302.84 Sexual Sadism

Book excerpt

By: American Psychiatric Association

Date: 1994

Source: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, D.C.: American Psychiatric Association, 1994.

About the Author: The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders was researched and written by the members of a series of Work Groups under the auspices of the DSM-IV Task Force, with clinical and administrative oversight provided by the American Psychiatric Association.

INTRODUCTION

Sexual sadism belongs to a class of psychopathology called the paraphilias, which refers to any of three different categories of pathological sexual activity: it can either include nonconsensual behavior with children or other unwilling individuals (not a willing partner), or it may involve non-human objects such as animals (bestiality) or objects such as shoes or umbrellas (fetishism), or it may entail the infliction of pain, suffering, or degradation/humiliation for either participant (masochism or sadism). The sexual activity can involve intense and arousing fantasies, sexual thoughts and desires, or actual sexual behaviors, and must occur over a period of at least six months (the activity can be recurrent or continuous) in order to meet diagnostic criteria. The objects or activity involved would not be considered sexually arousing to the general public. Another diagnostic component of the paraphilias is that they must significantly interfere with the individual's life in some manner, either in terms of personal relationships, occupational functioning, or in some other central way.

There are nine categories of paraphilia in the DSM-IV (as well as in the most current, DSM-IV-TR edition). They are: exhibitionism, fetishism, frotteurism, pedophilia, transvestic fetishism, voyeurism, sexual masochism, and sexual sadism, as well as paraphilia not other wise specified. In exhibitionism, the individual exposes his/her genitals to non-consenting strangers; persons with fetishism find inanimate objects such as specific articles of clothing (for example, shoes, women's undergarments, leather clothing) or specific body parts (for example, buttocks or feet) sexually stimulating. Pedophiles engage in sexual behavior with children who have not yet reached sexual maturity. Diagnostically, the pedophile must be at least five years older than the child; many incarcerated pedophiles report being attracted to a specific gender, age range, appearance, or body type. Persons with frotteurism make physical contact with non-consenting persons by either rubbing against them or touching them in some other intrusive or intimate manner with the hands or genitals. Frotteurism is often reported to occur in crowded public places such as buses, subways, escalators, or other locations in which rapid exit (from the area) and anonymity are the norm. Persons with transvestic fetishism are virtually always heterosexual males; they cross-dress in order to act out sexual fantasies. This generally involves arousal and masturbation.

In sexual masochism, the individual engages in sexual activity that involves being humiliated, degraded, or caused physical pain, by either being bound, hit or beaten, or injured in some other way (binding, whipping, cutting, burning, etc.). In sexual sadism, the individual inflicts the types of pain just described to others in order to become sexually aroused. In all of the paraphilias, the behavior must interfere with social, educational, or occupational functioning in order to meet diagnostic criteria. By definition, some of the paraphiliac behaviors are illegal (for example, pedophilia).

PRIMARY SOURCE

302.84 SEXUAL SADISM

The paraphiliac focus of Sexual Sadism involves acts (real, not simulated) in which the individual derives sexual excitement from the psychological or physical suffering (including humiliation) of the victim. Some individuals with this Paraphilia are bothered by their sadistic fantasies, which may be involved during sexual activity but not otherwise acted on; in such cases the sadistic fantasies usually involve having complete control over the victim, who is terrified by anticipation of the impending sadistic act. Others act on the sadistic sexual urges with a consenting partner (who may have Sexual Masochism) who willingly suffers pain or humiliation. Still others with Sexual Sadism act on their sadistic sexual urges with nonconsenting victims. In all of these cases, it is the suffering of the victim that is sexually arousing. Sadistic fantasies or acts may involve activities that indicate the dominance of the person over the victim (e.g., forcing the victim to crawl or keeping the victim in a cage). They may also involve restraint, blindfolding, paddling, spanking, whipping, pinching, beating, burning, electrical shocks, rape, cutting, stabbing, strangulation, torture, mutilation, or killing. Sadistic sexual fantasies are likely to have been present in childhood. The age at onset of sadistic activities is variable, but is commonly by early adulthood. Sexual Sadism is usually chronic. When Sexual Sadism is practiced with nonconsenting partners, the activity is likely to be repeated until the person with Sexual Sadism is apprehended. Some individuals with Sexual Sadism may engage in sadistic acts for many years without a need to increase the potential for inflicting serious physical damage. Usually, however, the severity of the sadistic acts increases over time. When Sexual Sadism is severe, and especially when it is associated with Antisocial Personality Disorder, individuals with Sexual Sadism may seriously injure or kill their victims.

