Sexual masochism is a disorder in which one is sexually aroused by being bound, beaten, or otherwise made to suffer physical pain or humiliation.Sexual masochism falls under the psychiatric sexual disorders category of paraphilias, meaning "abnormal or unnatural attraction." Sexual masochism refers to engaging in or frequently fantasizing about being beaten, bound, or otherwise made to suffer, resulting in sexual satisfaction. Blindfolding, spanking and humiliation in the form of defecation, urination, or forced imitation of animals are other methods used by these patients. Masochists may inflict their own pain through shocking, pricking or choking. Approximately 30 percent also participate in sadistic behavior.
One particularly dangerous method is called hypoxyphilia (near-asphyxiation) caused by reducing oxygen level in the brain. This results in the accidental death of one or two per million people per year. To achieve near-asphyxiation, masochists might place a noose around their necks, chest compression, put airtight bags over their heads or use amyl nitrates ("poppers").Sadomasochistic relationships tend to be well planned, with partners deciding on a special word the masochist will use to indicate that the sadist should stop.
Sexually masochistic behavior is usually evident by early adulthood, and often begins with masochistic or sadistic play during childhood.The fantasies, sexual urges, or behaviors cause clinically significant troubles or difficulty in social, occupational, or other important areas in life.
There is no universally accepted theory explaining the root of sexual masochism, or sadomasochism. However, some theories attempt to explain the presence of sexual paraphilias in general. One theory suggests that paraphilias originate because inappropriate sexual fantasies are suppressed, and they become stronger as they are forbidden. When they are finally acted upon, a person is in a state of considerable distress and/or arousal. In the case of sexual masochism, masochistic behavior becomes associated with and inextricably linked to sexual behavior. There is also a belief that masochistic individuals actually want to be in the dominating role, which causes them to become conflicted and thus submissive to others.
Another theory suggests that sadomasochistic behavior is a form of escape. Through acting out fantasies, these people feel new and different. Some theories stem from the psychoanalytic camp. They suggest that childhood trauma (for example, sexual abuse) or significant childhood experiences can manifest as exhibitionistic behavior.Nathan, Gorman, and Salkind provide the following survey of theories on the topic: Behavioral learning models suggest that a child who is the victim or observer of inappropriate sexual behaviors learns to imitate and is reinforced for these behaviors. These individuals may be deprived of normal social sexual contacts and thus seek gratification through less acceptable means. Physiological models focus on the relationship between hormones, behavior, and the central nervous system with a particular focus on the role of aggression and male sexual hormones.
Treatment typically involves psychotherapy aimed at uncovering and working through the underlying cause of the behavior.