Trauma Psychotherapy With People Involved in BDSM/kink: Five Common Misconceptions and Five Essential Clinical Skills

Abstract

Psychotherapists’ negative misconceptions about people involved or interested in BDSM/kink can result in unethical clinical practices and ineffective or harmful therapeutic outcomes. Five of psychotherapists’ common misconceptions about BDSM/kink are: that BDSM/kink relationships constitute a fringe relational style or “alternative lifestyle,” that BDSM/kink is inherently abusive and causes trauma, that involvement in BDSM/kink is caused by past trauma, that BDSM/kink relationships are inferior to or less meaningful than non-BDSM/kink relationships, and that BDSM/kink is not clinically relevant or appropriate to discuss in trauma therapy. This article challenges these five common misconceptions, discusses relevant research findings, and explains five of the essential clinical skills for trauma psychotherapists working with people interested or involved in BDSM/kink relationships and practices: understanding and identifying BDSM/kink relational roles and headspaces, distinguishing BDSM/kink from abuse, understanding and identifying key components of non-abusive BDSM/kink, determining the clinical salience of BDSM/kink, and identifying and managing freefall.