Therapy and Behavioral Modification in BDSM

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Therapeutic Play

Therapeutic play refers to play that involves catharsis, healing, and other conscious choices by the partners to delve into or modify the bottom's behavior or feelings. The goal of therapy in BDSM is not to compete with, pretend to be, or supplant licensed therapists. It is instead an exploration of the fact that loving, caring partners often do help each other overcome trauma and challenges, and often do help each other strive for behavioral changes and improvements in their lives. The therapeutic model of BDSM has a long history and arises independently in many relationships.

Reinforcing Positive Self-Images and Insights into Oneself

For many people, the intensity of BDSM creates an environment of extremely intimate communication, connection, and trust between the partners. The experience of such intimacy alone is therapeutic for many people. Often therapeutic BDSM goes no further than that -- the reinforcement of the feeling that one is loved and is capable of love, no matter what one's flaws or previous experiences of life.

But some therapeutic BDSM goes further. For example, it is common for tops and doms to reassure bottoms and subs about their self-images and insecurities, or even to engineer play and aftercare to reinforce positive, beneficial self-views. A person without some inner doubts about his or her beauty, intelligence, competence, or desirability is rare. D/S offers a natural framework whereby the dom can sometimes offer the submissive reassurances and positive experiences bearing on all kinds of self-doubts.

Many people find that they happen on intriguing insights into themselves via play. The power of a caring relationship, the exploration of fantasies and new experiences, and the stress of intense scenes sometimes combine to give people moments of revelation or understanding of their inner selves. These insights usually come out gradually during aftercare and followup discussions, sometimes as long as months after a scene. Tops as well as bottoms find that intense play leads to surprising realizations that sometimes solve puzzles about themselves. For many people, these occasional insights into themselves and their partners, and the intimate discussions to which they lead, are an additional appeal of BDSM.

Behavioral Reform

Some kinds of therapeutic BDSM involve behavioral reform. Perhaps the bottom wants to effect an improvement in behavior or lifetime goals. Or perhaps the dom points out that a change in the bottom's behavior or attititudes would result in long-run benefits. For example, the bottom may wish to learn to focus more on work or set better priorities in life. A top or dom can help reinforce these goals by setting rewards and punishments to help induce these desired changes. Not all tops want to take on responsibility for major lifetime changes in their bottoms. Nevertheless, it is common for doms to want to improve their submissives in ways that are commensurate not only with immediate play concerns but also with their partner's lifetime opportunities.

Behavioral reform via BDSM is complex because punishment may in fact be a reward for many bottoms or submissives. Often, though, the dom's disappointment is a severe punishment in itself. Another complication of behavioral reform is that it is difficult to choose a feasible goal. In general, choosing clear, simple, attainable goals and working at one step at a time is more feasible than complex, long-term goals. Attentive repetitions of "Lose three pounds over the next two weeks" are more likely to be successful than "Lose 50 pounds over the next six months." Both positive and negative reinforcements matter, as well as the submissive's desire to achieve the goal.

Some methods used in accomplishing behavioral reform touch on conditioning, which is discussed in greater detail below.

Cathartic Experiences in Scene

Another frequent therapeutic application of BDSM occurs for bottoms who find that tears flow easily for them in scene. Such catharsis in scene is usually experienced as joyful and precious by the bottom. It can come as quite a surprise to the top, though, especially if the top has been causing an unusual amount of pain or emotional confusion. Sometimes before the tears flow, the bottom stops communicating or responding in a customary manner. Many tops stop scenes the first time they see tears to check in with the bottom. In my experience, though, the quiet flow of tears in scene is almost always consensual, cathartic, and a desired experience by the bottom. It is also surprising at first that the bottom usually cannot express why these tears came. There is no necessary reason; and it does not seem correlated with any negative experiences in the bottom's life. It may just be a relief from stress and the sudden feeling of the beauty of safety and love in the presence of one's partner.

A more dramatic but widely reported kind of catharsis sometimes occurs for those individuals who have experienced abuse in their lives. People who both do BDSM and were abused or raped as children (or adults) sometimes have an experience of enlightenment from playing consensually. The abuse they were subjected to was by definition not consensual, not something they could control, and not something they could get away from. By contrast, bottoming to a beloved under the circumstance of prior loving discussion and the top's clear concern and fear to violate consent is an enlightening from a burden of fear that may have been with the bottom for a lifetime. The simple gift of having safeword and the ability to stop the action -- and thus also the ability to choose to go on -- can be an act of joy, self-empowerment, and catharsis that changes someone's life.

Sometimes tops and bottoms agree to confront some fear or negative past experience head on by attacking it directly in scene. For example, someone subjected to rape at knifepoint may have put knives off limits in play, but may after a while wonder if the top's pulling out a knife, doing a rape scene, and doing exactly what the rapist did could be a form of self-help. Confrontational play of this sort is very unusual. Not only do most bottoms who have experienced such things not feel that they desire or would benefit from such direct confrontations, but many tops find they themselves cannot go through with anything so risky when it comes to their bottom's emotional states, even if the bottom is convinced it will turn out okay. But for others, it can be an appealing and potentially healing kind of play.

