La contrainte consentie : après le DSM-5, quelle thérapie BDSM ?

Abstract

ObjectiveBDSM is a nested acronym referring to practices of bondage and discipline, domination and submission, sadism and masochism. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the American Psychiatric Association despite its clinical justification, has depathologized “kinky sex — including cross-dressing, fetishes and BDSM. Paraphilias are now considered as “unusual sexual interests”. MethodSeveral psycho-sexological studies, which we analyze here, use sadomasochistic practices known as BDSM (Bondage, Domination, Sadomasochism) as psychic case studies, no longer as deviant behaviors, but on the contrary as “common” behaviors because they are adopted by a large number of individuals. These individuals use contracted consent in a specific context, with potential in a therapeutic context. ResultRather than considering these practices as a perversion, current studies on BDSM and the psychology of subsexualities have turned the analysis of deviance into a scientific study of the effects of BDSM practices, particularly their benefits on mood, stress or depression. DiscussionThe BDSM and Therapy project is also concerned with managing the possible risks of BDSM play and clarifying borderline situations where BDSM play is neither healthy nor useful. Does BDSM therapy aim to regulate practices and calibrate them? Members of the BDSM community have made the following points: Social barriers can develop between individuals and other followers; Alienation and isolation by way of stigmatisation, producing internalized negative stereotypes; The risk of extending boundaries too far in a scene; The potential for dehumanization and destruction in BDSM (unsafe situations). ConclusionBDSM therapy, both in clinical and in community practice, is based on consent. BDSM can provide a psychotherapy for the submissive subject, and also for the dominant character. BDSM, by way of the constraint involved, could alter the meaning of bodily suffering. BDSM does not always involve pain (it is for instance fluctuating in bondage or mental domination practices, and the sexual dimension varies considerably, and may be non-genital or even absent). In order to function, the BDSM therapeutic process requires at least three conditions: (1) the BDSM relationship involves a volunteering dominant and dominated; (2) this erotic pair acts in a strictly codified setting; (3) the dominant is “therapeutic” in that he/she shows empathy for the dominated.