**Unless the Sado-Masochism goes too far, those who use pain for pleasure do not need therapy.** - Taking pleasure, often sexually, from the ["inflicting or suffering of pain, hardship, or humiliation"](https://www.psychologytoday.com/us/blog/hide-and-seek/201408/the-psychology-sadomasochism) is totally fine so long as there is no direct seeking of or ultimate engagement with uninvited abuse or aggression. Anytime the acts of aggression turn or are non-consensual, then those who engage in Sado-Masochism might, indeed, need therapy to help them overcome traits that are harmful to others (or even themselves.)

To be clear, sadomasochism is sexually arousing to people. This isn't the same as (or even roughly related to) being stuck in an emotionally abusive relationship where you are constantly dominated against your will and your interests. Now, I will say this though: People should engage in as many sexual practices as they can find healthy satisfaction from. If sadomasochism is the ONLY way that you can get off, I feel it might be useful to expose yourself to other mediums and expand the diversity of your capacity for pleasure. This isn't just directed at sadomasochism either. This goes for everyone. Especially people with boring sex lives (so, actually, LESS likely to be a sadomasochist) e.g. you straight guys have really got to get into butt stuff, it's really awesome.

Sadomasochism necessarily inflicts pain or belittles one of the people involved. Kind of how MMA is designed specifically to hurt people. But like with MMA, the inherent risks the sadomasochistic community have had to face have given them a culture that is OBSESSED with safety, fairness, transparency, and consent. It's kind of bizarre to think of the "best" way to allow people to hurt each other. But... People want to do this. We're evolved to do this. If you're into it, this can be a healthy outlet, if you're careful.

