Sadism

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KEY POINTS

• Sadism is a sexual disorder. If you have this disorder, you are sexually excited by causing physical, mental, or emotional pain or suffering to another person. You may enjoy whipping, beating, shocking, or cutting your victim. Other acts involve being controlling, such as making your partner crawl or keeping your partner in a cage. Verbal abuse is common.
• Sadism may involve brutal rape, torture, or death of the victim in order to reach sexual excitement. Many sadists do not get help until they are arrested and the court orders treatment. Both therapy and medicines may be used to treat this disorder.

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What is sadism?

Sadism is a sexual disorder. If you have this disorder, you are sexually excited by causing physical, mental, or emotional pain or suffering to another person. You may enjoy whipping, beating, shocking, or cutting your victim. Other acts involve being controlling, such as making your partner crawl or keeping your partner in a cage. Verbal abuse is common.

Sadism can range from humiliating but not physically harming a willing partner to brutal rape, torture, or death of the victim.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Problems in your family when you were growing up may increase your risk. For example, child abuse, lots of conflict in the family, or a family history of mental illness.

Sexual sadism is more common in males. Sadism usually begins in the teen years or by early adulthood. It may start with sadistic play or fantasies in childhood.

What are the symptoms?

Symptoms may include:

• Being sexually aroused by causing pain or shame to your partner. Your sexual excitement may increase the more you make your partner suffer.
• Having fantasies, urges, or actions that upset you and cause serious problems in school, on the job, or in relationships.

How is it diagnosed?

Your healthcare provider will ask about your relationships, family history of any medical and mental problems, and any substance abuse. He will also ask about your symptoms and medical history and examine you. You may be referred to a mental health therapist for treatment.

How is it treated?

Many sadists do not get help until they are arrested and the court orders treatment. If you have sadism, get help before it becomes an even bigger problem.

Both therapy and medicines may be used to treat this disorder. Several types of therapy may help.

• Behavior therapy helps you recognize that the way you act affects others. This can help you change problem behaviors.
• Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.
• Conditioning therapy helps you learn to link thoughts and actions related to your sexual disorder with something negative, such as a foul odor or an image of getting caught. Over time, the negative thoughts help you to not act on your sexual thoughts.

Medicines may include hormones or medicines to correct the balance of chemicals in your brain. Both kinds of medicine help reduce sexual urges.

How can I take care of myself?

• Get support. Consider joining a support group in your area. Twelve-step sexual recovery programs can help. You can learn from others who have similar problems.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, try to quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or plans to do something that could cause a serious injury or death, such as using knives or suffocation during sex.

For more information, contact:

• National Alliance on Mental Illness (NAMI)
  800-950-NAMI
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net