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Cross-post: Is it Possible to Eradicate a Fetish?

By Dr. Michael Aaron, originally posted on December 8, 2014 on

In a recent post, I wrote about how the field of sexology is uneven in its application and rife with regional and individual biases, largely due to general sex phobia and a subsequent lack of empirical research within the field. Recently, a debate on the mailing list of one of the sexological organizations to which I belong touched again upon discrepancies within the field. The discussion in question concerned whether or not it is possible to eradicate a fetish. Most respondents were in agreement that, like a sexual orientation, eradicating a sexual fetish is not only not possible, but particularly in fetishes that cause no harm, even unethical.

One clinician, however, stated not only that eradicating a fetish is possible, but then went on to describe exactly how (he/she believes) it is done. The methodology described was so disturbing, however, that I felt it necessary to challenge the ideas presented and to present both his/her perspective as well as my response here on my blog as a cautionary tale to individuals who may have questions regarding their own sexuality so that the know what to avoid in therapy. I have eliminated any details that could reveal the identify of the other clinician.

Below is what the clinician wrote in support of fetish eradication. I am highlighting and italicizing the most objectionable aspects:

I don’t see a fetish as similar to sexual orientation – it is something that does reflect “something wrong”, and in my own experience, DOES respond to therapy! One issue is that sexual fetishes – paraphilias – typically involve sexual activity with something that does not provide the rewards that sex with another human does.  That is, talking, kissing, caressing, oral sex, intercourse, etc.  Compared to these things, really, what does masturbating while doing something like holding on to a shoe, cross dressing, etc. have to offer? In the cases I have had good results with, I have used some combination of procedures to reduce the arousal value of the fetishistic practice; and, at least as importantly, procedures to make good, open, rewarding sexual activity with a consenting adult available to the patient. This procedure  has  seen been termed “cognitive negative conditioning”.  Sometimes this been done with the patient sniffing disgusting aromas or unpleasant chemical agents, but I long ago stopped doing this, and went to the strictly cognitive negative conditioning procedures.  The reason for this was that I had a patient confess that he had indeed used all 7 of his ammonia vials this week – but he had broken them out in the parking lot just prior to coming in to see me!

The “cognitive negative conditioning procedures” involve having the patient spend….

time thinking about – and saying into the small tape recorder I give the patient -all the things that are now going wrong in his life because of his fetish; and what is likely to happen in the future for him, because of his fetish, really does reduce the arousal value of the fetish – and this is something that can’t be done in a couple of minutes, on just one day. One thing I have also found often really strongly effective as a negative involves children, if the patient has any. For example, I had one man who had a shoe fetish think about his children coming home from school in tears, saying how they were being teased about “What a freak your old man is – him and his shoe —— (expletive deleted).  In another case, we arrived at the man’s daughter saying her boyfriend was now forbidden to date her anymore:  “His parents said, ‘Come on, his Dad is some kind of a weirdo pervert!’ Oh Dad, how could you do this to me?”


While I always do the cognitive conditioning procedure with fetish patients, I sometimes also do the “stimulus satiation procedure”, which involves  changing the patients masturbation.  This is not something I usually use – it is reserved for patients who have what might be called an “extreme” fetish, and are also very well motivated. This procedure involves having the patient (at home, of course) masturbate using normal – non-fetish- stimuli/fantasy. Immediately after reaching orgasm, the man switches to his fetish, and continues to masturbate, without stopping, for a time that is unpleasant- I usually start the man with something like 10 or 15 minutes. During this time, the man will lose his erection; will not be aroused; and will likely find it painful.  Should any pleasure/arousal occur, he must immediately switch back to NORMAL stimuli. The major problem here is that it is some of the wives of the man with a fetish (I don’t think I am being sexist here; I just don’t recall ever seeing a female with what could be considered a genuine “fetish”) are so distressed by learning about his fetish that their interest/ability in sexual functioning with him are severely reduced.  I have found some success with this problem by putting off this part of the problem until we can say that his interest in the fetish is genuinely gone.

