“Beyond the Fifty Shades…”: Intersections of Sadomasochism and Sexual Torture

Tale of Torture:  The Premise

Torture has been an evolutionary human tool. Throughout history, philosophies, and mythologies, rulers, judges, and holy men have propagated or revoked practices of torture. Although mostly physical, targeted at inflicting bodily distress or discomfort, torture can be passive, emotional, psychological, or financial, all carrying the same aim: to perpetuate distress and pain in the individual. It has been mostly used as means of punishment or to extract valuable sources of information from the resources; however, also in intimidation, oppression, othering, and discrimination of the vulnerable for political, religious, social, or personal purposes. Psychologically, torture serves the narcissistic need of superiority and helps in denial of the perceived weakness and flaws of an individual, striving to prove one’s viewpoint as the most perfect one. ¹

Based on social attribution and learning theories, torture or infliction of bodily pain/distress can be a highly learnt behavior, one that can be easily modeled. The classical “frustration-aggression hypothesis” states that any form of emotional distress or frustration leads to a psychological void and a “need to respond by blocking it.” ² This need leads to aggression and violence; torture being one of its manifestations. Besides being considered to be an offence if performed beyond the legal purview, various forms of tortures also have pervaded our daily lives through intimate partner violence and sexual deviant actions (in their extreme form). Although the genesis of these 2 is conceptually different, the “grey lines” are often blurred when a consensual act of sexual deviation involving hierarchical force channels into aggression and eventually into domestic violence. The perceptions of these acts and the expression as well as intent of both the partners are equally important in both the medico-legal and psychological understanding of these terms. It is vital to understand here that repeated patterns of aggression or torture between 2 individuals often form the defining feature of their relationship, which is damaging for both the morality and psyche of the victim and the perpetrator. ³ Considering various sexual deviations such as sadism, masochism, and autoeroticism involve “aggression” in various forms, the intersections between sexuality and torture are prominent and nuanced, yet debatable. The dynamics differ from a consensual act of bondage, discipline, sadism, masochism to the graver fetishes of necrophilia and finally the heinous acts of “sex criminality.” Theories of criminology posit that “sexual sadists and killers” have a young-onset pattern of linking sexuality and torture for their own gratification or masking of their inferiority. ⁴ The types, intensities, and frequencies of the sexually aggressive acts vary over time based on the personality traits and environment. However, contrary to the popular belief, a sexually violent person is not always born. Turn of events and context of trauma are often the important factors that cause the transition from “timid to torturous” behavior. A large body of research is dedicated to what leads to an apparently timid person to take up “tortures” as an adaptive act in his or her daily life, including relationship with his or her partner. The understanding is still evolving. Keeping this in the background, this editorial will highlight these subtle intersections between certain sexual practices and torture.

Sexual Torture and Aggression: Beyond the “Obvious”

Literature has traditionally attempted to understand, theorize, categorize, and conceptualize the acts, forms, and rationale behind sexual violence. Mostly considered as an act that stems from love, affection, attraction, and reproductive needs, sexual activity also forms a “channel” for aggression, domination, and anger dyscontrol. Experts have suggested that certain or all forms of sexual violence be considered as “torture.”^5,6 Although in sociopolitical contexts, torture has been labeled as “legitimate” in some cases, sexual violence in any form, with or without consent, has serious psychosocial consequences on the victim and cannot be medically or psychologically justified. However, throughout history, during wars, conflicts, and invasions, “sexual torture” has been extensively documented as being inflicted on prisoners, especially the vulnerable groups based on age, gender, and social class, as a display of “power, dominance, and hierarchy.” This has been at times compared to the postwar rampage and vandalism, as both arise out of the “narcissistic need for establishing superiority” or to view in the other way as a “repression of an inferiority complex.” ⁷

