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Paraphilic Disorders -

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Patrick K. Faircloth, Ph.D., L.P.C.(AL/MI), N.C.C.Assistant Professor, Troy University,[email protected]

ALCA 2014 Conference – Huntsville, AL.Wednesday, November 19, 2014 -- 2:30 - 3:45 pm
Kinky Clients –Part 2– Building Theory and Skills to Counsel Clients with A BDSM Orientation
BDSM Misconceptions and Myths
BDSM is mostly about the “dominant” partner getting his/her way with a passive, exploited “submissive.”2.BDSM is about physical pain.3.BDSM activities inevitably escalate to extremes and/or become addictive.4.BDSM is self-destructive.5.BDSM stems from childhood abuse.6. BDSM is an avoidance of intimacy.7. BDSM is separate from “vanilla” sex.(Nichols, 2006)
What Studies Tell Us
Kolmes, Stock and Moser (2006) surveyed 175 participants who self-identified as practicing BDSM sexuality and who had therapy experience. Of these respondents, more than one-quarter did not disclose their BDSM sexuality to their therapists because they either felt their sexuality was unrelated to the reasons for entering therapy or they were afraid of the response of the therapist. Of those who disclosed, the respondents reported 118 incidents of biased or inadequate care in reaction to the disclosure, and 113 incidents of sensitive or culturally aware care by the therapist upon disclosure.Richterset al. (2008) found that BDSM practitioners scored no higher than the general population on measures of psychological distress, and male BDSM practitioners actually scored significantly lower on psychological distress than other men in their sample.Connolly (2006) found that individuals with BDSM orientations did not differ from the general population in terms of depression, anxiety or OCD.
What Studies Tell Us (continued)
The stigma of BDSM sexuality may interfere with access to mental health services, in the form of either prejudice on the part of the therapist or nondisclosure and self-censuring on the part of the client. The stigma of BDSM sexuality may also create dysfunction in a client-therapist relationship when the therapist assumes that the sexual activity is, by itself, an indicator of mental illness without understanding how the client experiences their BDSM sexuality, and communicates this prejudicial attitude to the client without demonstrating openness to other possibilities. Positive interactions between clients and therapists around BDSM sexuality disclosure are also experienced by clients and therapists.A discerning approach and knowledge base about BDSM sexuality on the part of the therapist will help avoid the impact of prejudicial stigma on the therapeutic relationship and help to establish a scientific basis for appropriate therapeutic interventions. (Hoff &Sprott, 2009).
Why Is Kink Sexually Appealing?
BDSM can be a lot of fun, and it can make sex very hot.Some people see BDSM sexuality as spiritual, not unlike Tantric sex.3. Others feel it enhances intimacy in a committed relationship,4. Some kinky practices explore the “shadow side” of sexuality.5. Some BDSM practitioners feel that this form of sexuality is a non-chemical way ofattaining pleasurable altered states of consciousness.6. The tremendous variety of activities encompassed within kink mitigates against thetendency for sex to become routine and monotonous, especially in monogamousrelationships.(Nichols, 2006)
What Are Kinky Activities?
In general, “kinky” sexual activities include one or more of the following characteristics:A hierarchical power structure, i.e., one person dominates and the other obeys/submitsIntense stimulation usually associated with physical or emotional pain, e.g., hitting, humiliationForms of sexual stimulation involving sensory deprivation, sensory confusion, or restraint, e.g., bondage, use of blindfoldsRole-playing of fantasy sexual scenarios, e.g., doctor-patient roles, abduction fantasiesUse of certain preferred objects and materials as sexual enhancers, e.g., leather, latex, stiletto heelsOther unusual sexual objects or practices often classified as a fetish orpartialism, e.g., fixation with feet, sexual play with urine(Nichols, 2006)In my experience this is not an exhaustive list.
What Do BDSM Clients Find Helpful?