So basically if someone shows up to this therapist with questions or concerns about a fetish, the patient will be subjected to shameful thoughts and experiences regarding his own children and will be pushed into unpleasant and painful physical sensations. Wonderful. Where can we all sign up? Look, whatever this therapist is up to is not only cruel and unusual, but according to the new changes in the DSM 5, in which paraphilias (fetishes) were de-pathologized, also highly unethical.  New studies keep being published showing that fetishes are not correlated to pathology. And this person considers himself a sexologist and sex therapist. This sex phobia and negativity must be stopped, especially in clinical settings, before more unwitting people put their trust in ignorant practitioners and get hurt. There is a word for illness cause by doctors– iatrogenic. My call to the mental health field: No more iatrogenic harm to patients around issues of sexuality.

Below is my reasoned response (which went unanswered):

Do you have any empirical evidence for the efficacy of your negative conditioning and aversive techniques for fetishes? Do you have supporting documentation on what percentage of fetishes “prevent, good, open rewarding sexual activity with a consenting adult”? Many of the clients I’ve seen who have discussed their fetishes have described them in ways that enhance, rather than diminish, their sexual functioning with consenting adults. And I’m also wondering why, when working with distressed wives of the fetishist, your first option appears to eradicate the fetish rather than help the wife process her distress and understand more about the fetish, as well as take a systemic look at what else is going on in the relationship. It also appears that you are lumping all fetishes together, including those that are merely optional, preferred, as well as exclusive. Are you aware that the DSM 5 differentiates between paraphilias (which are not pathological) and paraphilic disorders?

Celebrate the Sex Workers Project at emPOWER 2015!


Click here for tickets!

Cross-posted from The Sex Workers Project event page:

Come celebrate the success, community, and future of the Sex Workers Project! SWP is the only US organization offering client-centered legal and social services for sex workers and trafficking victims.

All tickets include an open bar and hors d’oeuvres until 9pm. Allies, Activists, and Sponsors will also receive access to VIP mezzanine with a private bar, and added bonuses. Stay and mingle for 2-for-1 drink specials while getting treated to great performances by friends of SWP.

Honor Weil Gotschal & Manges LLP for their wonderful work with SWP on Thursday, June 11th at Taj II Lounge at 48 W21st Street, and acknowledge the many accomplishments for equal human rights achieved through SWP’s work.

Read more…

Cross-post: GO Magazine proclaims “The Kink Doctor Is In”

Dulcinea Pitagora, founder of, was featured in an article in GO Magazine‘s April 2015 issue. Read the online version of the interview here, or click on the image below for a PDF of the print version.

The Kink Doctor Is In

Cross-post: GO Magazine proclaims “The Kink Doctor Is In”

Dulcinea Pitagora, founder of, was featured in an article in GO Magazine‘s April 2015 issue. Read the online version of the interview here, or click on the image below for a PDF of the print version.

The Kink Doctor Is In

Crosspost: Because Acupuncture Can Help

Originally posted on August 6, 2014 on What’s Wrong With You?

When I tell  people I’m an Acupuncturist there are always the inevitable questions. “Does it really work?” or a variation thereof, throwing in “placebo” for good measure. Sometimes it’s followed up with “Isn’t it expensive?” or “I don’t think my insurance covers it.”  And, of course, the perennial favorite: “Oh, needles! Doesn’t it hurt?”

When I began studying Acupuncture I would vociferously defend the validity of the medicine from every angle I could think of. I would go on and on about research, past and present. Discuss which ailments the World Health Organization or the National Institute of Health currently list as showing improvement with acupuncture. Medical conditions such as high blood pressure, chronic pain, insomnia and Bell’s Palsy, among many others.

