggressions, feelings of isolation, and feelings of being dismissed. The results suggest that organizations can increase inclusivity by understanding the unique costs faced by people of color with an awareness that these costs might be invisible to non-people of color, diversifying positions of authority and leadership, and teaching well-meaning members what types of behaviors could create a hostile environment., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

A noteworthy number of people are interested in BDSM (bondage and discipline, dominance and submission, sadism, and masochism). Fatal outcomes while participating in BDSM activities occur. The aim of this literature review is to give a better insight into potential dangerous BDSM play by summarizing published data on BDSM fatalities. A literature search was conducted. It was searched for non-natural death related to BDSM activity. Seventeen cases were found. The age of the deceased ranged between 23 and 49 years (mean age 34.9 years). Strangulation in the course of erotic asphyxiation was the most common cause of death (88.2%). In 13 cases, a toxicology report for the deceased was mentioned, of which in eight cases (61.5%) toxicology analysis was positive. In four of these cases, the BDSM partner was also tested positive with the same substance. Drugs or alcohol was involved in 64.3% of fatal BDSM play. In nine cases, the level of experience in BDMS activity of the deceased and the partner was described, and in all of them, the deceased and the partner were not new to BDSM play. Fatal outcomes of BDSM plays are rarer than autoerotic fatalities and natural deaths related to sexual activities. Safeguards and education on medical aspects exist in the BDSM communities. If they are followed by the practitioners, the risks of BDMS play can be reduced. Cases of non-natural death connected to BDSM are rare incidents and can be prevented., (© 2021. The Author(s).)

This article explores defensive modes of masochism based through the case study of Sarah, a 25-year-old patient who is regularly followed in psychoanalytical therapy. I will postulate the idea that fetishization of moral masochism should be seen from the perspective of melancholic processes. Drawing on several moments of her therapy, I will illustrate how the primitive idealization of the introjected and denigrated object in the melancholic process lays the conditions for a decisive moral masochism, and whose unconscious idealization defends against depressive breakdown.

On the threshold between loss and its representation: masochism as a defence against the risk of depression. This article explores defensive modes of masochism based through the case study of Sarah, a 25-year-old patient who is regularly followed in psychoanalytical therapy. I will postulate the idea that fetishization of moral masochism should be seen from the perspective of melancholic processes. Drawing on several moments of her therapy, I will illustrate how the primitive idealization of the introjected and denigrated object in the melancholic process lays the conditions for a decisive moral masochism, and whose unconscious idealization defends against depressive breakdown.

Background: Unusual sexual interests are largely intercorrelated, yet not much is known about underlying patterns of clusters between various sexual interests., Aim: To identify underlying clusters of unusual sexual interests using exploratory factor analysis., Methods: We conducted exploratory factor analysis with self-reported interest in a wide variety of unusual sexual acts for an online, international sample (N = 669; 61% female), and for women and men separately. Factor regression weights were correlated to self-reported sex life satisfaction, sexual outlet, and psychiatric symptoms., Outcomes: Participants rated the attractiveness of 50 unusual sexual activities, and reported on their sex life satisfaction (Arizona Sexual Experiences Scale), sexual outlet, and symptoms regarding ADHD (Adult ADHD Self-Report Screening Scale for DSM-5), depression, anxiety, and stress (Depression, Anxiety, and Stress Scale)., Results: We identified 5 factors of unusual sexual interests that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia (attraction to dirtiness or soiled things), and fetishism. For women, unusual sexual interests related to more psychiatric symptoms and higher sexual outlet, whereas this relation was less explicit for men., Clinical Implications: Different factors of unusual sexual interests may serve different underlying functions or motivations, for instance related to sexual, and emotional regulation. A better understanding of the nature of unusual sexual interests is important to be able to influence sexual interests that are unwanted or cause damage to others., Strengths & Limitations: Strength of this study include its anonymity, the avoidance of sexual orientation effects, and the possibility to indicate only a slight endorsement toward sexual items. Limitations include the sample's generalizability and the truthfulness of online responding., Conclusion: Unusual sexual interests could be clustered into 5 factors that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism. Schippers EE, Smid WJ, Huckelba AL, et al. Exploratory Factor Analysis of Unusual Sexual Interests. J Sex Med 2021;18:1615-1631., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