BDSM clients were also asked what professional psychotherapy practices they would consider especially beneficial to a BDSM client. These themes includedasking questions about BDSMHelping the client to overcome shame and stigma as related to the BDSM identityopen-mindedness and acceptancenot expecting the client to do all of the educating about BDSMunderstanding the distinction between BDSM and abusebeing someone who practices BDSM and identifies with the BDSM lifestylethe ability to appreciate the complexity of BDSM play and to realize that some clients need help to determine if they are using BDSM in a positive way in their lives.(Kolmes, Stock, & Moser, 2006)
Therapist’s Issues
The researchers identified and coded the major themes that emergedin response to the answers given by participants. Regarding reports of“biased, inadequate, or inappropriate care to a BDSM client in psychotherapy,” participants listed several major categories:Considering BDSM to be unhealthyrequiring a client to give up BDSM activity in order to continue in treatmentconfusing BDSM with abusehaving to educate the therapist about BDSMassuming that BDSM interests are indicative of past family/spousal abuseTherapists misrepresenting their expertise by stating that they are BDSM-positive when they are not actually knowledgeable about BDSM practices.(Kolmes, Stock,& Moser, 2006)
Questions For The Therapist
As a therapist how comfortable are you with your own sexuality? If you are not then you will have problems working with this group of people.“I notice I feel disgusted when my client tells me about sexual scenarios in which her partner has humiliated her. What triggers this disgust in me–is it the humiliation, the specific method of humiliation, etc.?”“Why is my reaction so strong and aversive? Might I secretly want to humiliate or be humiliated?”“If so, why does that scare me? Why do I think it’s ‘bad’ or ‘wrong’ for me to feel this way? Does it clash with other values? Does it trigger memories of past trauma or other experiences involving humiliation?” In the BDSM community, the term“squicked” refers to having a strong negative emotional reaction to an activitywhile knowing that you do not actually “judge” the activity as “wrong” or “bad.”This is a helpful and neutral way to think of suchcountertransferentialfeelings.(Nichols, 2006)
What If It Is Abuse?
If after searching one’s self for any issues of counter transference and being assured that none exist then the following questions can be very usefulHow does the client feel about his or her behavior? If the client is worried, can thisconcern be accounted for by internalized sex-negative attitudes, or is there substance tothe client’s fears?2. Is the behavior interfering with activities of daily life, such as work, family relationships, or friendships and social life? Caution is needed here; for example, isolation from friends may simply mean the kinky person needs to build a new supportgroup that is accepting of his or her lifestyle.3. Is the behavior compulsive?4. Is the client participating in genuinely risky behaviors.5. Does the sexual behavior seem to be making the client feel worse–more depressed, anxious, guilty, self-hating–rather than better?(Nichols, 2006)
My ApproachI approach the client:where they arefrom a place of non-judgmentwith a certain sense of notknowingnesswith an invitation for the client to educate me and yet being willing to self-educatepaying attention to power dynamicsThese things are perhaps considered core conditions, however due to unfamiliarity and perhaps unconscious judgments, personal triggers, counter transference, and blind spots, value projections can emerge during the therapeutic hour from the therapist.
BDSM Communities/Personal ObservationsIn the 1970s and 1980s the BDSM communities were very much a sort of word of mouth and tight knit experience.In the last several of decades with the advent of the internet things have gradually changed, with online groups, socialmedia (i.e.Fetlife),even virtual worlds like Second Life.Today if a person wants to explore any of the BDSM communities all they have to do is use a search engine like Google.Since the book Fifty Shades of Grey (James, 2012) there has been an explosion of people who are kinky curious and this has been an ongoing topic of discussion in the BDSM communities. This phenomenon has given raise to new comers who are not aware of cultural norms that older members were lead through. This causes many issues for good and bad new comers and more members of the communities are taking on policing, training, and leadership roles to assist with this situation.
Coming “out” once and twiceSome anecdotal information regarding a recent discussion with a man who is a retired therapist, and identifies as a Gay Dominant and other members of the LBGTQQIA2S communitiesChosen families: At least anecdotally, it is widely know in the BDSM and LBGTQQIA2S communities that many people are not accepted or even shunned by their family of origin, and so they choose a second family from their community. When such a person comes out a second time they can experience the same rejection from their chosen family.Challenges: Stigma & Threats to hard won support systemsFor example, a Gay man who comes out a second time as a submissive may lose the support of his first community. Whereas a submissive who comes out a second time as a Gay man may loose the support of his first community. In either case it is likely that you will see client’s like this currently or in the future, due to a loss of a primary support system.