Diagnostic criteria for 302.84 Sexual Sadism

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.

B. The fantasies, sexual urges, or behavior cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

SIGNIFICANCE

People who exhibit criminal sexually sadistic behavior as adults typically have a lengthy history of cruel, aggressive, humiliating, or degrading behavior toward others, often beginning in childhood. Early research on sadism referred to a constellation of behaviors called "the three D's": dread, dependency, and degradation. In essence, this means that the sexual sadist causes the sexual partner to feel terror or to fear for personal safety (possibly feeling as though death may be at the end point of the encounter), renders the sexual partner unable to defend him/herself, and then humiliates and causes him or her significant pain (typically of a sexual nature, sometimes involving various acts of torture). For a sexually sadistic individual, the act of inflicting significant pain (whether they involve fantasy alone, or actual physical behavior) is sexually arousing.

From a forensic standpoint, the weapon use, wound patterns, and timeline of the crime are analyzed in an effort to determine sexual sadism. In most sexually sadistic crimes, particularly those resulting in death (murder), there are indications—either at the scene, on the victim, or discernible at autopsy—that the physical suffering or torture of the victim occurred over a prolonged period of time (hours, days, or sometimes longer—weeks or months). Sexual sadists tend to have specific sets of behaviors in which they engage, often in particular sequences. They may use tools (either standard ones like saws, razors, fishing line, wire, and screwdrivers, or burning devices such as soldering tools, jeweler's torches, etc.) to cut, brand, shock (electrical shock), burn, mutilate, whip, hang, impale, or otherwise torture their victims, or to bind or restrain them (ligatures, tape, various types of cages, cuffs, masks, and the like). There is often a specific scenario involved in the act—from capture and abduction of the victim (either by coercion or by force), through restraint and torture, through release, escape, or eventual death. In a subcategory of paraphilia, some sexual sadists continue to mutilate the body after death (a variant of necrophilia).

As in most sexually related crimes, the motivations for the sexual sadist revolve around acting out issues around power, control, and rage. The release of sexual tension comes from the experience of causing another person to feel pain, to be humiliated, or to feel unrelenting fear.

The concept of sexual sadism was well documented in forensic and psychological literature by the late nineteenth century Krafft-Ebing; the concept of sadism is named for an eighteenth century French author called the Marquis de Sade, whose works combined eroticism, punishment, torture, and murder.

In the present day, sexual sadism falls on a continuum of behavior from fantasy that is not acted upon (extremely mild) to role play (very mild) to non-harmful consensual behavior in the BDSM (bondage-domination-sadism-masochism) subculture (mild) to damaging, dangerous, harmful but still consensual behavior (moderate) to non-consensual behavior, possibly ending in murder (severe and criminal). Statistically, criminal sexual sadism is predominantly practiced by males. The behaviors are generally first exhibited in late adolescence or early adulthood, and generally progress over time in degree, intensity, and frequency.

FURTHER RESOURCES

Books

Tbe Clinical and Forensic Assessment of Psychopathy: A Practitioner's Guide, edited by Carl B. Gacono. Mahwah, N.J.: Lawrence Erlbaum Associates, 2000.

Stephen J. Giannangelo. The Psychopathology of Serial Murder: A Theory of Violence. Westport, Conn.: Praeger Publishers, 1996.

Louis B. Schlesinger. Sexual Murder—Catathymic and Compulsive Homicides. Boca Raton, Fla.: CRC Press, 2004.

Periodicals

Web sites

NARTH. "Should These Conditions Be Normalized? American Psychiatric Association Symposium Debates Whether Pedophilia, Gender-Identity Disorder, Sexual Sadism Should Remain Mental Illnesses." 〈http://www.narth.com/docs/symposium.html〉 (accessed February 17, 2006).

Park Dietz and Associates. "Areas of Expertise." 〈http://www.parkdietzassociates.com/index3.htm〉 (accessed February 17, 2006).

University of Iowa Hospitals and Clinics. "Sadism." 〈http://www.uihealthcare.com/topics/mentalemotional-health/ment3168.html〉 (accessed February 17, 2006).