We examined the concordance of paraphilic interests and behaviors across 13 themes in an online sample of 1,036 men and women. Paraphilic interests were significantly and positively correlated with behaviors across all 13 themes. Associations were strongest for masochism and sadism, and weakest for pedohebephilia and frotteurism. Paraphilic interest and behavior were significantly and positively correlated after accounting for gender and sexual orientation. Moderated moderation analysis was significant for five themes. Gender was a moderator for eroticized gender, but only among heterosexual participants, where concordance was higher for heterosexual men than for heterosexual women. For both exhibitionism and frotteurism, gender was a significant moderator, but only for nonheterosexual participants, where concordance was stronger for nonheterosexual men than for nonheterosexual women. For pedohebephilia, interest was significantly associated with behavior for heterosexual men, heterosexual women, and nonheterosexual men, but not for nonheterosexual women. For zoophilia, there was a significant association between interest and behavior for heterosexual men, nonheterosexual men, and nonheterosexual women, but not heterosexual women. Additional analyses found sex drive moderated the positive associations of 7 of 13 paraphilic themes, with 5 of these 7 showing the expected effect of higher concordance of interests and behaviors at higher levels of sex drive.

A growing number of studies have demonstrated that BDSM (Bondage/Discipline-Domination/Submission-Sadism/Masochism) practices are not signs of mental illness. However, the reasons for engaging in such behaviors are not well understood, especially for sexual masochism or submission (m/s). A thorough review of the literature was conducted, as well as a search in Internet forums and an online survey to obtain testimonies that provide information on the origins of interest in m/s and the reasons for engaging in it. A qualitative content analysis was performed on narratives from 227 m/s practitioners. Sixteen themes emerged from this analysis, eight related to the origins of interest in m/s and eight to the reasons for engaging in m/s. The origins described were seen as either intrinsic or extrinsic. Reasons to engage in m/s were related to one of three main types of activities: use of interpersonal power; experiencing physical pain; and altering one's state of mind. These results concord with accounts found in non-academic books and small-scale studies suggesting that m/s interests are often present early in life and usually practiced to reach an altered state of mind associated with sexual arousal. Possible reasons for choosing m/s over more common means of mind alteration are discussed.

