Say the word “masochist” in casual conversation and people usually picture leather, rope, and safewords. Say it in a therapy session and it might mean something closer to picking the same bad partner twice or staying in a job that’s slowly grinding you down. Both uses are technically defensible.
That overlap is also the main reason conversations about the psychology of masochism go in circles: two people can use the identical word to mean genuinely different things and never notice.
In psychology, masochism describes finding relief, pleasure, or meaning in pain, humiliation, or difficulty. Researchers explain it through several overlapping mechanisms: a temporary escape from self-conscious awareness, shared brain circuitry between pain and reward, and associations built through safety, trust, and repetition.
In consensual sexual or recreational contexts, it isn’t a disorder. It only becomes one, Sexual Masochism Disorder, when the pattern causes significant distress or impairment for six months or longer.
Masochism Means at Least Four Different Things
Most of the confusion starts here. The word covers ground that clinicians, kink communities, and pop psychology all use differently, and the four meanings don’t translate cleanly into one another.
| Sense of the word | What it actually describes | Is it a disorder? |
|---|---|---|
| Clinical / paraphilic | Recurrent, intense arousal from being humiliated, bound, or made to suffer | Only when it causes significant distress or impairment for 6+ months (DSM-5-TR) |
| Consensual kink / BDSM | Deliberate, negotiated pain or power exchange for pleasure, connection, or stress relief | No. Research consistently finds no elevated psychopathology in practitioners |
| Colloquial “psychological” masochism | Self-sabotage, staying in situations that hurt you, unconsciously seeking punishment or failure | Not a formal diagnosis. Sometimes discussed as a personality pattern |
| Benign masochism | Enjoying safe, low-level unpleasantness on purpose: spicy food, sad films, hard workouts, horror movies | No. This one is close to universal |
A person can experience one of these without any of the others. Someone who loves horror movies and hot sauce isn’t necessarily interested in kink. Someone in a consensual BDSM relationship isn’t automatically dealing with self-esteem problems. Treating all four as a single phenomenon is where a lot of writing on this topic goes wrong, and it’s worth holding onto this table as you read the rest of this piece.
Where the Term Actually Came From
The word itself is barely 140 years old. Psychiatrist Richard von Krafft-Ebing coined “masochism” in his 1886 book Psychopathia Sexualis, naming it after novelist Leopold von Sacher-Masoch, whose fiction, most famously Venus in Furs, explored erotic submission. Sacher-Masoch reportedly hated the association.
Krafft-Ebing treated the pattern as a specific pathology: someone controlled by the idea of total submission to another person’s will, colored by lustful feeling. Pathology first, curiosity second. That framing stuck for the next century, and it’s a big part of why the word still carries clinical baggage the research doesn’t fully support.
Freud’s Three Kinds of Masochism
Sigmund Freud revised his thinking on this for decades, and by his 1924 paper The Economic Problem of Masochism, he’d split it into three types. They’re worth knowing because a surprising amount of modern writing on “masochistic personality” still borrows this framework without saying so.
Erotogenic masochism is the base layer: pain directly tied to sexual arousal. Freud considered this the root form, present in some degree in ordinary sexuality.
Feminine masochism is the confusing one, and Freud wasn’t describing women specifically. He used the term for passivity and fantasies of being punished or subordinated, then associated those qualities with femininity as he understood it at the time, a framing most modern psychologists consider dated and unsupported. Strip out the gendered language and what’s left is a pattern of finding pleasure in being placed in a passive, controlled position, something Freud thought showed up more often in men’s fantasy lives than women’s.
Moral masochism is the one with the most staying power. Freud described it as an unconscious need for punishment driven by guilt: chronic self-blame, self-sabotage, a pattern of engineering one’s own suffering with no sexual content at all. This is almost certainly what people mean when they call a friend “a bit of a masochist” for staying in a bad job or a bad relationship.
None of this is tested the way modern psychology tests a claim. Freud’s typology is a set of interpretations, not data. It’s still a useful map of the territory. Just don’t mistake it for evidence.
Baumeister’s Escape Theory: Trading Self-Awareness for Sensation
The modern account that researchers take more seriously starts with social psychologist Roy Baumeister, who published “Masochism as Escape From Self” in the Journal of Sex Research in 1988 and expanded it into a full book, Masochism and the Self, the following year.
Baumeister’s argument is that being a self-aware adult is exhausting. You’re constantly tracking obligations, rehearsing how you’re coming across, measuring your own performance against some ideal version of yourself.
Masochistic experiences interrupt that. Intense sensation, especially pain paired with restriction or humiliation, pulls attention down into the present moment and the body. The usual noise of self-monitoring goes quiet because there’s no longer room for it.
