BDSM
CEUs/OPD/CPD for this presentation can be found at allceus.com for clinicians in the US or Australia.allceus.com for clinicians in Australia.
Trigger Warning and Cautions~ The following presentation involves frank discussions of BDSM and sexuality.
~ While not graphic, some of the content might be triggering for some people.
~ This series is meant to provide an overview to help clinicians to understand kink, BDSM and Poly, but is by no means all inclusive. It is designed to increase awareness of common issues and help clinicians identify areas where they may need further training.
Objectives
~ Review the benefits of BDSM
~ Explore the prevalence of BDSM
~ Learn about BDSM relationship structures
~ Identify possible areas of physical and psychological injury that therapists need to be aware of
~ Dispel some common BDSM myths
~ Identify danger signs of abuse in BDSM
~ Explore the concept of consent and the impact of mental illness on the ability to consent
Benefits of BDSM (When done right)
~ Improves communication and increases intimacy
~ Encourages fidelity
~ Many who embrace the lifestyle are not interested in sabotaging the safety and trust that is imperative to its success.
~ Improved mental health
~ 2013 study from the Journal of Sexual Medicine, Medical Daily claims âpeople who practiced BDSM scored better on certain mental health indicators than those who had vanilla sex. The BDSM-friendly participants were less neurotic, more open, more aware of and sensitive to rejection, more secure in their relationships, and had a better overall well-being.â
Benefits of BDSM (When done right)
~ Reduced cortisol (Cutler, 2003, Sagarin et Al 2009)
~ Endorphin rush an âaltered state of consciousnessâ akin to a runnerâs high
~ Consensual BDSM Facilitates Role-Specific Altered States of Consciousness: A Preliminary Study. Psychology of Consciousness: Theory, Research and Practice 4 (1). Sept 2016
~ Increases confidence
~ Increases mindfulness. Participants enter a ‘flow state' of mindfulness, similar to the mindset athletes report when they're ‘in the zone'
BDSM Facts
~ No evidence that BDSM orientation is caused by childhood trauma or a history of abuse BDSM is simply a sexual interest or subculture attractive to a minority, and for most participants not a pathological symptom of past abuse or difficulty with “normal” sex.
~ Demographic and psychosocial features of participants in bondage and discipline, “sadomasochism” or dominance and submission (BDSM): data from a national survey. J Sex Med. 2008 Jul;5(7):1660-8.
~ BDSM does not [necessarily] cause distress and dysfunction, but sociocultural and political persecutions do. (Kleinplatz & Moser 2006; Richters, 2003)
BDSM Facts
~ Psychological characteristics of BDSM practitioners.
~ The results mostly suggest favorable psychological characteristics of BDSM practitioners compared with the control group
~ BDSM practitioners were less neurotic, more extraverted, more open to new experiences, more conscientious, less rejection sensitive, had higher subjective well-being, yet were less agreeable.
~ Comparing the groups, if differences were observed, BDSM scores were generally more favorably for those with a dominant than a submissive role, with least favorable scores for controls.
J Sex Med. 2013 Aug;10(8):1943-52.
BDSM Facts
~ Many BDSM participants perceive sexual BDSM experiences as not only significantly different from but also better than mainstream or “vanilla” sex.
~ BDSM participants construct sex as requiring genital contact, while framing sexual BDSM as creating sexual fulfillment not requiring normative indicators of sexual experiences (e.g., orgasm).
~ Sexual BDSM is centered on emotional and mental experiences, while sex is being centered on physical experiences.
~ Sexual BDSM experiences facilitate deeper interpersonal connections than those available in sex.
A “Different Economy of Bodies and Pleasures”?: Differentiating and Evaluating Sex and Sexual BDSM Experiences. J Homosex. 2017 Oct 26:1-29.
Prevalence
~ 46.8% of the total sample had ever performed at least one BDSM-related activity and an additional 22% indicated having (had) fantasies about it.
~ 12.5% of the total population indicated performing at least one BDSM-related activity on a regular basis.
~ BDSM and fetish interests were significantly higher in men than in women.
~ The older group (48-65 years) had significantly lower BDSM scores compared with their younger peers.
~ Of participants with a BDSM interest, 61.4% became aware of it before 25 years of age.
~ Fifty Shades of Belgian Gray: The Prevalence of BDSM-Related Fantasies and Activities in the General Population. J Sex Med. 2017 Sep;14(9):1152-1159
~ 15-20% of people in some studies in the US report engaging in BDSM
Starting with BDSM
~ People involved in BDSM stress the importance of everything being âconsensualâ so there will be much negotiation at the start about the things people do and do not enjoy, and the ways in which the relationship will be D/s. Checklists and contracts
~ BDSM communities and websites are a great place to look for more information from those who have been involved in these kinds of practices and relationships. Also local fetish fairs and kink events often include demonstrations and workshops
D/s Arrangements
~ People can identify as dominant, submissive, or switch
~ In a D/s relationship people may include power play in their sex life, and perhaps in other aspects of their relationship.
