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“The Invisible Gate”: Experiences of Well-Being in the Context of Kink Sexuality
Abstract
Past research has examined the incidence of psychological distress and mental disorders among people who practice alternative sexualities known as “kink” or BDSM, but there are very few studies of the positive impact of kink sexuality on psychological well-being. A total of 1,402 individuals participated in the 2016 National Kink Health Survey; 1,003 participants were included in the analysis presented here. Participants were included if they answered the survey question: (a) Do you feel that your involvement in kink has affected your mental health, either positively or negatively? Two other follow-up questions were asked: (b) If yes, has that effect been positive or negative or both?; (c) Please comment, if you would like, to expand on your experiences related to the last question. Results indicated that 66% of the 1,003 participants found that kink sexuality had a positive impact on their mental health, and qualitative analyses found that the impact focused on four areas of well-being: autonomy, positive relations with others, personal growth, and self-acceptance. Negative impacts were also noted, mostly in the area of difficult/negative relations with others that included stigma/prejudice, interest discrepancies within intimate relationships, and poor treatment or abuse from intimate partners. This research indicates that participation in kink sexuality can be a source of personal growth and healing, at least for some individuals.
Purpose of Review
This review summarizes recent empirical work concerning the intersection of BDSM or kink sexualities and LGBTQ+ sexual orientation populations. This review helps clinicians understand how kink behaviors may have positive impacts on clients and patients.
Recent Findings
Several studies have noted that non-heterosexual people are more likely to report involvement in BDSM and kink. Studies have documented motivations for kink that include desires for peak experiences, healing from past trauma, increased intimacy, and exploration of the self. A particular aspect of psychological well-being, autonomy, appears to be an empowering aspect commonly experienced by LGBTQ+ people engaged in BDSM.
Summary
There is some indication in the literature that LGBTQ+ individuals are more likely than heterosexuals to be involved in alternative sexuality practices such as kink, or are more likely to disclose their involvement. Motivations to engage in kink behaviors include motivations towards personal growth and self-actualization, as well as using kink for self-regulation of levels of stimulation, arousal, anxiety, or depression. These indicate that kink can have positive effects on people’s health.
Created by a team of clinicians and researchers (19 members), the practice guidelines presents the current best knowledge and practices for working with clients and patients who have strong interests in kink sexuality, who are kink-identified, or who are involved in fetish, BDSM, leather or kink communities.
People involved in kink (BDSM or fetish) subcultures often encounter stigma and bias in healthcare settings or when seeking psychotherapy. Such individuals typically encounter well-meaning clinicians who are not prepared to provide culturally competent care or who have not recognized their own biases. Over a two-year period, a team of 20 experienced clinicians and researchers created clinical practice guidelines for working with people involved with kink, incorporating an extensive literature review and documentation of clinical expertise. This article summarizes the guidelines and discusses relevant issues facing clinicians and their clients, as well as implications for clinical practice, research and training.
Bondage/discipline, dominance/submission, and sadism/masochism (BDSM; “kink”) are frequently pathologized as derivatives of abuse. Although the link is unsubstantiated, some kink-identified people who happen to be survivors of trauma may engage in kink, or trauma play, to heal from, cope with, and transform childhood abuse or adolescent maltreatment. The present study sought a thematic model (Braun & Clarke, Qualitative Research in Psychology, 3(2), 77–101, 2006) of trauma recovery through kink using a critical realist, inductive approach to inquiry. Participants were eligible if they had experienced early abuse, were adults, and practiced kink. Six superordinate themes were generated from semi-structured interviews with 20 participants from five countries: cultural context of healing (e.g. using BDSM norms and previous therapy to reframe kink and trauma), restructuring the self-concept (e.g. strengthening internal characteristics which had been harmed or distorted), liberation through relationship (e.g. learning to be valued by intimate others), reclaiming power (e.g. setting and maintaining personal
boundaries), repurposing behaviors (e.g. engaging in aspects of prolonged exposure), and redefining pain (e.g. transcending painful memories through masochism). Notably, participants only reported retraumatizing experiences prior to learning about the structural safeguards of BDSM. Research and clinical implications are discussed by drawing on general models of trauma recovery.
