The term sexual ‘masochism’ has been derived from the name of the Austrian novelist Leopold V Sacher-Masoch, whose fictional characters dwelt lovingly on the sexual pleasure of pain. The meaning of the term masochism has been broadened beyond sexual connotations, so that it includes deriving pleasure from self denial, fro expiatory physical suffering such as that of the religious flagellants and from hardship and suffering in general.

In sexual masochism, a person experiences sexual stimulation and gratification from the experience of pain and degradation in relating to a lover. Interpersonal masochistic activities require the participation of at least two people — one superior ‘disciplinarian’ and one obedient ‘slave’. Such arrangements are not uncommon in either heterosexual or homosexual relationships. Masochists do not usually want or cooperate with true sexual sadists, but with individuals willing to hurt or humiliate them within limits they set.

Sexual masochism appears to be much more common than sadism and sadomasochistic activities, including bondage discipline are often performed communally within ‘dungeons’ popular in majorities. Such activities might involve men being bound and whipped by women called ‘dominatrixes’ wearing tight leather or rubber outfits. These activities are playful rather than frightening, at least to the participants.

Autoerotic Asphyxia:

Autoerotic Asphyxia is a particularly dangerous form of sexual masochism which involves self strangulation to the point of oxygen deprivation. Coroners in most major cities of the United States are familiar with cases in which the deceased was found hanged next to a masochistic pornographic literature or other sexual paraphernalia. Accidental deaths attributable from this practice have been estimated to range between 250 and 1000 per year in the United States.

Treatments:

Significant progress has been made in developing moderately effective treatments for sexual masochism. One problem is that most individuals suffering from this disorder do not seek treatment for the condition but receive it only after they have been caught and detained in prison. Thus, their motivations for change may often stem from a desire to get released than from as genuine desire to change. Moreover, many do not readily admit to their deviant behavior and do not consider their therapist an ally.

Cognitive behavior therapy: this has proved to be moderately successful in bringing about changes in an significant number of these individuals.