Kinky Sex Gone Wrong: Legal Prosecutions Concerning Consent, Age Play, and Death via BDSM.

This commentary begins by describing the author's research and expert witness practice serving sex and gender minorities, especially practitioners of BDSM/kinky sex. Then, it reviews the three most common reasons that BDSM is legally prosecuted. First, consent: was this assault, rape, and/or kidnapping, or was it consensual kinky sex that either got out of hand or is now being strategically employed to punish the other partner? Second, age play: was this adult trying to have sex with children or was he (and it is virtually always men) intending to age play with an adult who is pretending to be an adolescent? Third, death by kinky sex: was this a person who murdered their lover or was this an accidental death? Finally, this article concludes with recommendations for kinksters who wish to assure consent and safe play, and for litigators involved in the prosecution of kinky sex.

Severe acute kidney injury due to violent sadomasochistic play.

Bondage and discipline, dominance and submission, sadism and masochism (BDSM) refers to a variety of primarily erotic practices. Although safety is crucial for most BDSM practitioners, there are violent forms that may cause serious injury. We present the case of 61-year-old man with no history of chronic kidney disease who developed severe acute anuric kidney injury following violent BDSM play. He had been strapped tightly onto a wooden spanking bench and then received approximately 1000 vigorous hits onto his bare buttocks and thighs. Subsequently, he developed haematuria and became anuric. Laboratory testing revealed strongly elevated serum creatinine levels. Kidney biopsy was unremarkable except mild tubulointerstitial damage. Urinary production increased spontaneously again after 4 days, and serum creatinine normalised over the course of 4 weeks. We believe that a combination of intermittent abdominal compartment syndrome and blunt kidney trauma may have been responsible for this severe acute kidney injury.

Lethal asphyxiation due to sadomasochistic sex training - How some sex partners avoid criminal responsibility even though their actions lead to someone's death.

INTRODUCTION: Erotic asphyxiation is a sexual phenomenon in which one partner reduces the other person's brain oxygen level through strangulation. This study analyzes deaths caused by sexually-motivated strangulation to cases of homicidal choking - summarizing criminal penalties for defendants, depending on the presence of drugs, or alcohol intoxication. METHODS: The mode of analysis involves three sources of data. First, a retrospective chart review of our clinics' two recent cases. Second, a meta-analysis of these materials in relationship to forensic reports obtained from prosecutor's office. Third, we examine the prevalence of death due to strangulation in erotic and non-erotic cases using central court database. Lastly, we provide the summary of interviews involving the country's only forensic unit, which investigates criminal cases involving voluntary and involuntary strangulation. RESULTS: In total, we analyzed 15 cases of sexual asphyxiation - 2 of our own; 5 reported in prosecutor's archives; 8 control cases ruled as a non-sexual homicide. The two of our clinical cases describe two victims of voluntary erotic asphyxiation, involving complex sexual environment in which a sexual partner accidentally strangulated the other one during sex. The first case describes a 30 years-old female, who required all of her past sexual partners to choke her with hands in order to reach orgasm. The second case is that of a 41 years-old homosexual male, who was still a novice to kinky play and succumbed to death as a result of being tied with a set of ropes around his neck and body. By combining findings from the analysis of our clinic's cases with 5 files obtained from prosecutor's office - we are able to compare results of these cases to controls (involving homicidal suffocation using the plastic bag). In our cases, the defendants who avoid serving prison time for strangulating in course of erotic play typically exhibit these characteristics - at the time of the killing, they were not under influence of drugs; the deceased had documented (based on witness interview, review of personal items, or medical documentation) long-standing paraphilic disorder. In controls, the likelihood of being convicted of voluntary manslaughter was lower for people who acted under the influence of drugs but higher for those under the influence of alcohol. CONCLUSIONS: These findings show that documented presence of paraphilic tendencies in the deceased might serve as grounds for not sentencing their sex partners for prison time if they acted to satisfy someone else's kinky needs.

Sadism, the Intuitive System, and Antisocial Punishment in the Public Goods Game.

In public goods situations, a specific destructive behavior emerges when individuals face the possibility of punishing others: antisocial punishment, that is, costly punishing cooperative individuals. So far, little is known about the (intuitive or reflective) processes underlying antisocial punishment. Building on the Social Heuristics Hypothesis and arguing that antisocial punishment reflects the basic characteristics of sadism, namely, aggressive behavior to dominate and to harm other individuals it is assumed that everyday sadists intuitively engage in antisocial punishment. Two studies document that activating (Study 1) and inhibiting (Study 2) the intuitive system when a punishment option can be realized in one-shot iterated public goods games increased (Study 1) and reduced (Study 2) antisocial punishment, in particular among individuals who reported a proneness to sadism. In sum, the present research suggests that sadistic tendencies executed intuitively play a crucial role regarding antisocial punishment in public goods situations.

Psychopathy and sexual sadism.

Psychopathic personality disorder and sexual sadism share several common characteristics, such as emotional detachment from the suffering of others or the preparedness to inflict pain or injuries. Based on a sample of 100 male forensic patients (all of them sex offenders, half of them sadistic), the concept of psychopathy and sexual sadism as a unified construct was tested empirically. Pooling indicator variables for psychopathic and sexually sadistic disorders showed that a two-factorial solution yielded a better fit than a single-factor model. The two factors identified psychopathy and sexual sadism as separate latent variables. More specifically, the data were compatible with a path model in which affective deficits and behavioral disinhibition of the psychopathy domain are precursors to sexually sadistic conduct.

