Researchers weigh the benefits and risks

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A recent article published in the Journal of Sex and Marriage Therapy examines the relationship between BDSM and childhood sexual abuse (CSA). The findings suggest that for some individuals, practicing BDSM can serve as a way to process and heal past trauma. However, it also carries risks of retraumatization.

CSA affects millions of children worldwide. The World Health Organization defines CSA as the involvement of a child in sexual activity that they cannot fully understand or consent to. It often involves an abuse of power and trust by an adult or older child. The psychological effects of CSA are profound and long-lasting, often extending into adulthood. Survivors often struggle with severe anxiety, depression, post-traumatic stress disorder, and low self-esteem.

BDSM refers to a variety of practices and role-play activities involving bondage, discipline, dominance, submission, sadism, and masochism. These activities are characterized by consensual power dynamics and often involve the use of pain to enhance sexual satisfaction. Central to ethical BDSM practices is the principle of mutual consent, with all participants agreeing to the boundaries and activities involved.

“Our interest arose from our clinical practice with survivors and from questions from professionals wondering how to respond to BDSM practices with trauma survivors,” explains Ateret Gewirtz-Meydan, a senior faculty member at the University of Haifa School of Social Work and a certified sex therapist.

“We aim to better understand the unconscious mechanisms that may be at play and the potential therapeutic functions of BDSM practices among CSA victims. Given the profound and long-lasting effects of CSA, it is crucial to explore all possible pathways for healing and processing trauma, including those that are less conventional and more stigmatized.”

In reviewing previous studies, the researchers found that while there is some evidence to suggest a higher prevalence of trauma among BDSM practitioners, the data is inconsistent. Some studies indicate that individuals who practice BDSM report PTSD and trauma-related scores that are similar to those of the general population. For example, one study of Australian respondents found no significant relationship between BDSM practices and experiences of sexual abuse.

Another study among participants in Finnish BDSM clubs showed a higher prevalence of CSA compared to the general population, but the majority of BDSM practitioners reported no such history. This suggests that while a subset of BDSM practitioners may have experienced trauma, it is not a defining characteristic for most individuals in the community.

For some survivors of CSA, practicing BDSM can be a way to regain control and reframe their traumatic experiences, the researcher noted. Through the principles of safe, healthy, and consensual practices, BDSM allows survivors to set boundaries, negotiate power dynamics, and explore their bodies in a controlled and consensual environment.

This can lead to a form of trauma play in which survivors consciously relive their trauma from a position of power and agency. The process involves repetition and rescripting, transforming the negative emotions associated with past trauma into pleasurable sensations and feelings of mastery.

On the other hand, the researchers also examined scenarios in which BDSM practices might reproduce traumatic experiences for CSA survivors. They found that the intense power dynamics and physical sensations inherent in BDSM can sometimes mirror the traumatic experiences of abuse.

For example, consensual role-playing involving control and submission can trigger memories of previous non-consensual situations, which can lead to psychological harm. Furthermore, if BDSM activities do not strictly adhere to the boundaries of consent, survivors may have difficulty setting their boundaries, potentially reliving feelings of powerlessness and violation.

The researchers noted that dissociation, a common coping mechanism for trauma survivors, may be invoked during BDSM activities, further complicating the individual’s ability to distinguish between consensual play and past abuse. Dissociation is a psychological coping mechanism in which an individual disconnects from their thoughts, feelings, or sense of identity in order to distance themselves from overwhelming experiences. So while BDSM can be empowering for some, it may inadvertently re-traumatize others.

The article highlights “that the relationship between BDSM and CSA is multifaceted and complex,” Gewirtz-Meydan told PsyPost. “BDSM practices can potentially serve as a vehicle for trauma survivors to regain control, explore boundaries, and reimagine their relationship with their bodies in a consensual and safe environment. However, it is not a one-size-fits-all solution and should be approached with careful consideration and professional guidance.”

The findings should be interpreted with caution and are seen as preliminary insights into a complex and evolving field due to several factors. First, existing research on the relationship between BDSM and CSA is scarce and often inconsistent, making it difficult to draw definitive conclusions.

“A major caveat is the lack of sufficient empirical data to robustly support the proposed clinical perspectives,” Gewirtz-Meydan said. “The varying definitions and understandings of BDSM add complexity, and the motivations of CSA survivors who engage in BDSM are not fully understood. Additionally, there is limited research examining the potential risks and possibility of retraumatization for CSA survivors who engage in BDSM practices.”

Nevertheless, the study highlights the importance of clinicians approaching the topic of BDSM with care and not automatically viewing it as something abnormal or wrong.

“It is crucial for clinicians to approach this topic with sensitivity and avoid pathologizing BDSM practices,” Gewirtz-Meydan said. “Understanding the therapeutic potential of BDSM and promoting open, nonjudgmental conversations about it can help destigmatize and empower trauma survivors.”

“Our long-term goals include conducting more extensive empirical studies to understand the different pathways that may lead CSA survivors to engage in BDSM and the impact of these practices. We aim to provide clearer clinical guidance for therapists working with survivors who are prone to BDSM and to explore the broader applications of BDSM as a potential therapeutic tool for different types of trauma.”

The study, “The complex interplay between BDSM and childhood sexual abuse: a form of repetition and dissociation or a path to processing and healing?”, was authored by Ateret Gewirtz-Meydan, Natacha Godbout, Cloé Canivet, Tal Peleg-Sagy, and David Lafortune.

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