I would point out the sheer volume of hospitals around the US that have integrated some aspect of acupuncture into their facilities. Hospitals here in New York like Sloan Kettering, New York Presbyterian and Mount Sinai. In fact, a recent survey by the American Hospital Association showed that 42% of hospitals in the US has at least some kind of acupuncture available. Even the US Military has recognized the efficacy of acupuncture for better pain management, treatment of PTSD, and speeding the rehabilitative process.  A recently released report from the office of Veteran Affairs, highlighting the concern over their skyrocketing addiction and suicide rates, emphasized the efficacy of acupuncture versus pain medications for Afghan returnees.

Then I’d inform people most health insurance plans cover some CAM (complimentary/alternative medicine) treatments. Lots of people could use their insurance, they just don’t know. The New York State House and Senate has even passed a bill adding acupuncture to workman’s comp coverage. Now the Governor just has to sign it.

I started on the journey to become an acupuncturist after it effectively cured my arthritis. I know, I can’t say “cured” to a patient I ever plan to treat. It’s disingenuous and illegal.  It is, however, exactly what I experienced. I saw a wonderful Acupuncturist in midtown for 3 months. After 10 treatments all of my symptoms were alleviated and have not had a reappearance since. All the standard western interventions had done nothing for me except mask my pain and disrupt my digestion. I was amazed that pain I had been living with for 3 years diminished and disappeared in such a short time. It sparked a light in me and I decided I had to know how to do this, too. So my journey began.

Now that know for myself, I just keep it simple and answer the questions.

Does it hurt? Not really. The needles we use are pre-packaged sterile, single use stainless steel needles that are roughly the thickness of one of the hairs on your head.

Does it work? Yes. Speaking from both sides of the needle, I know firsthand how effective a handful of needles can be. I have treated or helped treat patients with a myriad of conditions, virtually all of whom saw definitively positive results from their time in treatment. I don’t bother with the naysayers; they like staying skeptical in the face of mounting evidence and that’s their prerogative.

Seriously though, if you and I were sitting around, talking about our health and life and stuff, drinking some coffee or whatever, and you asked me about it I’d say:

“Look, if you’ve been shot or you broke something or any other emergency, of course go to the emergency room. If you’re bleeding profusely or can’t breathe, please, go.”

Then I would pause, just a moment, maybe take a sip of that coffee or whatever…

“But if you’ve got anything else going on, and I really do mean anything, physically, mentally or emotionally, go see your acupuncturist.”

Thinking Globally about Sex and Gender: The Yogyakarta Principles

A couple of years ago I discovered a document called the Yogyakarta Principles on the Application of International Human Rights Law in relation to Sexual Orientation and Gender Identity, created in 2006 in Yogyakarta, Indonesia by the International Commission of Jurists and the International Service for Human Rights, on behalf of a coalition of human rights organizations in reaction to egregious international human rights violations pertaining to individuals marginalized for their sexual orientation and/or gender identifications.

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The introduction to the Yogyakarta Principles begins with…

“All human beings are born free and equal in dignity and rights. all human rights are universal, interdependent, indivisible and interrelated. sexual orientation1) and gender identity2) are integral to every person’s dignity and humanity and must not be the basis for discrimination or abuse” (p. 6).

…and ends with…

“The Yogyakarta Principles affirm binding international legal standards with which all states must comply. they promise a different future where all people born free and equal in dignity and rights can fulfill that precious birthright” (p. 7).

I’m an advocate for every clinician and educator’s (and every human, really) reading this document in its entirety. Though the abridged principles listed as follows can be interpreted in different ways out of context, thinking critically about them as they stand here is a useful exercise in itself:

  1. The right to the universal enjoyment of human rights.
  2. The rights to equality and non-discrimination.
  3. The right to recognition before the law.
  4. The right to life.
  5. The right to security of the person.
  6. The right to privacy.
  7. The right to freedom of arbitrary deprivation of liberty.
  8. The right to a fair trial.
  9. The right to treatment with humanity while in detention.
  10. The right to freedom from torture and cruel, inhuman or degrading treatment or punishment.
  11. The right to protection from all forms of exploitation, sale and trafficking of human beings.
  12. The right to work.
  13. The right to social security and to other social protection measures.
  14. The right to an adequate standard of living.
  15. The right to adequate housing.
  16. The right to education.
  17. The right to the highest attainable standard of health.
  18. Protection from medical abuses.
  19. The right to freedom of opinion and expression.
  20. The right to freedom of peaceful assembly and association.
  21. The right to freedom of thought, conscience and religion.
  22. The right to freedom of movement.
  23. The right to seek asylum.
  24. The right to found a family.
  25. The right to participate in public life.
  26. The right to participate in cultural life.
  27. The right to promote human rights.
  28. The right to effective remedies and redress.
  29. Accountability.

Some interesting questions to ponder:

What of the above principles most affect you?

Which do you take for granted?

Which have you fought for?

The NYC Healthcare Hustle

Guest blog post by Stephanie Schroeder, a freelance writer and activist based in Brooklyn, New York.

Three years ago I published memoir about my struggle with bipolar disorder, Beautiful Wreck: Sex, Lies & Suicide. I got a little press, didn’t make a dime, but I did somehow become an instant go-to person in the Brooklyn LGBTQ consumer community on where to find no/low cost mental healthcare care and treatment, and especially how to afford expensive psychiatric meds without insurance or with insurance, but without adequate coverage. I’m a self-taught expert on how to do workarounds of the shitty healthcare systems we have in the US. I call this the NYC Healthcare Hustle, and healthcare professionals and friends alike refer folks in need to me regularly to see if I can help.

Here are a few inquiries I’ve received/exchanges I’ve had on social media in just the past month:

I signed up for “Obamacare” for $490 on January 1. I still don’t have a card and I don’t show up in the system. I’ve made several calls and just get the runaround. Still can’t get the abilify. I wonder if i will ever see a national healthcare plan in my lifetime. I need medical care with this fucking diabetes!!! Fuckers! I feel helpless with this shit.

I would love to have health insurance… That I could afford. The rates are just too expensive for the crap coverage I would be getting honestly. I think the cheapest plan I could get was $250 a month and it was really shabby insurance! I just couldn’t in my heart pay that much for something that wasn’t really covering me… And I do need it, for mental health. I’ve been lucky to find things like the shine program that help get these services for free.

I can’t find a new fucking psychiatrist who takes my insurance or reach my GP to talk about someone prescribing for me moving forward!

I have a question about medication and suicidality. My mind isn’t working well due to a dismal trial on Geodon (which helped me a lot once in the past, but this time the side effects and the side effects of the medicines I tried that treat Geodon side effects are very devastating and not at all tolerable) and due to just its nature, I guess. Abilify. I think you said it saved your life. I don’t want to live my life any more, but at the same time I wish I could at least have a chance at life. My psychiatrist is on vacation (until April 1) and I can’t wait that long. Do you know of a clinic or some other place where I could see a psychiatrist without being hospitalized? I have a private therapist who I adore – she doesn’t have any leads on a psychiatrist (she is a social worker.) I am on Wellbutrin SR (generic) and I think it has stopped working.  Do you know of anywhere that I can just walk in for help…?

The Affordable Care Act has not made healthcare better for most people I come into contact with, including myself. The reality is that the actual lack of affordable healthcare is making us sick(er). There are a lot of folks both within and outside the LGBTQ community who need help, need it now, and need it to be free or very low cost. The government of this country, state and city won’t help. I’ve appealed to many elected and appointed government officials in my lifetime mostly without response—or with the most lame, inane and canned responses ever. It’s not surprising, but it is disheartening.