Now, what constitutes torture? It is generally considered to be “bad or evil.” Stone ⁸ considers torture as an intentional and methodical infliction of considerable suffering on a person or a group of persons. As per its literary meaning, torture is defined as the infliction of severe pain, physical or psychological, especially as means of punishment, revenge, conflict, coercion, anguish, anger, or sheer cruelty. ⁹ The subjective and destructive nature of torture can vary widely; however, irrespective of the type, “hierarchical power” acts as the driving motivation of torture and “powerlessness and despair” are its consequences. ⁹ Sexual sadism is considered to be an “extreme form” of the same, when underlying sexual arousal results from infliction of pain, humiliation, or torture on the other person. ⁸ Power and the need to control are the main constructs as per the “master-slave” relational theory that explains the dynamics of dominance and submission. While, as mentioned before, the experience can be pleasurable and satisfying to both the partners, transitions from “sexual fantasy” to “violence” are not uncommon and can impair the quality of life and relationships. ¹⁰ Besides physical infliction of pain and suffering, various other terms such as “tame, taunt, and torment” have been used in increasing order of severity, ranging from nonthreatening demand of obedience to sarcastic and provocative humiliation, and finally, the true infliction of suffering. ¹¹ Manifested by a variety of behaviors, torture is often reinforced by one of the partner’s “silence” irrespective of the discomfort, which wrongly implies to “consent and agreement,” thereby perpetuating the vicious cycle. The concepts of “will” and “consent” are as usual vital, but even if present cannot be considered as permanent and absolute in all sexual interactions. Studies have also shown that male gender, dominant attitudinal patterns, substance abuse, maladaptive coping styles, Cluster-B personality traits or disorders, and history of childhood abuse can increase “sexual aggression” among partners which has an increased risk of “pushing off limits” during sexual encounters. ¹² Eventually, the habit of exercising authority is contagious and depends on power, position, and context in any subsystem, family, or society. The famous Stanford Prison experiment showed how readily young students can be conditioned to become torturous and abusive, based on the “power position” allocated to them. ¹³

Similarly, one of the psychological explanation of sexual sadism is the “violent synergism” that gets accumulated over the varied torturous types of behavioral interactions, activating a psychosocial power struggle between conscious and unconscious minds of both the partners, analogous to that between a psychopath and his/her victim. ¹¹ This further gets reinforced by the immediate gratification of “gaining control over someone,” and the feeling of “perceived omniscience.” Self-satisfaction, relationship dynamics, sexual role plays, and fetishes, gender roles and identities, societal expectations, personality traits, and elements of intimacy between individuals can be important modifying factors.

Understanding the Psychosexual Correlations

Let us now come to one of the fundamental questions: Why would anyone experience pain, suffering, humiliation, and loss of control as sexually arousing which might be a fodder for the other partner to “dominate”? After all, these go against the principles of “self-concept and self-esteem,” which are integral to one’s identity. Various schools of thought mention sadomasochism in couples to be complementary versus sexual experimentation or exploration, often initiated during foreplay through subtle cues. ¹⁴ Richard Von Krafft Ebing, known as the Father of Modern Sexology, first described “masochism and sadism” in the late 1800s to denote “pathologically deviant” sexual behavior. The popular criticism holds that all nonreproductive sexual interactions were allegedly “pathologized” by him. Originating from writers Von-Sacher-Masoch (Book: Venus in Furs) and Marquis de Sade (Book: The Misfortune of Virtue), respectively, masochism and sadism emerged as 2 complementary yet unique aspects of sexuality where “activity” and “passivity” can be alternated between the partners. ¹⁴ Sadomasochism has had its psychoanalytic share of explanation representing “undoing castration threat” to “moral masochism” (unconscious desire of punishment), which can be an offshoot of disturbed interpersonal relationships and attachments. ¹⁵ Originally used as separate terms by Krafft Ebing, Freud combined them using “sadomasochism” in Three Essays on the Theory of Sexuality (1905), where he explained sadism as the “distortion of aggressive component of the male sexual instinct” and masochism as a “form of sadism directed against the self”. ¹⁶ The common flaw in many such explanations has been equating such sexual fetishes to “perversions,” consideration of masochism as a “normal and natural inclination for women,” and scant discourse on the genesis of sadomasochism in women and other genders. Although a detailed discussion of the theories of sadomasochism is beyond the scope of this article, it is important to understand that “sexual sadism or masochism” within the context of mutual consent is not a diagnosable clinical condition (paraphilia), and needs to be distinguished from the nonconsensual acts of sexual assault, violence, and aggression. The “grey boundaries” however can be blurred when the mutual understanding of the partners is compromised leading to psychological and legal issues.

