Professional work

Abstract Firenze Abstrakt Firenze

Abstract Firenze Abstrakt Firenze

Kjær, R.: ”Stigma, Psychiatry and the sadomasochism-fetish population”
Foredrag på World Psychiatric Association International Thematic
Conference:
” Treatment in Psychiatry: an update”. Symposium SS20.2 Firenze
11.11.2004
WPA Section “Psychiatry and Human Sexuality

Stigma, Psychiatry and the Sadomasochism – Fetish Population

The prevailing attitudes and related myths in the western societies about this population are presented, and contemporary stigma theory is used to analyze the relationship between the mechanisms of stigmatization, stereotyping and discrimination and these attitudes. Members of this population experience harassment, loss of jobs and custody of their children and this is often legitimized by lay people referring to the categorization of these three sexual orientations as diseases in the ICD system.

The ICD-10 diagnoses F-65.0 (fetishism), 65.1 (fetishistic transvestism) and 65.5 (sadomasochism) give occasion for labeling as mentally ill a large population that does not fill the ordinary scientific criteria for psychiatric disorders. Possible psychiatric problems and disorders in this population that are presented to the clinician can better be described as in any other population by using the ordinary diagnoses that are not connected to specific sexual behavior.

In contrast to the fight against stigma related to schizophrenia, the sadomasochism – fetish population as a minority group faces stigmatization, to which our non-updated psychiatric profession is contributing.

The shortcomings of the present three diagnoses in the ICD-10 are discussed. The use of diagnoses based on myths and not science also gives the psychiatric profession a bad reputation. A revision is suggested to reduce this double-stigma.

R. Kjaer
M.D. Psychiatrist. Private practice

World Psychiatric Association – Symposium S08.5


World Psychiatric Association International Thematic Conference
“Diagnosis in Psychiatry: Integrating the Sciences”
Vienna, Austria June 19-22, 2003

Symposium SO8.5
Classification of Sexual Disorders
WPA Section “Psychiatry and Human Sexuality”
Friday, 20 June, 2003

I World Psychiatric Association diskuteres det ulogiske i kriteriene for tre ICD-10 diagnosene F65.0 Fetisjisme, F65.1 Fetisjistisk transvestittisme og F65.5 Sadomasochisme slik de nå er oppført, og man må forvente en betydelig endring av diagnosene ved neste revisjon av den internasjonale diagnosemanualen ICD-10, som utgis av Verdens Helseorganisasjon.

Spesialist i psykiatri, og faglig medlem av LLHs Diagnoseutvalg, Reidar Kjær, deltok 19.-22. juni 2003 på diagnosekongressen til World Psychiatric Association (WPA) i Wien i forbindelse med den forestående revisjon av diagnosemanualen ICD-10. Det er WPA som er den viktigste fagorganisasjon i revisjonsarbeidet med psykiatridelen av World Health Organization’s diagnoseliste som er offisiell liste i Norge.

Reidar Kjær deltok blant annet med foredraget:
”Do we need all the Paraphilias?” Det var plassert i symposiet Classification of Sexual Disorders (S08.5) og ble avholdt fredag 20.juni i kongressenteret i Hofburg i Wien.

Sammendrag (abstrakt) av Kjærs foredrag:

”Do we need all the Paraphilias?”
The ICD-10 diagnoses F-65.0 (fetishism), 65.1 (fetishistic transvestism) and 65.5 (sadomasochism) are no longer used in everyday Norwegian Psychiatry. But they still figure in the International and National ICD-10 manual. This paper addresses the pros et contras in the ongoing discussion about the revision of the diagnoses. A possible approach could be that national health authorities formally decided not to use these diagnoses, as was done in Denmark with 65.5 in 1995, and propose to delete them from the ICD list at the next revision. Parts of this discussion can be followed on the website www.revisef65.org

Abstraktene til denne konferansen ble trykket i et særnummer av bladet World Psychiatry som er Official Journal of The World Psychiatric Association.
WPA har mer enn 150.000 psykiatere som medlemmer fordelt på 106 medlemsland.

Dokumentasjon:
http://www.wpa2003vienna.at/home_E.htm

http://www.mednet.org.uy/spu/wp/WPA_Symposia.pdf

Bibliography 1 – ReviseF65


This bibliography is broken into two sections:

  1. Texts concerned with the F65 classification system
  2. Recommended general publications

This is an extract from Datenschlag’s BISAM bibliography. The complete version is available at www.datenschlag.org/english/bisam/. This version does not contain the abstracts, just the bibliographic notes.

Compiled by Kathrin Passig (picture left).
Please send corrections and additions tó [email protected].

This version: September, 2003

Bibliography 1 – ReviseF65
Texts concerned with the F65 classification system

[APA52] American Psychiatric Association (ed.). Diagnostic and Statistical Manual of Mental Disorders (DSM). American Psychiatric Association, Washington, D.C., 1952.

[APA68] American Psychiatric Association (ed.). Diagnostic and Statistical Manual of Mental Disorders. Second Edition (DSM-II). American Psychiatric Association, Washington, D.C., 1968.

[APA80] American Psychiatric Association (ed.). Diagnostic and Statistical Manual of Mental Disorders. Third Edition (DSM-III). American Psychiatric Association, Washington, D.C., 1980.

[APA87] American Psychiatric Association (ed.). Diagnostic and Statistical Manual of Mental Disorders. Third Revised Edition (DSM-III-R). American Psychiatric Association, Washington, D.C., 1987.

[APA94] American Psychiatric Association (ed.). Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition (DSM-IV). American Psychiatric Association, Washington, D.C., 1994.

[APA00] American Psychiatric Association (ed.). Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, Text Revised (DSM-IV). American Psychiatric Association, Washington, D.C., 2000.

[Bay87] Ronald Bayer. Homosexuality and American Psychiatry: The Politics of Diagnosis. Princeton University Press, Princeton, New Jersey, 1987.

[Bre89] Norman Breslow. Sources of Confusion in the Study and Treatment of Sadomasochism. Journal of Social Behavior and Personality, 4(3), (1989), pp. 263-274.

[BRW93] Bernd Brosig, Klaus Rodewig, Regina Woidera. Die Klassifikation von Sexualstörungen in der ICD-10: Ergebnisse der ICD-10-Forschungskriterienstudie. In: Wolfgang Schneider (ed.), Diagnostik und Klassifikation nach ICD-10, Kap. V: eine kritische Auseinandersetzung; Ergebnisse der ICD-10-Forschungskriterienstudie aus dem Bereich Psychosomatik/Psychotherapie, vol. 17 of Monographien zur Zeitschrift für psychosomatische Medizin und Psychoanalyse. Vandenhoeck und Ruprecht, Göttingen, 1993. pp. 200-209.

[BB77a] Vern Bullough, Bonnie Bullough. Sin, Sickness, Sanity: A History of Sexual Attitudes. New American Library, New York, 1977.

[Bul76] Vern L. Bullough. Sexual Variance in Society and History. University of Chicago Press, Chicago, 1976.

[Bul94] Vern L. Bullough. Science in the Bedroom: A History of Sex Research. Basic Books, New York, 1994. www2.hu-berlin.de% /sexology/GESUND/ARCHIV/LIBRO.HTM.

[BDD94] Vern L. Bullough, Dwight Dixon, Joan Dixon. Sadism, masochism and history, or when is behavior sado-masochistic? In: Roy Porter, Mikulás Teich (eds.), Sexual Knowledge, Sexual Science: The history of attitudes to sexuality. Cambridge University Press, Cambridge, 1994. pp. 47-62.

[Cap91] Paula J. Caplan. How do they decide who is normal? The bizarre, but true, tale of the DSM process. Canadian Psychology, 32(2), (1991), pp. 162-170.