Experienced tops tend to talk a lot about their encounters with therapeutic play in one form or another. But one thing that does not get talked about enough in my opinion is whether playing intentionally in such a way and having it work out for the better (which in fact is often the case when intensely therapeutic play is done with lots of forethought and caring between the partners) does not also reward the bottom for reliving the horror. That is, the very act of creating a crisis that is resolved in scene via the reassurance and beneficence of the top's caring aid can be addictive. The risk of the bottom's wanting to remain dependent and continue to re-enact the catharsis of safety and love may be well worth taking for the potential benefit of ridding oneself of a lifetime of other horrible memories and fears. Maybe this kind of addiction is quite harmless for most people, a kind of fetish no different from any other fetish. But it is something that seems potentially worrisome that I have nevertheless not seen openly discussed. I do sometimes see people doing BDSM get wrapped up in what looks to me like living and reliving certain angers and affirmations. I do not pretend to have any guidelines, though, as to what might signal a potentially unhealthy version of such reliving.

Breaking in Scene

Breaking the bottom refers to the intentional, consensual subjection of the bottom to some horrifying fear, undesired memory, or terrible experience in scene to the point that the bottom completely loses self-control and any background realization that this is a scene with a caring partner. The term usually implies the top's violating (with prior consent) some limit the bottom has that is deeply fundamental to the bottom's core. However, sometimes people break down in scene unexpectedly if an activity cuts too close to the core.

Breaking is unquestionably life-modifying for people. No one gets broken and comes away from the experience unchanged.

Breaking someone in scene typically requires putting that person together again. Do you want a lifetime of responsibility for causing profound emotional disruption to someone in scene? The aftercare for breaking scenes can last a long time. Allocating a weekend and then following up with a few weeks of caring discussions might still not be enough. It is a good idea to talk about extreme possibilities and responsibilities of each partner in advance.

What happens when a person breaks depends on the person and the situation. The person might curl up in distant silence, going away emotionally (see Part 2). Flashbacks, tears, and anger may get all mixed together. Most commonly, the person becomes both physically and emotionally out of control, crying, flailing, screaming, or raging. In the next section on rage we discuss some ideas for how to handle such situations.

Rage in Scene

Rage is a state that bottoms sometimes get into, sometimes accidentally, sometimes in therapeutic play, or sometimes during breaking scenes. The depth of the person's rage varies. Sometimes the bottom has a vague awareness that this is a scene, but either feels safe enough to let go to strike wildly at the top or to struggle wildly in the chains. Other times the bottom completely loses the sense of where he or she is or what is going on.

Rage is sometimes cathartic for individuals to let out of themselves in the context of a scene with a conscientious, watchful top. The experience of extreme challenge to the point of being broken to uncontrollable crying or driven to rage is appealing to some bottoms. However, dealing with rage in scene is risky for both partners. While all extreme states require alertness on the part of the top, rage entails some special considerations.

If the bottom goes into a rage there is often no time to consider unexpected safety concerns. The top instantly has to look to physical safety issues for both partners. People who are raging do not always respond to pain in ordinary ways. A bottom who ordinarily might stop from a sharp smack, a joint twist, or pressing on a pressure point may not respond at all while in a rage.

Although physical accidents in well-considered scenes are amazingly rare in my experience, dislocated shoulders, cracked ribs, and frightening head-banging can happen in seconds in scenes if the bottom goes into an uncontrollable rage. Unconsciousness is also possible. The top as well as the bottom can be at risk, either because of the bottom's flailing or attack, or because of the top's own bending over backwards to protect the bottom from self-harm.

In terms of emotional safety, more often than not, the wisest thing for the top is to press into or at least not draw back from the situation. Suddenly jerking the bottom out of a flashback or extreme state of rage, panic, or emotional distance is almost never emotionally ideal for the bottom. Although what is happening may be frightening to the top, such states are moments for the top to set aside his or her own fears and focus on what the bottom needs, weighing both emotional and physical safety factors. Sometimes, the safest thing to do is to wind the scene down gently or to redirect it. But the observation of many experienced tops based on their experiences and ex-post discussions with their bottoms is that if the top has the physical safety issues more or less under control, the top's courage to stick with the bottom and come out the other side is usually the better choice. Suddenly calling an end to the scene often turns out to be the poorest choice. Bottoms who are suddenly yanked out of extreme states can come back feeling disorientation, humiliation that they caused such "problems" for the top, panic at what they could not complete, and incapacitation by what they cannot begin to explain in words in the near-extreme state they are still in.