Havelock Ellis mentioned unclear divide between “sadists” and “masochists” and linked them to eroticism, challenging the historical link with abuse and torture. ¹⁷ Baumeister reported “sexual masochism” neither to be self-defeating nor self-destructive, but rather highly contextualized. ¹⁸ Multiple population-based surveys have shown widespread prevalence of masochistic tendencies in both the genders, which do not cause impairment in daily functioning. ¹⁹ Psychiatry has traditionally struggled between the dimensional and categorical understanding of psychopathology, and Diagnostic and Statistical Manual (DSM)-5 differentiates “masochistic sexual interest” from “sexual masochism disorders” based on “reported psychosocial difficulties.” However, these “perceived difficulties” can also be ambiguous based on sociocultural connotations of sexuality and sexual beliefs, and often under-reported. ²⁰ This can either lead to propagation of sexual violence on the one hand and pathologizing “consensual sexual masochism” on the other. Masochism has been proposed to be an “ideal act of fulfillment that is self-serving” to simulate a “potentially threatening situation,” thereby increasing the emotional closeness with the “controlling” partner. Role reversal is common and does not necessarily depend on the gender. ²¹ Love, intimacy, and seduction in general mostly involve both the elements of domination and submission, and to pathologize it as “sexual deviant disorder” is unjust. However, the concept itself being of paradoxical nature, what starts as a sexual experimentation for both may transit to “sexual aggression” for one, if certain individual limits are pushed too far, irrespective of consent. Societal expectations, institutions of marriage and inherent need for “submission and satisfying” the partner might further perpetuate aggressive sexual practices, if coercive.

Ranging from Freudian “unconscious or repressed” sexual behavior to the social attribution, behavioral, and humanistic schools of contemporary psychology, the psychosexual intersections between sex, violence, and torture have always been debated. The various possible intersections between sex and violence (or self-torture) discussed in the literature (along with the spectrum from healthy practice to harmful implications) are as follows:^10-12,22,23

Masturbation (widely prevalent form of self-stimulation that can in some cases be addictive and compulsive masturbatory practices)

Sexual asphyxiation/autoeroticism (self-arousing desire of psychological gratification that also contains elements of risk taking, impulsivity, abuse, torture, helplessness, and narcissism. In extreme forms can be violent and dangerous)

Sexual bondage (part of sadomasochism: “soft” forms to “hard-core and extreme” forms of bondage, discipline, sadism, masochism to simulate helplessness and humiliation)

Sadomasochism (sex-aggression fusion; can have various forms and extent)

Contribution of pornography (inconclusive evidence related to its influence on rape, domestic violence, sexual dysfunction, marital disharmony, and child sexual abuse)

Sexual aggression/coercion (sexual interactions that can range from healthy coercive practices to sexual assault, marital rape, and intimate partner violence)

