On April 24th 2014 I gave a lecture on BDSM in sexual care and health care to over a hundred doctors, psychologists, sexologists and psychiatrists. This lecture was part of a conference on practical aspects of sexual care and health care, a conference which I organised with the Sexology Practice in Tilburg, in collaboration with the Elisabeth Hospital in Tilburg. The conference was accredited by the NVVS (Nederlandse Wetenschappelijke Vereniging voor Seksuologie), the Dutch sexology organisation. This text is a rough summary of my lecture on BDSM.
As a psychologist I have specialised in working with sexual minorities, including SMers. Not only have I personally been involved in the BDSM scene for close to a decade, I’ve studied scientific research on the subject and worked with dozens of kinksters. When other professionals contact me with questions about BDSM they often seem a bit concerned or unsure of what to do. My message today is: BDSMers are great clients and it’s an advantage if your client turns out to be kinky!
We’re talking about a large group. It is estimated one in ten people have an interest in BDSM, and around 3 to 4 % identify as SMer. The BDSM population consists of about as many women as men. Of women, 65% prefer the submissive role and 30% identify as dominant. Men are usually dominant (60%) and 30% call themselves submissive. An interesting finding is that around 50% of both men and women enjoy both roles.
Kinksters might engage in bondage, sensory play, humiliation, roleplay (including Master/slave), painplay and many other activities. Note the use of the word ‘play’ – for many kinksters it is precisely that, a form of play. BDSM is fun, brings excitement and happiness into their lives and feels like a healthy part of who they are and what they do. For example, two friends of mine have a continuous D/s relationship. One of the rules in their relationship is that she cannot have any crisps without his permission. So there she is, holding her hand just above a bowl of crisps, not touching them and there’s a huge grin on her face. He tries to look stern “I said no, girl. You don’t want to get into trouble, trust me”. Her hand hovers there for a bit, then she grabs hold of one of the crisps, pushes it into her mouth and runs, laughing and protesting. BDSM can bring excitement and fun to everyday situations.
It appears to be impossible to distinguish kinksters from non-kinksters, except for the fact that kinksters are kinky. Contrary to what early psychologists believed, BDSM is not correlated with any Axis I classifications (depression/trauma/etc), any Axis II classification (personality disorders) or anything negative or pathological at all. Quite the opposite, actually. Some research has shown significantly higher levels of education and income than in the general population, show that kinksters are more involved in community service and a recent study in Tilburg show favourable psychological characteristics in BDSMers.
So, if these kinksters are all so happy and healthy, why are they looking for help from psychologists, doctors and other professionals? Well, for the same reason non-kinky people need help… and a few other kink-specific problems. It’s important to remember that BDSM is not always part of the problem. A depression can just be a depression, no matter how perverted your client is. But kinksters can present some pretty kink-specific problems that can be puzzling to non-kinky professionals. For example, many couples experience that all the ‘workload’ is on the Dominant partner’s shoulders. The sub wants more D/s, the sub wants more play, but the Dominant has to do it, organise it. I discuss a couple where the sub is the active type, if she wants something done she’ll do it, and the Dom is more the laid-back type. Both partners want more BDSM in their lives, but after a long day of getting the kids to school, working all day, coming home, doing the housework, getting dinner ready, putting the kids to bed and finally landing their behinds on the couch in the evening, playing feels like “another item on my to-do list” for the Dominant, whereas the submissive would love to wind down with some kink. I ask the audience what they would advise, and we discuss the option of putting more of the ‘workload’ for play on the submissive. Subs can be ‘Rupsje Nooitgenoeg’ (The Very Hungry Caterpillar) so being realistic about the amount of time and energy that is available for kink seems important.
I was once contacted by a social work organisation that offered assisted-living housing. One of their clients came out as kinky and had started to attend BDSM parties and munches. They were quite alarmed and wondered if they would one day find their client dead in the gutter after one of these parties, they imagined the BDSM scene was a very violent place. They were also concerned their client was too obsessed with BDSM, as she had started wearing a BDSM symbol around her neck and had BDSM-themed art on her walls. I explained ‘BDSM puberty’. When people find out they’re kinky (or gay) they can go through a phase where it’s all they can think or talk about. Visit ALL the gay bars, be active in ALL the gay rights movements, wear ALL the rainbows! Or, in the case of a kinkster, visit ALL the events, wear ALL the outfits, have ALL the play! I was able to reassure the professionals in this organisation that there was no problem.
But BDSM can be risky, although not in the way a non-kinkster might think. I showed the audience two pictures of BDSM, one with a quite serene and artsy bondage scene and one with a black and blue behind. Bruises and welts might seem scary but are in reality usually harmless, it’s actually the bondage scene that poses more risks. Heavy psychological play might seem intimidating. But kinksters do not display above average symptoms of PTSS (post-traumatic stress disorder), trauma or distress. Accidents, however, do happen. A worrying finding is that kinksters do not usually feel comfortable seeking medical or psychological help, as they are afraid of judgement and discrimination. Sadly, this fear is often justified. SM participants lose custody of children, security clearances, inheritances, jobs, are disowned, assaulted and are victims of persecution and prosecutions. In my own kinky social circle I know of three parents who were reported to Child Services exclusively because of their kink. BDSM can be risky because the non-kinky world makes it risky.
People who don’t deviate from sexual norms usually don’t really have to talk about what they do. There’s a script that can be followed: first kissing, touching breasts, stimulating genitals with hands or mouth and finally penetration. This script can be harmful and does cause sexual problems, but it alleviates you from the responsibility of talking about your desires. When you start to deviate from that heterosexual vanilla norm however, the scripts become useless and you have to communicate your wants and needs. Or else you might show up with diapers while your partner was getting ready for a suspension-scene! In practice this means your kinky clients are used to talking about sex, consent, boundaries and fantasies. They use things like safewords, activity-lists and soft and hard boundaries. Their experience in open communication is a great advantage in therapy sessions. I’ve noticed kinky clients are very willing to do their homework and are creative and playful. Kinky clients are fun clients. And honestly, they often have ‘fun’ problems. I recently saw a couple who wanted help because, when she was being cheeky, he didn’t give her a big smack across the face!
And with kinky clients, as a professional you can really make a difference, which makes working with this population all the more rewarding. I’ve spoken with numerous kinksters who have been told they were sick, they weren’t capable of intimacy, who have received treatment to get rid of the kink. By simply listening, helping them with their actual problems instead of making a problem out of BDSM, by offering some psycho-education on sexuality and diversity, you can make such a difference in a kinkster’s life.
Working with kinky clients can be a learning experience for professionals. Be aware of your own preconceptions, not everything you’ve heard or seen on tv is necessarily true. Be responsible for your own education, too often professionals bring their ignorance and curiosity into their working relationship and use their client’s time to ask questions when they should’ve done their own homework. There are many books and websites on BDSM, including my own (marijkespraktijken.nl). Learn to differentiate between your own emotional reaction and another person’s experience. When you’re a heterosexual man, imagining sex with another man might evoke some pretty negative emotions, but this doesn’t mean there’s anything wrong with homosexual sex. By the same token, some things in BDSM might repulse or frighten you, but this does not automatically mean there’s anything wrong. Be sensitive to the difference between your intuition as a professional, and your emotional ‘squick’ reaction to something that’s not for you.
Sex is intimacy, pleasure, connection, and in BDSM people try to be honest about their fantasies, they’re vulnerable, they bring their guards down, trusting that they will be accepted and loved. And whether we’re kinky or not, I think that’s something we’re all into.