I recently convened a group of radical queers to mobilize on behalf of our community. We are a small group—consumers and providers, and some who identify as both—concerned about the lack of information about and resources, in NYC, for quality, LGBTQ-affirmative, culturally competent affordable mental healthcare treatment and affordable prescriptions. We are concerned about the lack of choices, of various barriers to access as well as the lack of actual providers who are affordable, especially in light of the ACA. We aim to act as a resource/clearinghouse to our community/communities to find and publicize existing free and low-cost resources as well as develop new options.

Following are some ideas we initially conceived:

  • Establishing and maintaining a website listing relevant and updated resources for free/low-cost healthcare. This would provide detailed information and tips, not just a web links. We also discussed creating and distributing a zine.
  • Creating a cooperative of psychotherapists and psychiatrists who volunteer to take on one pro bono client for as long as they need assistance. This might also involve a community fundraising campaign on a crowdsourcing platform asking folks to donate the cost of one of their own therapy sessions to another community member in need to fund this project.
  • Training and coordinating peer counselors to support those in the community with mental health needs.

I’m also personally interested in coordinating a medication exchange. I’m more about rogue than my brethren, even while I respect the limitations of those colleagues with professional licenses. My idea is that folks donate surplus psychiatric medications whether they have extra, no longer take a certain drug, get free samples, etc. These are then passed along to others who need psych meds, but who cannot afford to purchase them, and there are a lot of folks in dire need. I had to stop taking Abilify for several months a few years ago because I could not afford the almost $700 price tag. I lived very precariously without my antipsychotic medication, thank goodness I have an excellent support network who helped me get through it, not everyone does. We created medication exchanges for HIV drugs—we can do it with psych meds.

I’ve applied for a few small seed grants, mostly to get a website with resources up and running. I envision this resource to not be a simple web listing of people and places, but one where those who have worked with, or tried to access, various resources, give tips and where commentary/narrative from those who have researched different resources accompanies listings.

Stay tuned for the NYC Healthcare Hustle Project to launch sometime in the fall of 2015.
[email protected]

Manhattan Alternative Represented at Upcoming SSTAR Conference

Dr. Eli Mayer will be presenting a talk on Saturday, March 28 at the 40th annual conference of the Society of Sex Therapists and Researchers (SSTAR) in Boston.  The theme of this year’s conference is: Healthy Sexuality as a Human Right: Making Sex Therapy Available to Diverse Populations.  The conference provides an opportunity to educate “mainstream” sex therapists and researchers about how to provide quality Sex Therapy to those of us whose sexual interests and gender identities diverge from what has traditionally been considered the norm.Screen Shot 2015-03-22 at 12.06.31 PM

It was forty years ago that modern sex therapy to shape with Dr. Helen Singer-Kaplan’s book: The New Sex Therapy was published.  At this conference, Dr. Eli Mayer hopes to help bring the members of the organization in line with contemporary thinking, and has titled his talk The New New Sex Therapy: Working Productively With Nonnormative Populations.  He looks forward to sharing information from the conference with everyone when he returns.  To be continued…

Intimate Partner Violence in Sadomasochistic Relationships

The following is an excerpt from research inspired by four individuals’ experiences of intimate partner violence in the context of what they had initially believed to be consensual sadomasochistic relationships. The individuals came forward with the common motivation of giving hope to others who have felt similarly trapped by the conspiracy of silence, and to help generate discussion in support of those who find themselves in an abusive relationship disguised as D/s.


Contemporary society has come far in progressing towards tolerance, and perhaps even acceptance, of individuals who may not look or act the way the statistical majority does in terms of sexual and gender expression. Having said that, human consciousness remains overwhelmingly confined by rigid heteronormative definitions of sexual orientation and gender identification, which reinforce binary stereotypes and the pathologization of individuals who identify outside of the mainstream. The enduring stigma around engaging in Bondage and Domination/Dominance and Submission/Sadism and Masochism/Sadomasochism—also known as BDSM, SM, S&M, kink, and D/s1—impedes the recognition and acceptance of normative D/s relationships, disallowing a context in which intimate partner violence can be recognized. In other words, when mainstream society ignores the fact that BDSM can be a healthy form of sexual expression, and conflates it with intimate partner violence (IPV), it is difficult for someone experiencing abuse within the context of a D/s relationship to seek and receive support from health care providers, law enforcement, society at large, and among peers.

