Sexual Masochism involves the act of being humiliated, bound, beaten and otherwise made to physically suffer for purposes of sexual stimulation. While the fantasy of such things is not unusual, it is the acting upon these fantasies that can run the risk of true peril. The characteristics of Sexual Masochism are as follows:

Repeatedly for at least 6 months, the patient has intense sexual desires, fantasies or behaviors concerning real acts of being beaten, bound, humiliated or otherwise made to suffer.
     

This causes clinically important distress or impairs work, social or personal functioning.

These patterns of behavior are not only disruptive to social and occupational functioning, but they run the risk of threat to physical safety. Hypoxyphilia for example, involves the cutting off of oxygen supply for purposes of sexual stimulation. While some may engage in minor sexual masochism, there are those who increase the risk to safety over the years, often thereby insuring that the risk of serious injury occurs.

Associated Features:

Abuse (past or present)
Somatic or Sexual Dysfunction
Sexually Deviant Behavior

Differential Diagnosis:

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Mental Retardation.
Dementia.
Manic Episode.
Schizophrenia.

Cause:

Although the actual cause of the paraphilia is unclear it may be caused by the association of pleasant responses to a particular stimulus which one would not regard as pleasant. Most paraphilic fantasies begin in late childhood or adolescence and continue throughout adult life. Intensity and occurrence of the fantasies are variable, and they usually decrease as people get older.

Treatment:

The accepted forms of treatment involve psychological therapy and in some cases drug therapy.

Counseling and Psychotherapy [ See Therapy Section ]:

Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with paraphilia's.

Pharmacotherapy [ See Psychopharmacology Section ] :

Hormones are prescribed occasionally for individuals who experience intrusive sexual thoughts, urges, or abnormally frequent sexual behaviors. Almost always the treatment must be long-term if it is to be effective.