The practice of pornography needs a special mention here. It refers to the portrayal of sexual subject matter for the exclusive purpose of sexual arousal (literature, animation, or videos). There is contradictory literature to link pornography with sexual violence. General population surveys of consumers have reported increased sex crimes in the population. ²⁴ A meta-analysis by Hald et al ²⁵ showed significant association between pornographic use and violent attitudes toward women. Whether pornography creates gender-based stereotypes is debatable; however, it has been proven to affect understanding and ideas about sexuality. Sexual knowledge, attitudes toward the opposite sex, quality of sex life, and perceived sexual satisfaction were reported to be enhanced as self-perceived effects in a study done on young adults in Denmark. ²⁶ Math et al ²⁷ had studied the association between reported the incidence of sexual crimes over 4 decades in India and the availability of online pornography with a special focus on violence against women. Although there were statistically significant correlations between the number of internet users and the crime rate, the growth in the rape rates was not significant. The authors advocated for further longitudinal research to explore the effect of pornography on sexual aggression and cautioned against the interpretation of such studies to have a definitive evidence, as stigma and under-reporting of sexual crimes in many countries is a norm, rather than exception. Although it is obvious that pornography does not have a homogenous effect on the target population across ages and cultures, the depiction of specific violence, bondage, sadomasochism, and torture in its extreme forms (including necrophilia) has been shown to affect the sexual attitudes and practices of individuals, possibly increasing “ violent practices” and rape-myths in those at risk. ²⁸ Beyond the theoretical debate, pornography in any form has the potential to trigger the “grey area” crossing the paths between sexuality and violence.

Treading a “Slippery Slope”

Sexuality is a basic need for human survival and procreation and has multidimensional facets. Manifestations of love, affection, and passion through sexual practices can be socioculturally polymorphic, with no strict “right or wrong.” Many of them involve aggression and “imaginative foreplays” that can range from benign fantasies to physically and emotionally inflicted sufferings. Sexuality itself being a tabooed subject, perceptions related to “sexual torture” have only been studied in limited nations and groups. Knowledge-attitude-practice related to various angles of sexuality also tend to affect understanding and appreciation of the “red flags” demarcating violence from mutually enjoyable consensual sadomasochism: individual comfort, dignity, mutual respect, and psychosocial dysfunction being the most vital parameters of assessment. The acts of sexual torture can escalate from mere disciplining to those of cruelty and having legal, physiological, and psychosocial implications for both the victim and the perpetrator. Sexual torture can also be a potential trigger and risk factor for marital discord, extramarital relationships, depression, anxiety disorders, chronic posttraumatic stress, and sexual abuse, and finally, some of these can heighten the suicidal risk in vulnerable individuals, in the absence of social support and understanding.^3,6,8 With the rise in intimate partner violence behind “closed doors,” the role of mental health professionals will be paramount to discern “dysfunction” from the “usual” along the spectrum of normalcy. This can be achieved by understanding the sociocultural variations in sexuality and the individualistic contexts in couple dynamics, exploring the sexual myths, and finally estimating the effect of media, society, and pornography on the sexual relationship. Understanding the use, form, and context of “aggression” in sex and the perceptions of both the partners involved is important, rather than a blunt medicalization of any sexual deviation merely as a “disorder.” Couple dynamics, gender orientation, sexual relationship, contexts of sexual violence, emotional aftermath, mutual reactions to the event of “force,” personality traits, substance use, and presence of the preexisting psychiatric disorders are essential components of psychosexual history while exploring sexual violence in a couple. Standard guidelines exist for the assessment of the same. ²⁹ Irrespective of its form, sexual torture is damaging, contagious, and self-propagating. An unwilling “agreement” between partners simply for the societal preservation of relationship, the taboo of reporting, stigma, and the shame related to discussion of “intimacy” with a third person are often the main factors of sexual violence that create a “psychological justification” for both partners involved. ¹¹ This creates a never-ending “vicious cycle” of unhealthy practice “beyond the limits of tolerance.” The author would like to stress on the fact that we are not talking about an overt rape or sexual assault here, which is obviously an offence, but a spectrum of sexually aggressive and fantasized behaviors which were once mutually agreed upon, but can eventually turn into more than “what was expected.” Encouraging partners to disclose their “comfort zone” and to reveal sexual violence is extremely important, without the fear of legal hassles and policies. What constitutes these “limits” can be highly heterogeneous and individualized, but this multifaceted interlocking of sexuality and violence forms a “slippery slope” for both the care-providers and the service-users, which necessitates research, scientific discourse, sensitivity, and conceptualization of the “healthy-unhealthy distinction” rather than just “categorizing or pathologizing” certain variations of sexuality.