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Shrinks Who Kink: When You and Your Therapist Love BDSM

For kinky people, finding a shrink who knows the difference between ball gags and cock and ball torture can be a godsend.

by Alice Sanders
May 23 2016, 2:00pm

Illustration by Eleanor Doughty

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."

Read More: What Happens When a BDSM Author Converts to Christianity

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."

A recent study showed that those into BDSM are more likely to understand issues of consent. Photo by Juan Moyano via Stocksy

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."

Therapist and client might never run into each other outside the therapeutic space—but that doesn't happen if both are into BDSM. Photo via Wikimedia Commons

But Joanna calls into question the concept that the therapist is ever really a 'blank screen.' "I don't try to conceal the fact I'm kinky, and similarly I don't conceal that I'm queer. I want to model that I'm not ashamed rather than risking appearing complicit in the shame that marginalized people are often made to experience." There's an untrue assumption, she says, that presenting in a normative way is somehow 'blank.' "Why is it more acceptable to model that than a queer proud person?"

But perhaps the most important reason for a therapist to come out as kinky is the not-inconsiderable chance that therapist and client might end up at the same event and lock eyes over a whipping bench. Once Joanna has acknowledged that her and a client are both kinky, she will encourage them to tell her if they plan to attend a play party or fetish night. If it became clear that she and a client were planning to go to the same event, she is likely not to attend. The other option is to talk about it: "We may negotiate how it would work depending on the size of the event and what it was."

So what happens if a therapist crosses paths with their client at a fetish club? The usual professional policy for running into someone out of the therapeutic space is to only acknowledge them if they acknowledge you first. This prevents putting a client in a situation where they have to explain themselves if they don't want to. Katie thinks it doesn't have to be that different when it comes to kink, adding "but it brings in an element of something that at the moment I just feel quite uncomfortable about." That element, I'm guessing, is the awkwardness that might come from spotting your shrink in a dog collar—or vice versa.

But different people have different boundaries when it comes to seeing their clients at kink events. Joanna used to belong to a professional group of kinky therapists; much of their conversation centred on this problem, and everyone came to different conclusions. "Some therapists have policy statements of the way they deal with clients in kink communities and how they'll interact at the same events," she says, adding that no therapist would ever engage in play with a client.

For kinky therapists, there may even be the temptation to distance themselves from the kink community to avoid clients altogether. Joanna points out that this may be detrimental to both their social and professional lives: "What does that bring into the therapy session, if you've had to give up something that's really important to you? People need to coexist in small communities. It's not about the therapist having to sacrifice everything for their client." She suggests that it would be preferable, should the therapist choose to attend the event, to negotiate with the client to decide upon appropriate boundaries within the event space, and process how that was for the client during the following session.

Katie, on the other hand, feels the only way she can currently deal with the situation is to remove herself from the kink scene; she says she needs to withdraw until she feels a bit clearer about how to manage it. "I take the clinical responsibility I've got very seriously and I just don't want to fuck it up."

What is very clear is that both of these therapists have given a great deal of consideration to how to be out and proud as kinky, but still behave ethically and function with their clients in such a small community. In therapy as in kink, it's all about boundaries.

* Both names have been changed

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