The Experiential Part of the PresentationAs we discuss the following vignettes keep in mind that I am approaching working with these clients with certain fundamental beliefs.They are members of a sexual minority and as such are protected under the policies of ALGBTICAL.We are not just talking about a sexual practice but in some cases arguably a sexual orientation.People with a BDSM orientation are still people first, this is just a part of their total identity.If the person is not observing S.S.C. or R.A.C.K. then it is likely that what they are engaging is not BDSM but illegal abuse!
VignettesYour client is a gay leather boy orboi, and is torn between staying in the closet with his family or moving in with his/her gay leather Daddy or MommyYour client informs you that he/she really wants to do what his Master wants and engage in“scat play”but he is afraid of getting a disease. However he/she afraid that if he does not do this he will lose this relationship, because he/she will not be a“serious”slave.Your client is has read the 50 Shades Books andwentto a play party in a private dungeon in a person’s home and had to go to the hospital. Your client wishes to continue to explore this but safely.Your client has been in the BDSM world for 7years and has an expressed BDSM orientation.However, she/he played with a person that ignored his/her safe word and has been having nightmares, reliving the event that happened 3 months ago.Your client is worried that if he/she give his/her partner pain as requestedthentheirsadist will be unleashed and he/she will be hated by the partner. However, if he/she does not do this the partner may seek this elsewhere.
Reading List
Baldwin, G. (2002).SlaveCraft: roadmaps for consensual erotic servitude : principles, skills, and tools. Los Angeles, CA:DaedalusPub. Co.Bean, J. W. (2005). Mummification Down at the End of Bondage Street. :NazcaPlains Corp.Bean, J. W., & Smith, S. (2005). Flogging: the basics and beyond. Las Vegas, NV:NazcaPlains Corp.FifthAngel(2010). The Finer Points of Pain and Pleasure.CreateSpaceIndependent Publishing Platform.Forbes, G. (2010). The Adult Spanking & Discipline Handbook. :NazcaPlains Corp.Harrington, L. (2009). Rope, bondage, and power. Las Vegas, Nevada:NazcaPlains.Kent, D. (2004). The Better built bondage book. Ottawa: Mental Gears Pub.Lyon, C. M. (2012). Leading and Supportive Love: the truth about dominant and submissive relationships.
Reading List (continued)
Masters, P. (2009). This curious human phenomenon. Las Vegas, Nev.:NazcaPlains.Midori (2001). The seductive art of Japanese bondage. Emeryville, CA: Greenery Press.Morgynn, L. C. (2009). Protocols: a variety of views. Las Vegas, Nev.:NazcaPlains.Reilly, S. (2008). The Submissive Activity Book: building blocks to better service.Rinella, J. (2003). The complete slave: creating and living an erotic dominant/submissive lifestyle. Novato, Calif.:DaedalusRinella, J., & Bean, J. W. (1994). The master's manual: a handbook of erotic dominance. Los Angeles, CA:DaedalusPub. Co.Rubel, R. J. (2006). Master/slave relations: handbook of theory and practice. Las Vegas, Nev.:NazcaPlains Corp.Rubel, R. J. (2007). Protocols: handbook for the female slave. Las Vegas, Nev.:NazcaPlains.
Reading List (continued)
Rubel, R. J. (2008). Communications 401: the advanced course. Las Vegas, Nev.:NazcaPlains.Rubel, R. J. (2008). Master/slave relations: solutions 402--living in harmony. Las Vegas, Nev.:NazcaPlains Corp.Rubel, R. J. (2008). Playing exchange books: playing with disabilities. Las Vegas, Nev.:NazcaPlains.Rubel, R. J. (2008). Protocol handbook for the leather slave: theory and practice. Las Vegas, Nev.:NazcaPlains Corp.Rubel, R. J. (2008). The art of slavery. Las Vegas, Nev.:NazcaPlains.Rubel, R. J. (2009). Age play. Las Vegas, Nev.:NazcaPlains.Rubel, R. J. (2010). Squirms, screams, and squirts: the workbook.S.l.:NazcaPlains Corporation.
