What makes Therapeutic BDSM therapy?

Last week I received an email with an interesting proposition and its a potential partnership I have not stopped thinking about since I opened the message.

The email itself referred to the practice of using BDSM in conjunction with clinical therapy as way to resolve depression, anxiety, trauma, and intimacy issues. I found this a little humorous as it was only within the last 50 years that a majority of kinks, as we know them today, have slowly been de-pathologized by a mental health community that used to call them paraphilias. My initial reaction was the gatekeeping one with a thread of purism. Therapy, in the clinical sense, relies on evidence-based practices. Evidence-Based Practices (EBPs) are approaches to care, intervention, or treatment that are grounded in scientific research and have demonstrated effectiveness through rigorous evaluation. They integrate three key components:

1. Best Available Evidence: Use of high-quality research, such as randomized controlled trials, systematic reviews, and meta-analyses, to identify methods proven to be effective.

2. Clinical Expertise: Application of professional judgment, skills, and experience to adapt the evidence to the individual needs and contexts of the client.

3. Client Values and Preferences: Inclusion of the client's preferences, values, and circumstances in decision-making to ensure the approach aligns with their unique situation.

To this counselor's credit, they did not claim the inclusion of BDSM as an evidence-based practice. They are also not the facilitator of the BDSM scene, as that would be highly unethical. Essentially, what they are suggesting is something similar to how sex surrogacy is used. Sex surrogates and clinical sex therapists often work collaboratively to help clients address sexual health and intimacy challenges. This partnership creates a safe, structured environment where clients can explore and overcome issues they may struggle to resolve through traditional therapy alone. I imagine the process would be similar for a BDSM provider and a BDSM-certified therapist.

So yes, I wrote this off for a number of reasons: clinical, ethical, financial...there is little more than anecdotal evidence to support BDSM as a legitimate intervention. Then I had to sit back and consider one very important fact: It's not my place to gatekeep what someone perceives as supportive and healing.

The origins of the word 'therapy" align more with a general concept of healing rather than a clinical intervention and I'm afraid the modern medical model is a little to blame for that. Psychologists, LCSWs, LMHCs, LMFTs, and LPCs are all licensed practitioners and they are licensed by their respective state governing body and national boards. As clinicians, we get roped into the medical model that relies on evidence-based practice despite loads of data that says it isn't the intervention that heals, it's the human connection. How many of us have tried again and again to find a therapist only to realize its a lot like dating? Just because someone is certified in EMDR or Trauma focused-Cognitive Behavioral Therapy or any other highly manualized modality, it doesn't guarantee a good fit. They still need to vibe with you, otherwise the rest of the process doesn't flow.

I actually found a BDSM partner I had a vibe with before I found a therapist who I felt listened and heard. My BDSM partner trusted me, gave me constructive feedback, made me laugh, and helped inspire confidence. Confidence that I knew what I was doing and that I carried intrinsic worth that I was able to maintain outside of our BDSM scenes. It felt safe and it was my responsibility to help him feel safe during those scenes. For someone who hates being spoken down to, doubted, yelled at, and criticized, this time to play was invaluable to me and through it, I began to construct hard boundaries with those around me actively benefiting from my passivity. It became easier for me to assertively tell people I would not accept the dynamics of our relationship.

On the flip side of this dynamic, my submissiveness reached a new understanding too. It was a gift, something to be respected and protected. No one could demand it from me and, once given, I could take it back at any time. I didn't owe anyone anything as a submissive. With the right person, I could be fragile, vulnerable, and bratty. I could cry, scream, fight, and run and it was all taken in stride and processed with trust and understanding, not invalidation, guilt-trips, and gaslighting.

This week, I was reminded of this. The past month has been a non-stop train of stress, bad news followed by disappointment, followed by more bad news. Miscommunication and arguments. Pipes leaking. Car trouble. Money suddenly getting a lot tighter. Family health issues. Political drama. Coworkers making simple tasks impossible because they weren't asking for help! Finally, I woke up one morning to go for a run at the gym and had a panic attack on the treadmill. That was the breaking point for me. I called out of work that day and told everyone I'd be unreachable. I unplugged and the first thing I did was eat a hearty breakfast with my husband. The kids were out of the house all day and we had the place to ourselves. The silence and lack of constant demands was lovely. We sat down and watched a movie that we'd both been looking forward to, played a game or two online. Neither of us scheduled anything that needed to be done. We just chose to exist and do whatever came to mind.

It dawned on me that with the house to ourselves for the whole day, we could actually have sex like adults and not have to be quiet about it. I had been missing this so much. We moved ourselves to the bedroom where it started out very sensual and romantic...until I recalled how he told me he had been feeling, how he was also feeling a lack of control in his life. I took that opportunity to remind him how he'd always have sexual control over me, to use me as he wanted thanks to our Free-use agreement. That he could say who, what, when, and how and I would obey. And he smiled and said those magic words we praise-kinkers love so very much. "Good girl."

Three hours and 30 minutes later, we had gone through a plethora of BDSM activities. Cock worship, impact play, bondage and restraint, biting and bruising, finally putting the violet wand to use (WHICH WAS AMAZING!), throat fucking, and some otherwise very rough sex. And I didn't have to hold back. It wasn't until the prolonged spanking session that I realized I no longer felt the pressure in my chest from that morning. My brain didn't feel exhausted and I wasn't carrying this sensation of generalized anxiety. The only thing I felt bad about was the redness of my poor husband's hand just before he switched to the leather paddle. And those bruises remain a glorious and visible reminder of such an intimate moment we both shared. I wore a loose shirt to the gym this morning and the hickeys and bruises on my breasts would have been visible to anyone looking my way while I was in Plank. I'm just grateful no one made the wrong assumptions if they did happen to see anything.

Days later, we still get a thrill talking about it and he tells me how proud he was, and still is, of himself for being able to provide that for me. And I love being a part of that validation for him, that he can and does give me everything I could want and more. Anything we discuss regarding a dynamic that involves extra people...that would be the proverbial cherry on top of our already amazing and satisfying sex life. Unnecessary and, as such, completely optional.

I trusted him in those moments. I trusted him not to hurt me in any way I didn't want to be hurt and he delivered on that and then some. Each time I've removed my clothes, I look at my marks in the mirror and smile. The skin of my ass and hips was still warm to the touch a full day later. And I love seeing him look at the marks and smile at his handiwork. It was a visceral reminder of how power-exchanges can address so much more than sexual desire. Would those experiences have carried the same meaning if anyone else had done them? Maybe, depends on my relationship with that person. I just know that for me, it's the individual the energy flows from, not just the action the individual is taking.

So can BDSM be therapeutic? Yes, absolutely it can be. Can anyone who does BDSM do it, or benefit from it, therapeutically? No. But they won't hear it from me, most likely because of the ball gag in my mouth.