Sadism and masochism
Synonyms and keywords: sadism; sexual sadism; sexual sadism disorder; SM; S&M; masochism

# Overview
Sadism refers to sexual or non-sexual gratification in the infliction of pain or humiliation upon another person. Masochism refers to sexual or non-sexual gratification from receiving the infliction of pain or humiliation.
Often interrelated, the practices are collectively known as sadomasochism as well as S&M or SM. These terms usually refer to consensual practices within the BDSM community.

# Psychological Categorization
Both terms were coined by German psychiatrist Richard von Krafft-Ebing in his 1886 compilation of case studies Psychopathia Sexualis. Pain and physical violence are not essential in Krafft-Ebing's conception, and he defined masochism (German "Masochismus") entirely in terms of control. Sigmund Freud, a psychoanalyst and a contemporary of Krafft-Ebing, noted that both were often found in the same individuals, and combined the two into a single dichotomous entity known as sadomasochism (German "Sadomasochismus")(often abbreviated as S&M or S/M). This observation is commonly verified in both literature and practice; many sadists and masochists define themselves as "switchable"capable of taking pleasure in either role. However it has also been argued (Deleuze, Coldness and Cruelty) that the concurrence of sadism and masochism in Freud's model should not be taken for granted.
Freud introduced the terms "primary" and "secondary" masochism.  Though this idea has come under a number of interpretations, in a primary masochism the masochist undergoes a complete, not just a partial, rejection by the model or courted object (or sadist), possibly involving the model taking a rival as his or her preferred mate.  This complete rejection is related to the death drive in Freud's psychoanalysis (Todestrieb).  In a secondary masochism, by contrast, the masochist experiences a less serious, more feigned rejection and punishment by the model.  Secondary masochism, in other words, is the relatively casual version, more akin to a charade, and most commentators are quick to point out its contrivedness.
Rejection is not desired by a primary masochist in quite the same sense as the feigned rejection occurring within a relatively equal relationship--or even where the masochist happens to be the one having true power (this is the problematic that underlies the analyses of Deleuze and Sartre, for example).  In Things Hidden Since the Foundation of The World Rene Girard attempts to resuscitate and reinterpret Freud's distinction of primary and secondary masochism, in connection with his own philosophy.
Both Krafft-Ebing and Freud assumed that sadism in men resulted from the distortion of the aggressive component of the male sexual instinct. Masochism in men, however, was seen as a more significant aberration, contrary to the nature of male sexuality. Freud doubted that masochism in men was ever a primary tendency, and speculated that it may exist only as a transformation of sadism. Sadomasochism in women received comparatively little discussion, as it was believed that it occurred primarily in men. Both also assumed that masochism was so inherent to female sexuality that it would be difficult to distinguish as a separate inclination.
Havelock Ellis, in Studies in the Psychology of Sex, argued that there is no clear distinction between the aspects of sadism and masochism, and that they may be regarded as complementary emotional states. He also made the important point that sadomasochism is concerned only with pain in regard to sexual pleasure, and not in regard to cruelty, as Freud had suggested. In other words, the sadomasochist generally desires that the pain be inflicted or received in love, not in abuse, for the pleasure of either one or both participants. This mutual pleasure may even be essential for the satisfaction of those involved.
Here Ellis touches upon the often paradoxical nature of consensual S&M. It is not only pain to initiate pleasure, but violenceor the simulation of violenceto express love. This contradictory character is perhaps most evident in the observation by some that not only are sadomasochistic activities usually done for the benefit of the masochist, but that it is often the masochist that controls them, through subtle emotional cues received by the sadist.
In his essay Coldness and Cruelty, (originally Presentation de Sacher-Masoch, 1967) Gilles Deleuze rejects the term 'sadomasochism' as artificial, especially in the context of the prototypical masochistic work, Sacher-Masoch's Venus In Furs.  Deleuze instead argues that the tendency toward masochism is based on desire brought on from the delay of gratification.  Taken to its extreme, an infinite delay, this is manifested as perpetual coldness.  The masochist derives pleasure from, as Deleuze puts it, The Contract: the process by which he can control another individual and turn the individual into someone cold and callous.  The Sadist, in contrast, derives pleasure from The Law: the unavoidable power that places one person below another.  The sadist attempts to destroy the ego in an effort to unify the id and super-ego, in effect gratifying the most base desires the sadist can express while ignoring or completely suppressing the will of the ego, or of the conscience.  Thus, Deleuze attempts to argue that Masochism and Sadism arise from such different impulses that the combination of the two terms is meaningless and misleading.  The perceived sadistic capabilities of masochists are treated by Deleuze as reactions to masochism.  Indeed, in the epilogue of Venus In Furs, the character of Severin has become bitter from his experiment in masochism, and advocates instead the domination of women.
