Sexy sadism: Entertainment through pain

Sadism (the act of obtaining sexual arousal through the giving of physical or psychological pain) and masochism (the act of obtaining sexual arousal through the receiving of physical or psychological pain) are paraphilias that are often viewed as two variations of the same phenomenon. However, this blog briefly examines sexual sadism in isolation.

The psychiatrist Richard von Krafft-Ebing is often credited with introducing the term “sadism” in his 1886 sexology book Psychopathia Sexualis deriving the name from the Marquis de Sade, whose French novels often featured such behaviour. Despite the increase in knowledge of (and theorizing about) sexual sadism, the psychopathology of the behaviour is still uncertain, and an all encompassing theory of the etiology of sexual sadism has yet to be developed and empirically tested. Furthermore, the labelling and defining of sexually sadistic behaviour is further complicated by the fact that many people enjoy some form of aggressive behaviour during sex (e.g., spanking, the gentle biting of nipples, love bites) making the label sadomasochism seem somewhat inappropriate.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders that sexual sadists require “psychological or physical suffering (including humiliation)” of their victims to induce sexual excitement, whereas the World Health Organization’s International Classification of Diseases defines sadism as the “preference for sexual activity that involves bondage or the infliction of pain or humiliation”. However, those that have carried out research in the field claim that such definitions are difficult to apply in practice, resulting in experienced clinicians interpreting screening criteria inconsistently in the diagnosis of sexual sadism.

The situation was complex even when Krafft-Ebing first wrote on the topic. For instance, he described what he believed were distinct subtypes of sexual sadism including (i) lust murder (where sexual arousal is integral to the act of killing), (ii) necrophilia (discussed in a previous blog), (iii) injury to women through flagellation or stabbing, (iv) defilement of women; (iv) other types of assaults on women, such as cutting off their hair; (v) whipping of boys; (vi) sadism toward animals; and (vii) sadistic fantasies without the occurrence of any actual sadistic acts. Another sadistic act that has been reported in more recent times is ‘piqeurism’ where the assailant stabs a female victim (typically breasts or buttocks) and then runs away.

The true prevalence of sexual sadism among the general population is unknown. Alfred Kinsey’s seminal studies of human sexual behaviour in the late 1940s and early 1950s reported that 22% of the males and 12% of the females responded erotically to stories with sadistic themes. Other research studies estimate that 10-20% of couples have engaged in sadomasichistic activities during sex but that much of this is symbolic. However, most of the little research that has been published on sexual sadism tends to be based on sex offenders and sexual killers.

Among sex offenders, the prevalence of sexual sadism is estimated to occur in between 2% and 5% of offences. However, these estimates have been reported to be much higher (as much as 50%) depending upon the criteria that are used to define and diagnose sexual sadism in the first place. Prevalence estimates are further complicated because some in the area note that sadism and masochism are complementary disorders or separate poles of the same disorder. There is certainly a lot of empirical support that sadism and masochism often co-occur such as psychiatrist Dr Andreas Spengler’s study of 245 German sadomasochists published in the Archives of Sexual Behavior. Spengler’s study reported that among his sample, 30% were heterosexual, 31% bisexual and 38% homosexual. Just under a half (43%) developed their sadomasochistic desires after adolescence, and – perhaps surprisingly given the link to compulsive behaviour – sado-masochism was low frequency activity (with a median average of only five SM experiences per year among the respondents).

In a study led by Dr Gene Abel (now Director of the Behavioral Medicine Institute of Atlanta, US), it was reported that 18% of sadists were also masochistic, 46% had raped, 21% had exposed themselves, 25% had engaged in voyeurism and frottage, and 33% had molested children. Similarly, other researchers the Institute of Psychiatry, London) have noted an overlap among various paraphilias. Their sample comprised 87 rubberites, 38 leatherites, 133 sadomasochists, 205 transvestites (including transsexuals) and 25 dominant females. They found that 4% of sadomasochists were also transvestites, 29% of sadomasochists were also fetishists, and 35% of sadomasochists were also fetishists and transvestites. Gosselin and Wilson also reported that the most common objects used by sadists to inflict pain on their sexual partners were belts, whips, canes, shoes and paddles.