[FS99] L. Fischer, G. Smith. Statistical Adequacy of the Abel Assessment for Interest in Paraphilias. Sexual Abuse, 11(3), (1999), pp. 195-206.

[Gay97] J.J. Gayford. Disorders of sexual preference, or paraphilias: a review of the literature. Medicine, Science, and the Law, 37(4), (1997), pp. 303-315.

[Ger92] Bernard Gert. A sex caused inconsistency in DSM-III-R: the definition of mental disorder and the definition of paraphilias. Journal of Medicine and Philosophy, 17(2), (1992), pp. 155-171.

[HS02] Russell B. Hilliard, Robert L. Spitzer. Change in criterion for paraphilias in DSM-IV-TR. American Journal of Psychiatry, 159(7), (2002), p. 1249.

[McC99] Nathaniel McConaghy. Unresolved Issues in Scientific Sexology. Archives of Sexual Behavior, 28(4), (1998), pp. 285-318.

[Mon84] John Money. Paraphilias: Phenomenology and classification. American Journal of Psychotherapy, 38(2), (1984), pp. 164-179.

[Mos01] Charles Moser. Paraphilia: A Critique of a Confused Concept. In: Peggy J. Kleinplatz (ed.), New Directions in Sex Therapy: Innovations and Alternatives. Brunner-Routledge, Philadelphia, 2001. pp. 91-108.

[MK02] Charles Moser, Peggy J. Kleinplatz. Transvestic fetishism: Psychopathology or iatrogenic artifact? New Jersey Psychologist, 52(2), (2002), pp. 16-17. http://home.netcom.com/~docx2/tf.html.

[MK03] Charles Moser, Peggy J. Kleinplatz. DSM-IV-TR and the Paraphilias: An Argument for Removal. Paper presented on May 19, 2003 at the Annual Meeting of the American Psychiatric Association, 2003. http://home.netcom.com/~docx2/mk.html.

[MO+93] Aribert Muhs, Christina Öri, Ingrid Rothe-Kirchberger, Wolfram Ehlers. Die Klassifikation der Persönlichkeitsstörungen in der ICD-10. Ergebnisse der Forschungskriterienstudie. In: Wolfgang Schneider (ed.), Diagnostik und Klassifikation nach ICD-10, Kap. V: eine kritische Auseinandersetzung; Ergebnisse der ICD-10-Forschungskriterienstudie aus dem Bereich Psychosomatik/Psychotherapie, vol. 17 of Monographie zur Zeitschrift für psychosomatische Medizin und Psychoanalyse. Vandenhoeck und Ruprecht, Göttingen, 1993. pp. 132-149.

[PF+92] Harold Alan Pincus, Allen Frances, Wendy Wakefield Davis, Michael B. First, Thomas A. Widiger. DSM-IV and New Diagnostic Categories: Holding the Line on Proliferation. American Journal of Psychiatry, 149(1), (1992), pp. 112-117.

[PT94] Roy Porter, Mikulás Teich (eds.). Sexual knowledge, sexual science: the history of attitudes to sexuality. Cambridge University Press, Cambridge, 1994.

[SZ+96] H. Saß, M. Zaudig, I. Houben, H.-U. Wittchen. Einführung zur deutschen Ausgabe: Zur Situation der operationalisierten Diagnostik in der deutschsprachigen Psychiatrie. In: American Psychiatric Association (ed.), Diagnostisches und statistisches Manual psychischer Störungen DSM-IV. Hogrefe, Verlag für Psychologie, Göttingen, Bern, Toronto, Seattle, 1996. pp. IX-XXIV.

[Sch95] C.W. Schmidt. Sexual psychopathology and the DSM-IV. American Psychiatric Press Review of Psychiatry, 14, (1995), pp. 719-733.

[Sho97] Edward Shorter. A History of Psychiatry. John Wiley, New York, 1997.

[Sup84] Frederick Suppe. Classifying Sexual Disorders: The Diagnostic and Statistical Manual of the American Psychiatrical Association. Journal of Homosexuality, 9(4), (1984), pp. 9-28.

[WHO48] World Health Organization (ed.). Manual of the international statistical classification of diseases, injuries and causes of death: sixth revision of the International lists of diseases and causes of death, adopted 1948 / compiled under the auspices of the World Health Organization. WHO, Geneva, 1948.

[WHO57] World Health Organization (ed.). Manual of the international statistical classification of diseases, injuries, and causes of death: based on the recommendations of the Seventh Revision Conference, 1955, and adapted by the Ninth World Health Assembly under the WHO nomenclature regulations. WHO, Geneva, 1957.

[WHO67] World Health Organization (ed.). International classification of diseases: manual of the international statistical classification of diseases, injuries, and causes of death, based on the recommendations of the Eighth Revision Conference, 1965, and adopted by the Nineteenth World Health Assembly. WHO, Geneva, 1967.

[WHO77] World Health Organization (ed.). Manual of the international statistical classification of diseases, injuries and causes of death: based on the recommendations of the Ninth Revision Conference, 1975, and adopted by the Twenty-ninth World Health Assembly. WHO, Geneva, 1977.

[WHO92] World Health Organization (ed.). The ICD-10 Classification of Mental and Behavioural Disorders. Clinical descriptions and diagnostic guidelines, vol. I. WHO, Geneva, 1992.

[WHO93] World Health Organization (ed.). The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic criteria for research, vol. II. WHO, Geneva, 1993.

 

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This bibliography is broken into two sections:

  1. Texts concerned with the F65 classification system
  2. Recommended general publications

This is an extract from Datenschlag’s BISAM bibliography. The complete version is available at www.datenschlag.org/english/bisam/. This version does not contain the abstracts, just the bibliographic notes.

Compiled by Kathrin Passig (picture left).
Please send corrections and additions tó [email protected].

This version: September, 2003

Bibliography 2 – Recommended general publications

[AS+01] Laurence Alison, Pekka Santtila, N. Kenneth Sandnabba, Nikolas Nordling. Sadomasochistically Oriented Behavior: Diversity in Practice and Meaning. Archives of Sexual Behavior, 30(1), (2001), pp. 1-12.

[All40] Clifford Allen. The Sexual Perversions and Abnormalities: A study in the psychology of paraphilia. Oxford University Press, London et al., 1940.

[Bau88] Roy F. Baumeister. Masochism as Escape from Self. Journal of Sex Research, 25, (1988), pp. 28-59.

[Bau89] Roy F. Baumeister. Masochism and the Self. Lawrence Erlbaum Associates, Hillsdale, 1989.

[Bau91] Roy F. Baumeister. Escaping the Self: Alcoholism, Spirituality, Masochism. Harper Collins, New York, 1991. 268 pages, masochism on pp. 115-138.

[Bau97] Roy F. Baumeister. The Enigmatic Appeal of Sexual Masochism: Why People Desire Pain, Bondage and Humiliation in Sex. Journal of Social and Clinical Psychology, 16(2), (1997), pp. 133-150.

[BB97] Roy F. Baumeister, Jennifer L. Butler. Sexual Masochism: Deviance without Pathology. In: Donald Richard Laws, William O’Donohue (eds.), Sexual Deviance: Theory, Assessment, and Treatment. Guilford Publications, New York, 1997. pp. ?-?

[Bie98] Robert V. Bienvenu II. The Development of Sadomasochism as a Cultural Style in the Twentieth-Century United States. Dissertation, Indiana University, 1998. www.americanfetish.net.

[BBJ93] Gloria G. Brame, William D. Brame, Jon Jacobs. Different Loving: The World of Sexual Dominance and Submission. Villard, New York, 1993.