Before Deleuze, however, Sartre had presented his own theory of sadism and masochism, at which Deleuze's deconstructive attack, which took away the symmetry of the two roles, was probably directed.  Because the pleasure or power in looking at the victim figures prominently in sadism and masochism, Sartre was able to link these phenomena to his famous philosophy of the Look of the Other.  Sartre argued that masochism is an attempt by the For-itself (consciousness) to reduce itself to nothing, becoming an object that is drowned out by the "abyss of the Other's subjectivity"   By this Sartre means that, given that the For-itself desires to attain a point of view in which it is both subject and object, one possible strategy is to gather and intensify every feeling and posture in which the self appears as an object to be rejected, tested, and humiliated; and in this way the For-itself strives toward a point of view in which there is only one subjectivity in the relationship, which would be both that of the abuser and the abused.  Conversely, of course, Sartre held sadism to be the effort to annihilate the subjectivity of the victim.  That would mean that the sadist, who is exhilarated in the emotional distress of the victim, is such because he or she also seeks to assume a subjectivity which would take a point of view on the victim, and on itself, as both subject and object.
This argument may appear stronger if it is somehow understood that the Look of the Other is either only an aspect of the other faculties of desire, or somehow its primary faculty.  It does not account for the turn that Deleuze took for his own philosophy of these matters, but this premise of desire-as-Look is associated with the view always attacked by Deleuze, in what he regarded as the essential error of "desire as lack," and which he identified in the philosophical temperament of Plato, Socrates, and Lacan.  For Deleuze, insofar as desire is a lack it is reducible to the Look.
Finally, after Deleuze, Rene Girard included his  account of sado-masochism in Things Hidden Since the Foundation of The World, originally Des choses cachees depuis la fondation du monde, 1978, making the chapter on masochism a coherent part of his theory of mimetic desire.  In this view of sado-masochism, the violence of the practices are an expression of a peripheral rivalry that has developed around the actual love-object.  There is clearly a similarity to Deleuze, since both in the violence surrounding the memory of mimetic crisis and its avoidance, and in the resistance to affection that is focussed on by Deleuze, there is an understanding of the value of the love object in terms of the processes of its valuation, acquisition and the test it imposes on the suitor.
Many theorists, particularly feminist theories, have suggested that sadomasochism is an inherent part of modern Western culture. According to theirTemplate:Who theories, sex and relationships are both consistently taught to be formulated within a framework of male dominance and female submission. Some of them further link this hypothesized framework to inequalities among gender, class, and race which remain a substantial part of society, despite the efforts of the civil rights movement and feminism.
There are a number of reasons commonly given for why a sadomasochist finds the practice of S&M enjoyable, and the answer is largely dependent on the individual. For some, taking on a role of compliance or helplessness offers a form of therapeutic escape; from the stresses of life, from responsibility, or from guilt. For others, being under the power of a strong, controlling presence may evoke the feelings of safety and protection associated with childhood. They likewise may derive satisfaction from earning the approval of that figure (see: Servitude (BDSM)). A sadist, on the other hand, may enjoy the feeling of power and authority that comes from playing the dominant role, or receive pleasure vicariously through the suffering of the masochist. It is poorly understood, though, what ultimately connects these emotional experiences to sexual gratification, or how that connection initially forms.  Dr. Joseph Merlino, author and psychiatry adviser to the New York Daily News, said in an interview that a sadomasochistic relationship, as long as it is consensual, is not a psychological problem:
It is usually agreed on by psychologists that experiences during early sexual development can have a profound effect on the character of sexuality later in life. Sadomasochistic desires, however, seem to form at a variety of ages. Some individuals report having had them before puberty, while others do not discover them until well into adulthood. According to one study, the majority of male sadomasochists (53%) developed their interest before the age of 15, while the majority of females (78%) developed their interest afterwards (Breslow, Evans, and Langley 1985).
With the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994 new criteria of diagnosis were available describing Sadomasochism clearly not as disorders of sexual preferences. They are now not regarded as illnesses in and of themselves. The DSM-IV asserts that "The fantasies, sexual urges, or behaviors" must "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning" in order for sexual sadism or masochism to be considered a disorder. 
The manuals' latest edition (DSM-IV-TR) requires that the activity must be the sole means of sexual gratification for a period of six (6) months, and either cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning" or involve a violation of consent to be diagnosed as a paraphilia.
Overlays of sexual preference disorders and the practice of Sadomasochism practices can occur, however.
without consent, its attempted murder/rape.

