If you search, you’ll find that “BDSM Coach” is an actual job title on LinkedIn. The largest international convention in middle America is the International Mr. Leather contest, which brings together over 20,000 kinky attendees from all over the world. Nearly six million members belong to Fetlife, a Facebook-like online social network for folks into fetishes. Even Harvard University has a formally recognized student-run BDSM club.
So why does it seem that so many psychotherapists did not get the memo on working in a culturally competent way with this established sexual subculture? “The fact is kinky desires were — until rather recently — widely pathologized by the psychological community,” says Lauren Krpan, licensed professional counselor and trained sex therapist. “But so was homosexuality until the 1970s. We are working on removing stigma. There is nothing wrong with you if you’re kinky; it’s just your identified sexuality.”
What Is Kink?
Kink is an umbrella term that covers sexual practices outside the accepted “norm,” such as BDSM, leather and other fetishes. BDSM includes consensual bondage and discipline (B&D), dominance and submission (D&S), and sadism and masochism (S&M). Whereas “vanilla” is the term coined by the kink community to refer to non-kinky folks. Whatever the kink, the community’s common value is that erotic power exchange is okay as long as it’s “safe, sane and consensual.” That phrase was adopted by the community in 1983. A newer concept — “risk-aware consensual kink” — recognizes few activities are 100% risk-free and supports individuals in exercising awareness, choice, and consent in kinky encounters.
In the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the Paraphilia category of diagnoses, which includes “atypical sexual desires and behaviors,” underwent a significant revision thanks to the work of sexual freedom advocates and a growing body of psychological research. Published by the American Psychiatric Association (APA), the DSM is the authoritative guide to the diagnosis of mental disorders used by health care professionals in the United States. In the DSM-5, Paraphilias are no longer considered de facto psychologically unhealthy. Therapists are only to focus clinical attention on a client’s kink if they are experiencing distress that significantly impairs functioning due to their atypical sexuality. A study by the National Institutes of Health on psychological characteristics of BDSM practitioners concurred: “We conclude that BDSM may be thought of as recreational leisure, rather than the expression of psychopathological processes.”
Who Is Kinky?
Kink by nature is subjective. It’s what an individual perceives as non-normative, with “normative” being a socially constructed word regulated by society. It’s a continuum of experience, of taste, of preferences. We are trying to get the morality piece to the side, because that is subjective, just as personal preferences are. Results from a National Coalition for Sexual Freedom 2008 survey show a widely varied community of kinky practitioners, with demographics including diversity in age, sex, gender, race, employment status, and sexual orientation (both heterosexual and LGBTQ).
So why don’t people seek help for other issues?
“Many kinky people have not gotten help for trauma, abuse, or even medical treatment because of their fear of shame, blame, and refusal of treatment or pathological thinking of the providers they may see,” says Lauren Zerbst, licensed clinical social worker and sex therapist. Their concerns are not unfounded. According to a survey from the National Coalition for Sexual Freedom, 48.8% of BDSM practitioners reported being discriminated against by a medical doctor, and 39.3% reported being discriminated against by a mental health practitioner.
“When kinky clients first come to see me for treatment, they often report a deep sense of aloneness,” says Simon Weismantel, licensed social worker. “Their kink can make them feel more different than they actually are from other people. They can feel separate and ashamed because of stigma, without knowing there is a caring and inclusive community.” Weismantel understands the hesitation, but is hoping to diffuse it. “For decades, the psychological community was not helpful,” says Weismantel, whose graduate thesis focused affirming therapy with BDSM clients.
He also recognizes that it can be hard to find the right therapist. According to Ortmann and Sprott (2012), it’s estimated that 5 million people in the US are kinky, but there are only about 500 kink-informed therapists in practice. For kinky clients, finding a therapist with whom their full sexual selves are welcome and accepted is the first step in getting the proper treatment they deserve.
Fortunately, there is now a growing body of kink aware and kink friendly practitioners — those who are familiar with the language and terminology of the community and who provide a welcoming and nonjudgmental environment for therapy. Krpan suggests that some may want to seek out a “kink informed” practitioner — someone who has completed specific training and who is constantly learning about effective care and support for kinky people. “A client should not feel the need to educate their therapist on a community’s BDSM practices, lingo or larger cultural issues related to ongoing experiences of stigma and discrimination.”
Contrary to the Stigma
A final closing note: a study published in 2013 in the Journal of Sexual Medicine found that “BDSM practitioners were less neurotic, more extraverted, more open to new experiences, more conscientious, less rejection sensitive, [and] had higher subjective well-being.” In the end, it may be the social stigma and disconnection from community that causes the stress, not the kink itself. A kink-aware professional is one who leaves those external trappings at the door, so that you can work on what’s important to you.