Purpose of review
This review is to characterize the theoretical and empirical literature about alternative sexual behaviors, predominantly known under the umbrella of bondage and discipline, dominance and submission, and sadism and masochism (BDSM, also known as “kink”). The overview is to aid the clinician in understanding how particular studies might fit into the larger context of the scholarly and empirical literature in order to judge the generalizability of conclusions. The specific concern of whether there are health disparities for this stigmatized sexuality is considered and explored.
Recent findings
The literature contains a wide range of positions and perspectives, ranging from always pathologizing BDSM behavior to proposing therapeutic functions of BDSM behavior. There are significant differences across professions in treatment of BDSM, and the medical literature is noted for being disorganized and piecemeal and starting to change over the past 5 years in ways that addresses the earlier problematic approaches that may have hindered clinical practice.
Summary
Empirical evidence suggests significant stigma impacting the health of BDSM-identified patients and impacting the healthcare service provided to kinky sex practitioners. The empirical and scholarly literature about BDSM or kink demonstrates a trend that addresses the stigma of alternative sexualities, but more work is needed.
Some books break myths. Others break silences. A few break new ground. The Health of Sexual Minorities achieves all three aims.
The first book of its kind, this resource offers a multidimensional picture of lesbian, gay, bisexual and transgender (LGBT) health across clinical and social disciplines to give readers a full and nuanced understanding of these diverse populations. Here are real-world matters of definition and self-definition (including sexual identity, gender identity, and anti-identity), meticulous analyses of stressor and health outcomes, an extensive coverage of research methodology concerns, and critical insights into the sociopolitical context of LGBT individuals’ health and lives.
-Developmental issues across the lifecourse
-Human rights and ethical issues
-Global perspectives of LGBT health
-Physical and mental health issues
-Issues and concerns of racial/ethnic minority groups
-Health concerns of lesbian and bisexual women
-Prejudice and homophobia as social stressors
-A comprehensive review of quantitative and qualitative research methodology
-Tobacco, alcohol, and substance use issues
-The current state of LGBT health care and strategies for improvement
-The impact of the HIV/AIDS epidemic on LGBT communities
The Health of Sexual Minorities is an advanced-level text whose scope and accessibility makes it useful to a broad audience. Over 50 contributors have made this a work of crucial importance to public health and health care professionals and biomedical and social science researchers. The Health of Sexual Minorities encourages clear thinking, informed practice, and effective, progressive policy for improved health and well-being of LGBT individuals and communities.
Introduction:
Recent studies have suggested that, in contrast to traditional psychopathologic explanations, bondage and discipline, dominance and submission, and sadomasochism (BDSM) could be understood as recreational leisure. However, the theoretical framing of BDSM as potential leisure has not been empirically explored.
Aim:
To conduct an initial empirical exploration to determine whether BDSM experience fits established characteristics of recreational leisure.
Methods:
A convenience sample of BDSM participants (N = 935) completed an online survey (9 demographic questions and 17 leisure questions) that assessed BDSM experience according to important attributes of leisure. Responses also were assessed and statistically compared as being primarily casual or serious leisure according to general BDSM identities (ie, dominants vs submissives vs switches).
Main outcome measures:
BDSM experiences were assessed as a form of potential leisure.
Results:
Most BDSM experiences met leisure criteria. Participants reported that "most of the time or nearly always" BDSM was associated with a sense of personal freedom (89.7% of participants), pleasure or enjoyment (98.5%), sense of adventure (90.7%), use of personal skills (90.8%), relaxation or decreased stress (91.4%), self-expression or exploration (90.6%), and positive emotions (96.6%). BDSM seemed to function as primarily serious, rather than casual, leisure, but important statistical differences were observed based on specific BDSM identities.
Conclusion:
A leisure science perspective could be valuable to researchers and clinicians in reinterpreting the wide range of diverse BDSM motivations and practices.
