Sexual Masochism

Running head: SEXUAL MASOCHISM

Sexual Masochism

Crystal Demoreta-Braza

Rowan-Cabarrus Community College

NUR 210

Ms. Abel

Sexual Masochism

Masochism is a general paraphilia, and is an abnormal or unnatural sexual attraction. It is recurring sexually arousing fantasies, urges, or behaviors in which the person is beaten, bound, or humiliated in order to achieve sexual excitement (Sexual Disorders 2001). Bondage, blindfolding, and use of urine and feces are some methods used by people with sexual masochism. These urges or behaviors must last at least six months for a diagnosis to be made. The most common fantasy is that of being raped while restrained, so escape is impossible. A potentially dangerous or even fatal form of masochism is asphyxiating the partner with a noose or plastic bag at climax to enhance the orgasm (Bobrin, D. 2002).

Most patients admit to having masochistic fantasies in early childhood and many of them have fetishes (handcuffs, leather masks, and whips). They have begun to engage in masochistic acts by early adulthood.

There are several different theories about the cause of sexual masochism such as childhood sexual abuse or other childhood experiences that may influence later exhibitionist behavior. The need to give or receive pain for sexual gratification stems back to when one was a child. If the only attention a child received from their parents was punishment, then being punished was a pleasurable thing. The child might continue to do things in order to get punished because he/she knows they will finally get attention. There are three other explanations why people engage into masochism, and they are behavioral, compensation, and physiological models.

Behavioral models imply that if a child is subject to inappropriate sexual behavior they learn to imitate such behavior later in life. Compensation models imply that if deprived of normal social/sexual experiences, people will seek gratification via less socially accepted ways,

Physiological models compare the relationship between hormones, behavior, and central

nervous system (Sexual Masochism Treatment 2005).

Treatment is aimed at finding and working through the underlying cause, this is done with psychotherapy and a proper medication regimen. Both treatment modalities hopefully will reduce masochistic behavior particularly the dangerous kind. There are two particularly important therapies to treat sexual masochism, cognitive-behavioral therapy and orgasmic reconditioning. Cognitive-behavioral therapy helps the patient control the undesirable behaviors by avoiding situations that may generate initial desires. Orgasmic reconditioning is used by letting patient masturbate to normal stimulus but prior to orgasm, the patient is told to concentrate on a more acceptable fantasy (Treatment for Sexual Masochism 2005). Types of medications used are Clomipramine, a tricyclic antidepressant, Fluoxetine, a SSRI, and the hormone Depo-Provera. These work by decreasing the level of circulating testosterone, therefore reducing sex drive and aggression.

People diagnosed with sexual masochism often have coexisting paraphilias such as coprophilia, and urophilia. Coprophilia is defined as an abnormal often obsessive interest in excrement, especially the use of feces for sexual excitement. Urophilia is defined as a sexual