Background: BDSM is an acronym describing bondage and discipline, dominance and submission, and sadism and masochism. Afflicting or receiving pain is usually an important part of the BDSM interaction., Aim: This research will focus on better understanding the aspect of pain within a BDSM interaction., Methods: Submissive and dominant counterparts of 35 couples were recruited to participate in a BDSM interaction, of which 34 dominants and 33 submissives were included in the analyses. A non-BDSM interested control group (n = 27) was included to control for social interaction, of which 24 were included in the analyses., Outcomes: This research investigates the differences in (i) baseline pain thresholds, (ii) the impact of a BDSM interaction on those thresholds, and (iii) threshold moderating factors like pain cognition between submissive and dominant BDSM participants and control individuals., Results: BDSM practitioners have a higher pain threshold overall and a BSDM interaction will result in a temporary elevation of pain thresholds for submissives. Additionally, pain thresholds in dominants will be dependent upon their fear of pain and tendency to catastrophize pain and submissives will experience less fear of pain than the control group., Clinical Implications: By further enhancing our understanding of the mechanisms behind a BDSM interaction in this way, we aspire to relieve the stigma these practitioners still endure., Strengths & Limitations: This is one of the first studies of its kind with a large sample size compared to similar research, which makes it a significant contribution to the field. It must be mentioned that there is a possible selection bias because recruitment was only done through the Flemish BDSM community and specifically those who visit clubs. Additionally, pain threshold remains a subjective measurement, which must be taken into account., Conclusion: This study helps shed further light on the biological processes behind a BDSM interaction through pain threshold measurements. Wuyts E, De Neef N, Coppens V, et al. Beyond Pain: A Study on the Variance of Pain Thresholds Within BDSM Interactions in Dominants and Submissives. J Sex Med 2021;18:556-564., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Recent research has indicated that participation in BDSM (bondage-discipline, dominance-submission, and/or sadism-masochism) is not associated with psychological distress or psychopathology but that sexual roles may be associated with personality characteristics, specifically interpersonal dominance and empathy., Aim: The present study examined potential differences between those who identify as dominant, switch, and submissive on interpersonal dominance and empathy., Methods: Individuals who identified as members of the BDSM community were recruited online via a social networking site., Main Outcome Measures: Self-reported demographic variables, the Personality Assessment Inventory, Dominance subscale, and the Interpersonal Reactivity Index Empathic Concern subscale., Results: Participants were well distributed across sexual roles (n = 279; 25.4% dominant, 38% submissive, 36.6% switch), identified as primarily female (59.5%), primarily heterosexual (53.4%), and the most common age group was 25-34 years (27.2%). BDSM role was associated with scores on the Dominance subscale; dominant BDSM practitioners scored significantly higher on the Dominance scale than switches, who in turn scored significantly higher than submissives (dominant mean [M] = 61.44, standard deviation [SD] = 8.26; switch M = 53.99, SD = 11.18, P < .01; submissive M = 49.41, SD = 11.46, P < .01). There were no differences on the measure of empathy between dominant, submissive, and switch BDSM practitioners. On average, individuals who identified as submissives and switches scored in the average range on the Dominance scale compared with the normative sample, and individuals who identified as dominants scored higher but not in the markedly elevated range., Clinical Implications: The study provides information on the relationship between interpersonal dominance as a personality trait and dominance as a sexual role and has implications for reducing stigma related to these practices., Strengths and Limitations: The study contributes to the growing literature suggesting that while BDSM roles may correspond with specific personality characteristics, they are not indicative of personalities significantly different than the general population's. The study also included individuals who identified as switch, a group often excluded from quantitative research in the BDSM community. The sample was, however, recruited exclusively online, and findings may not be applicable to all BDSM practitioners., Conclusion: These findings suggest that there are no differences in empathy between BDSM practitioner roles, and although there are differences in interpersonal dominance, these characteristics are not likely to be prominent in individuals' everyday interactions. Jansen KL, Fried AL, Chamberlain J. An Examination of Empathy and Interpersonal Dominance in BDSM Practitioners. J Sex Med 2021;18:549-555., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Abstract: Sadomasochism is the sexual interest, psychosexual deviance or sexual crimes that are sexually aroused by suffering or causing others to suffer. This study summarizes the concept, assessment and diagnosis, categories and symptoms, psychological and biological mechanisms, judicial disposition and clinical intervention strategies of sadomasochism from the perspectives of clinical medicine, law, criminology and psychology, suggests that further research should take local people with sadomasochism preference and local patients as research objects, pay attention to different types of sadomasochists, conduct bottom-up research, explore the core elements and manifestations of sadomasochism, and accurately define and classify sadomasochism, construct an effective scale, a erectile measurement sexual stimulation system and a diagnostic criteria; discuss evaluation methods combined with crime scene data; discuss the validity of masochists' consent combined with diagnosis; establish targeted criminal correction programs and a treatment and rehabilitation system to provide reference for the improvement of medical, judicial and mental health services., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Forensic Medicine.)

Background: BDSM is an abbreviation used to reference the concepts of bondage and discipline, dominance and submission, sadism, and masochism, enacted by power exchanges between consensual partners., Aim: To shed light upon the rewarding biological mechanisms associated with BDSM interactions., Methods: A group of 35 BDSM couples (dominant and submissive counterparts) were recruited and tested during a BDSM interaction, with an additional control group of 27 non-BDSM interested people tested in a normal social interaction., Outcomes: We compared the evolution of the stress and reward hormone levels of cortisol, beta-endorphins, and endocannabinoids (2AG and anandamide) in a group of BDSM practitioners before and after an active BDSM interaction with the levels in control individuals., Results: We showed that submissives showed increases in cortisol and endocannabinoid levels due to the BDSM interaction, with dominants only showing increased endocannabinoid levels when the BDSM interaction was associated with power play., Clinical Implications: This study effectively provides a link between behavior that many think of as aberrant on one hand, and biological pleasure experience on the other, in the hope that it may relieve some of the stigma these practitioners still endure., Strengths & Limitations: It is one of the first and largest studies of its kind, but is still limited in sample size and only represents a specific population of Flemish BDSM practitioners., Conclusion: Even though this is one of the first studies of its kind, we can conclude that there is a clear indication for increased pleasure in submissives when looking at biological effects of a BDSM interaction, which was related to the increases in experienced stress. Wuyts E, De Neef N, Coppens V, et al. Between Pleasure and Pain: A Pilot Study on the Biological Mechanisms Associated With BDSM Interactions in Dominants and Submissives. J Sex Med 2020;17:784-792., (Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To study symptoms of neurotic disorders and social masochism in chemical addicts., Material and Methods: Thirty outpatients of the Novosibirsk Regional Clinical Addiction Dispensary were studied. Corresponding scales and questionnaires, along with a social masochism questionnaire developed by the authors, were used. Results were compared to those of 25 healthy people., Results and Conclusion: A significantly higher level ( p ≤0.05) of the following neurotic disorders: sleep disturbances, hysterical neurotic disorder, anxious neurotic disorder, social maladaptation and depressive neurotic disorder as well as a subclinical level of anxiety and depression were observed in chemical addicts. Moreover, patients with chemical dependence revealed significantly higher ( p ≤0.05) indicators of aggression, victim behavior and social masochism (different types of aggression, victimization, irritability, negativism, resentment, guilt, self-harming behavior, hypersocial behavior, provoking and uncritical behavior, the role of the victim, negative perception and a general indicator of social masochism). The correlations between indicators of the affective sphere, manifestations of social masochism and neurotic disorders in individuals with chemical dependence were identified.