The authors of the special section on positive psychology (see records 2014-52523-006; 2014-52523-007and 2014-52523-008) utilize the rich foundation of positive psychology as a springboard to assess LGBT health, imploring psychologists to include LGBT concerns in their study of positive psychology and to include positive psychology in the study of LGBT health. The authors introduce the reader to the “three pillars” of positive psychology and systematically explore these pillars as they may be (and, in many cases, have been) applied to understanding the health of LGBT populations. An important contribution of the articles in this section is that the authors review the rich psychological theory to which we can anchor research on positive psychology in LGBT populations. But a challenge remains in conceptually clarifying and organizing research constructs that are relevant to this work. Although it is unlikely that researchers will come to an agreement about which construct, or even which theoretical perspective to use, it is important that we gain some clarity about what these concepts mean.
This article serves as the first in a series of 4 articles providing a theoretically and empirically informed approach to understanding lesbian, gay, bisexual, and transgender (LGBT) individuals and communities from the perspective of positive psychology. Termed LGBT strengths, this perspective aims to complement existing perspectives in LGBT psychology focused on distress and pathology to provide a more balanced and representative understanding of LGBT lives. In the present article we provide an introduction to the 3 pillar model of positive psychology and its relevance to the unique experiences of LGBT individuals. Drawing connections between positive psychology and related strengths-based concepts within the existing literature in LGBT psychology, we provide evidence for LGBT strengths across the 3 pillars and within diverse populations of sexual and gender minorities. Discussing the role and importance of fostering a psychological science of these strengths informed by an understanding of the diversity and complexity of LGBT lives, we conclude with an overview of the goals of this series and introduce the subsequent articles in the series which will address implications of LGBT strengths for theory, research, training, and practice.
The primary objectives of this article are (a) to put forth an explicit operational formulation of positive human health that goes beyond prevailing "absence of illness" criteria; (b) to clarify that positive human health does not derive from extant medical considerations, which are not about wellness, but necessarily require a base in philosophical accounts of the "goods" in life; (c) to provoke a change of emphasis from strong tendencies to construe human health as exclusively about the mind or the body toward an integrated and positive spiral of mind-body influences; (d) to delineate possible physiological substrates of human flourishing and offer future directions for understanding the biology of positive health; and (e) to discuss implications of positive health for diverse scientific agendas (e.g., stress, class and health, work and family life) and for practice in health fields (e.g., training, health examinations, psychotherapy, and wellness intervention programs).
It has been generally thought that the practice of bondage-discipline, dominance-submission, sadism-masochism (BDSM) is in some form associated with psychopathology. However, several more recent studies suggest a relative good psychological health of BDSM practitioners.
The aim of this study was to compare scores of BDSM practitioners and a control group on various fundamental psychological characteristics.
For this aim, 902 BDSM and 434 control participants completely filled out online questionnaires. Associations were examined using χ2 tests of independence with φ and Cramer's V as effect size measures and eta or Pearson's correlation. Group differences were tested using analysis of covariance, with partial η2 as effect size measure. A priori contrasts were tested using α = 0.01 to correct for multiple testing; for all other tests we used α = 0.05, two tailed.
The study used Big Five personality dimensions (NEO Five-Factor Inventory), attachment styles (Attachment Styles Questionnaire), rejection sensitivity (Rejection Sensitivity Questionnaire), and subjective well-being (World Health Organization-Five Well-being Index).
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 four 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.
We conclude that BDSM may be thought of as a recreational leisure, rather than the expression of psychopathological processes. Wismeijer AAJ and van Assen MALM. Psychological characteristics of BDSM practitioners. J Sex Med 2013;10:1943–1952.
Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
Reigning measures of psychological well-being have little theoretical grounding, despite an extensive literature on the contours of positive functioning. Aspects of well-being derived from this literature (i.e., self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth) were operationalized. Three hundred and twenty-one men and women, divided among young, middle-aged, and older adults, rated themselves on these measures along with six instruments prominent in earlier studies (i.e., affect balance, life satisfaction, self-esteem, morale, locus of control, depression). Results revealed that positive relations with others, autonomy, purpose in life, and personal growth were not strongly tied to prior assessment indexes, thereby supporting the claim that key aspects of positive functioning have not been represented in the empirical arena. Furthermore, age profiles revealed a more differentiated pattern of well-being than is evident in prior research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Well-being is a complex construct that concerns optimal experience and functioning. Current research on well-being has been derived from two general perspectives: the hedonic approach, which focuses on happiness and defines well-being in terms of pleasure attainment and pain avoidance; and the eudaimonic approach, which focuses on meaning and self-realization and defines well-being in terms of the degree to which a person is fully functioning. These two views have given rise to different research foci and a body of knowledge that is in some areas divergent and in others complementary. New methodological developments concerning multilevel modeling and construct comparisons are also allowing researchers to formulate new questions for the field. This review considers research from both perspectives concerning the nature of well-being, its antecedents, and its stability across time and culture.
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."
As a result of recent media interest, the practice of BDSM has become more mainstream yet remains marginalized. Now more than ever, greater numbers of heterosexual and LGBTQ couples are starting to explore some form of BDSM. However, profound misunderstandings continue leading to unintentional physical and psychological harm. Drawing on current research and ethnographic narratives from the kink community, this book seeks to provide psychotherapists with an introductory understanding of the culture and practice of BDSM, and presents specific therapeutic concerns related to common misconceptions. This book strives to de-pathologize BDSM practices, while also providing concrete ways to distinguish abuse from consent, harmful codependency, and more. Packed with practical suggestions and rich case studies, this book belongs on the shelf of every therapist seeing BDSM and kink clients.
Emotion regulation involves the pursuit of desired emotional states (i.e., emotion goals) in the service of superordinate motives. The nature and consequences of emotion regulation, therefore, are likely to depend on the motives it is intended to serve. Nonetheless, limited attention has been devoted to studying what motivates emotion regulation. By mapping the potential benefits of emotion to key human motives, this review identifies key classes of motives in emotion regulation. The proposed taxonomy distinguishes between hedonic motives that target the immediate phenomenology of emotions, and instrumental motives that target other potential benefits of emotions. Instrumental motives include behavioral, epistemic, social, and eudaimonic motives. The proposed taxonomy offers important implications for understanding the mechanism of emotion regulation, variation across individuals and contexts, and psychological function and dysfunction, and points to novel research directions.
© 2015 by the Society for Personality and Social Psychology, Inc.
Work in body studies and theories of affect challenge the mind/body dualism where human action/behavior is shown to be an embodied, lived event. More specifically, bodily practices not only inform/shape human subjectivity but convey what language-words-often cannot. BDSM is one such practice that illuminates embodied subjectivities, where the flesh proves pivotal to one's orientation to/with the world. In this article I explore women BDSMers who, as survivors of sexual violence, engage in BDSM rape play. BDSM rape play foregrounds the flesh, exemplifying quite powerfully "bodily capacity," one where bodily disintegration that occurred with the sexual assault is disrupted through bodily recuperation. This felt experience-the body as the source of insight-carries considerable weight, and should inform our thinking when it comes to feminist explorations of sexuality and those contentious and controversial practices such as BDSM.
Previous research on BDSM (bondage-discipline, domination-submission, sadomasochism) tends to treat practitioners as a homogenous group and lumps dominants (desire to take control) and submissives (desire to be controlled) together. Research suggests that personality traits, such as extraversion, relate to a variety of sexual attitudes and behaviours. To date, the research on personality and BDSM is scant and often does not distinguish BDSM preferences. The current study compared BDSM practitioners with self-identified preferences for dominance to those preferring submission on their self-reported levels of desire for control, empathy, honesty-humility, emotionality, extraversion, agreeableness, conscientiousness, openness to experience, altruism, self-esteem, and life satisfaction. BDSM practitioners (n=270; 80 dominants and 190 submissives) completed an online questionnaire package. Dominants scored significantly higher than submissives on desire for control, extraversion, self-esteem, and life satisfaction. Submissives scored significantly higher than dominants on emotionality. Dominants and submissives did not differ on empathy, honesty-humility, conscientiousness, openness to experience, altruism, or agreeableness. These findings demonstrate that there are unique features that characterize BDSM practitioners who prefer the dominant and submissive orientations.
