Tuesday, February 23, 2010
Sexual Sado-Masochism
4:07 PM | 
Diposkan oleh
Hermanto
Sexual Sadism
The terminology of this disorder was named after the Marquis de Sade, an 18th century French author and military officer who was repeatedly imprisoned for his violent sexual acts against women.
Most persons with sexual sadism are male and before the age of 18 years.
Sadism is a defense against fears of castration; persons with sexual sadism do to others what they fear will happen to them and derive pleasure from expressing their aggressive instincts.
Sexual sadism is related to rape, although rape is more aptly considered an expression of power. Some sadistic rapists, however, kill their victims after having sex (so-called lust murders).
According to John Money, there are five contributory causes of sexual sadism :
· Hereditary predisposition
· Hormonal malfunctioning
· Pathological relationships
· History of sexual abuse
· The presence of other mental disorders.
DSM-IV-TR Diagnostic Criteria for 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 the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.
B. The person has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.
Sexual Masochism
Masochism’s terminology from the activities of Leopold von Sacher-Masoch, a 19th century Austrian novelist whose characters derived sexual pleasure from being abused and dominated by women.
According to DSM-IV-TR, persons with sexual masochism have a recurrent preoccupation with sexual urges and fantasies involving the act of being humiliated, beaten, bound, or otherwise made to suffer.
Sexual masochistic practices are more common among men than among women.
Psychodynamic
SigmundFreud believed masochism resulted from destructive fantasies turned against the self.
In some cases, persons can allow themselves to experience sexual feelings only when punishment for the feelings follows. Persons with sexual masochism may have had childhood experiences that convinced them that pain is a prerequisite for sexual pleasure. About 30% of those with sexual masochism also have sadistic fantasies.
Moral masochism involves a need to suffer, but is not accompanied by sexual fantasies.
DSM-IV-TR Diagnostic Criteria for 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.
Treatment
1. Psychotherapy
· Insight-oriented psychotherapy : to help them understand the dynamics of behavioral patterns. Supportive psychotherapy : to help them repair the interpersonal, social, or occupational damage that occurs.
· Cognitive behavioral therapy : helps them recognize dysphoric states that precipitate sexual acting out.
· Marital therapy or couples therapy : to help them regain self-esteem.
2. Pharmacotherapy
Prognosis
Because of the chronic course of sexual masochism and the uncertainty of its causes, treatment is often difficult. The fact that many masochistic fantasies are socially unacceptable or unusual leads some people who may have the disorder not to seek or continue treatment. Severe or difficult cases of sexual masochism should be referred to professionals who have experience treating such cases.
Prevention
Because it is sometimes unclear whether sadomasochistic behavior is within the realm of normal experimentation or indicative of a diagnosis of sexual masochism, prevention is a tricky issue. Often, prevention refers to managing sadomasochistic behavior so it primarily involves only the simulation of severe pain and it always involves consenting partners familiar with each other's limitations.
