BDSM among childhood abuse survivors: Researchers weigh the benefits and risks

A recent paper published in the Journal of Sex & Marital Therapy explores the relationship between BDSM and childhood sexual abuse (CSA). The findings suggest that for some individuals, engaging in BDSM may serve as a means of processing and healing from past trauma. But it also carries risks of retraumatization.

CSA affects millions of children worldwide. Defined by the World Health Organization as the involvement of a child in sexual activity they cannot fully comprehend or consent to, it often involves an abuse of power and trust by an adult or older child. The psychological impacts of CSA are profound and long-lasting, often extending into adulthood. Survivors frequently struggle with severe anxiety, depression, post-traumatic stress disorder, and low self-esteem.

BDSM refers to a variety of practices and role-playing activities involving bondage, discipline, dominance, submission, sadism, and masochism. These activities are characterized by consensual power dynamics and often involve the use of pain to enhance sexual gratification. Central to ethical BDSM practices is the principle of mutual consent, where all participants agree to the boundaries and activities involved.

“Our interest originated from our clinical practice with survivors, and with questions raised by professionals who wonder how to react toward BDSM practices in trauma survivors,” explained Ateret Gewirtz-Meydan, a senior faculty member at the School of Social Work at the University of Haifa and a certified sex therapist.

“We aim to better understand the unconscious mechanisms that might be at play and the potential therapeutic functions of BDSM practices among CSA victims. Given the profound and long-lasting effects of CSA, it is crucial to investigate all possible avenues for healing and processing trauma, including those that are less conventional and more stigmatized.”

Reviewing prior studies, the researchers found that while there is some evidence suggesting a higher prevalence of trauma among BDSM practitioners, the data is inconsistent. Some studies indicate that individuals who engage in BDSM report PTSD and trauma-related scores similar to the general population. For instance, one study among Australian respondents revealed no significant relationship between BDSM practices and experiences of sexual abuse.

Another study among participants in Finnish BDSM clubs showed a higher prevalence of CSA compared to the general population, but the majority of BDSM practitioners did not report such a history. This suggests that while a subset of BDSM practitioners might have experienced trauma, it is not a defining characteristic for most individuals in the community.

For some survivors of CSA, engaging in BDSM could offer a pathway to reclaim control and reframe their traumatic experiences, the researcher noted. Through the principles of safe, sane, and consensual practices, BDSM allows survivors to set boundaries, negotiate power dynamics, and explore their bodies in a controlled and consensual environment.

This can lead to a form of trauma-play where survivors deliberately revisit their trauma from a position of strength and agency. The process involves repetition and rescripting, where the negative emotions associated with past trauma are transformed into pleasurable sensations and feelings of mastery.

On the other hand, the researchers also investigated scenarios where BDSM practices might reproduce traumatic experiences for survivors of CSA. They found that the intense power dynamics and physical sensations inherent in BDSM can sometimes mirror the traumatic experiences of abuse.

For instance, consensual role-play involving control and submission might evoke memories of past non-consensual situations, leading to psychological harm. Additionally, if BDSM activities do not adhere strictly to consent boundaries, survivors might struggle to assert their limits, potentially re-experiencing feelings of powerlessness and violation.

The researchers noted that dissociation, a common coping mechanism for trauma survivors, could be invoked during BDSM activities, further complicating the individual’s ability to distinguish between consensual play and past abuse. Dissociation is a psychological coping mechanism where an individual detaches from their thoughts, feelings, or sense of identity to distance themselves from overwhelming experiences. Thus, while BDSM can be empowering for some, it can also inadvertently retraumatize others.

The paper highlights “that the relationship between BDSM and CSA is multifaceted and complex,” Gewirtz-Meydan told PsyPost. “BDSM practices can potentially serve as a medium for trauma survivors to reclaim control, explore boundaries, and reshape their relationship with their bodies in a consensual and safe environment. However, it is not a one-size-fits-all solution and should be approached with careful consideration and professional guidance.”

The findings should be interpreted with caution and seen as preliminary insights into a complex and evolving field due to several factors. First, the existing research on the relationship between BDSM and CSA is sparse and often inconsistent, making it difficult to draw definitive conclusions.

“A significant caveat is the lack of sufficient empirical data to robustly support the clinical perspectives proposed,” Gewirtz-Meydan said. “The varied definitions and understandings of BDSM add complexity, and the motivations of CSA survivors engaging in BDSM are not fully understood. Furthermore, there is limited research on the potential risks and the possibility of re-traumatization for CSA survivors engaging in BDSM practices.”

Despite this, the review emphasizes the importance of clinicians handling the topic of BDSM with care and not automatically treating it as something abnormal or wrong.

“It is crucial for clinicians to approach this topic with sensitivity and avoid pathologizing BDSM practices,” Gewirtz-Meydan said. “Understanding the therapeutic potential of BDSM and fostering open, non-judgmental conversations about it can contribute to destigmatizing and empowering trauma survivors.”

“Our long-term goals include conducting more comprehensive empirical studies to understand the different trajectories that may lead CSA survivors to engage in BDSM and the impacts of these practices. We aim to provide clearer clinical guidelines for therapists working with survivors who are inclined towards BDSM and to explore the broader applications of BDSM as a potential therapeutic tool for various types of trauma.”

The study, “The Complex Interplay between BDSM and Childhood Sexual Abuse: A Form of Repetition and Dissociation or a Path Toward Processing and Healing?“, was authored by Ateret Gewirtz-Meydan, Natacha Godbout, Cloé Canivet, Tal Peleg-Sagy, and David Lafortune.