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Kink in the Clinic

Clinical Guidelines for Working with Kink Practitioners

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Presenter:

Ray A. White, Ed.S.

Licensed Professional Counselor/ Mental Health Service Provider/ Approved Supervisor

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Disclaimer

The content of this presentation reflects the research, thoughts, and opinions of the presenter … not necessarily any sponsor or employer.

© 2024 Whitewood Counseling & Consultation

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Outline:

  • Kink Proclivity
  • Kink Practices
  • Pathology or Pacification
  • Clinical Guidelines

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Proclivity.1

68.8% report at least one BDSM fantasy or practice.

Holvoet, et.al., 2017

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Proclivity.2

46.8% performed at least one BDSM related activity.

Holvoet, et.al., 2017

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Proclivity.3

67% reported BDSM entry via media sources.

17% reported BDSM entry via relationship.

Walker, 2022

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Proclivity.4

Age of BDSM fantasies = 13-15 years old

Age of BDSM entry = 18-22 years old

Walker, 2022

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Proclivity.5

Though BDSM proclivity may develop prior to college for many, college provides the freedom necessary to begin exploring and cultivating both normative and alternative sexual identities and novel sexual experience.

Lindgren, el.al. 2009

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Practice.1

BDSM

(BD)SM = Bondage & Discipline

B(DS)M = Dominance & Submission

BD(SM) = Sadism & Masochism

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Practice.2

Bondage & Discipline

Almost 50 percent of both women and men have fantasized about being tied up in order to obtain sexual pleasure.

Dominance & Submission

Sixty-five percent of women and more than 50 percent of men have fantasized about being dominated sexually.

Sadism & Masochism

Almost 25 percent of women and more than 40 percent of men have fantasized about spanking or whipping someone for sexual pleasure

~Joyal (2017)

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Practice.3

The Basic Tenets of BDSM

SAFE

SANE

CONSENSUAL

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Practice.3A

Risk

Aware

Consensual

Kink

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Practice.4

KINK

Achieving sexual arousal from a particular behavior. For example: Having rope restraints applied.

FETISH

Achieving sexual arousal from a particular object. For example: Wearing a certain piece of clothing or gear.

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What are some of the most common K/F?

Dominance/Submission Roleplay

Spanking Body Worship

Bondage Orgasm Denial

Sensory Deprivation Lingerie / Outfits / Fetishwear

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Pathology or Pacification.1

Pathology: To behave in an extreme or unacceptable way…

Pacification: An attempt to create or maintain peace…

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Pathology or Pacification.2

What do most people think?

What do you think?

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Pathology or Pacification.3

Research indicates that people into BDSM are psychologically healthy and no more likely to have suffered child abuse or sexual trauma than anyone else.

In fact, a Dutch study shows that compared with the general population, in some ways BDSM Players might be psychologically healthier. (Psychology Today 4/2015)

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Pathology or Pacification.4

Scientists at the University of Illinois measured cortisol levels (a key stress hormone) before and after participants BDSM Play and found decreased cortisol levels, showing that BDSM reduced players’ emotional stress.

(Psychology Today 4/2015)

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Pathology or Pacification.5

There have been multiple cases of individuals who participate in Kink play who report that the practice provides a release which keeps them from pursuing various potentially harmful behaviors.

For example, those who indicate a problem with substance abuse, find they have less need for substances when they maintain their Kink practices.

Or cutters who report less of a need to “cut” when they participate in their Kink practices.

The bottom line seems to be that their Kink play serves as a pacification mentally and emotionally removing (or decreasing) the desires to use substances or cut.

For these folks, Kink becomes a harm reduction strategy….

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Why BDSM?

Researchers at Idaho State University asked 935 kinksters what BDSM meant to them. The top answers were personal freedom (90 percent), adventure (91 percent), self-expression (91 percent), stress relief (91 percent), positive emotions (97 percent), and above all, pleasure (99 percent).

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Counselor Discrimination…

Indeed a 2008 survey of kinksters by the National Coalition of Sexual Freedom (NCSF) found that 39.3% of total respondents (346) were discriminated against by mental health practitioners.

Kinkaphobia is Pervasive in the Mental Health Field (Psychology Today)

Here were some of the comments…

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Client Experiences…

  • "I was told by a licensed psychologist that I was a sick individual and that if I did not get help immediately, and change the way I lived, that I would never have a productive life, and that I would never find any happiness. By fitting into the 'norm' I would be a more socially 'productive' person, and I would be able to live a 'normal' life."
  • "The therapist refused to continue to see me until I acknowledge that I was being 'Abused'."
  • "Mental Health Professional said I was psychologically unsound. That no one in their right mind would consent to 'those types' of activities."

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Kinkaphobia

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Clinical Guidelines

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TASHRA

The

Alternative

Sexualities

Health

Research

Alliance

https://www.tashra.org/

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TASHRA’S Mission

TASHRA’s educational mission advocates that healthcare providers should approach providing care to kink-identified people in the same manner they would approach any distinct culture or subculture that is marginalized by mainstream culture.

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Printable Set of Guidelines

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The Organization of the Guidelines…

AREA 1: Foundational Knowledge, Skills, and Attitudes (#1-9)

AREA 2: Life-Span Developmental Issues (#10-13)

AREA 3: Assessment & Interventions (#14-19)

AREA 4: Professional Education, Training, and Community Care (#20-23)

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Quick View Handout - Kink & Clinical Guidelines

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Self Report Counseling Competence

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education} Vol. 4 - Issue 1 (2022)

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Cultural Humility vs. Cultural Awareness

vs. Cultural Competence

Cultural Awareness is like knowing Walmart carries shoes.

Cultural Competence is like knowing what style shoes Walmart carries.

Cultural Humility is like buying the shoes and wearing them, feeling how they feel.

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Popular Resources

  1. EveryDay Health
  2. Fetlife.com (adult site)
  3. F-List (roleplay site)
  4. Bdsmtest.org

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Clinical Resources

Book: Becoming A Kink Aware Therapist by Shahbaz & Chirinos

Article: Becoming Kink-aware - a necessity for sexuality professionals … Sexual & Relationship Therapy, 2015 - Vol. 30 No. 2, 196-210

Article: Therapy Experiences of Clients With BDSM Sexualities … Electronic Journal of Human Sexuality, 2009 - Vol. 12

Clinical Practice Guidelines for Working with People with Kink Interests … kinkguidelines.com

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