Borderline Personality Disorder and Sexual Masochism: Treating the Roots of Dysfunction

Borderline personality disorder and sexual masochism can share an uneasy relationship stemming from sexual victimization. The roots of BPD are often deeply connected to early traumas, which may spark the evolution of sexual masochism. By treating your BPD using trauma-focused therapies, you can come to better understand your desires and behaviors and discover how to experience more positive expressions of sexuality.

When Fifty Shades of Grey was first published in 2011, it opened up widespread discourse about the nature of sexual masochism to audiences that had never before contemplated the issue. Is masochism just a fancy term for victimization? Or is it an expression of healthy sexual desires?

Within the BDSM community, of course, these questions are nothing new. They have been vigorously debated for centuries, particularly since the Marquis de Sade introduced the language of sadomasochism to the masses over two centuries ago. And the answer is that there is no one answer to these questions. In certain contexts, masochism can indeed be manifestations of taboo but ultimately healthy sexual interests. But in other contexts, it becomes something darker, blurring the line between positive sexual expression and abuse. This is particularly true when borderline personality disorder and masochistic sexuality overlap.

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Borderline Personality Disorder and Masochistic Sexuality

The relationship between borderline personality disorder (BPD) and sexuality is complicated. Sexual impulsivity and promiscuity can be a critical factor in BPD diagnoses—a fact that is not without controversy, as sexual impulsivity and promiscuity tend to be evaluated differently for men than for women. What may be defined as promiscuity in a woman may, for a man, be dismissed as simply sowing wild oats. But the important piece of the puzzle is not simply that sexual behavior is impulsive or promiscuous, but that it is potentially self-damaging. This is the nexus where BPD and masochism meet for so many.

Sexual masochism has long been anecdotally observed in people suffering from borderline personality disorder. This past April, however, the connection went beyond anecdote, entering the realm of empirical evidence. According to a study published in the Archives of Sexual Behavior, researchers found that “sexual masochism disorder was 10 times higher in BPD women than in women with other personality disorders.” Furthermore, those women who identified as masochists reported “more child sexual abuse, more hostile/dismissing attachments, higher sensation seeking, and more frequently exploratory/impersonal sexual fantasies than BPD without sexual masochism.” The findings reveal that women with borderline personality disorder are at significantly increased risk for participating in high-risk sexual activities that could compound existing suffering and lead to serious emotional and physical injury.

The Traumatic Roots of BPD

So what accounts for the relationship between borderline personality disorder and sexual masochism? The answers are complex and not fully understood. However, researchers believe that sexual abuse likely plays a significant role. Indeed, the connections between BPD and sexual trauma are undeniable; a study published last year in the Industrial Psychiatry Journal found that approximately 50% of people diagnosed with borderline personality disorder experienced some form of childhood sexual abuse and others have estimated the number to be as high as 75%.

While the exact causes of BPD remain elusive, it is believed that the condition often develops as a disordered way of coping with the overwhelming distress brought on by traumatic events. Becky Oberg writes, “BPD is a natural reaction to unnatural trauma.” As such, sexual trauma is often the nucleus of BPD itself; the fear of abandonment, fractured sense of identity, unstable relationships, and poor emotional regulation all germinate from the extraordinarily destabilizing events that disallow healthy psychological development. The emotional volatility, impulsivity, and self-injury so often present in those with BPD can then be understood as logical ways to modulate deep inner pain and exert control over a life in constant turmoil.

The Evolution of Sexual Masochism

Self-injury can mean many things. Sometimes it comes in the form of cutting, sometimes it comes in the form of burning, sometimes it comes in the form of hitting. And sometimes it comes in the form of sexual masochism. Just as in the case of other self-injurious practices, physical pain during sexual activity can release endorphins that create a rush, a high, or simply a feeling of calmness. In this context, masochism provides a powerful coping mechanism to address what is experienced as unbearable emotional distress.

But sexual masochism is not solely a chemical experience. Rather, it can allow you to, in essence, recreate the dynamics of traumatic sexual experiences and reframe them within an ostensibly consensual context. This can help you achieve a sense of retroactive control over situations in which you experienced a loss of control. In some ways, this approach functions as a dysfunctional type of exposure therapy as you seek to counteract the damage of the original trauma. Ultimately, however, it doesn’t work; engaging in traumatic sexual practices does not erase past violations and it keeps your sexuality defined by trauma rather than authentic desire.

In other cases, sexual masochism evolves out of early conditioning; if your introductions to sex happened within a context of violence, degradation, and powerlessness, it is possible that your own sense of sexuality come to revolve around these qualities. Sex, violence, and victimization have become inextricably connected in your mind and in your physicality, preventing you from being able to feel desire for other types of sexual interactions. Even if you recognize the destructive nature of this phenomenon, you may feel powerless to change it.

Treating BPD to Create Holistic Healing

People with borderline personality disorder, like everyone else, can experience sexual masochism in a way that is normal, benign, and even healthy. However, for many, it is anything but—in fact, it is a symptom of, and perpetuates, deep emotional distress in response to traumatic experiences. Not only does this keep you trapped in an ongoing state of dysfunction, it can also put you at risk for new psychological traumas and even physical injury. Furthermore, it prevents you from being able to discover and experience authentic sexual desires and pleasures beyond the limits of your disorder; it keeps you hidden from your true self.

Engaging in comprehensive, residential borderline personality treatment allows you to begin the process of finding meaningful relief from the overwhelming emotions that define your disorder. By combining dialectical behavioral therapy, cognitive behavioral therapy, and psychodynamic therapy with trauma-focused therapies like somatic experiencing and EMDR, you can come to understand the roots of your disorder and gain the skills to cope with distress in positive, healthy ways. In processing your experiences of trauma and sexuality in a validating and safe context, you can discover the true relationship between your borderline personality disorder and sexual masochism. What you uncover may be difficult and even painful, but with the guidance of expert clinicians, you can move toward more positive expressions of sexuality, improved interpersonal relationships, and restored inner harmony.

Interest in sexual masochism is nothing to be ashamed of. The ways human being experience sexuality are vast, complex, and endlessly varied. But if you are struggling with borderline personality disorder and masochism, it is essential to recognize that your sexual proclivities may be a symptom of your disorder and could be perpetuating your pain. With the right treatment, you can separate symptomatology from your true desires and connect with your authentic self to create a more tranquil, joyful, and pleasurable future.

Bridges to Recovery offers comprehensive residential treatment for people struggling with mental health disorders as well as co-occurring substance abuse and eating disorders. Contact us to learn more about our renowned Los Angeles programs and how we can help you or your loved one start on the path to lasting wellness.