This isn’t Baumeister’s only application of the idea. He later used a similar escape-from-self framework to explain other behaviors that trade long-term consequences for short-term relief from self-awareness, materialistic overspending among them. The common thread across all of them is narrowed attention. Shrink your focus down to right now, and the weight of being you lifts, at least for a while.
The Neuroscience: How Pain Turns Into Reward
Pain and pleasure aren’t processed in separate parts of the brain the way most people assume. They share circuitry, particularly in the nucleus accumbens, the insula, and the brain’s endogenous opioid system. When you’re hurt, your brain releases endorphins, your own internal painkillers, and those endorphins activate the same dopamine pathways involved in reward and motivation. That’s the same cascade behind a runner’s high.
Context decides how that cascade gets interpreted. A 2016 fMRI study in the journal Pain, led by researchers at Heidelberg University, compared people who practice sexual masochism against a control group while both received identical laser-induced pain. Outside of any masochistic context, both groups’ brains processed the pain the same way, activating the same threat-related regions to the same degree.
But when the masochists viewed masochism-themed imagery while receiving that same pain, their brains shifted processing away from emotional, threat-related pathways and toward purely sensory ones, and they rated the pain as noticeably less unpleasant. Nothing about the physical stimulus changed. Only the meaning attached to it did.
That’s the mechanism researchers sometimes call “good pain”: the body’s warning system firing normally, but the brain relabeling the situation as safe instead of dangerous, because it has learned through context and repetition that this particular pain isn’t going to hurt it.
Benign Masochism: The Version Almost Everyone Already Practices
You don’t need any interest in kink to be a masochist by one entirely legitimate scientific definition. Psychologist Paul Rozin coined the term benign masochism to describe something close to universal: the pleasure people take in things their body initially registers as a threat, once the mind confirms there’s no actual danger.
In a 2013 study in Judgment and Decision Making, Rozin and his co-authors catalogued 29 activities that produce this kind of “hedonic reversal,” including eating chili peppers, watching sad movies, riding roller coasters, getting a deep-tissue massage, and pushing through exhausting exercise. The pattern they found across the board: people tend to prefer the negative reaction dialed up to just below the point where it stops being tolerable. Not a little spicy. Almost too spicy.
Rozin’s own shorthand for the mechanism is “mind over body”: your body reacts as if something bad is happening, tears, a racing heart, a burning tongue, and your mind gets to enjoy the fact that it isn’t fooled. That gap between the body’s alarm and the mind’s confidence is where the pleasure lives. It’s the same basic ingredient that shows up in sexual masochism and BDSM, minus the erotic or interpersonal layer stacked on top.
What the Research Says About People Who Practice BDSM
For most of the twentieth century, clinicians assumed anyone drawn to consensual pain or power exchange was working through some form of pathology. The data doesn’t back that assumption up.
The most cited study here is Wismeijer and van Assen’s 2013 research in the Journal of Sexual Medicine, comparing 902 BDSM practitioners against 434 non-practitioners on personality, attachment style, rejection sensitivity, and subjective well-being. The BDSM group scored better on nearly every measure: less neurotic, more extraverted, more open to new experience, less sensitive to rejection, and higher overall well-being.
The researchers’ own conclusion was blunt: BDSM looks more like a recreational leisure activity than an expression of psychopathology. A more recent replication out of Spain, published in the Journal of Homosexuality, found much the same pattern, again linking BDSM participation to secure attachment and lower neuroticism, most strongly among people in dominant roles.
Worth saying plainly: this isn’t unanimous across every single study. Smaller samples using different methods, including one Bayesian analysis of practitioners recruited from online forums, found submissive-identified participants reporting somewhat higher rates of depression and anxiety than dominant-identified participants. The largest and most-replicated studies point toward BDSM practitioners generally showing favorable psychological profiles. But generally isn’t universally, and role seems to matter more than researchers first assumed.
One more piece worth knowing. Some practitioners describe entering an altered state during intense scenes, commonly called subspace, or topspace for the dominant partner.
Researcher Brad Sagarin has proposed this reflects transient hypofrontality, a temporary dialing-down of the brain’s higher executive functions, comparable to states reported by long-distance runners and experienced meditators. It’s one more thread of evidence that what happens during consensual masochistic play resembles other well-studied altered states more than it resembles pathology.
When Masochism Crosses Into a Clinical Disorder
Having masochistic fantasies, even intense or frequent ones, is not by itself a mental disorder. The DSM-5-TR is explicit that diagnosis requires two things together, not one.
Criterion A is the interest itself: recurrent, intense sexual arousal from being humiliated, beaten, bound, or otherwise made to suffer, present for at least six months. Criterion B is the part that actually decides the diagnosis: that interest has to cause clinically significant distress or impairment in work, relationships, or other major areas of life. Meet Criterion A alone and what you have is a masochistic sexual interest. You need Criterion B as well to meet criteria for a disorder.
