BDSM Was Once in the DSM

“BDSM Was Once in the DSM“ was written for BDSMforyou.nl by Mistress Moriah.

What does BDSM have to do with the DSM (apart from three matching letters)? A book full of mental health diagnoses, otherwise known as the “bible” of psychiatry. The DSM, short for Diagnostic and Statistical Manual of Mental Disorders. It is a kind of big dictionary of every possible mental disorder. And yes, BDSM was once listed in there too – as something that could do with some attention.

What actually is the DSM?

The DSM is essentially a handbook for mental health professionals. It was created to keep everything clear and organised. It was first published in 1952 by the American Psychiatric Association. It became a key reference work for determining whether or not someone had a psychological disorder.

Since that first version, the DSM has been revised and expanded countless times. Over the years the list of disorders grew longer, and so did the debate about what actually counts as “normal” behaviour and what doesn't. With every new edition there was fierce wrangling between psychiatrists, psychologists, sociologists and – let's certainly not forget – public opinion. Because although the DSM is a scientific work, there is also social pressure on what does and doesn't belong in it.

Where does BDSM fit into this story?

In the early editions of the DSM, sexually “deviant” behaviour, which is how BDSM was regarded, was seen as problematic. At that time there was a deep-rooted idea that anything outside standard heterosexual, missionary sex was a sign of mental instability. You can imagine that this was a rather restrictive view, and in fact it said more about the conservative society of the day than about the people who enjoyed BDSM. At that moment the DSM reflected not only medical insights, but also the cultural and moral norms of the time.

BDSM in the DSM: a (sometimes painful) history

In the early versions of the DSM (think DSM-I and DSM-II), various sexual preferences, including BDSM, were described as “sexual deviations.” BDSM was lumped together with other forms of sexuality that weren't considered “normal”, such as homosexuality, fetishism and transsexuality. The idea was simple: if you enjoyed activities that weren't considered mainstream sex, then there was something about you that needed fixing.

But times changed, and thankfully so did the DSM. In the DSM-III, which came out in 1980, people began to recognise that not all forms of BDSM were problematic. It was still described as a paraphilia, a term used for sexual preferences that deviate from the norm. But there was an important change: only if the sexual preference caused distress or discomfort, or if the behaviour was harmful to others, was it seen as a problem. In other words: if you enjoyed BDSM without it troubling you, there was no reason for concern.

The big breakthrough: DSM-5 and a new view of BDSM

Fast-forward to the DSM-5, the most recent version, published in 2013. The psychiatrists and psychologists behind the DSM finally made the decision to remove BDSM from the list of mental disorders, unless compulsive or harmful aspects were involved. It was a huge step forward and a confirmation that BDSM in itself is not a sign of a psychological disorder. The DSM-5 now holds that sexual preferences are only a problem if they lead to significant distress or impairment, or if the behaviour harms others without their consent.

For many BDSM practitioners this was an important step towards acceptance and understanding. The change made it clear that BDSM is a valid form of expression, and that consent and mutual agreement form the core. It also acknowledged that sexuality in all its variety can be a healthy and normal expression of being human, as long as it is done with respect and care.

Why this change?

You might wonder why it took so long before this change was made. The change in the DSM came partly from greater knowledge and research in the fields of sexuality and psychology, but also from societal changes. Views on sexuality and personal freedom have changed enormously over the past decades. More and more people came out openly about their sexual preferences, and scientists began to understand that sexuality is incredibly complex and diverse.

In addition, it became increasingly clear in psychology that not everything that is out of the ordinary has to be problematic straight away. Many people who practise BDSM do so in a healthy, responsible and safe way. What's more, studies have shown that BDSM enthusiasts are often exceptionally good at communicating, setting boundaries and building mutual trust. In the end the DSM had to keep up with these new insights and acknowledge that BDSM is not an automatic indication of psychological problems.

What does this mean for the BDSM community now?

For many people in the BDSM community, the removal of BDSM from the DSM feels like a liberation. The stigma that clung to this sexual preference for so long is slowly but surely starting to disappear. It creates room for a more open and honest conversation about sexuality, in which people don't have to be afraid of being judged for their preferences or perhaps even their orientation.

Even so, there is still work to be done. Although the DSM-5 is a step in the right direction, there are still misunderstandings about BDSM in society. Many people still think BDSM is synonymous with violence or loss of control, while in practice it often shows quite the opposite. Consent, safety and communication are important elements of any BDSM experience.

Mistress Moriah

Source

Text: Mrs Moriah
Image: 123rf.com