Given that the issue of IPV in heterosexual relationships has traditionally been assumed solely to affect heterosexual women, and that stereotypical gender roles promote the assumption that the submissive partner is always female, a similar assumption follows that IPV in D/s relationships would be directed toward the submissive partner. While the literature indicates that this is predominantly the case, it is important to note that it is possible for any gender to abuse any other gender2,3,4, and that there can be a discordance between traditional gender and power roles within D/s relationships5; therefore, it is no less plausible that dominant partners can be abused by submissive partners, regardless of gender. Abusive tendencies are rooted in maladaptive characteristics specific to the individual6; they are not necessarily associated with biological sex, gender identity, sexual orientation, or BDSM-orientation. Non-consensual D/s relationships are a specific type of IPV, characterized by a lack of pleasure and the presence of enduring, permeating fear or discomfort on the part of the abused partner that is not confined to a consensual sexual encounter, and do not always occur in the direction of dominant to submissive partner7.  Unfortunately, there is no specific data to reference as there has been no research to date looking at instances of IPV in D/s relationships; this lack of research in effect reinforces and is reinforced by the conspiracy of silence around abuse.  It can be difficult for anyone who has experienced IPV to seek support, and those who are BDSM-oriented face the additional challenge of the common mainstream misconception that even consensual D/s relationships are abusive.

Institutional sexism affects all individuals who have experienced IPV, mainstream or non-mainstream, regardless of gender identity, sexual orientation, or BDSM-orientation. There is, however, an intersectionality of discrimination that can exponentially affect BDSM-oriented individuals. To begin with, there is a reinforcing relationship between socially sanctioned gender roles and institutional sexism8. This is an issue for any gender—all individuals who are subjected to IPV suffer neglect and mistreatment at the hands of patriarchal and misogynistic institutions. Likewise, when a non-mainstream sexual orientation is added to the mix, neglect and mistreatment by the same institutions intensify.

The situation is dire but not hopeless. With continued efforts to educate society and give voice to those in marginalized communities, policy can change, and supports for every survivor of abuse can be put in place. Imagine a world in which BDSM participants felt they could freely discuss their preferences and proclivities with their medical and mental health providers without fear of judgment or stigmatization. Health care providers might then have on file certain preferences that might cause specific types of marks, and might notice a congruent pattern with consensual markings. It follows that health care providers would also have the ability to notice when marks fall outside of an individual’s patterns and preferences, and that an open line of communication could be established to determine whether the marks had been consensually obtained or were the result of IPV.

There is much work to be done towards creating an ideal support system for survivors of IPV in D/s relationships. There is a need for training among medical and mental health professionals on how to recognize their own biases, and understand the difference between normative expressions of BDSM and IPV. There is a need to educate the general population in this way as well, so that the difference between abuse and BDSM becomes clear and easier to recognize for those in both mainstream and BDSM communities. There is a need to employ and train law enforcement that is less aligned with patriarchal and overly moralistic attitudes and beliefs, and more empathetic and culturally competent. Finally, there is a need within the BDSM community to promote a clear understanding of the scaffolding of consent: 1) negotiation of common interests; 2) agreement on both a verbal and nonverbal safeword; 3) a commitment to continually attain explicit, rescindable consent; and 4) the incorporation of aftercare, not only as a means of returning to a cognitive and emotional baseline, but as a means for ensuring all parties involved enjoyed and understood the experience in roughly the same way. The key to accomplishing all of the above seems to be in transparent and explicit communication, and the raising of silenced voices.


