Sexual masochism
ICD-10 F65.51 is a billable code used to indicate a diagnosis of sexual masochism.
Sexual masochism is characterized by the act of deriving sexual pleasure from being humiliated, beaten, bound, or otherwise made to suffer. This condition is classified under paraphilic disorders in the DSM-5 and ICD-10, indicating that the behaviors may cause significant distress or impairment in social, occupational, or other important areas of functioning. Individuals with sexual masochism may engage in consensual BDSM practices, which can include a range of activities that involve power exchange and physical sensations. It is essential to differentiate between consensual practices and those that may lead to non-consensual harm or distress. The diagnosis requires that the individual has acted on these sexual urges with a non-consenting partner or that the sexual masochistic fantasies cause clinically significant distress or impairment. Understanding the nuances of this condition is crucial for accurate diagnosis and treatment, as it intersects with issues of impulse control, personality disorders, and gender identity, often reflecting deeper psychological needs or maladaptive behaviors.
Detailed patient history, including sexual history and consent documentation.
Patients presenting with distress related to sexual practices or fantasies.
Understanding the patient's perspective on their sexual behaviors and the context of their relationships.
Thorough psychological assessment and evaluation of maladaptive behaviors.
Therapy sessions addressing sexual identity and relationship dynamics.
Focus on the psychological impact of sexual masochism on the patient's mental health.
Used during therapy sessions addressing sexual masochism.
Document the focus of therapy and any progress made.
Psychiatrists should note the patient's consent and the therapeutic context of discussions.
Sexual masochism involves deriving pleasure from being harmed or humiliated, while sexual sadism involves deriving pleasure from inflicting harm or humiliation on others. Both can be part of consensual BDSM practices but are distinct in their focus.