This article reviews research and interventions that have grown up around a model of psychological well-being generated more than two decades ago to address neglected aspects of positive functioning such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from 6 thematic areas are examined: (1) how well-being changes across adult development and later life; (2) what are the personality correlates of well-being; (3) how well-being is linked with experiences in family life; (4) how well-being relates to work and other community activities; (5) what are the connections between well-being and health, including biological risk factors, and (6) via clinical and intervention studies, how psychological well-being can be promoted for ever-greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience - the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered. © 2013 S. Karger AG, Basel.
Knowledge of psychological well-being persistently lags behind knowledge of psychological dysfunction. The imbalance is evident in magnitude of research-studies of psychological problems dwarf the literature on positive psychological functioning-and in the meaning of basic terms (e.g., typical usage equates health with the absence of illness). A person is viewed as mentally sound if he or she does not suffer from anxiety, depression, or other forms of psychological symptomatology. This prevailing formulation never gets to the heart of wellness; to do so, we must define mental health as the presence of the positive. To explicate the positive is, however, to grapple with basic values and ideals of the human experience. These values are no less evident in definitions of human suffering, although consensus in identification of the negative is somehow easier to achieve. Despite these challenges, much has been written, within the field of psychology and outside it, regarding the contours of positive psychological functioning.
Based on extensive ethnographic research in a public SM (sadomasochism) community, this paper frames SM as recreation. Drawing
on Robert Stebbins’ work on “serious leisure” (1982), I posit that in order to more adequately understand SM as it occurs
in this community, we need to shift from mainstream assumptions of SM as (simply) “kinky sex” to a more nuanced perspective.
I explore the unique skills required in order to engage in SM, as well as the benefits and rewards that participants derive
from it, in order to illustrate that SM can be more usefully understood as serious leisure.
KeywordsBDSM-Sadomasochism-Leisure-Serious leisure-Edgework-Sexuality
Psychological and medical perspectives on sadomasochism (SM) have historically been concerned with understanding it as a form of psychopathology. In the past (but still often today) studies of SM have been concerned with extreme and most often non-consensual acts. More recently, however, there has been growing interest in exploring the meaning of sadomasochism in non-pathological ways. Safe, Sane and Consensual includes work from across the social sciences exploring a variety of aspects of SM from a non-pathological perspective. There are discussions of the history and culture of SM, medical and legal understandings, along with theory and original research on the topic. There are also sections on SM and psychotherapy and writing on bridging the academic/activist divide. The book includes contributions from an international group of academics, practitioners and activists and represents some of the most recent cutting edge work in the field by leading scholars.
The effect of the individual analyst on research findings can create a credibility problem for qualitative approaches from the perspective of evaluative criteria utilized in quantitative psychology. This paper explicates the ways in which objectivity and reliability are understood in qualitative analysis conducted from within three distinct epistemological frameworks: realism, contextual constructionism, and radical constructionism. It is argued that quality criteria utilized in quantitative psychology are appropriate to the evaluation of qualitative analysis only to the extent that it is conducted within a naive or scientific realist framework. The discussion is illustrated with reference to the comparison of two independent grounded theory analyses of identical material. An implication of this illustration is to identify the potential to develop a radical constructionist strand of grounded theory.
Arousal: The secret logic of sexual fantasies
- M Bader
Bader, M. (2002). Arousal: The secret logic of sexual fantasies. St. Martin's Press.
Perks, problems and the people who play: A qualitative exploration of dominant and submissive BDSM roles
- A Hebert
- A Weaver
Hebert, A., & Weaver, A. (2015). Perks, problems and the people who play: A qualitative exploration of dominant and submissive BDSM roles. Canadian Journal of
Human Sexuality, 24(1), 49-62.
Sexual outsiders: Understanding BDSM sexualities and communities
- D Ortmann
- R Sprott
Ortmann, D., & Sprott, R. (2013). Sexual outsiders: Understanding BDSM sexualities
and communities. Rowman and Littlefield.