April 27

BDSM Mental Health Impact – Harmful or healthy?


One of the earliest records of BDSM dates back to 3100 BC in Ancient Mesopotamia, from the Goddess of Inanna—the Goddess of passion and fertility—who was known to “whip her constituents into a pure and wild sexual frenzy.

While BDSM has really hit the mainstream in recent years, rest assured you’re not the first one to have such desires, fantasies, kinks, or fetishes.

While BDSM is nothing new, modern culture has begun to question the “normality”—whatever that means—of BDSM.

Thankfully, modern psychology has begun to study BDSM mental health, the people who partake in it, and the dynamics within it. 

Goddess of Inanna

While BDSM is nothing new, modern culture has begun to question the “normality”—whatever that means—of BDSM. Thankfully, modern psychology has begun to study BDSM mental health, the people who partake in it, and the dynamics within it. 

The American Psychological Association & BDSM Mental Health...

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (or DSM-V), published by the American Psychological Association, doesn’t list sexual fetishism as a mental disorder so long as the person doesn’t “feel personal distress about their interest.”

The previous iteration, the DSM IV, however, listed a whole slew of kinks as mental disorders. But times are changing… Especially due to one particular Dutch study published in the Journal of Sexual Medicine that The Daily Mail wrote about, headlining the article “S&M enthusiasts are ‘healthier and less neurotic' than those with a tamer sex life.”

While that is quite the sensationalist headline, it might be onto something. Let’s do a deep dive into the world of BDSM Mental Health and where it lies within the discussion of this underground lifestyle.

What is BDSM? 

Let’s define BDSM...

Strictly speaking (ahem), BDSM is an acronym that stands for bondage/discipline, domination/submission, and sadism/masochism.

More broadly speaking, BDSM entails a lot of different fetishes and kinks from role-playing to rope bondage.

Studies report that anywhere between 2 and 62% of adults partake in BDSM. That’s hardly a definitive number, and many other studies report higher numbers. In 2017, a Belgian study surveyed 1027 adults and 47% reported that they have experimented with BDSM and 69% reported that they have BDSM fantasies. 


If scientific evidence isn’t for you, we can find some empirical evidence from the kinky social media website, fetlife.com. The home page boasts that they have over 10 million members worldwide.

The kinksters have spoken. There are plenty of adults who participate in or fantasize about consensual BDSM.

BDSM, the DSM, and the Mental Health Industry 

As stated above, the DSM is the Diagnostic and Statistic Manual of Mental Disorders published by the American Psychological Association. It is widely regarded as the standard for psychopathology in the mental health industry and is regularly updated to reflect changes. 

The current version, the DSM V, has, to a small extent, loosened its definition of “mental disorder” with regard to sexual behavior. The DSM IV, however, listed many “deviant” sexual acts as “paraphilias.” 

Paraphilias are defined as “a pattern of recurring sexually arousing mental imagery or behavior that involves unusual and especially socially unacceptable sexual practices.”

The American Psychiatry Association denotes eight specific paraphilias.

⭕ Exhibitionistic disorder
⭕ Fetishistic disorder
⭕ Frotteuristic disorder,
⭕ Pedophilic disorder
⭕ Sexual masochism disorder
⭕ Sexual sadism disorder
⭕ Transvestic disorder,
⭕ Voyeuristic disorder.

Right off the bat, we can see a huge issue with grouping criminal activities, such as pedophilia and frotteurism, with consensual sadism or masochism.

Unfortunately, the DSM V still does group all of these together.

And there are plenty of people who object to this broad grouping of all these “disorders,” with this study published in The Journal of Sexual Medicine saying, “these definitions of ‘anomalous’ or ‘atypical’ sexual interests are recurrently debated, as they engender more problems than solutions.”

On top of the issues with the DSM V and its take on kinky behavior, finding a kink-friendly therapist can be an issue for some. Meghan Cleveland, a licensed marriage and family therapist says “The sad truth about the mental health field, is that awareness and education on sexuality is incredibly lacking.”

She continues, “many individuals who are kinky or practice alternative lifestyles, find themselves struggling to find a therapist who is non-judgmental and educated surrounding Kink.”

Suffice it to say, the mental health industry has made some strides in the right direction, but there’s still plenty of progress to make. The question of whether someone who participates in BDSM is (or should be) pathologized as mentally disordered still stands.

This brings us to one study conducted by Dr. Andreas Wismeijer, a psychologist at Tilburg University in the Netherlands, and the subsequent article that The Daily Mail published.

Breaking Down the Dutch Study

Let me be clear from the start: The Daily Mail’s claim that “enjoying the snap of the whip or the clink of chains on skin could make you more psychologically healthy than those who enjoy a more mundane sex life,” is, at best, slightly misguided, and, at worst, deliberately disingenuous.

Despite the results of the study, to say that people who practice BDSM are “more psychologically healthy” than people who don’t practice BDSM is a big stretch. 

The study in question, which you can find the abridged version here, was a study that surveyed 902 BDSM practitioners and 434 control participants. 

The study sampled the BDSM practitioners by posting an ad on “the largest BDSM forum in the Netherlands,” and the control group was sampled by posting an ad in a popular Dutch women’s magazine called Viva.

While the researchers told the BDSM practitioners this study involved “mapping the psychology of the practice of BDSM,” they told the control group that it was “a study about human behavior.”