[Bre89] Norman Breslow. Sources of Confusion in the Study and Treatment of Sadomasochism. Journal of Social Behavior and Personality, 4(3), (1989), pp. 263-274.

[BEL85] Norman Breslow, Linda Evans, Jill Langley. On the Prevalence and Roles of Females in the Sadomasochistic Subculture: Report of an Empirical Study. Archives of Sexual Behavior, 14, (1985), pp. 303-317.

[BEL86] Norman Breslow, Linda Evans, Jill Langley. Comparisons Among Heterosexual, Bisexual and Homosexual Male Sado-Masochists. Journal of Homosexuality, 13(1), (1986), pp. 83-107.

[BB77a] Vern Bullough, Bonnie Bullough. Sin, Sickness, Sanity: A History of Sexual Attitudes. New American Library, New York, 1977.

[BB94] Vern L. Bullough, Bonnie Bullough (eds.). Human sexuality: an encyclopedia. Garland, New York / London, 1994. www2.hu-berli% n.de/sexology/GESUND/ARCHIV/SEN/INDEX.HTM.

[Cap84] Paula J. Caplan. The Myth of Women’s Masochism. American Psychologist, 39(2), (1984), pp. 130-139.

[FM91] Gerald I. Fogel, Wayne A. Myers (eds.). Perversions and Near-Perversions in Clinical Practice: New Psychoanalytic Perspectives. Yale University Press, New Haven, Conn., 1991.

[Gat00] Katherine Gates. Deviant Desires. Juno Books, 2000.

[LC95] Law Commission. Consent in the Criminal Law: A Consultation Paper, vol. 139 of Law Commission Consultation Paper. Her Majesty’s Stationery Office, London, 1995.

[LMJ94] Eugene E. Levitt, Charles Moser, Karen V. Jamison. The Prevalence and Some Attributes of Females in the Sadomasochistic Subculture: A Second Report. Archives of Sexual Behavior, 23(4), (1994), pp. 465-473.

[Mos88] Charles Moser. Sadomasochism. Journal of Social Work \& Human Sexuality, 7(1), (1988), pp. 43-56. Special Issue: The Sexually Unusual: Guide to Understanding and Helping.

[Mos92] Charles Moser. Lust, lack of desire, and paraphilias: Some thoughts and possible connections. Journal of Sex and Marital Therapy, 18(1), (1992), pp. 65-69.

[Mos99] Charles Moser. Health Care Without Shame. A Handbook for the Sexually Diverse and Their Caregivers. Greenery Press, San Francisco, 1999.

[Mos99a] Charles Moser. The psychology of sadomasochism (S/M). In: Susan Wright (ed.), SM Classics. Masquerade Books, New York, 1999. pp. 47-61.

[Mos01] Charles Moser. Paraphilia: A Critique of a Confused Concept. In: Peggy J. Kleinplatz (ed.), New Directions in Sex Therapy: Innovations and Alternatives. Brunner-Routledge, Philadelphia, 2001. pp. 91-108.

[MK02] Charles Moser, Peggy J. Kleinplatz. Transvestic fetishism: Psychopathology or iatrogenic artifact? New Jersey Psychologist, 52(2), (2002), pp. 16-17.. http://home.netcom.com/~docx2/tf.html.

[MK03] Charles Moser, Peggy J. Kleinplatz. DSM-IV-TR and the Paraphilias: An Argument for Removal. Paper presented on May 19, 2003 at the Annual Meeting of the American Psychiatric Association, 2003.
http://home.netcom.com/~docx2/mk.html.

[ML87] Charles Moser, Eugene E. Levitt. An Exploratory-Descriptive Study of a Sadomasochistically Oriented Sample. Journal of Sex Research, 23, (1987), pp. 322-337. Also published in [Wei95].

[MM96] Charles Moser, J.J. Madeson. Bound to be Free: The SM Experience. Continuum, New York, 1996.

[Noy97] John K. Noyes. The Mastery of Submission. Cornell University Press, Ithaca et al., 1997.

[Oos00] Harry Oosterhuis. Stepchildren of Nature: Krafft-Ebing, Psychiatry, and the Making of Sexual Identity. University of Chicago Press, Chicago, 2000. 321 pages.

[Sar88] Thomas O. Sargent. Fetishism. Journal of Social Work \& Human Sexuality, 7(1), (1988), pp. 27-42. Special Issue: The Sexually Unusual: Guide to Understanding and Helping.

[Spe77] Andreas Spengler. Manifest Sadomasochism of Males: Results of an Empirical Study. Archives of Sexual Behavior, 6, (1977), pp. 441-456.

[Sto91] Robert Stoller. Pain and Passion: A Psychoanalyst Explores the World of S\&M. Plenum Press, New York, 1991.

[Wei94a] Thomas S. Weinberg. Research in Sadomasochism: A Review of Sociological and Social Psychological Literature. Annual Review of Sex Research, 5, (1994), pp. 257-279. Also published in [Wei95], pp. 289-303.

[Wei95] Thomas S. Weinberg (ed.). S\&M – Studies in Dominance and Submission. Prometheus Books, New York, 1995.

[Wil87] Glenn Wilson (ed.). Variant Sexuality: Research and Theory. Johns Hopkins University Press, Baltimore, 1987.

[Wri99] Susan Wright (ed.). SM Classics. Masquerade Books, New York, 1999.


Love is no disease!

Text in this column by reviseF65

Europride Köln 2002. Photo: Smia-Oslo

DSM – Diagnostic and Statistical Manual of Mental Disorders

About The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)

By Svein Skeid

The American Psychiatric Association, APA, considerably revised their Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. SM and Fetishism were considered to be healthy forms of sexual expression, as long as they do not impair the daily functioning of the subject.

According to DSM-IV, SM and Fetishism only become diagnosable dysfunctions when the urges, fantasies or behaviors “cause clinically significant distress or impairment in social, occupational or other important areas of functioning.”

In addition APA said that “a paraphilia must be distinguished from the non-pathological use of sexual fantasies, behaviors or objects as a stimulus for sexual excitement.”

The DSM-IV revision, in 1994, was seen as a step forward, but is far from satisfactory. Stigma knowledge shows that many psychological, physical and social problems are not caused by the individual afflicted, but by taboos, prejudices, and discrimination imposed by the environment.

According to Charles Moser, the diagnostic criteria changed yet again in 2000 for the worse introducing version DSM-IV-TR (2000).

According to The Differential Diagnosis of the Paraphilias “A Paraphilia must be distinguished from the non-pathological use of sexual fantasies, behaviors, or objects as a stimulus for sexual excitement in individuals without a Paraphilia. Fantasies, behaviors, or objects are paraphilic only when they lead to clinically significant distress or impairment (e.g., are obligatory, result in sexual dysfunction, require participation of nonconsenting individuals, lead to legal complications, interfere in social relationships). (DSM, p. 568)

“The way this diagnosis is interpreted, any reason that you are seen by a physician or therapist (including court order, as to assess who should get custody of your children in the event of a divorce), can bring about the diagnosis even if it has nothing to do with the issue being investigated.”  Charles Moser on the ReviseF65 discussion group January 22, 2006.

In a press release November 25, 2008, NCSF, National Coalition for Sexual Freedom says about DSM-IV TR:

“We know from the hundreds of requests for help that NCSF gets every year through our Incident Response program that the Sexual Sadism, Sexual Masochism, Fetishism and Transvestic Fetishism diagnoses in the DSM reinforce the negative stereotypes and stigma against alternative sexual behaviors.”

From the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders

The DSM-IV defines mental disorders. Previous editions of the DSM listed sadism and masochism as diagnosable disorders just for having such fantasies or urges over a period of time. The new edition adds modifying criteria: with both masochism and sadism, both A & B criteria must be met in order to make a diagnosis. That is, you must have the fantasies, urges, etc., and the fact that you have them must make you effectively dysfunctional in an important area of your life.

