Parents walk in park with child in between, swinging child into airAn autism diagnosis can be challenging for a family. Often, the people affected most are the couple who are parenting the child on the spectrum. When my own son was diagnosed in 2001, my husband and I embarked on an arduous journey. It was not only a journey to help our son reach his full potential, but also an opportunity for our relationship to mature and change for the better. This journey happened before I became a therapist, and it was the impetus for my going on to become one. In my practice, I now help couples achieve the same development. So many therapies and interventions are readily available to autism families, but they are primarily centered on the affected child. Here are a few ways I’ve seen couples counseling benefit the parents specifically.

The Top-Down Approach

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There’s a saying here in the South: “If Mama ain’t happy, ain’t nobody happy.” I’ve found that statement is often true for these couples as well. When parents are dealing with their own issues as a couple, their parenting typically becomes easier. The ability to make decisions, to react appropriately, and to set limits and boundaries for their children can be less stressful when they find support in one another. This is true of any family, but it is even more crucial for the autism-affected family, as their stress tends to be compounded by lack of sleep, health concerns, and the pressure of making decisions that may affect the child’s growth and education.

Children with autism can be extra sensitive to the emotional state of those around them. So when the parents ignore their own emotional and relational needs, the child may have more difficulty coping in the household. Additionally, self-regulation is typically a challenge for kids on the spectrum, so if a parent has not learned how to manage their own outbursts, it’s unlikely the child will either.

Processing the Grief

In my office, the first place I start with a couple is in processing their grief. Couples who have received a new diagnosis of autism for their child are usually in a tremendous amount of emotional pain. This is an experience they did not necessarily sign up for, and adjusting to it can be difficult. In my experience as a parent, my son developed typically during the first year and a half of his life and then regressed. This was both confusing and heartbreaking, as it caused me to question my parenting ability.

The primary area where I see couples struggle is in feeling alone because the other person isn’t “on the same page.”

Grief is generally the source of the couple’s pain and an area that many parents need to be encouraged to venture into. This is where the counselor can be extremely helpful. From a therapist perspective, I like to start by asking about the diagnosis experience. Having each parent tell their story of how it unfolded can have tremendous benefits for the relationship, as it tends to move that grief process forward. Few people ask parents what it’s like for them, and the diagnosis experience has been identified in the research as one of the most difficult. It can even result in posttraumatic stress reactions (Kuhn 2006). This grief also tends to be cyclical, as it may come back around during different times of maturation in the child’s life. A counselor who is aware of these issues can help a couple navigate these rough waters.

Making Decisions Together/Getting on the Same Page

The primary area where I see couples struggle is in feeling alone because the other person isn’t “on the same page.” Often this can be due to being in different stages of the grief process. But it also can come as a result of ineffective communication skills or poor relationship boundaries. I’ve heard comments in my office such as, “If my husband would only read this book I just finished, he would understand our son better!” or, “If my wife would just give our daughter a good spanking, she would behave in the grocery store!” While these statements are not only (in my opinion) untrue, they are also indications the couple may be more interested in being “right” than “connected.” Or perhaps they don’t feel they are being heard.

Since autism encompasses multiple areas of functioning in a child, there are many areas where the couple’s opinions can collide. Special diets, deciding between therapies, and discipline strategies are just a few of the areas where my husband and I have collided. However, it was often less about the decision to be made and more about our own “stuff” that had been there all along. Once we learned how to set healthy boundaries with each other, to communicate effectively and respectfully, and to nurture one another’s needs, we could make these decisions more effectively and without resentment.

Finding a Counselor Who “Gets It”

I’m often told by the people who come to me for help that they feel better just knowing I’ve been where they are. While it is true that a shared experience can be helpful, it is only one of many things a counselor can bring to the table. When looking for a counselor who can help most effectively, it may be best to find someone who has good clinical couples counseling skills, who is licensed to do the work, and who has a few additional skills in the areas of grief, parenting, and even trauma. Someone who specializes in autism spectrum issues would be ideal, but clinicians specializing in coping with chronic illness also have the skill set necessary to help you navigate the autism road. The designation is less about autism being identified as an “illness” (although some of these children have multiple health issues), but rather the self-care and life-balance skills these clinicians incorporate into their specialty.

In the 20 years we’ve been raising my son, I can honestly say the road has not been easy, nor has maintaining a healthy marriage. But as clichéd as it may sound, it has made my husband and I better people, and our relationship has improved as a result of the work we have done. I’m not sure if we would have been able to get here without that pain, but what I am sure of is we wouldn’t have made it alone. Autism cannot be faced without support, and counseling is one of the things that helped us get where we are today.

