Sexual Sadism

Sexual sadism is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a mental disorder. A person who is living with this condition becomes aroused by fantasizing or participating in scenarios where they are hurting or humiliating another individual.

Symptoms of Sexual Sadism

  • This sexual disorder is named for Marquis Donatien de Sade, who wrote novels about the idea of getting pleasure from inflicting pain.
  • Sexual fantasies about harming an adult, child or animal are part of the disorder. If an individual has been having fantasies of this nature for six months or more, they meet the criteria for diagnosis under the DSM.
  • The person must be experiencing difficulties or impairment in his or her personal relationships or job as a result of their fantasies or behavior to be diagnosed as a sexual sadist.
  • The majority of sexual sadists are male.
  • The sexual sadist will likely start having fantasies about domination and inflicting pain in adolescents.
  • An individual who has these types of sexual fantasies may progress to the stage of starting to act them out in a real, as opposed to simulated, setting.
  • Activities that a sexual sadist may engage in include hitting, whipping, burning, cutting or biting. He or she may wish to urinate or defecate on the other person.
  • With time, the sexual sadist’s behavior will escalate from exploring this theme with a consenting partner to performing acts on an unwilling one. The individual needs to increase the level of violence to get sexual gratification.
  • In scenarios where the encounter with a sadist is not consensual, rape and/or murder may be carried out. The stimulus for the sadist is domination over and fear of the victim during the acts of violence.

Treatment of Sexual Sadism

People who fit the criteria for sexual sadism may not seek treatment on their own due to feelings of shame or concerns about being reported to the authorities if they have been engaging in non-consensual sadistic activities. Once a person has been charged with an offense, the justice system’s focus is on segregation from society and punishment.

Behavior therapy is a common approach to treating sexual sadism patients. The individual learns how to change their arousal patterns to more socially accepted ones. The therapy may also include social skills instruction to help the patient develop more positive ways of interacting with others.

Along with talk therapy, the sexual sadism patient may be prescribed medications. If there is concern about an individual harming someone else, administering female hormones or antiandrogen drugs can help to reduce testosterone levels. Some SSRI (Selective Serotonin Reuptake Inhibitors), which are used to treat depression, may also be helpful in treating this disorder. The number and intensity of sadistic fantasies tends to decrease with age.

A person who knows or suspects that the definition of sexual sadism applies to them can be helped if they receive appropriate treatment from a trained professional. Seeing a therapist with experience treating sexual sadism or going to a sexual addiction treatment facility can help the patient start his or her recovery.

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