Reading List (continued)
Smith, S. (2007). Rope bondage: precision and persuasion with rope. Las Vegas, Nev.:NazcaPlains.Wagner, R. (2013). The Gospel of kink: A modern guide to asking for what you want and getting what you ask for. Las Vegas, NV: TheNazcaPlains Corporation.Warren, J., & Warren, L. (2007). The loving dominant (New and improved ed.). San Francisco, Calif.: Greenery Press.Weal, J. D. (2011). Theleatherman'sprotocol handbook: a handbook on "old guard" ritual, traditions, and protocols. Las Vegas, Nev.:NazcaPlains.Williams, D., & Williams, D. (2010). Living M/S. :NazcaPlains Corp.Wiseman, J. (1996).Sm101: A realistic introduction. (2nd ed.). Emeryville, CA: Greenery Press.Wiseman, J. (2000). Jay Wiseman's erotic bondage handbook. Emeryville, CA: Greenery Press.
ReferencesArredondo, P.,Toporek, M. S., Brown, S., Jones, J., Locke, D. C., Sanchez, J. andStadler, H. (1996)Operationalizationof the Multicultural Counseling Competencies. AMCD: Alexandria, VA. Retrieved November 18, 2013, from of Lesbian, Gay, Bisexual, and Transgender Issues in Counseling. (2009).Competencies for counseling with transgender clients. Alexandria, VA: Author. Retrieved November 18, 2013, from of Lesbian, Gay, Bisexual, and Transgender Issues in Counseling. (2012).Competencies for Counseling with Lesbian, Gay, Bisexual, Queer, Questioning, Intersex and Ally Individuals.Retrieved November 18, 2013, from Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders(5th ed.). Arlington, VA: American Psychiatric Publishing.BDSM image. Retrieved November 18, 2013, from
ReferencesConnolly, P.H. (2006). Psychological functioning of bondage/ domination/sado-masochism (BDSM) practitioners. Journal of Psychology & Human Sexuality, 18(1), 79-120.Historyof the Leather Pride Flag (n.d.) Retrieved November 18, 2013, from, E. L. (2012).Fifty shades of Grey. New York: Vintage Books.Kolmes, K, Stock, W. & Moser, C. (2006). Investigating bias in psychotherapy with BDSM clients. InKleinplatz& Moser (Eds.) Sadomasochism: Powerful pleasures. Binghamton, NY: Harrington Park Press, Inc.Hoff, G., &Sprott, R. A. (2009). Therapy experiences of clients with BDSM sexualities: listening to a stigmatized sexuality.Electronic Journal of Human Sexuality,12.Milar, K.S., (2011, February). The Myth Buster: Evelyn Hooker’s groundbreaking researchexplodedthe notion thathomosexualitywas a mental illness, ultimately removing it fromtheDSM.Monitor on Psychology, 42(2), 24.Nichols, M. (2000). Therapy with sexual minorities. In S.Leiblum.&R. Rosen, (Eds.).Principles and practice of sex therapy (pp. 335-367).NewYork: Guilford.
ReferencesRichters, J., deVisser, R. O.,Rissel, C.E.,Grulich, A.E., & Smith, A.M. (2008). Demographic and psychosocial features of participants in Bondage and Discipline, Sadomasochism or Dominance and Submission (BDSM): Data from a national survey. Journal of Sexual Medicine, 5(7), 1660-1668.Reinisch. J.M., & Beasley, R., (1990).Kinsey Institute New Report on Sex,St. Martin's Press: pg. 162-163.Shainberg, S. (2002). Secretary - Movie Trailer. Retrieved November 18, 2013, from, S. (Producer), &Shainberg, S. (Director). (2002).The Secretary[Motion picture].United States: 2002 Lions Gate Entertainment.triskelion. 2013. Retrieved November 18, 2013, from Flag was unveiled during the Master/slave Conference2005 (n.d.) RetrievedNovember18, 2013, from
ReferencesWiseman, J. (1996). SM101: A realistic introduction. San Francisco: Greenery Press.Wright, S. (n.d.).SM is Safe, Sane, and Consensual. Retrieved November 18, 2013, from, S. (2008a). In Their Own Words. Retrieved November 18, 2013, from, S. (2008b). In Their Own Words. Retrieved November 18, 2013, from





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Paraphilic Disorders -