Diagnosic criteria for 302.83 Sexual Masochism

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound or otherwise made to suffer.

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Diagnostic criteria for 302.84 Sexual Sadism

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.


DSM Revision White Paper: http://ncsfreedom.org/index.php?option=com_keyword&id=305

Charles Moser and Peggy J. Kleinplatz:
DSM-IV-TR and the Paraphilias:
An Argument for Removal
http://home.netcom.com/~docx2/mk.html

Support the ICD project SM is healthy Remove SM/fetish diagnoses

Support the ICD project SM is healthy Remove SM/fetish diagnoses

SM and Fetishism are positive and healthful parts of peoples lives. To accept one’s SM orientation, preference, sexuality and love is essential for a healthy life, identity and decisive for the ability to protect oneself against sexually transmitted diseases.


SM is love – not a disease
Europride in Cologne 2002. Photo by Svein Skeid,
Smia-Oslo.

Love and respect are basic parts of SM relationships. Stigmatizing minorities by diagnosing their sexual orientation is on the contrary as disrespectful as discriminating people because of their race, ethnicity or religion.

For many years homosexuality has been abolished as a disease by the World Health Organization (WHO). But did you know that leather men and SM dykes are still not reported off the sick list? SM sex is even now considered an illness by the WHO, despite the fact that US psychiatrists removed it from their DSM manual eight years ago.

In connection with Europride 2002 the ICD project asks for testimony, quoted reference and supporting evidence from psychiatrists, psychologists, sexologists and reseachers of human sexuality in order to remove Fetishism, Sadomasochism and Transvestic Fetishism as paraphilic diagnoses from ICD, The International Classification of Diseases published by the World Health Organization (WHO).

The initiative of individuals is always to be welcomed, but even more efficient would be the formation of local and national working groups which are able to approach to the professionals in question.

Women suffer the most harassment
Branding perfectly healthy sexuality is an unacceptable insult to the dignity and integrity of the people who enjoy these safe, sane and consensual practices. Stigmatizing minorities by diagnosing their sexual orientation is as disrespectful as discriminating people because of their race, ethnicity or religion.

Even though the paraphilias in question are very rarely used, the stigma of being diagnosed make harassment of sexual minorities legitimate. The U.S. Leather Leadership Conference documents that between one-third and one-half of the leather/SM population suffer discrimination, violence or persecution because of their sexual orientation and identity. As with other assaults, women suffer the most harassment, losing their job or even their children, because of their SM love, lifestyle and self-expression.

Because lesbians also experience physical attacks – approximately one out of every four SM dykes consider or actually commit suicide because of severe persecution by their fellow-sisters – the U.S. National Organization for Women, NOW in 1999 erased previous censure of sadomasochism from their “Delineation of Lesbian Rights” policy.

The United Nations High Commissioner for Human Rights in 2001 became involved in the question of such abuses, and has registered individual cases of violence against SM practitioners worldwide.

Healthy leather people
In recent years as more research has been published, also the mental health and medical communities have begun to accept that SM is a safe and legitimate pursuit.

Sadomasochism is considered to be a healthy form of sexual expression as long as it does not impair the daily functioning of the subject, according to the latest 1994 edition of American Psychiatric Association Diagnostic & Statistic Manual (DSM-IV).

Denmark, as the first European country, totally removed the diagnoses of Sadomasochism from their national version of ICD in 1995 because this non-violent and healthy activity was considered as a private matter by the Health Authority.

In the rest of Europe and the world, fetishists, SM’ers and transvestites are still considered among the mentally ill by the ICD psychiatric authorities.

Wir brauchen ICD-Arbeitsgruppen Entfernt SM und Fetisch Diagnosen

Trotz neuer Forschungsergebnisse hat sich der Blick der Psychiatrie auf die Themen SM, Fetischismus und fetischistischer Transvestitismus (TV) kaum geändert in den letzten 100 Jahren.

Die meisten Wissenschaftler, die US Psychiater und der Staat Dänemark haben im letzten Jahrzehnt Lederleute als gesund eingestuft. Trotz dieser Tatsache werden Fetischismus, fetischistischer Transvestitismus und Sadomasochismus immer noch als Geisteskrankheit gebrandmarkt von der Weltgesundheitsorganisation (WHO), die nächste Revision des WHO Diagnosehandbuchs ICD-10 ist abzuwarten. Diese Revision wird in wenigen Jahren stattfinden.

In den Vereinigten Staaten von Amerika wurden 1994 die Diagnosen im DSM – dem Diagnostic & Statistical Manual – bedeutend überarbeitet. Sadomasochismus wird als eine gesunde Ausdrucksform der Sexualität betrachtet, so lange das Alltagsleben der betreffenden Person nicht beeinträchtigt wird.

Wie früher die Diagnose Homosexualität, die bei der WHO nicht mehr existiert, werden die SM und Fetisch Diagnosen selten in der ärztlichen Praxis benutzt, um Menschen zu helfen. Im Gegensatz dazu rechtfertigt das Stigma, das diesen Diagnosen anhaftet, diverse Formen der Verfolgung und Diskriminierung dieser sexuellen Minderheit in der Gesellschaft. Die ReviseF65-Gruppe kann dokumentieren, dass Menschen ihre Arbeitsplätze, das Sorgerecht für ihre Kinder usw. verlieren wegen ihrer Vorliebe für SM, diesen Lebensstil und ihre Selbstentfaltung. Diese Diskriminierung ist großteils eine direkte oder indirekte Folge dieser Diagnosen.

Vor über 30 Jahren betrachtete die Schwulenbewegung es als eine wichtige Grundlage, zuerst die Diagnose Homosexualität aus der International Classification of Diseases (ICD) zu entfernen, bevor überhaupt weitere Verbesserungen in Bezug auf die Menschenrechtssituation möglich waren. Wenn eine Gruppe als geisteskrank betrachtet wird, hören nur sehr wenige Menschen Deinen Argumenten für den Abbau von Vorurteilen in der Gesellschaft zu.

Die ReviseF65 Bewegung hat heute dasselbe Ziel. Wir betrachten unprofessionelle und stigmatisierende SM- und Fetischdiagnosen als eines der größten Hindernisse, die dem entgegenstehen, dass für uns die Menschenrechte akzeptiert werden. Die Abschaffung dieser Diagnosen ist ein sehr wichtiger Schritt in den Bemühungen, Vorurteile gegenüber der SM-Leder-Fetisch-Bevölkerung abzubauen.

Das pansexuelle ReviseF65 Komitee mit Sitz in Norwegen konzentriert sich auf die fehlende wissenschaftliche Basis der heutigen Diagnosen und versucht, ein internationales Netzwerk von Aktivisten und Experten aufzubauen, um diese Diagnosen zu entfernen.

Was kannst Du in Deinem Land tun?

Wie früher bei der Diagnose Homosexualität; je mehr Länder ihre nationalen SM und Fetisch Diagnosen entfernen, desto größer ist die Wahrscheinlichkeit, dass die Weltgesundheitsorganisation folgen wird. Nationale ICD-Diagnosen können nur von Gruppen in den entsprechenden Ländern entfernt werden. Diese Arbeit muss von der SM-Leder-Fetisch-Bewegung selbst gemacht werden. Du kannst nicht erwarten, dass irgendwer für Deine Freiheit gegenüber solcher Diskriminierung kämpft, wenn Du es nicht selbst tust.

Die Hilfe von Individuen ist immer willkommen, aber effektiver ist es, lokale und nationale Arbeitsgruppen zu gründen, um die betreffenden Experten für mentale Gesundheit anzusprechen.