The researchers had the participants self-report their answers on four different surveys:

  • Five Factor Personality Inventory
  • 40-item Attachment Styles Questionnaire
  • Rejection Sensitivity Questionnaire
  • The World Health Organization Five Well-being Index

The researchers controlled for age, sex, and gender. The results found that people who participated in BDSM were: less neurotic, more extroverted, more open to new experiences, more conscientious, less sensitive to rejection, and had higher subjective well-being.

They did find, however, that the BDSM practitioners tended to be “less agreeable” than the control group. 

These are interesting results, no doubt, but there are some limitations to the study. To be fair, every scientific study has limitations. That’s why there’s a “limitations” section included in every study published in every scientific journal. 

The good news is that “sources of funding” and “conflicts of interest” are arguably the two biggest limiting factors in the validity of a study, and this study was reported to have neither. But that doesn’t mean there aren’t any. 

The first one is that both groups (the BDSM practitioners and the “vanilla” control group) were told two different purposes of the study. On top of that, the surveys were self-reported, and as Kristalyn Salters-Pedneault, Ph.D. reports, “[participants] are more likely to report experiences that are considered to be socially acceptable or preferred.”

Another notable limitation is the sample of the control group. Namely, the control group consisted of 70% women and participants were recruited from an ad in a women’s magazine.

This means this control group was not representative of the general population. That said, those who completed the study in the BDSM practitioners group were 51% male and 49% female, which is more representative of the general population. 

This doesn’t mean the study is completely invalid or that we can’t take valuable information from it. But for The Daily Mail to take these results and interpret them as “S&M enthusiasts are ‘healthier and less neurotic’ than those with a tamer sex life” is transparently sensationalist. 

The main researcher of the study, Dr. Andreas Wismeijer, wrote in the conclusion, “We conclude that BDSM may be thought of as a recreational leisure, rather than the expression of psychopathological processes.”

This is a much more accurate—and, given the mental health industry’s assessment of kinky, “non-normative” behavior, a needed—representation of the results.

Ultimately, this is good news for everyone. If you’re a kinkster, hopefully, you’ll find some relief that you’re less likely to be pathologized as “non-normative” or “disordered.”

And if you’re someone who enjoys a more “vanilla” sex life, please understand that people who participate in S&M aren’t necessarily “healthier and less neurotic” than you, despite what The Daily Mail says.

Can BDSM be Good for You?

I don’t think it’s a secret that Escaping Vanilla is a pro-kink website. But, in the same way, we ask “vanilla” people not to judge us for our sexual proclivities, we 'kinksters' will offer you the same respect and won’t judge you for yours.

With that said, this next section is for those of us who do participate in such activities, and of course, we’ll extend this as an invitation to those who have an interest in BDSM but have yet to try it. 

Come on in! The water’s warm…

As someone who’s been a part of the kink world for over a decade and regularly checks in with best kink practices (known as safe, sane, and consensual), I can assure you there are some benefits—no matter how empirical—to BDSM. This, of course, is for people who are into (or curious about) BDSM. If BDSM doesn’t interest you, that’s great, too!

More Effective Communication

Kinksters regularly engage in what’s called a “pre-scene negotiation” where both (or all) parties discuss what they want, what they need, and what their limits are for the scene. The study I just linked says, “Through the use of role identifier-specific language patterns and behaviors kinksters cooperatively and collaboratively construct consent in pre-scene negotiations.”

Given the never-to-be-understated importance of consent, communication, and trust in BDSM, this is a practice that can improve your communication around your sexual needs.

It Can Rid Ourselves of Toxic Shame

The sad truth is that many of us have been inundated with shaming messages about our sexuality from a young age. Rachel Keller, a liscensed certified social worker says “shame tends to diminish when it is brought into the open and met with love and compassion.”

Embracing vulnerability and discussing your sexual desires, fantasies, and kinks with a trusted partner is a great beginning to ridding ourselves of unhealthy shame around our sex lives.

It Establishes Trust

Regardless of what kink, fantasy, or role-play you want to engage in, they all require a significant level of trust. Michael Castleman, M.A., says “When trust trumps the possibility of harm, the result can feel incredibly intimate and erotic.”

Engaging in new activities with your partner can help create a new level of trust.

While these benefits may or may not have a direct benefit to your mental health, I can say in good conscience, that I truly believe it provides indirect benefits to it.



The bottom line is, life is too short not to have great sex—whatever your definition of great sex is. Whether it involves a soft, white linen duvet draped over your mattress or a black leather sex swing hanging from your ceiling, do whatever makes you feel best, physically and emotionally.

The mental health industry has had a long-standing issue with kinky behaviors, but the good news is, that seems to be changing. I’ll reiterate it one last time: the claim that The Daily Mail made that as “S&M enthusiasts are ‘healthier and less neurotic' than those with a tamer sex life” is a stretch. 

This is good news for “vanilla” lovers, as it doesn’t mean you’re less healthy than kinksters.

But in the defence of kinksters, it firmly pushes back against the idea that by engaging in these behaviors, you should be pathologized you as “disordered.”

The acceptance of BDSM still has a long way to go, and the mental health industry needs to do more research, but we are getting there. And if the psychiatry world is going to continue imposing its puritanical and outdated views on us kinksters, I agree with Edward Shorter, PhD, when he says, “it’s time for psychiatry to bow out of the bedroom."

==> Check out our other BDSM articles here.


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