Sexual Sadism and Masochism
Bethany Lohr and Henry E. Adams
A thirty-five-year-old married writer entered into therapy because of distressing impulses of a sadistic nature. He has been married for fifteen years and has sex with his wife about once a week. The individual's fantasy life is predominantly heterosexual, although he has felt sexually attracted to males since childhood, but resisted acting on these impulses until mid-adulthood Before that, he felt sexually aroused by homosexual pornography, particularly that with sadistic content. Although also aroused by sexually explicit videos of heterosexual interactions, he was never excited by heterosexual activity with sadistic content.
The patient married in hopes of diminishing his homosexual sadistic fantasies, but his sadistic impulses continued, and fantasies during masturbation were of binding and whipping another man. About eight years ago, the patient went to a gay bar with an associate from his office who was aggressive, demanding, and openly homosexual. The associate indicated that the bar was often frequented by "the leather crowd who like S&M." The patient had a brief homosexual encounter with someone he picked up in the bar in hopes of satisfying and squelching his sadistic impulses. Several weeks later, the patient could not resist going back to the S&M bar; his sadistic urges had escalated At the bar, he met a man who was sexually aroused by being beaten, and the patient engaged in pleas-