Last updated on October 21st, 2026 at 10:58 pm
On June 18, 2018, the World Health Organization announced that sadomasochism would leave its international list of mental disorders. Under ICD-11, consensual pain play between willing adults finally became officially treated as simply private behavior rather than a psychiatric illness.
Sadism and masochism sit at the heart of the “SM” in BDSM, yet both words still carry heavy baggage from their clinical past.
A sadist enjoys giving consensual pain or intensity, while a masochist enjoys receiving it within agreed limits.
Many people feel curious about both sides, and plenty switch depending on partner, mood, or scene.
Pain play can deliver an endorphin rush, cathartic tears, and deep intimacy, but it also carries genuine physical and psychological risk.
Definitions, a side-by-side comparison, the science of pleasurable pain, safety habits, and the clinical line between preference and disorder are all covered here.
Table of Contents
What Are Sadism and Masochism in BDSM?
In BDSM, sadism means enjoying giving consensual pain, intensity, or humiliation, while masochism means enjoying receiving it.
Both happen only between willing adults who negotiate limits in advance, which separates them from cruelty or abuse.
Where the Words Came From
Both terms began in nineteenth-century psychiatry rather than in the kink communities that use them today.
According to Encyclopaedia Britannica’s entry on sadism, German psychiatrist Richard von Krafft-Ebing introduced the word, naming it after the eighteenth-century writer the Marquis de Sade.
He paired it with masochism, and for generations doctors treated both as illnesses requiring cure.
That view shifted slowly as researchers began separating consensual kink from genuine distress.
Today, clinical manuals distinguish between an interest and a disorder, a change examined in detail further down this page.
Sadism vs Masochism: Key Differences
The two roles complement each other, and the table below shows how they compare in a typical consensual dynamic.
| Feature | Sadist | Masochist |
|---|---|---|
| Role in pain play | Gives sensation or intensity | Receives sensation or intensity |
| Main source of pleasure | Partner’s reactions and shared intensity | Sensation, release, and surrender |
| Key responsibility | Reading signals and controlling intensity | Communicating limits and feedback |
| Common headspace | Concentration and control | Floaty or euphoric release |
| Typical risk | Misjudging force or ignoring cues | Pushing past safe limits |
Neither role automatically matches dominance or submission, because some dominants dislike giving pain and some submissives avoid receiving it.
Types of Sadists and Masochists
Pain play takes many forms, and most people enjoy some styles while disliking others entirely.
The Physical Sadist
A physical sadist enjoys delivering sensation through impact, clamps, pinching, or temperature, while watching a partner’s reactions closely.
Their pleasure comes from crafting intensity that a partner genuinely wants, rather than from inflicting damage.
Skill matters enormously, because physical sadists must know anatomy, warm-ups, and safe target zones.
The Emotional Sadist
An emotional sadist prefers psychological intensity, such as teasing, humiliation, fear play, or mind games, rather than physical pain.
These scenes can feel even more powerful than impact, so negotiation needs extra care.
Readers interested in humiliation and mind games can learn how to keep emotional play safe.
The Physical Masochist
A physical masochist enjoys receiving pain, which can feel exciting, grounding, cathartic, or deeply relaxing.
Some chase endorphin highs, while others enjoy testing endurance or surrendering control of their body.
Many favor particular sensations, such as thuddy impact, sharp stings, or nipple play intensity, while disliking others.
The Emotional Masochist
An emotional masochist finds release in consensual humiliation, degradation, or vulnerability, within carefully negotiated words and scenarios.
The experience can feel cleansing, particularly for people who shoulder heavy responsibility in daily life.
Clear lists of welcome and banned words protect against real emotional wounds that linger afterward.
The Sadomasochist or Switch
A sadomasochist enjoys both giving and receiving pain, sometimes with different partners or during different scenes.
Experience on both sides can deepen empathy, because each role teaches what the other feels.
Switches still negotiate each role separately, since limits for giving and receiving can differ widely.
The Science of Pleasurable Pain
Enjoying an unpleasant sensation is far more ordinary than it sounds, even outside BDSM.
In a 2013 study of 390 adults, psychologist Paul Rozin and colleagues identified 29 initially aversive activities that many people enjoyed.
Examples included the burn of chili peppers, tearful films, and exhausting exercise sessions.
They called this benign masochism, meaning pleasure in experiences the brain falsely reads as threatening.
Consensual pain play may work similarly, because the danger feels real while the setting stays safe.
Endorphins, adrenaline, trust, and anticipation combine to turn sensation into release, though research on the exact mechanisms remains limited.
Safe Practices for Pain Play
Pain play demands more preparation than most kink, because physical harm can happen quickly and quietly.
- Negotiate in detail: Agree on activities, tools, body areas, intensity, and agreed pain limits before any scene.
