Broadly
by Alice Sanders
Finding a therapist can be a major problem for anyone who’s into BDSM or fetish. The most recent version of the Diagnostic and Statistical Manual of Mental Disorders, updated in 2013, is the first version in the 62-year history of psychiatry’s diagnostic bible that does not classify BDSM as a marker of mental illness. But surveys show that far more people are into kink than commonly assumed: A 2008 survey from Durex found that 36 percent of people in the US deploy masks, blindfolds, and bondage tools as part of their sexual repertoire.
Kinky people need therapy to deal with the stresses of life just as much as their vanilla peers, but they can run into problems when trying to find a therapist who knows the difference between a dungeon monitor and a domme. Demand for kink-identified therapists has led to websites like LGBTQ-oriented Pink Therapy in the UK and the National Coalition for Sexual Freedom in the US. On the NCSF website, therapists are divided into three classifications: kink friendly, kink-aware, and kink-knowledgeable.
“By stating that you work with kinky clients you’re raising the possibility that you’re also kinky,” says Joanna*, an integrative therapist working in London. “Some clients will make that assumption, especially if you have a high level of kink knowledge.” She goes on to say that she’s comfortable outing herself as a BDSM practictioner to a client if they have explicitly told her that they are part of the community.
There are good reasons to do this. Clients often come to her having already had a bad experience with a therapist who lacked BDSM understanding. Katie*, a psychodynamic therapist also working in London, tells me that she sees one kinky couple who have been through four previous professionals. “I believe they’ve been treated poorly by the therapists they’ve approached.”
More than just a simple lack of knowledge of kink, vanilla therapists can sometimes bring their own negative preconceptions of BDSM to sessions. It’s something both Joanna’s clients and friends have had to deal with in the past. “Therapists have suggested that kink is externalized self-harm; that’s it’s problematic playing with power, that it’s a form of unhealthy risk taking.” She explains that some keep bringing up kink as symptomatic of a deeper mental health issue, but kink-positive therapy means that “clients can reveal this information in passing, and it’s accepted as a normal healthy part of their relationship.”
Kink can sometimes involve behaviors that someone not in the scene may struggle to wrap their head around (toenail fetishes, anyone?) and clients often don’t want to waste time educating a kinky therapist on the terminology and dynamics of the scene. When a shrink come out as kinky, it’s not just to assure their clients that they won’t have a bad experience in therapy, but to show they can have a positive one.
“There’s often an assumption that BDSM-ers are attempting to re-enact childhood abuse, whereas no studies have ever found any correlation,” Joanna explains of non-kinky therapists. With those who do incorporate S&M into their personal lives, however, “there’s a better understanding of the differences between consensual kink and an abusive dynamic, which may be more difficult for therapists who aren’t kinky themselves.” In fact, a recent Northern Illinois University study showed that those who participated in BDSM are far more likely to understand key issues of consent.
But identifying yourself as a kinky professional can come with its challenges, too. Therapist and client will usually have zero relationship outside of the therapeutic space, but that isn’t possible in places with small kink scenes. It brings with it the risk that the client will learn personal details about a therapist. Katie suggests that any extra information revealed to a client can tamper with the therapeutic process. “You can get into a bit of a problem if a client is able to glean so much information they can say, ‘That person is like me, that’s why I’m going to them.'”
Therapy relies on the client being able to create their own reality around the ‘blank screen’ of the therapist—the fears and emotions that a client projects onto their shrink can be very useful as insights to work with—and real information about a therapist can ruin the process. It might be harder for a client to open up if they know that they shop for spanking paddles at the same leather hardware store. As Kate puts it: “There’s a reason it’s easier to pick up the phone and call the Samaritans than a member of your family.” …