That two-part structure is deliberate. It’s the same reason a licensed clinician wouldn’t diagnose someone for practicing consensual BDSM with no distress attached to it. The interest has to be actively causing a problem. Being unconventional isn’t enough on its own.
One specifier worth flagging: DSM-5-TR asks clinicians to note whether asphyxiophilia, breath control, is involved, because unlike most kink activities, it carries a real risk of injury or death even when practiced carefully by experienced people. This is one of the few corners of this whole topic where the professional consensus is unambiguous.
Informed caution matters more than confidence, and anyone drawn to this specific practice is better served learning from qualified educators than improvising.
Masochism Is Not the Same as Self-Harm
These two get conflated constantly, and the confusion isn’t harmless. Clinically and functionally, they’re different things.
Consensual masochism, sexual or recreational, is mutually negotiated, happens with informed consent, is motivated by pleasure or connection, and doesn’t typically leave lasting damage.
Non-suicidal self-injury is private, self-directed, motivated by a need to cope with overwhelming emotional distress, and is treated in the DSM-5-TR as its own condition worth studying, one that clinicians take seriously as a risk marker in its own right. One is a documented, researched form of consensual play or sexuality. The other is a coping mechanism associated with real risk and deserves professional support, not a label borrowed from an unrelated context.
If you’re trying to work out which one describes a pattern you’re seeing in yourself or someone else, the honest answer is that it’s a conversation for a therapist, not a checklist. The distinction matters too much to guess at.
[A brief note if you’re reading this for reasons beyond a content project: if any of this feels close to home, a licensed therapist can help you sort out what you’re actually experiencing, and that’s a stronger next step than trying to self-diagnose from an article.]
Common Misconceptions, Corrected
“Masochists must have low self-esteem”
The research doesn’t support this as a general rule, at least not for consensual kink. The Wismeijer data found BDSM practitioners reporting higher subjective well-being than non-practitioners, not lower. Where this myth holds a grain of truth is in Freud’s older sense of the word, moral masochism, the self-sabotage pattern, which genuinely does sometimes track with low self-worth. That’s a separate phenomenon from sexual or recreational masochism, though, and lumping them together is exactly the mistake this whole topic invites.
“It always comes from childhood trauma or abuse”
This one persists mostly because it fits a satisfying narrative. Large-scale studies of BDSM practitioners have generally not found elevated rates of childhood abuse compared with the general population.
Some individuals do connect their interests to earlier experiences. Plenty don’t, and can’t identify an origin story at all beyond “I’ve always found this appealing.” Treating trauma as the default explanation says more about lingering cultural discomfort with the topic than about what the evidence actually shows.
“Wanting to be hurt means wanting to be a victim”
This confuses the fantasy with the reality. Consensual masochism runs on negotiation beforehand, a clear way to stop things immediately (commonly a safeword), and aftercare once the scene ends. The person on the receiving end typically retains more control than it looks like from outside, including the power to end things at any point. That’s close to the opposite of victimhood, which by definition involves no control and no consent.
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Frequently Asked Questions
Not by itself. Masochistic interests only meet criteria for Sexual Masochism Disorder when they cause significant distress or impairment for six months or longer. Most people with masochistic interests, including those who act on them through consensual BDSM, never come close to meeting that bar.
More common than most people assume. A 2020 systematic review found that 40 to 70 percent of adults report having had BDSM-related fantasies, though actual participation runs lower, generally cited around 20 percent. A large Belgian population study found similar numbers: about 47 percent had tried at least one BDSM-related activity, while 7.6 percent identified as BDSM practitioners.
Both patterns show up in the research. Some people trace their interest back to childhood or adolescent fantasy. Others discover it in adulthood, sometimes through a specific partner or experience. There’s no single developmental pathway that explains everyone, which is itself a useful finding. It argues against any one-size-fits-all origin story, no matter how often one gets repeated online.
None of this makes masochism simple. It’s a word doing at least four different jobs, propped up by theories from three different eras of psychology, and the honest state of the research is that it’s well-supported for the consensual, recreational version and considerably messier for the “why does this person exist at all” version that pop psychology keeps trying to answer with one tidy explanation. The mechanisms are real. The stigma just hasn’t caught up to them yet.
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Hijab Zehra is an MPhil-qualified clinical psychology professional with an academic background in mental health, emotional wellbeing, behavioural patterns and psychological assessment. Her work focuses on helping individuals understand anxiety, mood changes, stress responses, emotional regulation and the psychological factors that affect daily functioning. Through CureOnCall, she contributes to patient-friendly mental health content that explains complex psychological concerns in a clear, practical and supportive way.
