Sexual Masochism

Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer.

The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Masochistic acts that may be sought with a partner include spanking, whipping, beating, electrical shocks, cutting, "pinning and piercing" (infibulation), and humiliation (e.g., being urinated or defecated on, being forced to crawl and bark like a dog, or being subjected to verbal abuse). Forced cross-dressing may be sought for its humiliating associations.

The individual may have a desire to be treated as a helpless infant and clothed in diapers ("infantilism") and/or engage in a dangerous form of Sexual Masochism, called "hypoxyphilia," which involves sexual arousal by oxygen deprivation obtained by means of chest compression, noose, plastic bag, or mask.

Associated Features

Some males with Sexual Masochism also have Fetishism, Transvestic Fetishism , or Sexual Sadism.

Course

Masochistic sexual fantasies are likely to have been present in childhood. Sexual Masochism is usually chronic, and the person tends to repeat the same masochistic act. Some individuals with Sexual Masochism may engage in masochistic acts for many years without increasing the potential injuriousness of their acts. Others, however, increase the severity of the masochistic acts over time or during periods of stress, which may eventually result in injury or even death

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.