# Differential Diagnosis
- Antisocial personality disorder
- Hypersexuality
- Alcohol abuse and substance abuse
- Transvestic fetishism

# Diagnostic Criteria

## DSM-V Diagnostic Criteria for Sexual Sadism Disorder

## DSM-V Diagnostic Criteria for Sexual Masochism Disorder 

# Real Life
The term BDSM describes the activities between consenting partners that contain sadistic and masochistic elements. Many behaviors such as erotic spanking, tickling and love-bites that many people think of only as "rough" sex also contain elements of sado-masochism. Note the issue of legal consent may not be accepted as a defense to criminal charges in some jurisdictions, and very few jurisdictions will permit consent as a defense to serious bodily injury.
In certain extreme cases, sadism and masochism can include fantasies, sexual urges or behavior that cause significant distress or impairment in social, occupational, or other important areas of functioning, to the point that they can be considered part of a mental disorder.  However, this is an uncommon case, and psychiatrists are now moving towards regarding sadism and masochism not as  disorders in and of themselves, but only as disorders when associated with other problems such as a personality disorder.
"Sadism" and "masochism," in the context of consensual sexual activities, are not strictly accurate terms, at least by the psychological definitions.  "Sadism" in absolute terms refers to someone whose pleasure in causing pain does not depend on the consent of the "victim."  Indeed, a lack of consent may be a requisite part of the experience for a true sadist.  Similarly, the masochist in consensual BDSM is someone who enjoys sexual fantasies or urges for being beaten, humiliated, bound, tortured, or otherwise made to suffer, either as an enhancement to or a substitute for sexual pleasure, usually according to a certain scripted and mutually agreed upon "scene."  These "masochists" do not usually enjoy pain in other scenarios, such as accidental injury, medical procedures, and so on.
An example is the Roman Catholic practice of flagellation.
Similarly, the exchange of power in S&M may not be along the expected lines.  While it might be assumed that the "top"the person who gives the sensation or causes the humiliationis the one with the power, the actual power may lie with the "bottom," who typically creates the script, or at least sets the boundaries, by which the S&M practitioners play.  Ernulf and Innala (1995) observed discussions among individuals with such interests, one of whom described the goal of hyperdominants (p. 644):

# Fiction
Many of Marquis de Sade's books, including Justine (1791), Juliette (1797) and  The 120 Days of Sodom (published posthumously in 1905), are written from a cruelly sadistic viewpoint. Leopold von Sacher-Masoch's novel Venus in Furs (1870) is essentially one long masochistic fantasy, where the male principal character encourages his mistress to mistreat him.
In Pauline Reage's novel Story of O (1954), the female principal character is kept in a chateau and educated by a group of men using a wide range of BDSM techniques. "O"'s submission is depicted as consensual. A particular revelation of the story is that it is possible to gain power over someone as their victim.
As with many sexual interests, sadomasochism is a popular subject in erotica. While S&M erotica is often about consensual humiliation and power exchange, consent is often abandoned as serves fantasy. The contemporary novelist Anne Rice, best known for Interview with the Vampire, wrote the sadomasochistic trilogy The Claiming of Sleeping Beauty (1983-85) and Exit to Eden (1985) under the pseudonym of A. N. Roquelaure.
In Steven Shainberg's film Secretary (2002), the two leading characters fall in love with each other due to their dependence on one another as their sadomasochistic releases.