1 Connolly, P. H. (2006). Psychological functioning of bondage/domination/sadomasochism (BDSM) practitioners. Journal of Psychology & Human Sexuality, 18(1), 79–120. doi: 10.1300/J056v18n01_05

2 Ard, K. L. & Makadon, H. J. (2011). Addressing intimate partner violence in lesbian, gay, bisexual, and transgender patients. Journal of General Internal Medicine, 26(8), 630-633.

3 Enos, V. P. (1996). Prosecuting battered mothers: State laws’ failure to protect battered women and abused children. Harvard Women’s Law Journal, 19, 229-268.

4 Rohrbaugh, J. B. (2006). Domestic violence in same-gender relationships. Family Court Review, 44(2), 287-299.

5 McClintock, A. (1993). Maid to order: Commercial fetishism and gender power. Social Text, 37, 87-116.

6 Moore, K. J., Greenfield, W. L., Wilson, Kok, A. C. (1997). Toward a taxonomy of batterers. Families in Society: The Journal of Contemporary Human Services, 83(4), 352-360.

7 Nichols, M. (2011). Couples and kinky sexuality: The need for a new therapeutic approach. American Family Therapy Academy Monograph Series, 7, 25-33.

8 Joseph, J. A., Pitagora, D., Tworecke, A., & Roberts, K. E. (2013). Peering into gaps in the Diagnostic and Statistical Manual of Mental Disorders: Student perspectives on gender and informing education. Society for International Education Journal: Engaging with Difference, Gender and Sexuality in Education, 7(1), 104-127.

Grappling with Consensual Non-consent, part 2

Continued from Grappling with Consensual Non-consent, part 1.

Langdridge’s1 chapter on the eroticization of pain in BDSM interactions describes the concept of losing control in a different way. Though CNC is not mentioned explicitly, the type of interaction described intimates an interaction that is initially consensual, but then brings the bottom to an altered state of consciousness in which there is a complete loss of agency and separation from reality, which the author notes can result in a greater sense of intimacy and bonding between the parties involved1. Though this and the previous school of thought are contrasting on the surface, it seems in some way a question of semantics, or perhaps more accurately, individual differences in perception. That is to say, while a given person in the bottom role might be able and want to hold a suspension of disbelief during a scene, and a given person in the top role might be able to orchestrate a scene that makes this possible, others may not be able to sustain that illusion and still attain the kind of CNC experience they want, and so they may need to approach it in a different intellectual way. Both of these instances of CNC might appear to be played out in the same manner, and may result in a similar experiential trajectory.

Just as there are different ways to conceive of consent and CNC, there are differences in meaning that each individual attaches to their BDSM play. With this in mind, it stands to reason that almost every BDSM scene could be considered analogous to a CNC scene, in that consent is negotiated and obtained, there is an illusion of a loss of control, and there is a way for the bottom to end the scene. The potential for trouble enters into any BDSM scene—whether or not it includes CNC—when negotiation occurs and consent is obtained, but there is a lack of compassion or connection between the top and bottom, and therefore there is a greater margin of error and potential for dissatisfaction. There is also the case of a participant’s misrepresentation, or one who is under the influence of alcohol or a substance; these scenarios would further confound the potential for a successful BDSM and/or CNC scene. This begs the question of whether it is always possible to assess the level of trust that a bottom has for their top, or to know someone’s ability to trust or be trusted. Further, if a top is deemed trustworthy, does it follow that they would never allow a scene to go too far? If that is the case, does it then nullify or reinforce the premise of CNC? It seems possible to split hairs indefinitely, but in all cases, the way CNC is defined and enacted seems to be a matter of perspective and context.

