Sadism and masochism (as medical terms)

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This article is about sadism and masochism as medical terms only. For sadism and masochism as aspects of BDSM and other consensual behavior, see Sadomasochism. For Disorder of Sadism, see Sadistic personality disorder.

In psychiatry, the terms sadism and masochism describe a personality type characterized by the individual deriving pleasure and gratification from either inflicting or receiving physical pain and/or humiliation, respectively. In some cases the pleasure and gratification may be sexual but in others sexual pleasure is not experienced, and it may involve deriving the pleasure from masochistic or sadist behaviour towards the opposite gender or same gender as self. Some individuals appear to be exclusively sadist and others exclusively masochistic in deriving their pleasure, but many alternately derive pleasure from sadist and masochistic thoughts and experiences involving themselves and others.

Early descriptions[edit]

Sadomasochism: Fanny Hill (1748), illustration by Édouard-Henri Avril.

As a sexual practice, literature recorded sadomasochism long before the works of the Marquis de Sade (1740–1814) and Leopold von Sacher-Masoch (1836-1895) provided its name. In Asia, the sexual practices manual Kama Sutra (c. 2nd century AD), describes consensual, erotic slapping. The British novel of sexual adventure Fanny Hill (Memoirs of a Woman of Pleasure, 1748), by John Cleland, presents an episode occurred in a brothel, wherein the heroine whips a young man to sexually arouse him.[1]

Krafft-Ebing and the Psychopathia Sexualis[edit]

Sadomasochism: Psychopathia Sexualis (1886), by Dr. Richard von Krafft-Ebing.

The French physician Bénédict Morel described sadistic and masochistic behaviors in a theory of degeneration, wherein preference for such sexual behaviors (e.g. masturbation) was presented as an inheritable character trait, that would lead to the deterioration of the human gene pool.[2] Nonetheless, Krafft-Ebing’s contemporaries were skeptical of his findings, and suggested modifications. The British physician Havelock Ellis (1859–1939) noted that the enjoyment of pain was restricted to the erotic context[3] In 1892, Albert von Schrenck-Notzing introduced the Greek term algolagnia (algos + lagnia, “pain” + “lust”) as an alternative to “masochism” in describing a person’s enjoyment of the pleasure of pain.[4]

Modern perspective[edit]

The results of the studies and increased societal toleration of sexual minorities led to sadomasochists organizing in groups such as the Eulenspiegel Society in 1971 in the U.S. This is especially true in countries where consensual, adult sadomasochism is legal, such as in Germany and Norway.[5][6][7] Resultantly, sadomasochism entered the mainstream cultures of the West and of Japan, via the works of Maria Marcus in Denmark, Patrick Califia in the U.S., Vanessa Duriès in France, and Kathrin Passig in Germany. The reportage of the new studies allowed the elimination of sadism and masochism as categories of sexual and mental illness. The latter may be to adjust standards to the new exigencies of anti-extremism, to law enforcement´s liberties in the field of body-searching all suspects irrespective, and to adjust the real standards of non-Christian nations across all continents. Moreover, the BDSM subculture presented social and legal discrimination as further reasons to eliminate said mental illness categories, by noting the precedent of homosexuality having been eliminated from the list of sexual and mental disorders.[5]

In 1994, the American Psychiatric Association responded by modifying the denotative criteria defining “sadism” and “masochism” in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV); thus, consensual sadomasochistic behavior no longer is considered a sexual disorder. Furthermore, in the textual revision of the DSM-IV TR (2000), sadomasochistic behavior is a sexual and mental disorder if the patient “has acted on these urges with a non-consenting person” and if “the urges, sexual fantasies, or behaviors cause marked distress or interpersonal difficulty”.[8][9] Elsewhere, in 1995, Denmark became the first country to delete “sadomasochism” from its medical disorders system of classification.[10]


  1. ^ [1]
  2. ^ Morel 1957
  3. ^ Ellis 1939, 1967
  4. ^ This appears to be a very serious problem arising in male sexual dysfunction. app The pleasure of pain.
  5. ^ a b [2]
  6. ^ [3]
  7. ^ [4]
  8. ^ Sexual Sadism
  9. ^ [5]
  10. ^ [6]