Sadism and masochism are often discussed under the common category sadomasoch­istic (SAY-doh-ma-suh-kis-tik) (SM) behavior because they are two variations of the same phenomenon: the association of sexual expression with pain. Furthermore, the dynamics of the two behaviors are similar and overlapping. Thus in the discussion that follows we will often refer to SM behavior or activities. However, a person who engages in one of these behaviors does not necessarily engage in the other, and thus sadism and masochism are actually distinct behaviors. The American Psychiatric Association (2000) underlines this distinction by listing these paraphilias as separate categories: sexual sadism and sexual masochism. Sexual masochism is the only paraphilia that is expressed by women with some frequency (American Psychiatric Association, 2000). (People who engage in SM often label these activities as bondage-domination-sadism – masochism, or BDSM; Gross, 2006.)

Labeling behavior as sexual sadism or sexual masochism is complicated because many people enjoy some form of aggressive interaction during sex play (such as "love bites") for which the label sadomasochistic seems inappropriate. Alfred Kinsey and his colleagues (1948, 1953) found that 22% of the males and 12% of the females in their sample responded erotically to stories with SM themes. In another study, approximately 25% of both sexes reported erotic response to receiving love bites during sexual interac­tion (Gross, 2006). Another survey of 975 men and women found that 25% reported occasionally engaging in a form of SM activity with a partner (Rubin, 1990). There are indications that ease of access to people with SM inclinations, facilitated by the Inter­net, has resulted in an increased number of people who are exploring their SM interests (Gross, 2006; Kleinplatz & Moser, 2004).

Although SM practices have the potential for being physically dangerous, most par­ticipants generally stay within mutually agreed-on limits, often confining their activities to mild or even symbolic SM acts with a trusted partner. In mild forms of sexual sadism the pain inflicted is often more symbolic than real. For example, a willing partner may be "beaten" with a feather or a soft object designed to resemble a club. Under these con­ditions the receiving partner’s mere feigning of suffering is sufficient to induce sexual arousal in the individual inflicting the symbolic pain.

People with masochistic inclinations are aroused by such things as being whipped, cut, pierced with needles, bound, or spanked. The degree of pain that the person must experi­ence to achieve sexual arousal varies from symbolic or very mild to, rarely, severe beatings or mutilations. Sexual masochism is also reflected in individuals who achieve sexual arousal as a result of"being held in contempt, humiliated, and forced to do menial, filthy, or degrading service" (Money, 1981, p. 83). The common notion that any kind of pain, physical or men­tal, will sexually arouse a person with masochistic inclinations is a misconception. The pain must be associated with a staged encounter whose express purpose is sexual gratification.

In yet another version of masochism, some individuals derive sexual pleasure from being bound, tied up, or otherwise restricted. This behavior, called bondage, usually takes place with a cooperative partner who binds or restrains the individual and some­times administers discipline, such as spankings or whippings (Santilla et al., 2002). One survey of 975 heterosexual women and men revealed that bondage is a fairly common practice: One fourth of respondents reported engaging in some form of bondage during some of their sexual encounters (Rubin, 1990).

Many individuals who engage in SM activities do not confine their participation to exclusively sadistic or masochistic behaviors. Some alternate between the two roles, often out of necessity, because it may be difficult to find a partner who prefers only to inflict or to receive pain. Most of these people seem to prefer one or the other role, but some are equally comfortable in either role (Mosher & Levitt, 1987; Taylor & Ussher, 2001).

Research has indicated that individuals with sexual sadistic tendencies are less common than their masochistic counterparts (Sandnabba et al., 1999). This imbal­ance might reflect a general social script—certainly it is more virtuous to be pun­ished than to carry out physical or mental aggression toward another. A person who needs severe pain as a prerequisite for sexual response may have difficulty finding a cooperative partner. Consequently, such individuals may resort to causing their own pain by burning or mutilation. Likewise, a person who needs to inflict intense pain to achieve sexual arousal may find it difficult to find a willing partner, even for a price. We occasionally read of sadistic assaults against unwilling victims: The clas­sic lust murder is often of this nature (Money, 1990). In such instances orgasmic release may be achieved by the homicidal violence itself.