Beispiele für nationale Strategien

Wir denken, dass, abhängig von der fachlichen und politischen Situation des Landes, die Strategie entweder lokal oder national begründet sein sollt.

  • Erwerbt die Unterstützung von sexualwissenschaftlichen, psychologischen und psychiatrischen Gesellschaften auf nationaler Ebene. Die Erfahrung mit den Diagnosen über Homosexualität hat gezeigt, dass diese Organisationen der Schlüssel für die nationale Entfernung von Diagnosen sein können.
  • Beeinflusst die politische Gesundheitsverwaltung, die SM und Fetisch Diagnosen von der nationalen Liste der psychiatrischen Diagnosen zurückzuziehen, wie es der Dänische Gesundheitsminister 1995 getan hat.
  • Verbreitet die Information über die Arbeit von Revise F65 über die ICD und verlinkt die Webseite. Wenn Ihr informiert und Eure Stimme gehört werden soll, dann beteiligt Euch an der Email-Diskussionsgruppe auf http://www.revisef65.org/moderator.html und informiert andere darüber.
  • Kooperiert mit anderen schwullesbischen und Fetisch/SM Initiativen, um nationale Strategien für die Abschaffung der Diagnosen zu planen.

Unterstützung des ICD Projekts

Das ReviseF65 Projekt wurde aufgrund einer Initiative der nationalen Versammlungen der Norwegian National Association for Lesbian and Gay Liberation (LLH) 1996 und 1998 eingerichtet.

Die 21te Europäische Konferenz der ILGA in Pisa, Oktober 1999, entschied, das ReviseF65 Projekt zu unterstützen, und bat den Vorstand um Hilfe beim Zugang zu Informationskanälen.

Die Generalversammlung der ECMC in Milano, August 2000, beschloss einen Antrag auf Einrichtung einer Gruppe mit demselben Ziel.

Die Vorstände der Norwegian Association of Gay and Lesbian Physicians HLLF (rechts) und die Norwegian Society for Clinical Sexology NFKS (links) entschieden 2003, das ReviseF65 Projekt zu unterstützen.

Beteiligte Organisationen
Das ReviseF65 Projekt besteht aus SM/Leder/Fetisch Männern und Frauen, die Organisationen von Leder- und SM-Schwulen, -Lesben, -Bi- und -Heterosexuellen repräsentieren, sowie Experten aus der Sexualwissenschaft, Psychologie und Psychiatrie.

LLH, Landsforeningen for lesbisk og homofil frigjøring – Norwegian National Association for Lesbian and Gay Liberation

SLM-Oslo, Scandinavian Leather Men, Oslo

Verkstedet Smia-Oslo

SMil Norge


Gesunde Leder-Leute
Foto von der Europride in Köln 2002.

© ReviseF65.org

Ziel des ReviseF65 Projekts ist die Entfernung der Diagnoseschlüssel Fetischismus, Transvestitismus und Sadomasochismus aus der Internationalen Klassifizierung der Krankheiten, die von der Weltgesundheitsorganisation veröffentlicht wird.


Diagnoseschlüssel zur Diskriminierung – die ICD-10 und die sexuellen Minderheiten

Kink-Aware Professionals in Berlin

BVSM e.V. (Bundesvereinigung Sadomasochismus) kooperiert mit dem ReviseF65-Komitee bei den Bemühungen, die stigmatisierenden SM- und Fetischdiagnosen aus der von der WHO (Weltgesundheitsorganisation) veröffentlichten ICD zu entfernen. Die BVSM arbeitet an der Streichung dieser Diagnoseschlüssel in der nationalen ICD-Version von Deutschland.
Die Ziele der BVSM sind die Bereitstellung einer Plattform für Projekte und ein Netzwerk von Aktivisten, Wissen zu sammeln, Forschung und Lehre zu unterstützen, Information bereitzustellen, Interessenvertretung und Werben um Akzeptanz in der Öffentlichkeit.
BVSM-Archiv: wissenschaftliche BDSM-Bibliothek und historisches Archiv für die Szene.
AK Psychologie: der Arbeitskreis beschäftigt sich mit Psychologie, Sexualwissenschaft und verwandten Themen; der AK ist korporatives Mitglied der BVSM.

SMart-Rhein-Ruhr e.V. unterstützt das ICD-Projekt und hat den Abbau von Vorurteilen gegenüber SM in der Gesellschaft zum Ziel. SMart arbeitet seit 1992 mit Nichtregierungsorganisationen zusammen, seit 1996 mit nationalen wissenschaftlichen Gesellschaften und kooperiert mit ReviseF65. SMart hat 15 BDSM-Communities in 11 Städten in Deutschland.
BDSM-Bibliothek & Archiv: Wissenschaftliche BDSM-Bibliothek mit Material über das DSM und die ICD, Medizin, Psychologie, Soziologie, Philosophie, Theorie, Literatur, Kunst, Geschichte und Kultur. Beinhaltet ein Archiv der BDSM-Subkultur in Deutschland und ein Pressearchiv.

BDSM-Berlin e.V. setzet sich in Zusammenarbeit mit der “Norwegian Association for Lesbian and Gay Liberation” (LLH) dafür ein, Fetischismus und Sadomasochismus als Diagnosen aus der ICD-10 entfernen zu lassen. BDSM-Berlin organisiert auch Öffentlichkeitsarbeit und ein Verzeichnis von deutschen “Kink Aware Professionals“.

Der Papiertiger. Encyclopedia of BDSM-terms. Eine Enzyklopädie des Sadomasochismus.

Die Datenschlag-Chronik des Sadomasochismus.

World Psychiatric Association – Symposium S08.5

World Psychiatric Association International Thematic Conference
“Diagnosis in Psychiatry: Integrating the Sciences”
Vienna, Austria June 19-22, 2003

Symposium SO8.5
Classification of Sexual Disorders
WPA Section “Psychiatry and Human Sexuality”
Friday, 20 June, 2003

I World Psychiatric Association diskuteres det ulogiske i kriteriene for tre ICD-10 diagnosene F65.0 Fetisjisme, F65.1 Fetisjistisk transvestittisme og F65.5 Sadomasochisme slik de nå er oppført, og man må forvente en betydelig endring av diagnosene ved neste revisjon av den internasjonale diagnosemanualen ICD-10, som utgis av Verdens Helseorganisasjon.

Spesialist i psykiatri, og faglig medlem av LLHs Diagnoseutvalg, Reidar Kjær, deltok 19.-22. juni 2003 på diagnosekongressen til World Psychiatric Association (WPA) i Wien i forbindelse med den forestående revisjon av diagnosemanualen ICD-10. Det er WPA som er den viktigste fagorganisasjon i revisjonsarbeidet med psykiatridelen av World Health Organization’s diagnoseliste som er offisiell liste i Norge.

Reidar Kjær deltok blant annet med foredraget:
”Do we need all the Paraphilias?” Det var plassert i symposiet Classification of Sexual Disorders (S08.5) og ble avholdt fredag 20.juni i kongressenteret i Hofburg i Wien.

Sammendrag (abstrakt) av Kjærs foredrag:

”Do we need all the Paraphilias?”
The ICD-10 diagnoses F-65.0 (fetishism), 65.1 (fetishistic transvestism) and 65.5 (sadomasochism) are no longer used in everyday Norwegian Psychiatry. But they still figure in the International and National ICD-10 manual. This paper addresses the pros et contras in the ongoing discussion about the revision of the diagnoses. A possible approach could be that national health authorities formally decided not to use these diagnoses, as was done in Denmark with 65.5 in 1995, and propose to delete them from the ICD list at the next revision. Parts of this discussion can be followed on the website www.revisef65.org

Abstraktene til denne konferansen ble trykket i et særnummer av bladet World Psychiatry som er Official Journal of The World Psychiatric Association.
WPA har mer enn 150.000 psykiatere som medlemmer fordelt på 106 medlemsland.

