Psychotherapeutic Issues with “Kinky” Clients

Abstract

People whose sexual repertoire includes BDSM, fetish, or other "kinky" practices have become increasingly visible, on the Internet, in the real world, and in psychotherapists' offices. Unfortunately, the prevailing psychiatric view of BDSM remains a negative one: These sexual practices are usually considered paraphilias, i.e., de facto evidence of pathology. A different, affirming view of BDSM is taken in this paper. After defining BDSM and reviewing common misconceptions, a variety of issues the practitioner will face are described. These include problems of countertransference, of working with people with newly emerging sexual identities, working with spouses and partners, and discriminating between abuse and sexual "play."

Perks, problems, and the people who play: A qualitative exploration of dominant and submissive BDSM roles

“…Several of the identified benefits had been previously suggested to be benefits of BDSM by other researchers, clinicians, and authors. The benefits of communication, trust, and intimacy discussed by Nichols' (2006) all made up facets of improved romantic relationships, which also supports Kleinplatz' (2006) recommendation that traditional couples could learn a lot from BDSM practitioners. Participants in the current study also commonly reported that great sex was a benefit (subsumed under pleasure and arousal), which is congruent with Kleinplatz et al's (2009) finding that sadomasochism practitioners report that they are in a particularly good position to experience optimal sex due to skills learned from BDSM play.…”

“…Similarly, what she called empowerment was mentioned by dominants in the categories of control or power, confidence, and freedom from day-to-day roles, but was not a theme for submissives. However, it is important to note that Nichols (2006) identified benefits of BDSM practice overall, and was not necessarily suggesting that these benefits applied to both roles equally. Moreover, submissives may be empowered by being able to give up control as they are choosing to follow their desire to be dominated.…”

“…The benefit of psychological release was also found by Lindemann (2011) in her study of professional dominatrices and Moser and Levitt's (1987) finding that a majority of BDSM practitioners enjoy BDSM as much as or more than vanilla sexual activity was supported. What Nichols (2006) called exploration and excitement roughly map onto the benefit of fun, variety, and going beyond vanilla, as well as pleasure and arousal. Similarly, what she called empowerment was mentioned by dominants in the categories of control or power, confidence, and freedom from day-to-day roles, but was not a theme for submissives.…”

“…Nichols (2006), based on her extensive background of more than 20 years providing therapy for kinky clients, proposed numerous advantages of BDSM, such as personal empowerment, improved communication between partners, excitement because of the diversity and taboo nature, and spiritual benefits. It has also been argued to be cathartic, allowing for both physical and mental release; indeed, some professional dominatrices consider their role to be similar to that of a therapist (Lindemann, 2011).…”

Women’s Introduction to Alternative Sexual Behaviors through Erotica and Its Association with Sexual and Relationship Satisfaction

“…Some studies have found that these behaviors enhance personal empowerment resulting in improved communication between partners, which can be therapeutic for the relationship (Kleinplatz 2006;Kleinplatz et al 2009;Lindemann 2011;Nichols 2006). Conversely, other researchers argue that practicing BDSM without a foundation of trust can result in relationship problems and disappointment due to the social stigma and resulting shame that surrounds these behaviors (Connolly 2006;Hebert and Weaver 2015).…”