Every scene is different. Faced with a raging, hysterical, or curled-up bottom, you just go by the seat of your pants. If you are the top, then the bottom is your entrusted responsibility, with no one but you to make the right decisions. You weigh all the information you have got and do the best you can.

Conditioning from Extreme Play

There are many risks from extreme play, some of which have been discussed above. However, one risk that is quite general is that of conditioning. Negative conditioning happens when some kind of play goes awry in such a way that it causes the bottom to no longer enjoy or want to experience it. Positive conditioning happens when someone is permanently caused to enjoy things that were not previously enjoyed. Both things happen in BDSM.

A common example of positive conditioning in BDSM sometimes happens when a bottom who may fear or not want to experience pain comes to experience it in a sexually enjoyable context. For example, someone who never liked having his or her nipples pinched may come to find it very hot if it is introduced in the right circumstances.

Unfortunately, there is no guarantee. If you do not like or want to like pain, it is highly unlikely that anyone is going to make you like pain just by associating it with sexual pleasure for you. Most people I know who have experienced positive conditioning speak of it as if it was a surprising, though happy, coincidence. It is not something that is widely agreed that tops can engineer at will. This observation does not prevent some tops from making the claim that they can accomplish such things, of course! Claims of hypnosis and magic are in fact occasional playstyles promoted by tops who enjoy such forms of mind control. With the right interpersonal match, undoubtedly such experiences can be brought to pass. But most tops would not dream of claiming they could do such things with any bottom for any given, stated goal. As psychologists have long known, conditioning even animals is not a sure thing without highly controlled circumstances, and if consent were to be required, might be even harder to accomplish. It is not that there are no principles at all that are general, but just that conditioning humans is not a simple matter.

Practicality aside, fantasies by both tops and bottoms about scenes wherein the bottom is "trained" by association to beg for or want or desperately desire an otherwise unwanted act by associating the act with sexual pleasure are quite common. To a certain extent, some folks carry this kind of activity out at times. But the point here is that you can't typically count on such positive associations taking effect.

Negative conditioning also occurs, and is a risk of playing at edges. Sometimes scenes arranged in good faith just happen to push buttons or go too far. Neither party can predict every reaction in scene, much less every reaction that follows up on a scene. Pushing some kind of play like breath control or a rape scene risks stumbling on the bottom's finding afterwards that he or she is simply horrified by ever doing such a thing again. This can happen even if all parties agree they acted in good faith based on prior negotiations.

Most negative conditioning I am aware of, along with situations where attempts at positive conditioning have gone awry, happily are not permanent. One of the more common examples of conditioning gone awry is when bottoms are taught to orgasm on command, only to find that when the relationship breaks down months or years later, they now cannot have orgasms at all. The deprivation of the stimulus that brought them to orgasm is not something with an easy replacement. It is a very scary experience. Happily, this seems to pass within six months or so for most people from whom I have heard this. But it is a risk someone should consider before agreeing to something like being taught to orgasm on command.

Negative conditioning to the point of panic at previously pleasurable experiences are also reported on occasion. Common examples are bondage, oral sex, rape scenes, and breath control. Again, most people report that these associations seem to pass in time. Someone who experiences a bad scene -- a scene that goes wrong or goes too far for one reason or another -- often experiences only temporary trauma if the top acted in good faith and is willing to talk things out in aftercare. This does not mean, though, that the trauma and conditioning necessarily pass in a matter of hours. The effects can linger for months. In cases where the top acted in bad faith or the partners cannot talk out the experience, the results may indeed be permanent. For a frank discussion of ideas for handling bad scenes as well as other responsibilities of tops, see The Topping Book, by Dossie Easton and Catherine A. Liszt.

It is hard to have a good sense of the relative permanence of negative conditioning because bad scenes are not always talked about. Part of that may be embarrassment. Part may be because these matters are private matters that most importantly require resolution by private discussion between the partners. Whatever the reasons, though we all know that bad scenes and negative conditioning occur at times for anyone who plays frequently, we really may not know all the possibilities of permanent negative conditioning that results.

For many people willing to play with consensual nonconsensuality, breaking, therapy, rage, or other intense states in scene, the possibility of negative conditioning is a known and acceptable risk. Bad things happen sometimes; your life and what you enjoy can change. But for others the risk is not one that is desired. If risk at such levels is not for you, don't do it.

More complex still is consensually using negative conditioning to induce fears and horrors in the bottom, perhaps with the intent of adding activities and play that satisfy the partners where there was no such fear or hatred previously. That this kind of play is extremely risky and can cause long-term emotional damage is clear. On the other hand, if fear is something you crave but cannot find yourself easily convinced by (say, because you trust your top to not actually damage you, so if your top pulls out even a gun in scene you would know it was just a threat and not something actually to fear), extreme pain or extreme subjugation to the point that you fear something you never previously feared can sometimes be induced. That such play might have long-term consequences is obvious. The costs and benefits are both complex.

Continue on to Part 5: Partners and Parties
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