The concept of the death drive: a clinical perspective.

This paper discusses Freud 's theory of the death drive in the light of clinical experience with severely self-destructive personality disorders, and contemporary object relations theory. Repetition compulsion, sadism and masochism, negative therapeutic reaction, suicide in depressed and in non-depressed patients, and destructive group processes are explored from this perspective. The paper concludes that the concept of the death drive is clinically relevant, but that this condition needs to be traced to the general dominance of aggressive affects as the primary etiological factor; only under severely pathological circumstances does this dominance lead to a focused drive to self-destruct.

El papel de la libido en la autoagresión y el masoquismo / No disponible

El autor aborda la comprensión de los fenómenos de autoagresión, sosteniendo la tesis de que detrás de ellos se ocultan dos finalidades fundamentales: Por un lado, con la destrucción activa de aspectos propios y objetales se busca que cese el sufrimiento que acarrean deseos libidinales altamente evolucionados que han fracasado una y otra vez. Por el otro, a través de actos en los que predomina el sadismo primitivo se busca la satisfacción libidinal propia de niveles regresivos, a los que se acude corno último recurso restante, en el transcurso de lo que aparece corno una especie de efecto dominó que llega hasta los puntos de fijación primarios (AU)

The paedophile and his inner world: theoretical and clinical considerations on the analysis of a patient.

The main feature of the treatment of the paedophile is the distance that separates the analyst from the patient. However hard the analyst tries to understand his patient, the paedophile's world appears to him, especially at the beginning of the treatment, incomprehensible, disheartening and distant. This paper describes the analytic therapy of a paedophile patient. The psychopathological organization that dominates his inner world originates from a delusional nucleus in which an object (a child or an adolescent) is idealized and worshipped in place of the parents. This object promises all manner of pleasure and happiness. The positive outcome of this patient leads one to believe that, if analytically treated, some paedophile patients are open to therapeutic transformation.

Mecanismos de defensa en las neurosis / No disponible

La teoría de la represión como mecanismo defensivo central en las neurosis es el primer aporte original y fundamental de Freud. Esta defensa aparta de la conciencia las representaciones inconciliables con el yo, que son displacenteras o penosas, y que en última instancia corresponden a las ten¬dencias censurables del Edipo. Con la profundización del estudio de los distintos tipos de neurosis, la represión pasa a ser un caso particular de defensa, específico de la histeria. Las distintas modalidades defensivas son las determinantes de los diferentes cuadros clínicos. La proyección, por ejemplo, juega un rol esencial en la formación de las fobias, siendo el peligro pulsional interno proyectado en el mundo exterior, localizando en el espacio un objeto que produce miedo, evitando así la angustia ante las fuerzas internas desconocidas. Los mecanismos que caracterizan a la neurosis obsesiva son el desplazamiento del afecto sobre representaciones anodinas, alejadas del conflicto original, el aislamiento y la anulación retroactiva. La tendencia a anular es similar a la tendencia a reprimir, y puede presentarse como un síntoma en dos tiempos, de manera que a una acción que ejecuta una determinada prescripción le sucede una segunda que la suprime o la deshace. La regresión de la libido a la fase sádico-anal es una defensa contra las tendencias fálicas asociadas al Edipo y la amenaza de castración. Una vez efectuada la regresión, la defensa se vuelve contra los impulsos sádico-anales (AU)

The theory of repression as the central mechanism in the neuroses is Freud´s first original and important contribution. This defence withdraws from conscience those representations irreconcilable to the ego, which are unpleasant or sad, and which correspond to anadmissible Oediapl tendencies. After further study of the different types of neurosis, repression becomes a particular type of defence specific of hysteria. Different defensive modalities are seen to dominate different clinical pictures. Projection, for instance, plays a crucial role in the development of phobias, when the internal instinctual threat is projected outside, onto the external worls. The fear-producing objects is thus located outside, and axiety towards internal unknown danger is avoided. The mechanisms of obsessional neurosis are displacement of affect onto indifferent representations, removed from the original conflict, isolation, and retroactive annullement. The latter may appear as a symptom in two moments, so that ana action carrying out a particular prescription is followed by a second one that eliminates or undoes it. Libidinal regression to the anal-phallic phase is a defense against the phallic tendencies linked to the Oedipus complex and castration anxiety. Once regression takes place the defence turns against anal-sadistic impulses (AU)

[Age-related factors of psychopathology of impulse control disorders]. / Vozrastnye aspekty psikhopatologii impul'sivnykh vlechenii..

15 children and adolescents with impulse control disorders (mean age 12.9 years) were examined. These disorders were presented as dromomania, kleptomania, aggressive-sadistic actions, tricholillomania, pyromania; a combination of different types was observed in some cases. Schizophrenia was diagnosed in 7 cases, affective disorders--in 8 patients. Independently of the nosologic unity of the disease, development of the impulse control disorders took place in affective disorders which manifested either by monopolar course (depression) (11 cases), or by bypolar attacks with unclear outlines of the phases (4 patients). Psychopathology of impulse control disorders in children and juveniles was analogous to that of the adults, however, their structure wasn't so complex and development of the phases wasn't so clear.