- Confirm stop signals: Keep a stop word both partners trust plus a non-verbal alternative.
- Learn safe zones: Avoid kidneys, spine, joints, neck, and head, aiming impact at fleshy areas covered in impact play for pain lovers.
- Warm up gradually: Build intensity slowly, because sudden heavy strikes hurt in unwanted ways and raise injury risk.
- Assess risk honestly: Rate dangers for each activity, using frameworks for weighing pain risks honestly.
- Avoid breath play: Restricting breathing carries a serious risk of brain injury or death, even for experienced players.
- Plan care afterward: Endorphin crashes are common, so schedule aftercare after pain play for both partners.
Higher-risk activities, such as edge play involving blood, require specialist training and strict hygiene.
Preference or Disorder?
Enjoying consensual pain is not a mental illness, and both major diagnostic systems now reflect that distinction.
The MSD Manual’s clinical entry explains that masochistic interests alone do not meet criteria for a disorder.
Diagnosis requires recurrent, intense arousal plus marked, clinically relevant distress or impaired functioning lasting at least six months.
The same entry estimates lifetime masochistic interests at roughly 10% to 30% in Western populations, while the disorder itself affects far fewer people.
It also warns that some people escalate and stop using safe words, which can lead to serious injury.
WHO took a similar step when it decided to drop sadomasochism from its classification.
Campaign group Revise F65, which lobbied for the change, reported the June 2018 decision and quoted WHO describing such diagnoses as reflecting private behavior.
Consensual sadism and masochism therefore sit within ordinary sexual diversity, provided nobody experiences harm or distress.
Red Flags in Pain Play
- Ignoring safe words: Continuing after a stop signal turns play into assault, regardless of earlier agreement.
- Anger-driven pain: A sadist who hurts a partner while genuinely angry has crossed from play into abuse.
- Escalation without discussion: Steadily increasing intensity without renegotiation can lead to injury and resentment.
- Pain as self-punishment: A masochist seeking pain to cope with shame or crisis may need professional support instead.
- No aftercare: Walking away after intense pain leaves a partner vulnerable to drop and distrust.
Myths About Sadism and Masochism
- Myth: Sadists are cruel people. Consensual sadists take pleasure in shared intensity, and most are deeply attentive partners.
- Myth: Masochists enjoy all pain. Most masochists enjoy specific sensations in specific contexts, and stubbed toes still hurt.
- Myth: Pain play means trauma. No solid evidence links consensual pain play to past abuse or mental illness.
- Myth: Sadists must be dominant. Some sadists happily take orders, and many dominants never give pain at all.
Readers wanting more can visit pages on sadistic dominants and their craft and masochistic submissives. Our overview of the S and M in BDSM places pain play within the wider picture.
Conclusion
WHO’s 2018 decision confirmed what many practitioners already knew: consensual pain play between adults is a preference, not a pathology.
Sadism means enjoying giving intensity, masochism means enjoying receiving it, and many people enjoy both.
Benign masochism research suggests pleasurable pain is surprisingly ordinary, although scientists still debate precisely how it works in the brain.
Safe play still requires detailed negotiation, clear signals, safe zones, gradual warm-ups, and generous aftercare.
Your next step: list three sensations you might enjoy and three you never want, then compare lists with your partner.
Frequently Asked Questions
How does a sadist differ from a masochist?
A sadist enjoys giving consensual pain or intensity to a willing partner, while a masochist enjoys receiving it, and both roles depend on negotiated limits and mutual trust.
Is sadomasochism a mental disorder?
No, consensual sadomasochism is not a disorder, and clinicians diagnose a disorder only when interests cause marked distress, impair daily functioning, or involve people who did not consent.
Why do masochists enjoy pain?
Masochists may enjoy endorphin highs, emotional release, surrender, or the thrill of intensity, and research on benign masochism suggests pleasurable pain is surprisingly common in ordinary everyday life.
Can someone be both a sadist and a masochist?
Yes, many people enjoy both giving and receiving pain, sometimes with different partners or scenes, and they usually negotiate separate limits for each separate role they take on.
Disclaimer: This article is for educational and informational purposes only and does not constitute medical, psychological, or therapeutic advice. All content assumes and is intended for consenting adults (18+). This site does not endorse or provide instruction for any non-consensual activity, or any content involving minors. If you are exploring kink, BDSM, or fetish practices, consult reputable educational resources and, where relevant, a licensed sex therapist or medical professional. If you are in crisis or experiencing abuse, contact appropriate local support services immediately.
Morgan Ellis is the author and researcher behind Kink: BDSM and Fetish Chronicles. With years of study into the psychology, research, and lived experience of alternative sexuality, Morgan writes about kink, BDSM, and fetish from an educational, judgment-free perspective — grounded in consent, communication, and safety. Every article on this site reflects a commitment to honest, responsible information for curious and experienced adults alike.