What is masochism?

Masochism is a sexual disorder. If you have this disorder, you are sexually excited by being shamed or being made to suffer during sex. You seek partners to tie you up, shame, blindfold, or hurt you. You may enjoy being whipped, beaten, shocked, cut, or pierced. Other acts involve being controlled, such as making you crawl or keeping you in a cage. Verbal abuse is common.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Stress plays a part. You may be at higher risk due to problems such as abuse, financial stresses, or the loss of a relationship.
• Problems in your family when you were growing up may increase your risk. For example, child abuse, lots of conflict in the family, or a family history of mental illness.

The disorder most often starts in early adulthood, although you may have had fantasies about being hurt when you were a child.

What are the symptoms?

Symptoms may include:

• Being sexually aroused by pain or shame. Your sexual excitement increases the more your partner makes you suffer.
• Having fantasies, urges, or actions that upset you and cause serious problems in school, on the job, or in relationships.

How is it diagnosed?

Your healthcare provider will ask about your relationships, family history of any medical and mental problems, and any substance abuse. He will also ask about your symptoms and medical history and examine you. You may be referred to a mental health therapist for treatment.

How is it treated?

Many people with this disorder do not get help until they are seriously hurt. If you have masochism, get help before it becomes an even bigger problem.

Both therapy and medicines may be used to treat this disorder. Several types of therapy may help.

• Behavior therapy helps you recognize that the way you act affects others. This can help you change problem behaviors.
• Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.

Medicines may include hormones or medicines to correct the balance of chemicals in your brain. Both kinds of medicine help reduce sexual urges.

How can I take care of myself?

• Get support. Consider joining a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, try to quit. Avoid alcohol and drugs. Exercise according to your healthcare provider’s instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don’t seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or asks a partner to do something that could cause a serious injury or death, such as using knives or suffocation during sex.

For more information, contact:

• National Alliance on Mental Illness (NAMI)
  800-950-NAMI
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net