Introduction: Erotic target identity inversions (ETIIs) are poorly studied paraphilias that involve sexual arousal by the idea or fantasy of being the object of one's sexual desires., Aim: To conduct a large non-clinical online survey to investigate self-reported sexual arousal, behavioral expression, and psychological correlates of 4 proposed ETIIs., Methods: A total of 736 natal males and 549 natal females responded to items about self-reported sexual arousal to the idea of acting as an animal (autoanthropomorphozoophilia) or the idea of acting as a child or infant (autonepiophilia), natal males reporting arousal to the idea of acting as a woman (autogynephilia), and natal females reporting arousal to the idea of acting as a man (autoandrophilia). Data pertaining to sexual orientation, childhood gender nonconformity, gender identity discomfort, autism, masochism, and humiliation were also collected., Main Outcome Measures: The main outcome was a measure of self-reported arousal and expression of the ETIIs being explored using 4 items: arousal level (-3 to 3) when imagining being the erotic target exemplar; frequency of engagement in dressing or behaving like their preferred target (0-4); strength of feeling that they would be better off as the target (0-4); and the frequency of consideration of making physical changes to look or function more like the target (0-4)., Results: Mild levels of reported sexual arousal to the idea of being the preferred erotic target were common among the 4 groups, characterizing about half of them. Gender identity discomfort was associated with autogynephilia, autoandrophilia, and autoanthropomorphozoophilia. Greater gender nonconformity was associated with autogynephilia, autoandrophilia, and autonepiophilia. Autism scores were associated with autoandrophilia and autonepiophilia. Masochism was not associated with ETII scores, but humiliation was., Clinical Implications: Findings suggest that it may be important to distinguish between subgroups of those with different levels and types of ETII arousal/expression., Strengths & Limitations: Strengths of this study include the large, non-clinical sample of men and women for the investigation of ETIIs and the inclusion of measures of psychological correlates. The use of an Internet sample with self-report measures may be unrepresentative, although the Internet has the advantage of allowing recruitment from stigmatized or unusual groups. The cross-sectional nature limits our conclusions, as no causal inferences can be made., Conclusion: The results support the concept of ETIIs as a paraphilic dimension in non-clinical samples and the possible role of gender-related psychological factors. Brown A, Barker ED, Rahman Q. Erotic Target Identity Inversions Among Men and Women in an Internet Sample. J Sex Med 2020;17:99-110., (Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose of Review: Coercive sexual sadism can be distinguished from consensual BDSM (bondage discipline/dominance submission/sadism masochism) role-play and from everyday sadism, a personality trait. The purpose of this paper is to provide a systematic qualitative review of the pertinent literature on coercive sexual sadism from the last three years., Recent Findings: Clinical assessment of sexual sadism can be made more objective through behavioral checklists based on crime scene actions. The latent structure of sexual sadism is likely dimensional, placing the disorder at the upper end of a continuum of sexually aggressive behavior. Sexual sadism does not seem to increase the risk of violent offense recidivism (including sexual contact offenses) above and beyond the risk implied by established risk factors of delinquency. Coercive sexual sadism denotes a disposition for sexually aggressive behavior. Whether this disposition is put into practice is likely due to other trait and state variables. Treatment studies are completely lacking in the recent literature.