Reference:

Kuhn, J. C., & Carter, A. S. (2006). Maternal self-efficacy and associated parenting cognitions among mothers of children with autism. American Journal of Orthopsychiatry, 76(4), 564-575. Retrieved from http://dx.doi.org/10.1037/0002-9432.76.4.564

Rear view image of person in long dress staring out windowed doorsDomestic abuse/violence, also known as intimate partner abuse/violence, is not a new phenomenon. We’ve studied families whose relationships include verbal abuse, emotional abuse, and/or physical aggressiveness, and those where factors such as addiction, alcoholism, and other struggles are also present.

While some people may be under the impression that urban living and low socioeconomic status are the sources of domestic violence, or that IPV only occurs among certain populations, the truth is that domestic violence occurs across the entire spectrum of wealth and social status.

When we see wealthy families in the media, on television shows such as Lifestyles of the Rich and Famous or Keeping up with the Kardashians, we may come away envying their wealth and possessions. Many of those families, and others not portrayed on television, may, however, often feel at odds with how they can have an internal experience that matches their outside environment. They may feel pressure to maintain a public face of contentment with their position and wealth, no matter the turmoil they experience privately. Wealth does not solve all of a person’s problems, and no matter a person’s means (or lack thereof), they may still experience mental health concerns, emotional struggles, family troubles, and any number of other life challenges.

Consider the following statistics about domestic violence:

Challenges to Seeking Help in Affluent Populations

Highly educated, high-income individuals may experience additional barriers when attempting to seek help for domestic violence within their partnership or family. Affluent individuals may be more likely to have power and influence, maintain their privacy, and live in isolated or remote locations, though of course this is not always the case. While these may be considered protective factors in some instances, they can also make it more difficult for victims (partners or children) to seek help. When a partner who is abusive has the means to keep a partner, children, or other family members isolated, as well as power and influence, the victim may feel powerless to seek help and fear they will not be believed if they report abuse. They may fear further emotional or physical abuse, or, when children are involved, the possibility of losing their children. If the partner who is abusive fears ruin should the abuse come to light, there may be the potential for greater harm.

Among women who have been highly educated and women who earn high incomes, there is also often a great deal of self-judgment and self-blame for becoming victims. Many women may feel they somehow should have known better than to put themselves into an abusive situation and may be reluctant to seek help out of embarrassment or shame.  This is another barrier to obtaining help and support. Some individuals may find it easier to deny the abuse in order to better cope with it. The thought of leaving, of seeing an attorney and ending the marriage, may be frightening, and some may find it too overwhelming or difficult to contemplate.

For many people, the words “domestic violence” bring to mind a situation in which a man abuses a woman. But abuse also occurs in LGBTQ+ families and relationships, and individuals of any gender may be abusive or experience abuse. In situations where a man experiences abuse, he may feel ashamed or fear losing his credibility and status, due to heteronormative ideals and gender role stereotypes. Some men may feel greatly ashamed of being victimized and avoid disclosing abuse and seeking help as a result.

While it bears repeating that abuse occurs in families of all income levels, it is also true that abusive individuals who wield a great deal of influence and power may readily go to great lengths to make it difficult for a person to leave. A situation also becomes infinitely more complex when children are involved.

Domestic violence in affluent families often extends beyond an emotional component and revolves around financial control and power, which can be utilized to hurt and control a partner and children. Domestic violence in affluent families often extends beyond an emotional component and revolves around financial control and power, which can be utilized to hurt and control a partner and children. If those experiencing the abuse were to bring it to light, the abusive partner could potentially lose their political, corporate, social, or financial status, as well as their family. Because a partner who is abusive is not likely to desire any of these outcomes, they may do whatever possible to keep their family under their control.

The fear of losing everything may go both ways, though. A partner who takes steps to escape abuse and an abusive partner also stands to lose in all those areas. For some, the risk may be too great, and they may remain in an abusive relationship, hoping their partner will eventually improve, change, or stop the cycle of abuse altogether.

Getting Help After Intimate Partner Abuse

When a partnership or family relationship is characterized by violence, battery, or other assault, the first concern should always be the safety of those who have experienced abuse. CPS, police, and other authorities may need to be involved to help survivors safely leave the home. Mental health professionals who have been informed about intimate partner abuse should take steps to assist the survivor in formulating an exit strategy and plans to get to safety with their children. This process must be confidential and anonymous, as statistics show 75% of IPV victims killed by an abusive partner are killed after they leave the abusive environment.

