Imagine finally working up the courage to see a therapist about something that’s bothering you, mentioning in passing that you’re into BDSM, and watching the conversation swerve entirely onto your sex life. For many kinky people, that’s not imaginary. It’s why kink-aware therapy matters.
What the research says
In 2006, Keely Kolmes, Wendy Stock and Charles Moser surveyed people who practise BDSM about their experiences of therapy. Many described biased or inadequate care: therapists who assumed kink was a sign of past abuse or mental illness, who treated it as the problem when it wasn’t why the client had come, or who needed educating about the basics. The authors used these accounts to set out guidelines for kink-aware practice.
The evidence also challenges the idea that kink is inherently unhealthy. A Dutch study by Andreas Wismeijer and Marcel van Assen (2013) compared over 900 BDSM practitioners with a control group. The BDSM group were, on average, less neurotic, more extraverted and more open to experience, were more securely attached, and reported higher subjective wellbeing.
Diagnostic manuals have shifted too. The DSM-5 distinguishes between having unusual sexual interests (a paraphilia) and having a disorder, which requires distress, impairment or harm to others. The ICD-11 goes further, focusing paraphilic disorders on non-consenting others or significant distress or risk, meaning consensual kink between adults is not a disorder.
A grain of glitter ✨
The Wismeijer and van Assen study recruited through BDSM websites, so participants may have been especially comfortable with their identity, and the study can’t tell us about cause and effect. The Kolmes study captured experiences rather than measuring how common bias is. Our own earlier post (“Kink, Attachment and the Past: Untangling a Tricky Question”) shows that the relationship between kink and past experiences is complex. Kink-aware therapy isn’t about assuming everything is fine; it’s about not assuming anything.
What kink-aware therapy looks like
- Your therapist knows the basics (consent frameworks, negotiation, aftercare) so you don’t have to teach them.
- They focus on what you want help with, which may have nothing to do with kink.
- They can tell the difference between consensual play and abuse.
- They’re curious without being voyeuristic.
See also “Three Hours to Kink-Aware?” for what training can (and can’t) achieve.
Every unicorn deserves a stable where its tack doesn’t raise eyebrows.
Further reading
- Kolmes, K., Stock, W. & Moser, C. (2006). Investigating bias in psychotherapy with BDSM clients. Journal of Homosexuality
- Wismeijer, A. A. J. & van Assen, M. A. L. M. (2013). Psychological characteristics of BDSM practitioners. The Journal of Sexual Medicine
- World Health Organization, ICD-11: paraphilic disorders