Couples and Kinky Sexuality: The Need for a New Therapeutic Approach

Abstract

Recent decades have seen changes in the way gays, lesbians, bisexuals, and transgender people are viewed by mental health professionals, but this comparative enlightenment has not extended to the so-called “paraphilias.” The mainstream view in the mental health field is still that non-standard sexual practices are pathologies which should be included in the diagnostic manual. This paper presents an alternative view, first defining Bondage, Dominance, and Sado-Masochism (BDSM) – or “kink” – and then summarizing the data about practitioners of BDSM. Some clinical issues such as countertransference, differentiation of problem behaviors from those that are merely unusual, and provision of resources to isolated clients are delineated. Case vignettes are presented for illustration.