Some individuals with Sexual Masochism may engage in masochistic acts without increasing the potential injuriousness of their acts. Others, however, increase the severity of the masochist acts over time or during periods of stress, which may eventually result in injury or even death.
The paraphiliac focus of Sexual Sadism involves acts in which the individual derives sexual excitement from the psychological or physical suffering of the victim. Some individuals with this Paraphilia are bothered by the sadistic fantasies, which may be invoked during sexual activity but not otherwise acted on. Others act on the sadistic sexual urges with a consenting partner (who may have Sexual Masochism). Still others with sexual sadism act on their sadistic urges with non-consenting victims. In all of these cases, it is the suffering that is sexually arousing. .
Sadistic fantasies or acts may involve activities that indicate the dominance of the person over the victim. They may also involve restraint, blindfolding paddling, spanking, strangulation, torture mutilation, or killing. The age at onset of sadistic activities is variable, but is commonly by early adulthood. Sexual sadism is usually chronic.
Usually the severity of the sadistic acts increases over the 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.
The majority of sadists establish relationships with masochists to derive mutual sex gratification. Moser and Levitt (1987) estimate that millions of Americans engage in sexual practices that involve the infliction of pain or humiliation. The majority of sadistics and masochists lead otherwise conventional lives, and there is some evidence that they are above average in income and educational status. Although a great many are switchable, that is, able to take both dominant and submissive roles, masochists outnumber sadists.