As long as the sadomasochistic sex has healthy boundaries, then there is no need for therapy. I have little experience of sadomasochistic sex but I do have a little experience and have interacted with a few people who do enjoy these practices and have observed their online forums. So the following is very much ”just an opinion.” I mean by this, it is very far from an extensively researched opinion by someone who considers himself to be an expert. I think a fair representation of sadomasochistic sex is: the infliction of, or reception of physical or psychological pain, suffering, degradation or humiliation, with the intent of deriving sexual or sensual pleasure, or emotional/psychological relief. I mention in the above, psychological/emotional relief, as some people in the sadomasochistic community, do not enjoy what is done to them, at the time it is being done to them, but gain pleasure or psychological relief after the act. With some of these people sadomasochistic sex, is a relief from a strong psychological impulse or on rare occasions, relief from a very strong emotionally damaging experience that has happened in their lives. Additionally, some people who practice sadomasochistic sex who say they never enjoy what is being done to them directly, say instead, they gain their pay off because their partner enjoys it. So let's a have a look at acts that are called sadomasochistic sex acts, so we have some examples of what we are discussing. Would you define being spanked as sadomasochistic sex? This is where one adult spanks another, often causing pain, typically on their buttocks, with the idea of gaining and/or giving pleasure. (In the forum I have observed this is called: Impact play.) Well first it must be noted there is no actual “sex” in this act. However, by convention and definition, a sadomasochistic sex act, does not have to involve actual sex, just pleasure from an act that gives or receives pain, or humiliation, degradation, or has any kind of dominant and submissive power dynamic between the participants. Spanking someone’s buttocks is a sadomasochistic sex act, because there is a power dynamic between the participants, that brings pleasure to one or both, the fact there is no actual sex doesn’t mean it is not sadomasochistic sex. Additionally, it should be noted, not all the pleasure derived from being spanked necessarily comes from the sadomasochistic power dynamic because the buttocks are considered erogenous zone; it is a zone of the body, that has lots of nerve endings, and so is particularly noted for giving pleasure. So then, as well as the social dynamic (the relationship between the participants) and a purely psychological dynamic (what is going in each person’s mind, according to their own interpretation and fantasies), there is a sensual/physical element to. So to return to the statement we are discussing, can we say every man or woman, that enjoys being spanked for pleasure, whether for the psychological and social aspect (for perhaps being “naughty”) or being spanked for the physical aspect (because the sharp or thud like pain, arouses their senses) needs therapy? I think the answer would be qualified by questions like: Is there any damage to the person’s being spanked buttocks? Is it permanent damage or something (bruises) that will heal and they are happy to live with that? How often do they enjoy this practice? (I mean are days of their lives spent in one go) being spanked, or is it done on occasions on weekends? Are they addicted to the practice because there is something else in their lives they are not facing up to? Is it consensual? I think the answers to the above questions would tell if the person “needed therapy”. I think most people would agree, if sadomasochistic sex is done with some form of self-control, with boundaries, if it brings pleasure or relief into their lives, and the practitioner is not using it to hide from something in their lives that should be dealt with, then it can be good or harmless. But what about more extreme cases, of sadomasochistic sex? What if someone enjoys being locked in a cage and feed and kept “prisoner” by someone who has the key? (This kind of practice is practiced by some people in the sadomasochistic community.) Well first of all the person in the cage will have given consent to be in the cage and will typically, have created boundaries to what they are willing to do/subjected to and not willing to do/subjected to. If they have not set clear boundaries, typically, this is because the person to be locked away trusts the person who is locking them away, to respect non expressed boundaries. Think about it: if the person, who is being locked away, has expressed boundaries that are respected by the person who is locking them away, well, isn’t the person in the cage in some sense in charge of what happens? This weird dynamic where the person who is being dominated (the submissive) is often in charge of what happens, makes it seem more of a game than a straightforward power dynamic. There is a term you often hear those involved in the Sadomasochistic community scene often use to describe their experiences, which encapsulates this weird dynamic. They refer to their sadomasochistic sexual experiences as “playing” To see if this person being locked away, needs therapy, I think again it would be fair to apply similar questions to the questions above. Is there any damage to the person’s being locked away? Is it physically safe? How often do they enjoy this practice? (I mean are days at a time, of their lives lost being locked away, or is it done on occasions on weekends, perhaps returning to work after a short weekend session ‘playing’?) Are they addicted to the practice because there is something else in their lives they are not facing up to? And of course, is it consensual? If the answers to these questions suggest that they have few boundaries or not in control of their lives or doing themselves permanent harm, then I think they might benefit from boundaries or therapy, as their sadomasochistic practices have become unhealthy. Let’s take it one step further and look at a case that I believe is clearly unhealthy. What about a case of someone who wants to be locked up in a cage and never let out? Or, as I have twice seen posts regarding, where someone claimed they wanted to be “walled or bricked up” inside a room, or under floorboards and never released. I think most people would say, rather than find someone to fulfil this fantasy, the person who desires it should see a doctor for help. My point here is, that clearly sadomasochistic practices can be taken too far and the person who has the desire, needs some help. (I have no idea whether the people that posted these sadomasochistic desires were serious or just expressing a fantasy they never really expected to live out). I have been told in the sadomasochistic community, lots of people express fantasies that they never want to live out. What did I mean, when I wrote above, concerning (what some people get out of sadomasochistic sex): “relief from” “an emotionally damaging experience?” I was thinking of a few posts I have seen online where the person posting claimed to have had experienced an emotionally damaging experience and had decided to “repeat it” in some sense, but with the added feature of them “being in control” or more in control. It sounds strange doesn’t it? What were the experiences they wanted to repeat? I saw two posts where someone claimed to have been attacked/raped and wanted to “play act” this experience out again.(A very dangerous idea, I think). Another was where someone had consented to be humiliated and then discovered later the experience was very emotionally damaging. In both these “for instances”, the persons posting believed that in some sense, acting out, the original traumatic experience, would give them some form of therapy. (I have no idea how serious, or truthful the people posting these desires in the forum were). 3 final points to note are: that the equipment for sadomasochistic sex is available to buy in many shops and BDSM fares, in many places, all over the world. The reason I draw your attention to this is that there is so much demand that people have created businesses that specialise in it. So these practices are by no means rare. Additionally I think it is worth mentioning, that some of the equipment sold include: “floggers” that the sellers describe as so light in impact (that give such light pain), that when used: “They cannot do any [physical] harm”. Lastly, although I haven’t considered the role of the dominant partner in the “playing” dynamics of sadomasochistic sex, the reader can easily do so, by asking the same questions of the dominant partner role, as I have of the submissive partner’s role. Then they can assess, for themselves whether the dominator’s role, is something that suggests that they need therapy. Considering all of the above, I think it is not true to say, everyone who performs sadomasochistic sex needs therapy, any more than it is to true say that everyone who drinks alcohol is an alcoholic and needs therapy. But it is true to say, some people performing sadomasochistic sex who take it to dangerous extremes, probably need therapy.