Many people in contemporary Western societies view sadomasochism in a highly negative light. This attitude is certainly understandable, particularly in peo­ple who regard sexual sharing as a loving, tender interaction between partners who wish to exchange pleasure. However, much of this negativity stems from a general­ized perception of SM activities as perverse forms of sexual expression that involve severe pain, suffering, and degradation. It is commonly assumed that individuals caught up in such activities are often victims rather than willing participants.

One group of researchers disputed these assumptions, suggesting that the tra­ditional medical model of sadomasochism as a pathological condition is based on a limited sample of individuals who come to clinicians’ attention because of person­ality disorders or severe personality problems. As with some other atypical behaviors discussed in this chapter, these researchers argued that it is misleading to draw conclu­sions from such a sample. They conducted their own extensive fieldwork in nonclini­cal environments, interviewing a variety of sadomasochism participants and observing their behaviors in many different settings. Although some subjects’ behaviors fit tradi­tional perceptions, the researchers found that, for most participants, sadomasochism was simply a form of sexual enhancement involving elements of dominance and sub­mission, role-playing, and consensuality, "which they voluntarily and mutually chose to explore" (Weinberg et al., 1984, p. 388). Another study of 164 men who were members of sadomasochism-oriented clubs revealed that these individuals were socially well adjusted and that sadomasochistic behavior occupied only a portion of their broader sexual lives (Sandnabba et al., 1999).

Many people who engage in SM activities are motivated by a desire to experience dominance or submission, or both, rather than pain (Weinberg, 1987, 1995). This desire is reflected in the following account, provided by a student in a sexuality class:

I fantasize about sadomasochism sometimes. I want to have wild animalistic sex under the control of my husband. I want him to "force" me to do things. Domination and mild pain would seem to fulfill the moment. I have read books and talked to people about the subject, and I am terrified at some of the things, but in the bounds of my trusting relationship I would not be afraid. It seems like a silly game, but it is so damned exciting to think about. Maybe someday it will happen. (Authors’ files)

Studies of sexual behavior in other species reveal that many nonhuman animals engage in what might be labeled combative or pain-inflicting behavior before coitus (Gross, 2006). Some theorists have suggested that such activity has definite neurophysiological value, heightening accompaniments of sexual arousal such as blood pressure, muscle tension, and hyperventilation (Gebhard et al., 1965). For a variety of reasons (such as guilt, anxiety, or
apathy), some people may need additional nonsexual stimuli to achieve sufficient arousal. It has also been suggested that resistance or tension between partners enhances sex and that sadomasochism is just a more extreme version of this common principle (Tripp, 1975).

Sadomasochism might also provide participants with an escape from the rigidly controlled, restrictive role they must play in their everyday public lives. This possibility helps explain why men who engage in SM activity are much more likely to play masoch­istic roles than are women (Baumeister, 1997). A related theory sees sexual masochism as an attempt to escape from high levels of self-awareness. Similar to some other behav­iors (such as getting drunk) in which a person may attempt to lose himself or herself, masochistic activity blocks out unwanted thoughts and feelings, particularly those that induce anxiety, guilt, or feelings of inadequacy or insecurity (Baumeister, 1988).

Clinical case studies of people who engage in sadomasochism sometimes reveal early experiences that may have established a connection between sex and pain. For example, being punished for engaging in sexual activities (such as masturbation) might lead a child or an adolescent to associate sex with pain. A child might even experience sexual arousal while being punished—for example, getting an erection or lubricating when his or her pants are pulled down and a spanking is administered (spanking is a common SM activity).

Many people, perhaps the majority, who participate in SM behaviors do not depend on these activities to achieve sexual arousal and orgasm. SM interests often exist con­currently with more conventional sexual desires (Kleinplatz & Moser, 2004). Those who practice sadomasochism only occasionally find that at least some of its excitement and erotic allure stem from its being a marked departure from more conventional sexual prac­tices. Other people who indulge in SM acts may have acquired strong negative feelings about sex, often believing it is sinful and immoral. For such people masochistic behavior provides a guilt-relieving mechanism: Either they get their pleasure simultaneously with punishment, or they first endure the punishment to entitle them to the pleasure. Similarly, people who indulge in sadism may be punishing partners for engaging in anything so evil. Furthermore, people who have strong feelings of personal or sexual inadequacy may resort to sadistic acts of domination over their partners to temporarily alleviate these feelings.