Taking pleasure in pain: How to understand masochistic sexual practices?

Taking pleasure in pain: How to understand masochistic sexual practices?  O. Benhamou. Sexologies, Volume 29, Issue 3, July–September 2020, Pages e85-e92. https://doi.org/10.1016/j.sexol.2020.01.002

Summary: The encounter with a patient who initially came to consult for sleep disorders, which concealed moral suffering linked to masochistic sexual practices with a Domina, was at the origin of this research work. The objective of this research is to try to understand how masochistic sexual fantasies emerge and what these sexual practices represent for their devotees, in terms of their psychological life and their sexuality. Sixteen subjects answered a questionnaire built on two axes: the sexual practices themselves (from the first fantasies to their implementation in sexuality), and the biographical path of the subjects (life history, relations with the family and the environment). This is a qualitative research, the results of which were treated in the form of thematic analysis and portraits of each subject, to reflect the uniqueness of their itinerary. The results of this research indicate that masochistic sexual practices always perform a function for those who choose them. They are most often a solution to an internal conflict linked to early relational modalities that generate suffering and/or traumatic experiences. They can also be a solution to sexual problems.

Keywords: MasochismPainSexual satisfactionViolenceFantasiesSexuality

Check also Physical Pain as Pleasure: A Theoretical Perspective. Cara R. Dunkley, Craig D. Henshaw, Saira K. Henshaw, and Lori A. Brotto. The Journal of Sex Research, Volume 57, 2020 - Issue 4, May 2 2019.
https://doi.org/10.1080/00224499.2019.1605328. Free at https://med-fom-brotto.sites.olt.ubc.ca/files/2019/05/Physical-Pain-as-Pleasure-A-Theoretical-Perspective.pdf

Abstract: Physical pain represents a common feature of Bondage and Discipline/Dominance and Submission/Sadism and Machochism (BDSM) activity. This article explores the literature accounting for how painful stimuli may be experienced as pleasurable among practitioners of BDSM, and contrasting this with how it is experienced as painful among non-BDSM individuals. We reviewed the available literature on pain and on BDSM, and used the findings to postulate a theory accounting for how painful stimuli are experienced as pleasurable. Our theory was then checked with BDSM practitioners. The emotional, physiological, and psychological elements of pain interact to facilitate the experience of pain as pleasure in BDSM. A multitude of interconnected factors was theorized to alter the experience of BDSM pain, including: neural networks, neurotransmitters, endogenous opioids and endocannabinoids, visual stimuli, environmental context, emotional state, volition and control, interpersonal connection, sexual arousal, and memories. The experience of pain in this context can bring about altered states of consciousness that may be similar to what occurs during mindfulness meditation. Through understanding the mechanisms by which pain may be experienced as pleasure, the role of pain in BDSM is demystified and, it is hoped, destigmatized.

Fig. 1:
1. Prior to the experience of pain, there is a preexisting emotional and interpersonal context based on present circumstances, memories of related past experiences, and the extent to which one feels in control. These situational factors may facilitate sexual arousal.
2. The presence of sexual arousal prior to (and/or alongside) the infliction of pain stimuli serves as an analgesic, altering levels of dopamine and oxytocin.
3. Contextual factors and sexual arousal lead to a positive anticipation of pain.
4. Context, sexual arousal, and the positive anticipation of pain set the stage for receiving pain sensations and fostering the experience of pain as pleasure.
5. Once pain is introduced, nociceptor stimulation engages bottom-up/top-down processing and produces changes in levels of dopamine, cortisol, endogenous opioids, and endogenous endocannabinoids, further influencing the psychological and physiological response to pain sensations.
6. These conditions may promote mindfulness and lead to an altered state of consciousness, colloquially called subspace, which contributes to the various mechanisms through which pain is experienced as pleasure in the context of BDSM.