Dokumentasjon:
http://www.wpa2003vienna.at/home_E.htm

http://www.mednet.org.uy/spu/wp/WPA_Symposia.pdf

Psychological Surrender

Is Sadomasochism a mental pathology?
From Kraft-Ebing to Carl Jung, through years of research on the ground, Dorothy Hayden express her conclusion about masochism. The proposal for a new Psychological approach to BDSM.

PSYCHOLOGICAL DIMENSIONS OF MASOCHISTIC SURRENDER

By Dorothy C. Hayden, CSW

“Proud to be a perv”. Picture from SM Pride 2003 in London by Svein Skeid.62AkselProudPerv7

A number of years ago, in connection with my work with sexual addiction, a number of lifestyle submissives started coming to me for treatment. Some of these people were extremely hesitant to discuss their reasons for seeking therapy; they were so ashamed of their fantasies and behaviors that it took years of working with them until I knew their real names or their telephone numbers. Patients who able to be forthcoming about their masochistic behaviors and fantasies were as confused as I was. One of my patients, giving me a written masochistic fantasy after months of resistance, said, “Here it is. This is what I came to therapy for. It’s terrible. It’s sick. It’s wonderful. I hate it; it’s my favorite fantasy. I can’t stand it, I love it. It’s disgusting. I don’t want to stop it.”

Learning about the world of S&M has been an invaluable experience to me. I had to admit to myself that, viewed from the perspective of what I knew about the nature of the individual self, masochism puzzled me by flying in the face of everything that was rational about the nature of the human personality. People want to be happy and to avoid pain and suffering. They seek to maintain and increase their control over themselves and their surroundings. And they desire to maintain and increase their prestige, respect, and esteem. Viewed from the perspective of these three principles about the self, masochism is a startling paradox. The self is developed to avoid pain, but masochists seek pain. The self strives for control, but masochists seek to relinquish control. The self aims to maximize its esteem, but masochists deliberately seek out humiliation.

UNCOVERING A WORLD

I heard stories of whips, canes, racks, cock-and-ball torture, dripping wax on naked skin, electronic devices designed to deliver just the right amount of pain, the difficulty of finding the right mistress, and the surprising number of “dungeons” that existed within a few block radius of my mid-town office. Time and again, men would talk of the frustration of being unable to entice their wives or partners, who found these sexual activities to be perverse, into engaging in the sexual behaviors that they most longed for. I suspected that there was a vast number of people who felt tremendous shame and isolation about masochistic submissive longings. I decided to check the clinical literature on masochism to better arm myself with some psychodynamic understanding of why these men, who so often felt shame-bound, were so keen to be dominated, hurt, tortured and humiliated by strong, dominate women.

This is what my research revealed: According to the Diagnostic and Statistical Manual of the American Psychiatric Association, (the shrink’s bible), anyone who engages regularly in masochistic sex is mentally ill by definition. There is a long tradition of regarding masochism as the activity of mentally ill sick individuals. Freud described masochism as a perversion. One of his followers linked masochism to cannibalism, criminality, necrophilia and vampirism. Another analyst said that all neurotics are masochistics. In short, clinical perspectives have regarded masochists as seriously disturbed.

THE THERAPEUTIC APPROACH

Krafft-Ebing, the nineteenth-century psychiatrist who coined the term, subsumed masochism under the broad heading of “General Pathology” in this famous volume, Psychopath Sexualize, in 1876. Masochism became a pathological, sexual and psychopathic phenomenon all at once.

“By masochism I understand a particular perversion of the psychical sexual life in which the individual affected, in sexual feeling and thought, is controlled by the idea of being completely and unconditionally subject to the will of a person of the opposite sex; of being treated by this person as a master — humiliated and abused. This idea is colored by lustful feeling; the masochist lives in fantasies, in which he creates situations of this kind and often attempts to realize them. By this perversion his sexual instinct is often made more or less insensible to the normal charms of the opposite sex – incapable of a normal sexual life – psychically impotent.”

It has become practically a dogma of psychoanalytic thought that masochism is a sexual condition in which punishment is required before satisfaction can be reached. Freud understood the phenomenon as resulting from an “unconscious feeling of guilt” as “a need for punishment by some parental authority. Writing in 1919, Freud found the genesis and reference point for masochism in the Oedipus-complex. Masochism, he said, actually begins in infantile sexuality, when the wish for the incestuous connection with mother or father must be repressed. Guilt enters at this point, in connection with incestuous wishes. The parent figure then becomes the dispenser of punishment instead of love and appears in desires for beating, spanking, etc. The fantasy of being beaten becomes the meeting place between the sense of guilt and sexual love. Whether it involves literal pain or not, the punishment desired by the masochist is enjoyed in and of itself. Punishment and satisfaction both give pleasure – and humiliation. Freud, in referring to masochism as a “perversion”, cemented it forever in the ghetto of the aberrant and deviant.

My research, however, did not jibe with my clinical reality. The people who presented to me were not immature or inferior. In fact, the reverse seemed to be the case. Masochists are more likely to be successful by social standards: professionally, sexually, emotionally, culturally, in marriages or out. They are frequently individuals of inner strength of character, possessed of strong coping skills with an ethical sense of individual responsibility. A famous study of the “sexual profile of men in power” found to the researchers’ surprise, a high quantity of masochistic sexual activity among successful politicians, judges and other important and influential men.

FROM PATHOLOGY TO LIFESTYLE

It became obvious to me that psychology’s theories of masochism were obsolete. In the 1960’s, homosexuality was deleted from the DSMIV and was recognized not as a pathology, but as a lifestyle choice.

It is my contention that the same should be done with masochism and that, like homosexuality, it needs to be removed from the rubric of “psychopathology” and be seen for what it is: a sexual lifestyle choice. It is the intention of this paper to suggest ways of understanding masochism without invoking theories of mental illness.

The questions, however, remained. I puzzled as to why so many men, raised in a culture that valued masculine initiative, assertiveness, and dominance, want to be relieved of these qualities and surrender their will to a strong, dominant woman who might torture, control and humiliate them. What was the basis of this compelling urge to surrender and serve, to relinquish control, to accept physical pain and emotional humiliation?

As I listened to my patients over the years, I began to see masochism less as a sexual aberration and more as a metaphor through which psyche speaks of its suffering and passion.

There was a definite connection between suffering and pleasure the intrigued me.

Clients spoke of the rapturous delight in submission, the worship, in wild abandon and the deliverance from the confining bondage of “normalcy”.

Ritualized suffering seemed to be a way of giving meaning and value to human infirmities. After all, there is no paucity of suffering in human life. None of us need go looking for pain. The suffering of helplessness, disappointment, loss, powerlessness and limitation, is a part of the human condition. It is my hunch that there is something like a universal need, wish or longing for surrender completely to certain aspects of human life and that it assumes many forms. This passionate longing to surrender comes into play in at least some instances of masochism. Submission, losing oneself to the power of the other, becoming enslaved to the master is the ever-available lookalike to surrender.

