Trauma psychotherapy with people involved in BDSM/kink: Five common misconceptions and five essential clinical skills

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Y. Gavriel Ansara, PhD Psychol, MSc Soc Psychol, MCouns, BA Intl & Cross-Cultural Health with African Studies, Dip Adv Clin Family Therapy, CCTP-II, CFTP, Ansara Psychotherapy & Imanadari Counselling Melbourne Branch. 



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.


Keywords: bdsm, kink, trauma, dominant, submissive, switch


Address for correspondence:
Y. Gavriel Ansara



The author thanks PACJA Editor Rhys Price-Robertson, Gene Melzack, Tucker Lieberman, and two anonymous peer reviewers for their editorial feedback. The author also thanks the many people involved in BDSM/kink who have shared the lived experiences and insights on which this paper is based. Portions of this paper have been presented in oral presentation form at: the Psychotherapy and Counselling Federation of Australia (PACFA) 2019 annual conference on Working with Trauma in Ultimo, New South Wales, on February 24, 2019; an Australian Psychological Society (APS) Professional Development training day in Melbourne, Victoria, on June 30, 2019; and, an oral presentation for the Australian College of Applied Psychology (ACAP) in Sydney, New South Wales, on July 11, 2019.