CNC is considered problematic by many who feel a sense of stigmatization by virtue of being BDSM-oriented. Many fear that assumptions will be made about the way certain people in the kink community play, and that these assumptions will be project misapprehensions onto the entire community, and further pathologize all BDSM participants2. This fear is not unfounded; unfortunately, the problem of abusers masquerading as conscientious and caring sadists has long been detrimental to the public perception of BDSM. Sexuality educator Dr. Charlie Glickman gave voice to this issue when he wrote that some people are drawn to BDSM not because they get pleasure from consensual BDSM interactions, but because they see it as an opportunity to manipulate people new to BDSM into accepting abuse, while convincing them that their boundaries and desires do not matter. Those new to the scene without an awareness of BDSM culture are particularly susceptible to believing such violence must be accepted2. Additionally, due to the stigma associated with being kink-identified, fewer people are willing to discuss the existence of such predators in the BDSM community because they are reluctant to exacerbate the already negative perception that mainstream society has about BDSM3.

Ironically, two recent textual analyses comparing BDSM and heteronormative relationships illustrated that the dynamics of a D/s relationship have the same discursive origins as traditional relationships, and fall prey to the same issues of inherent gendered power dynamics4,5. The distinguishing factor that some would say makes a full-time CNC relationship a better option than conventional relationship is the explicit negotiation of and agreement to power roles and behaviors, as opposed to most conventional relationships, wherein roles are assumed based on socially mandated gender roles handed down through generations of patriarchy. Similarly, CNC can be perceived as reminiscent of conventional sexual interactions. That is to say, in the former, consent may be more likely to be overtly agreed upon initially than in the latter, but in both cases there is an expectation of consent, and an assumption that consent will persist and not be rescinded unless the interaction/relationship is being terminated.

Along these lines, in Tsaro’s6 analysis of contemporary BDSM-themed texts, consent is sometimes described in mainstream representations of BDSM as being reinforced by the absence of overtly denying or rescinding it, which is reminiscent of typically gendered sexual assumptions4. This is of particular concern, as the media and entertainment industries often seek to sensationalize and distort reality and focus on the extreme in order to gain maximum reader- and viewership, at the same time doing a disservice to readers and viewers by communicating false information and reinforcing unhealthy social dynamics.

In summary, while grappling with the concept of CNC interactions may clarify certain aspects and suggest guidelines, there remain conflicts about its practice, which is oftentimes arbitrary and ill-defined. It stands to reason that the struggle among BDSM practitioners to agree on specific, inclusive, and clearly defined terminology to describe BDSM interactions and behaviors may represent avoidance and resistance based in a reaction to internalized stigmatization, as well as an indication that intellectualization cannot always address emotional and moral conflicts. In the end, it seems as though the best possible way to address the issue of CNC is to continue the conversation, and encourage open dialogues about sexuality and the vast range of sexual behaviors both within and outside of the kink community.


1 Langdridge, D. (2007). Speaking the unspeakable: S/M and the eroticization of pain. In D. Langdridge & M. Barker (Eds.), Safe, sane, and consensual: Contemporary perspectives on sadomasochism (pp. 85–97). Buffalo, NY: Prometheus Books.

2 Fowles, S. M. (2008). The fantasy of acceptable ‘non-consent’: Why the female sexual submissive scares us (and why she shouldn’t). In J. Friedman and J. Valenti (Eds.), Yes Means Yes: Visions of Female Sexual Power and a World Without Rape (pp. 117-125). Berkeley, CA: Seal Press. Kindle Edition.

3 Glickman, C. (August 8, 2011). BDSM & rape, what now? Retrieved from

4 Barker, M. (2013). Consent is a grey area? A comparison of understandings of consent in Fifty Shades of Grey and on the BDSM blogosphere. Sexualities, 16(8), 896-914. doi: 10.1177/1363460713508881

5 Faccio, E., Casini, C., & Cipolletta, S. (2014). Forbidden games: The construction of sexuality and sexual pleasure by BDSM ‘players.’ Culture, Health & Sexuality, 16(7), 752-764. doi: 10.1080/13691058.2014.909531

6 Tsaros, A. (2013). Consensual non-consent: Comparing EL James’s Fifty Shades of Grey and Pauline Réage’s Story of O. Sexualities, 16(8), 864-879. doi: 10.1177/1363460713508903