THE SUBSPACE

Submissives speak of a quality of liberation, freedom and expansion of the self in a scene as a situation similar to the letting down of defensive barriers. They speak of the experience of complete vulnerability. I believe that buried or frozen, is a longing for something in the environment to make possible surrender, a sense of yielding of the false self. The false self is an idea developed by a famous psychoanalyst who posited that most parents need their children to behave in circumscribed ways in order for the child to receive their love. For a child, parental love is a matter of survival, and so the child forges a “self” that they think will ensure parental love and approval. The false self is usually a “caretaker” self. A Scene sometimes allows for years of defensive barriers that support the false self to be broken through. It carries with it a longing for the birth of the true self. Deep down we long to give up, to “come clean”, as part of a general longing to be known or recognized. The prospect of surrender may be accompanied by a feeling of dread and or relief or even ecstasy. It is an experience of being “in the moment”, totally in the present. Its ultimate direction is the discovery of one’s identity, one’s sense of self, of one’s sense of wholeness, even one’s sense of unity with other living beings. Joyous in spirit, it transcends the pain that evokes it. One’s exquisite pain is sometimes akin to mystical ecstasy. Within the context of that surrender, a self-negating submissive experience occurs in which the person is enthralled by the dominant partner. The intensity of the masochism is a living testimonial of the urgency with which some buried part of the personality is screaming to be released. The surrender is nothing less than a controlled dissolution of self-boundaries.

The deeper yearning is the longing to be reached, known and accepted in a safe environment which narcissistic, dysfunctional or preoccupied parents were unable to provide the child at a young age.

Fantasies of being raped, which are very common, can have all manners of meanings. Among them, one will almost always find, sometimes deeply buried, a yearning for deep surrender. The submissive longs for and wishes to be found, recognized, penetrated to the core, so as to become real, or, as one analyst says it “to come into being.”

RITUALS AND CREATIVITY

In addition to the longing to surrender into a truer sense of self, masochistic behaviors have another meaning. People need and take delight in fantasy production. Ask the Disneyland folk who cater to adults as much as to children. Scenes have tremendous potential for potentiating fantasy. Costumes, rituals, scenarios, an endless variety of sex props, and elaborate sets reveal of the richness the creative inner life and speak to the very real human need for fantasy play. The fantasies are the carriers of a full spectrum of human feelings: to control, to be controlled, to tease, to be teased, to play, to please, and to achieve solace from the confines of the mundaness of ordinary life. They represent the suspension of normal reality that is an occasional necessity for all healthy people.

Probably the last thing masochism appears aimed at is balance. In keeping with its paradoxical nature, masochism provides not so much a state of weakness, but a sense of surrender, receptivity and sensitivity. Masochism is the condition of submitting fully to an experience, which counters lives that, in our Western society, are ego-centered, constrained, rational, and competitive. Strength can be a terrible burden. It is a constraint, which can be relieved in moments of abandonment, of letting down and letting go. So it is hardly surprising that the pull of masochistic experiences should be so strong in a culture the overvalues ego strength at the expense of a fuller experience of all dimensions of psychic life.

In conclusion, I believe that therapists need to radically alter their approach to doing psychotherapy with masochistic patients. My colleagues complain that masochists are difficult to “cure”. Perhaps because the paradigm from which these therapists operate are faulty. The recognition of value and meaning in the desire to suffer humiliation runs counter to the prevailing attitude in psychology. The main thrust of modern theory and practice has been toward ego psychology. The values of psychotherapy have been aimed, for the most part, at building strong, coping, rational problem-solving egos. Ego-values are certainly worthy ones, yet it costs something to gain strength, to cope, to be rational and to solve problems. This may account for the dissatisfaction many people feel after years of psychotherapy. Building a strong ego is only one side of the story; it neglects other, crucial parts of the human psyche. Modern psychology has been in large measure dominated by helping people develop independence, strength, achievement decisive action, coping and planning. What’s missing is attention to the more subtle dimensions of soul.

THE CHARM OF SHADOWS

The psychoanalyst most in tuned with the missing element in psychotherapeutic work with masochism is Carl Jung. Masochism may be imagined as cultivation of what Jung called the “shadow” – the darker, mostly unconscious part of the psyche which he regarded not as a sickness, but as an essential part of the human psyche. The shadow is the tunnel, channel, or connector through which one reaches the deepest, most elemental layers of psyche. Going through the tunnel, or breaking the ego defenses down, one feels reduced and degraded. Usually, we try to bring the shadow under the ego’s domination. Embracing the shadow, on the other hand, provides a fuller sense of self-knowledge, self-acceptance and a fuller sense of being alive. Jung’s idea of the shadow involves force and passivity, horror and beauty, power and impotence, straightness and perversion, infantilism, wisdom and foolishness. The experience of the shadow is humiliating and occasionally frightening, but it is a reduction to life&Mac220;to essential life, which includes suffering, pain, powerlessness and humiliation. Submission to masochistic pain, loss of control and humiliation serves to embrace our shadow rather than deny it. The result is the achievement of an inner life that accepts and embraces all aspects of our selves and allows us to live with a deeper sense of our true selves.

In conclusion, the psychotherapeutic community needs to re-examine masochistic submissions to see it not as a pathology but as a healthy vehicle for surrendering fixed defense mechanisms, for relinquishing control to something or someone greater than themselves, for achieving freedom from the pervasive and relentless need to cultivate, promote and assert the self, for gaining some relief from having to make innumerable choices and decisions, for engaging in healthy fantasy enactments, and for the exploration, acknowledge and acceptance the “darker” or “shadow” side of their personalities. In addition, many patients speak of achieving a loss of self-awareness that they describe as ecstasy or bliss in which the individual transcends his normal limits and ceases to be aware of self in ordinary terms.

A travesty of our profession is that we continue to try to “cure” a systems of beliefs and behaviors that enrich and enlivens the lives of so many people. The continuing pathologizing of masochism by keeping it in the DSMIV as a psychopathology and by most therapists’ efforts to “cure” masochists is in part responsible for the continued , shame, isolation and low self-esteem of these creative, spontaneous and courage people who want to be afforded the dignity of choosing their own form of non-exploitative sexuality.

ABOUT THE AUTHOR:

Dorothy Hayden, MBA, CSW, received her masters degree in clinical social work from New York University and has received advanced clinical training at the Post Graduate Center for Mental Health. She is a psychotherapist in private practice in New York City.

You can contact her with the E-mail: [email protected]
Dorothy Hayden, CSW
209 East 10th Street #14
New York, NY

Web site: www.sextreatment.com/

THE SO-CALLED “DEVIANT” SEXUALITIES: PERVERSION OR RIGHT TO DIFFERENCE?

This study, presented at the 16th World Congress of Sexology in Cuba 10-14 March, 2003, suggests that non-conventional sexual practices cannot be used as a diagnosed criteria of any kind, whichmeans that the only aspect that distinguishes these individuals from others is their sexual practices.

Author: Maria Cristina Martins, Clinical Psychologist and Specialist in Human Sexuality. Campinas, SP, Brazil

Co-author: Paulo Roberto Ceccarelli, Psychologist, Psychoanalyst, PhD in Psycopathology and Psychoanalysis by Paris VII, Paris, France; Appointed Professor of the Psychology Dep. of Pontifice Catholic University of Minas Gerais, Brazil.

INTRODUCTION

The Internet became one more vehicle where people, occasionally or routinely, may enjoy or accomplish sexual fantasies and desires, often unconfessable and frustrated in their love and sexual relationships, safely and anonymously, without their real identities being revealed.

Similarly, the Internet provides opportunities for men and women, regardless of sexual orientation, marital status or age, and with distinct sexual preferences, to make come true, in the “real” world, a contact started and kept through online communication (Martins & Grassi, 2001).

Starting from the premise that the definition of “normality” is historically and culturally built, concepts such as “normal”, “healthy” and “pathological” are being questioned by all professionals who are interested in the study and comprehension of human sexuality.

The innumerable manifestations of human sexuality, so as the most varied searches for pleasure, confirm once more that, for the human being, sexuality is not linked to procreation.