~ For most people, being D/s will be something that they only do some of the time (for example, just in pre-arranged scenes â often, but not always, involving sex)
~ Some people who are into D/s might have longer periods, such as a holiday, where they maintain their power dynamic.
~ Some have lifestyle or 24/7 arrangements; however, even in such cases much of their everyday life will probably not seem that different to anybody elseâs.
~ We discuss this further in the next episode on D/s and FLR Relationships
Frame and Flow
~ Scenes and âFrameâ is how people distinguish their pretend play from actual violence or domination; this frame hinges on the BDSM credo, âsafe, sane, and consensual.â
~ Flow is defined as a completely focused motivation and immersion/awareness in an act which includes
~ Intense and focused concentration on the present moment
~ Merging of action and awareness
~ Loss of reflective self-consciousness
~ A sense of personal control or agency over the situation
~ Clear goals
~ Experience of the activity as intrinsically rewarding
~ Development and Validation of a Scale to Measure Optimal Experience: The Flow State Scale JOURNAL OF SPORT & EXERCISE PSYCHOLOGY, 1996, 18, 17-35
Important Points with BDSM
~ Compared to other practices, BDSM has the risk of being much more physically or psychologically damaging when done âincorrectlyâ
~ Abusive Dom/Top/Master or one who disregards or pushes limits without consent
~ sub/bottom/slave who is engaging in the behaviors or lifestyle out of fears of abandonment
~ A practitioner who has a history of sexual, physical or emotional abuse who becomes âretriggered.â
~ Revictimized
~ Re-enacting
Subdrop
~ Regardless of trauma history, BDSM activities involve voluntarily pushing or allowing personal boundaries to be pushed.
~ During the scene the person may be âin the flowâ in âsub-space,â not self conscious and very attuned to the moment.
~ After the scene, it is not uncommon for the practitioner, particularly the sub/bottom to feel very vulnerable and exposed
~ Sub-drop refers to the sadness a submissive partner may feel once endorphins crash and adrenaline floods their body after a powerful scene
~ When sub drop happens, the submissive may experience feelings of depression, rejection, anxiety, fear, or even guilt.
Subdrop contâŚ
~ The endorphins and other hormones released during play leave your body in such a way that it takes time to rebuild the balance of hormones in your system.
~ Physical aspects: Fatigue, aches and pains and recovery from marks. You could feel like you have a hang over or partied too hard the night before.
~ Emotional aspects: Sadness, which if not cared for, could go into depression just from one play session.
~ You could feel lost and depressed for hours or days. You may just want to sleep it off.
~ People with a history of depression or bipolar disorder need to be extra aware of the impact of the hormone alterations
Sub-drop Intervention
~ It can be a somewhat scary experience, especially if it follows on the heels of what may have been an especially powerful and positive BDSM scene.*
~ Aftercare is essential to make sure that everyone involved feels safe and cared for after play time is over.
~ Aftercare means communicating and taking care of one another after the scene to ensure that all parties are 100% comfortable with what went down.
~ What each person needs for aftercare is very personal.
~ Doms should remember to ask the sub if they are going to need a specific type of aftercare.
~ Subs should not expect Doms to be mind readers.
Subdrop
~ Babysitters
~ Sometimes for one reason or another a top may not be able to commit time to aftercare and a bottom may crave extensive time even up to several hours after an intense scene.
~ Best Practices indicate it is important that a top spend the first 5 to 15 minutes doing some form of aftercare, so that an immediate feeling of abandonment does not set in, and there is a prenegotiated babysitter before the scene.
~ The babysitter will be an agreed upon person trusted by both parties to provide additional aftercare for the bottom once the top is required to leave.
~ http://bdsmwiki.info/Aftercare
Subdrop
~ Can occur more frequently in committed relationships
~ Laziness
~ More edges are pushed (more intensity)
Myths
~ The dominant partner is the one in control
~ BDSM usually consists of a dominant (âdomâ or âtopâ) partner and a submissive (âsubâ or âbottomâ) one. Although the Dominant would appear to be the one running the show, it is actually Doms that perform to please their subs. Hence, subs are often nicknamed âbossy bottomsâ
~ A person who is Dominant or submissive in real life will prefer a similar role in BDSM
~ It is not unusual for people who are Type A/alphas at work and in their relationships, to be submissive in the bedroom, and vice versa
~ It is not always about sex
Myths
~ The Dom/Domme has all the power
~ While in the scene the Dom is doing things to or requiring things of the sub that the sub wants and the Dom does too. The goal is the mutual satisfaction for both parties.
