The behavior of the sexual sadist extends across a wide spectrum. It is a question of degree and of acting or not acting upon intense sexually sadistic fantasies. Just as many pedophiles do not become child molesters, so there are people who, even though harboring sadistic sexual fantasies, do not act upon them. At the same time, without becoming involved in sexual crime, there are others who are ... [Show full abstract] driven by such fantasies to engage in sadomasochistic relationships. One may wonder why pain and love may coexist between two people involved in consensual sex and more specifically, who are the people who seek pain in a sexual encounter. A sadistic personality disorder may exist even outside the sexual realm. People thus affected usually exhibit cruel, demeaning, and aggressive behavior in social and work situations, showing lack of respect and empathy, with a behavioral trend toward violence and/or a demeaning humiliating attitude toward others while obtaining a concomitant pleasure in abusing them. When persons with this personality type also derive pleasure from sexually abusing sexual partners, they can be termed sexual psychopaths or, in the case of criminal acting out, sadistic sexual offenders. The pain inflicted by a sexually sadistic individual may be physical (e.g., bondage or restraining, complete immobilization, slapping, whipping, caning, biting, sensory deprivation) or psychological (e.g., degrading and humiliating remarks). In an extreme aberration of “love,” sadomasochism, the actors assume either a sadistic role or a masochistic role. The former are usually, but not always, male and the latter women. However, women may be sadistic and men are not excluded from being masochistic. In their sadomasochistic role, both types are driven by strong sadistic or masochistic fantasies. As is well known but bears repeating, the term sadism derives from the Marquis de Sade, a licentious, libertine French aristocrat who described his sexual orgies and confused sexuality in his 18th century writings. The term masochism, instead, took its name from the Austrian writer Leopold von Sacher-Masoch, among whose writings were descriptions of passive sexual behavior in consenting sadistic relationships. Finally, the term sadomasochism, which was thought to be a sexual perversion by Sigmund Freud, was coined by the Austro-German forensic psychiatrist Richard von-Krafft Ebing, also in the 18th century. At present, some sadomasochists join together in groups or association.