The dynamics of human sexuality – what leads an individual to have the sexuality one has – has been an object of study since ancient times, without a consent being reached, which has lead to the search of new paradigms for understanding the so-called “deviant” sexual behaviors.

One of the reasons that make the comprehension of unconventional sexual interests difficult is that the traditional sexual paradigm, based on psychology and psychiatry, as well as on popular opinion, assumes that procreation is the most important biological function (Fog, 1992).

Most collected and studied data about so-called “deviant” behaviors were based on cases considered pathological.

Such studies were made under the legal medical view, or having as reference people who sought for psychiatric and/or psychological treatment because their sexual preferences “deviated” from “normal” sexual behavior (Ceccarelli, 2000) – understood as heterosexual relationship, ending on genital penetration and with the intention of procreating.

Certain so-called “deviant” practices, such as Sexual Sadism and Masochism and also Fetishism, are categorized as “paraphilias” and disfunctional behaviors in the Diagnostic and Statistical Manual of Mental Disorder (Fourth Edition), DSM-IV, by the American Psychiatric Association (APA) and in the International Statistical Classification of Diseases and Related Health Problems – 10th revision (1999), by the World Health Organization, which has generated many debates regarding diagnostic criteria, with which many professionals who are interested in the study of “alternative” sexual practices do not agree.

This study aims to explore human sexuality in its most diverse variations such as BDSM (Bondage/Discipline, Dominance/Submission, Sadism/Masochism) or SM, and Fetishism, through an online questionnaire sent to a group of people who describe themselves as BDSM and Fetish practitioners, and who have in the Internet their referential for the exchange and search of information, as well as the search for partners who share the same sexual fantasies.

This study has no intention of encouraging or condemning the choice of sexual practices, but of exploring the diversity of adult human sexuality of a group of people in the context of the contemporary Brazilian society.

METHOD

An e-mail was sent to the various discussion groups and classified ads posted on websites directed to consensual BDSM and Fetish practitioners in Brazil, and who use the Internet as a means of exchanging and obtaining information and contact with people who share the same sexual fantasies. The exploratory character of the study was explained, that it would be conduced basically via e-mail, and that the real identity of the participants would be preserved. Those who were interested should be over 18 years old, their sexual orientation or marital status notwithstanding. It was asked to the volunteers that they got in touch by replying the sent e-mail. One hundred and eleven people from various Brazilian states manifested their interest in participating. They were sent, then, a questionnaire with questions such as why they used the Internet, which sexual practices they were involved in, how and when they became interested in sexual activities that were considered “different” and how they felt about having pleasure with practices that are considered unconventional.

Information on their age, religious formation, sex, marital status, education and sexual orientation were also the object of interest for the research. It was not the aim of the present study to establish diagnostic criteria of the researched sample, or describing in details the unconventional sexual practices.

DISCUSSION

In spite of the growing evolution observed along the years in human sciences and in the technologic and scientific fields, sexuality is still the object of much speculation, prejudice and taboo. If we observe the diverse current reactions in face of sexual manifestations, we will see how much such reactions remain unchanged throughout History. Although the sixties‘ “sexual revolution” and the innumerous movements aiming at the recognition of human rights (especially the feminist) have changed the social scenery, sexuality is still an enigma for the human being and the object of many discussions since antiquity.

From the 5th Century on, due mainly to the leading Christian Fathers – Augustine, Jerome and Thomas of Aquinas – sexuality was linked to and procreation: the unquestionable example that follows is the “naturally heterosexual” life of animals. All sexual practice that falls out of that norm would bring what is known as the “negative pleasure stigma”.

Then, a form of morality that is essentially a sexual morality appeared. Practices “against nature” – considered offensive to decency, to custom and to public opinion – bring out severe sanctions, so that “normal” may be kept.

However – History shows that – such an objective was never reached: sexuality always escaped all attempts of normatization (Ceccarelli, 2000).

In the late 19th Century, the contemporary psychiatric discourse appears, marked by the same moralistic view;

it maintains the theological and juridical positions, bringing to the medical order what was, until then, from the juridical. The great psychopatologists of that epoch, among them Havellock-Ellis (1888) and Kraftt-Ebing (1890), classified and labeled the sexual practices that escaped moral rules.

A detailed inventory of the so-called “deviant” sexualities was traced, in which new forms of sexual practices (those which use the other for obtaining pleasure and in which the natural finality of sexuality – procreation – is subverted) were created: homosexualism, voyeurism, exhibitionism, sadism, masochism, joining the endless psychiatric nosography of that time. It is also when some terms, that later became classical, are introduced: perversion (1882, Charcot and Magna), narcisism (1888, Havellock-Ellis), auto-erotism (1899, Havellock-Ellis), sadism and masochism (1890, Krafft-Ebing) [Ceccarelli, 2000].

In the late 19th Century and, in a stronger way, in the early 20th Century, Sigmund Freud, in his most important text on sexuality, the “Three Essays on the Theory of Sexuality” published in 1905, sustains that subordinating sexuality to the reproductive function is “a too limited criterion”. In Freudian perspective, sexuality is against nature, that is, as far as sexuality is concerned, there is no “human nature” (Ceccarelli, 2000).

Joyce McDougall and the concept of “Neo-Sexuality”

Contemporary author Joyce McDougall (1997) made an important and innovative reading of Freud, regarding perversion. According to the theoretical perspective of the author, the word “perversion” has a depreciative conotation and points towards negativity, since one never hears of someone who was “perverted” to good. The author maintains that, besides the moralistic implication in the vernacular use of the word, the current standard of psychiatric and psychoanalytic classification is equally questionable. When labeling and diagnosing someone as “neurotic”, “psychotic”, “psychosomatic” or “perverted”, the innumerable variations of psychic structures of each clinical category are not taken into account, losing sight of the most remarkable aspect of human beings in their genetic structure, which is their “singularity” (McDougall, 1997, p 186). Regarding the so-called perverted sexualities like fetishism and sadomasochist practices, she verifies that those occur in the quality of erotic games in sexual activities of non-perverted adults, be they heterosexual or homosexual, so that such practices do not provoke conflict, for they are not experienced as compulsive or as exclusive conditions for sexual pleasure. But heterosexual or homosexual adults who only have fetishist or sadomasochist erotic scripts, for whom those sexual practices are the only means of access to sexual relations, there must be care as to want those people to lose their heterodox versions of desire, simply because they may be considered symptomatic. Instead of “perversion”, McDougall (1997, p 188) prefers to name them “neo-sexualities”. According to the author, the term “perversion” would be more appropriated as a label for acts in which an individual imposes personal desires and conditions on someone who does not wish to be included in that sexual script (as in the case of rape, of voyeurism and exhibitionism) or seduces a non-responsible individual (as a child or a mentally disturbed adult) [McDougall, 1997, p 192].

Bullough about sadomasochism

Bullough about sadomasochism:
According to the American historian and sexologist Vern L. Bullough (picture),
vern_bulloughsadomasochism is about absolutely voluntaryness, reciprocity and equality. “Most sadomasochists live a entirely normal and law-abiding life gaining the society. You will not be able to indentify them neither in the street, nor at the workplace”, he says.
– Sadomasochism as a stimulating sex play, is very different from destructive and harmful violence, Bullough told “Fri Tanke”, the periodical of The Norwegian Humanist Association [Human Etisk Forbund], April 1997.

According to Bullough, sadomasochism was neither an illness nor a sin before the Austro-German psychiatrist Richard von Krafft-Ebing published the book Psychopathia sexualis in 1886 and later editions (Bullough, V. L., & Bullough, B., 1977. Sin, sickness & sanity. New York: Garland Publishing).

Vern L. Bullough (1928-2006), among many awards, have received the Alfred Kinsey Award for distinguished sex research.