There is a wide variety of psychological explanations relating to the etiology of sexual sadism although most recent reviews have claimed there has been little new contemporary theorizing. Most branches of psychology (psychophysiological, psychodynamic, cognitive, behavioural) have developed their own theories but little research has confirmed them. Psychobiological explanations of sexual sadism (including serial sex murderers) that have examined chromosomal, endocrine, hormonal, and/or neurological abnormalities have typically been based on single case studies or very small samples. Therefore results remain tentative and inconclusive.

Early behaviourist theories argued that sexual sadism begins during childhood development. Through both operant and classical conditioning, sexual urges, excitation, and/or arousal are consistently paired with aggressive stimuli. Sexual fantasy and masturbation then reinforce and maintain the sadistic behaviour. Other psychologists claim that personality may play a role in the conditioning process, along with social modelling and disinhibition.

More recently, Dr Malcom MacCulloch (probably best know as Moors murderer Ian Brady’s psychiatrist) claimed that behavioral explanations of the development of sadistic sexual fantasy don’t adequately explain the initial development of sadistic sexual fantasy. McCullogh and his colleagues attempted to explain the initial development of sexual sadism using research on early childhood abuse and animal models of conditioning. They claimed that sadistic fantasies resulted from a combination of early childhood abuse, classical conditioning, and operant conditioning.

Back in 1986, Katie Busch and James Cavanagh (who were both at Rush-Presbyterian-St. Luke’s Medical Center, US) stated that most of the work in this area consisted of unfounded statements unsupported by data, unevaluated case reports lacking rigorous evaluation of other contributory factors, and scientific case reports of individuals or small groups. A recent literature review by Canadian consultant Dr Pamela Yates and colleagues of the current research concluded that: “Regrettably, the same can be said today, over 20 years later”.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Abel, G. G., Becker, J., Cunningham-Rathner, J., Mittelman, M., & Rouleau, J. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153–168.

Busch, K.A., & Cavanagh, J.R. (1986). The study of multiple murder: Preliminary examination of the interface between epistemology and methodology. Journal of Interpersonal Violence, 1, 5–23.

Gosselin, C. C. (1987). The sado-masochistic contract. In G.D. Wilson (Ed.), Variant sexuality: Research and theory (pp. 229–257). Baltimore: Johns Hopkins University Press.

Gosselin, C. C., & Wilson, G. D. (1980). Sexual variations. London: Faber & Faber.

Kinsey, A., Pomeroy, W. B., Martin, C. E., & Gebhard, P. H. (1953). Sexual behavior in the human female. Philadelphia: Saunders.

Langevin, R. (2003). A study of the psychosexual characteristics of sex killers: Can we identify them before it is too late? International Journal of Offender Therapy and Comparative Criminology, 47, 366–382.

MacCulloch, M., Gray, N., & Watt, A. (2000). Brittain’s sadist murderer syndrome reconsidered: An associative account of the aetiology of sadistic sexual fantasy. Journal of Forensic Psychiatry, 11, 401–418.

MacCulloch, M., Snowden, P., Wood, P., & Mills, H. (1983). Sadistic fantasy, sadistic behavior, and offending. British Journal of Psychiatry, 143, 20–29.

Marshall, W. L., & Kennedy, P. (2003). Sexual sadism in sexual offenders: An elusive diagnosis. Aggression and Violent Behavior, 8, 1–22.

Marshall, W. L., & Yates, P. M. (2004). Diagnostic issues in sexual sadism among sexual offenders. Journal of Sexual Aggression, 10, 21–27.

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456

Yates, P.M., Hucker, S.J. & Kingston, W.A. (2008). Sexual sadism: Psychopathology and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment. pp.213-23o. New York: Guildford Press.