~ Either participant can terminate or break the scene at anytime.
~ Each participant has been well versed on the hard and soft limits of the other. Disregarding these limits or pushing without prior discussion is unacceptable.
Myths
~ It is anti-feminist—wellâŚyou decide
~ Current feminist viewpoints on BDSM practices continue to be controversial and at odds with one another.
~ Feminists who view BDSM as contradictory to feminism also often believe that women who engage in BDSM practices, especially submission, have been led by sexist power structures to believe that they enjoy these acts.
~ This feminist viewpoint argues that the individuals who enjoy playing a submissive role in the bedroom only enjoy it because they have been led to believe that it is what is expected of them and that they should enjoy it.
~ If these individuals were able to explore their sexual desires without the influence of a sexist power structure, they would come to very different conclusions about what they enjoy
Myths
~ It is abusive
~ Consent and an in-depth discussion of boundaries and physical and psychological safety are the absolute hallmarks of BDSM
~ Any experience of pain or humiliation by the sub has been prenegotiated and is a positive or erotic experience for the sub.
~ BDSM is always about sex
~ It is about sensation, pushing personal boundaries, exploring power dynamics submissive/acceptance/surrender
Best Practices
~ Start low and go slow
~ A highly skilled mountain climber may decide to brave the deadly faces of Mount Everest and come through alive and with a very dangerous, but also very rewarding experience that few others will ever know.
~ However, while they are able to informed choices about their consent with this activity, newer folks have too much to learn to really have much insight into wisely taking such a risk, therefore it is considered best practices to tell a beginner to stick to short, marked hiking trails in a moderate climate to start out.
Bondage
~ Why do some people like it?
~ Restraint
~ Sensuality
~ Trust building/connection
~ Excitement
~ Experimentation/something new
~ Dominance/submission
~ Being artistic
~ Role playing
~ Caveats
~ Asphyxiation
~ Nerves and circulation
~ Emotional responses
Abuse Test
~ Is it consensual?
~ Do BOTH parties have power and control?
~ Does it cause psychological harm to the person?
~ Abuse often makes the victim feel responsible for the abuse, yet powerless to change it?
~ Are behaviors and interactions characterized by respect?
Danger Signs— BDSM
~ Participants are subtly or not so subtly pushed to perform acts that they donât really like and are discouraged from declining or using a safe word as part of BDSM âgrowthâ or training.
~ Abusive bottoms may suggest Doms are not good âtopsâ if they donât like certain practices or donât feel comfortable taking specific activities to a certain level. Abusive tops may do the same.
~ A dangerous Dom is more likely to take the sub to the edge prematurely, to prove something about themselves. And once there, may play out a set of acts that have worked for them before â and not be fully present to the subâs experience.
~ In a healthy relationship, the Dom can take the sub to that edge in the appropriate time, remains aware of the subâs experience, and whether it has gone well or whether the sub has decided this is not an edge they want to play with ever again â they feel respected, loved and cared for.
Danger Signs— BDSM
~ Commentary about bottoms within a circle of tops (or others) that is degrading, and not in the consensual ways of degradation that have been carefully negotiated.
~ Participants (esp. Doms) that withdraw or stonewall when things donât go their way and say they just âneed spaceâ?
~ You basically being trained never to raise hard issues because you are rewarded with closeness when you donât raise anything and abandoned to your confusion and pain when you do.
~ Participants that engage in constant loyalty testing
Clinical Issues for BDSM
~ Two contraindications in the practice of BDSM
~ Anyone diagnosed with any SPMI (developmental, neurocognitive, autism spectrum), personality disorder, active psychotic disorder or active addiction that significantly and consistently impairs a clientâs judgement
~ Long term power exchanges should be avoided by people with a lack of a stable sense of self
Clinical Issues in BDSM
~ Three ways in which mental illnesses impact a clients ability to give consent.
~ Inability to understand the relevant information (whatâs going to happen)
~ Inability to foresee or understand consequences
~ Difficulty in reasoning about the potential risks and benefits
~ Inability to communicate consent
~ Factors that determine healthy versus unhealthy BDSM practice
~ Safe, sane and consensual
~ Mutual respect for the person, their limits and boundaries
~ High level of trust
~ Open and honest communication
Summary
~ BDSM covers a wide range of activities, almost all involving some level of power exchange.
~ BDSM practitioners have been found to be at least as âwell adjustedâ as sexually normative culture.
~ As many as 20-50% of people have engaged in some type of BDSM behavior, bondage and spanking being the most common.
~ BDSM is not something you jump into. There is much negotiation and learning to prevent psychological and physical harm.
~ The BDSM motto is safe, sane and consensual