The present study attempted to understand people's desires for aggressive and humiliating sexual play, both in terms of interests and fantasy. An evolutionary framework has been developed which generated five hypotheses to be tested. Evidence from a qualitative study of 102 participants identified 13 aggressive and sexual acts which were commonly preferred. A subsequent quantitative online study of 1026 men and women asked participants to rate the desirability of these acts. The results indicated that more than 70% of participants found at least one aggressive or humiliating sexual play desirable, whereas about half of the participants found at least three such acts desirable. Significant sex differences were also found, with men desiring to engage in such play more than women. This discordance was moderated by the willingness of each party to partially accommodate each other's desires. On the basis of these findings and the proposed theoretical framework, it is concluded that aggressive and humiliating sexual play constitutes a normal variation in sexual desire.

Introduction: BDSM (bondage and discipline, dominance and submission, and sadism and masochism) increasingly receives attention from the scientific community. Where earlier research efforts mainly focused on epidemiologic characteristics, psychological and biologic factors driving BDSM preferences have recently gained interest as well., Aim: To bring together all the existing scientific literature on BDSM from a biopsychosocial perspective., Methods: Based on the PRISMA guidelines, the current systematic review brings together all the existing literature on BDSM from a biopsychosocial perspective., Main Outcome Measure: Prevalence rates of BDSM interests were investigated in the literature, as well as the associations between BDSM interests on one hand and personality traits, adverse childhood experiences, education levels, sexual orientations and biological markers on the other., Results: Biologic factors such as gender identity, sex hormone levels, and the neurologic constitution of the brain's pain and reward systems influence BDSM orientation. With regard to psychological factors, both personality traits (eg, higher levels of openness or extraversion) and the presence of a personality disorder have been associated with a heightened interest in BDSM, although only limited supporting evidence is available. Additionally, sensation-seeking levels and impulsivity seem to contribute, because they presumably guide one's drive to explore new or more-intense kinks. Whereas attachment styles impact couple dynamics, they also influence willingness to explore limits in a BDSM context. Lastly, education levels impact relational and sexual dynamics., Strengths and Limitations: The limitations of the current review reflect those of the topical scientific literature. Although the number of studies focused on all aspects of BDSM is exponentially growing, most of these are only descriptive, and very few focus on underlying driving processes., Conclusion: From this biopsychosocial perspective, we offer a dimensional approach while integrating the factors driving the onset and evolution of BDSM interests. De Neef N, Coppens V, Huys W, et al. Bondage-Discipline, Dominance-Submission and Sadomasochism (BDSM) From an Integrative Biopsychosocial Perspective: A Systematic Review. Sex Med 2019;7:129-144., (Copyright © 2019. Published by Elsevier Inc.)

Malignant self-regard (MSR) was proposed as a particular type of self-structure that may account for similarities among a set of clinically relevant Personality Disorders (PDs) such as masochistic/self-defeating and depressive PDs that yet have failed to be adequately represented in the diagnostic manuals. The investigation on the MSR may provide a better framework upon which to understand the nature of these personality types and their discrimination from related constructs. The present study examines the psychometric properties of the Italian adaptation of the Malignant Self-Regard Questionnaire (MSRQ). Reliability and validity indicators are determined in a large sample of adults from general population (n = 2574). The measure was found to be reliable and valid, given its correlations with measures of depressive personality, negative affectivity, self-defeating, and vulnerably narcissistic personalities. MSR also can be meaningfully differentiated from a nomological network of related constructs, including sadness rumination, depression, neuroticism, extraversion, and grandiose narcissism. These findings suggest that MSR may be a personality component which includes a negativistic self-representation, vulnerability and hypersensitivity to judgment, sometimes compensated by perfectionistic tendencies. As a whole, results seem to support the reliability and the validity of the Italian adaptation of the MSRQ as a measure of the MSR., (Copyright © 2018. Published by Elsevier B.V.)

This study sought to gain insight into the attitudes, beliefs, and values that shape bondage/discipline/sadomasochism (BDSM) activities and to explore the degree and consequences of unintended or non-negotiated harms, including physical, emotional, and sexual violence. A qualitative approach, consisting of 22 semistructured interviews and over 150 hours of observations of BDSM events and activities, was used to develop an in-depth exploration of the lived experiences of participants. Thematic analysis was employed to elucidate the ways in which participants define and in some cases experience harm. Findings suggest that individuals construct rational identities that emphasize safe practices and managing harm; however; there are instances where "boundary slippage" occurs. Implications for understanding the dynamics as well as the potential dangers of "consensual" violence are discussed., (© 2018 Springer Publishing Company, LLC.)