Fundamentals, Types and Roles, Safety Rules, and More

By Nuna Alberts, LCSW. Listen to the Podcast at How To Sex.



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If you’ve ever fantasized about getting kinky in the bedroom, you’re not alone. The runaway success of E. L. James’s Fifty Shades of Grey trilogy of books; the three top-selling print and e-books in the United States between 2010 and 2019; not to mention the sales of the movies they generated, prove that interest in BDSM (bondage and discipline, dominance and submission, and sadism and masochism) is anything but rare.

BDSM can involve role playing, sensory manipulation, and more. Here are a few popular ways enthusiasts like to get kinky!

Prevalence: How Many People Practice BDSM?

Further proof: Nearly 47 percent of women and 60 percent of men have fantasized about dominating someone sexually, while slightly more women and less men are aroused by the idea of being dominated, according to a 2016 study. The same study also found that almost 47 percent adults would like to participate in at least one nontraditional type of sexual activity, and 34 percent said that they’d done so at least once in the past. No wonder if you search the phrase “BDSM” on Google it will return more than 500 million results. By comparison, the phrase “missionary sex” returns about 163 million results.

The History of BDSM: Not So New

Explore a little more and you’ll also discover that BDSM is nothing new. Among BDSM’s historical high points:

• Art and texts from ancient Greece and Rome show physical pain being used as an erotic stimulus, per the book An Illustrated History of the Rod, by William M. Cooper, first published in 1868.
• The Kama Sutra, the revered Sanskrit text on sexuality written in India about 2,000 years ago, describes six appropriate places to strike a person with passion and four ways to do it. It also has chapters titled “Scratching,” “Biting,” and “Reversing Roles.”
• The Marquis de Sade, a French aristocrat who lived from 1740 to 1814, wrote a variety of erotic novels and short stories involving being beaten and beating others. Eventually the author’s name gave rise to the term “sadism.”
• Similarly, the term “masochism” is derived from the name of Austrian nobleman and author Leopold von Sacher-Masoch, whose 1870 novel Venus in Furs describes a dominant-submissive relationship.
• Back in 1953, a Kinsey Institute study found that 55 percent of women and 50 percent of men were aroused by being bitten.
• And even pre-Fifty Shades of Grey, 36 percent of U.S. adults reported having had sex using masks, blindfolds, or other forms of bondage.

Is BDSM Still Considered a Medical Disorder?

At one time, mental health experts were dubious about whether those who practiced BDSM were mentally healthy. But the American Psychiatric Association took a huge step in destigmatizing kink with the release of the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. For the first time ever, the guidelines drew a clear distinction between consenting adults who engage in sexual behaviors outside the mainstream, such as BDSM, and those who force others to engage in those behaviors without consent.

That means simply experimenting with, say, whips and chains, is no longer a sign of mental illness that by itself “justifies or requires clinical intervention,” the manual states.

There are true sexual disorders that are similar in theme. Sexual sadism disorder, for instance, involves inflicting physical or psychological pain on another for the purpose of sexual pleasure. And sexual masochism disorder involves deliberately involving yourself in a situation in which you are humiliated, beaten, or abused for the purpose of sexual excitement.

The difference between these two disorders and BDSM is consent, in the case of sexual sadism disorder, and that BDSM does not go to the degree of causing significant distress or impairing function, in the case of sexual masochism disorder.

The Psychology of BDSM: Why Are People Drawn to It?

Most of the available evidence shows that the majority of BDSM enthusiasts are mentally healthy and typical in every respect except that they find traditional (“vanilla”) intimacy unfulfilling and want something more intense.

“People always ask if it’s normal to be interested in BDSM,” says Michal Daveed, a spokeswoman for The Eulenspiegal Society, a nonprofit organization in New York City that describes itself as the “oldest and largest BDSM support and education group” in the country.

“Normal is a funny word to describe a really widespread and diverse humanity. If your definition of normal is how many people are doing this, it’s way more people than you may think,” says Daveed. “And if your definition of normal is ordinary, the BDSM world is full of ordinary people whose sexuality happens to be hardwired a particular way.”

One landmark 2008 study backs Daveed up. It found that people who engaged in BDSM were more likely to have experienced oral sex or anal sex, to have had more than one partner in the previous year, to have had sex with someone other than their regular partner, and to have taken part in phone sex, visited an internet sex site, viewed an X-rated film or video, used a sex toy, had group sex, or taken part in manual stimulation of the anus, fisting, or rimming.

However, they were no more likely to have been coerced into sexual activity and were not significantly more likely to be unhappy or anxious. Indeed, men who had engaged in BDSM scored significantly lower on a scale of psychological distress than other men.

“Our findings support the idea that BDSM is simply a sexual interest or subculture attractive to a minority, and for most participants not a pathological symptom of past abuse or difficulty with ‘normal’ sex,” the researchers concluded.

“BDSM is a healthy expression of sexuality,” says Filippo M. Nimbi, PhD, a researcher at the Institute of Clinical Sexology and in the department of dynamic and clinical psychology at Sapienza University, both in Rome.

Dr. Nimbi is also the coauthor of a study that compared 266 consensual BDSM practitioners to 200 control subjects who described their sex lives as traditional. (10) Echoing the earlier study, the researchers found that the BDSM group tended to report fewer sexual problems than the general population.

“People engaging in BDSM are usually people who have thought a lot about their sexuality,” Nimbi said. “They have explored and faced their sexual boundaries. Basically, they know what they like, and they do it. This has a positive outcome on their sexual experiences and on the overall quality of their lives.”

Many people think it’s a pathology or a perversion to, say, want to be spanked hard and to be happy about that, he added. “We each develop our erotic fantasies from our different tastes, experiences, and curiosities, beginning in childhood and lasting until the end of our lives. Everyone is different. We can develop the same fantasy from different stories, and we can develop different fantasies from the same stories. Some people find in BDSM a way to be free, to get wild, to let go, and to play a different role from their everyday lives. And if they get satisfaction and respect the ‘rules,’ why should it be abnormal?”

The Physicality of BDSM: Why Does It Feel Good?

Patti Britton, PhD, MPH, cofounder of the credentialing and training institute Sex Coach U and a past president of the American Association for Sexuality Educators, Counselors, and Therapists (AASECT), as well as other experts are quick to point out that seeking the pain-pleasure connection is not unique to the BDSM community. Think of athletes who push past physical comfort to experience a “runner’s high,” or people who chase thrills by engaging in dangerous extreme sports, like skydiving. Think of the bliss that aficionados of super spicy food experience when biting into a pepper sets their mouth on fire, or the rush of