It may be hard to ask for help if you have experienced, or are currently experiencing, abuse from your partner. The first step is to tell someone. Whether you call a crisis hotline and share details of your situation anonymously, or confide in a parent, spiritual leader, mentor, or trusted coworker or friend, this step helps break down the barrier of silence many survivors of abuse feel trapped behind. By calling a crisis hotline, you can also learn about resources available to you. If you are injured or have a medical emergency, it may be best to call 911 or local law enforcement.

If you feel a friend or family member may be experiencing abuse, or you see something, I encourage you to say something. It may be best to let them know, privately, that you are there to listen if they need support or help. A simple show of support may help the person experiencing abuse feel safe enough to share. Nobody should have to live with this trauma and fear, but it may take you letting your loved one know you support them unconditionally to break the silence.

Is It Possible to Treat Intimate Partner Abuse?

I believe, in some cases, when a person who is abusive or controlling recognizes this fact and wants to change, it is possible for that individual to learn to address what has led them to be abusive and overcome it. Even if it is not possible for the relationship in which the abuse has occurred to continue, a person who was abusive may learn to avoid acts of abuse or violence in the future.

There are many factors that lead a person to commit acts of abuse, though none of these ever excuse the fact of the abuse occurring. Some people who abuse their partners may, as a result of childhood experiences, other history, or some other reason, may feel frustration and fear over the idea of losing their partner and so attempt to exert control. Individuals who come from abusive families may have learned abuse growing up. When they realize the source, they may be able to address it and learn to address their feelings and frustrations in loving, caring ways.

The fact that abuse is so often hidden and goes undiscussed among affluent individuals can make it harder to address and treat the causes of abuse. Those who are wealthy or have high social status may find it harder to access resources, or fear being met with disbelief if they attempt to seek help.

But I believe it is possible for some relationships that have been characterized by abuse to experience some level of healing and growth through therapy—though this does not always lead to a continuation of the relationship. Emotionally focused therapy, a therapeutic intervention designed to address distress in adult relationships, offers techniques for couples to learn how to address relationship conflict. Violence, however, is a contraindication for this approach—the tools utilized are considered to be ineffective when violence is present because the aggression and violence must be addressed first.

When I work with couples, I try to help them identify the loving feelings they have for one another and teach them to see their partner as a person they have chosen and want to be close to, a person whose happiness is important to them. I believe it is possible for people who have engaged in acts of abuse in the past to learn to work with their partner in healthy ways by learning how to communicate their attachment needs and how to heal and repair any damage or trauma in their past that may have led to the development of abusive or violent tendencies.

However, even when a partner who has been abusive is able to stop being abusive, under no circumstances should a partner who has been abused be encouraged to return to that relationship if they choose not to do so. Safety is the primary consideration, and those who have experienced abuse may never feel safe with a partner who has acted in abusive or violent ways. This decision must always be respected by all involved. 

If both partners feel safe and wish to work to repair a relationship in which abuse has occurred, relationship counselors can work with both partners, individually and together, to develop tools for safety, communication, and conflict resolution. Some individuals may find feelings of violence and aggression dissolve, significantly or even entirely, once they address past traumatic experiences. Others may experience the same effect when they work through concerns over losing a partner. However, this is not true for all situations, and moving forward in therapy may be at the discretion of the couple and the therapist working with them. Many therapists do not advise relationship counseling in some instances of IPV or domestic abuse but instead strongly encourage the partner who experienced the abuse to seek help and formulate a safety plan.

Therapy may progress slowly, as the therapist works to help the couple understand the basis of the abuse or the fear of losing one’s partner, and that abusive acts can be extreme manifestations of this fear and emotion. Some people who have not developed helpful or productive ways of addressing these emotions may resort to aggressive or violent tactics, simply out of being unable to deal with their feelings. I believe that most people do not truly want to hurt those they love, and that when a person is willing to change, they are able to do so, through extensive work on a personal level and in therapy.

Discussion about domestic violence has increased in recent years. In fact, October is dedicated to the awareness of domestic violence and intimate partner abuse. As a couples counselor, I work to address issues that may not be as readily discussed, such as abuse among affluent individuals. If you live in an abusive situation, I encourage you to reach out for help, even if you fear you may not be believed. A compassionate and qualified counselor will offer empathy and support and help you locate resources and assistance, no matter your status or situation.

References: 

  1. Domestic violence in affluent marriages. (2016, March 9). Retrieved from https://www.domesticshelters.org/domestic-violence-articles-information/domestic-violence-in-affluent-marriages#.Wfje-2hSzIU
  2. King, J. (n.d.). 5 challenges of wealthy abused women. Retrieved from http://www.preventabusiverelationships.com/articles/tiffanys_abuse_264.php
  3. National Coalition Against Domestic Violence. (2015). Domestic violence national statistics. Retrieved from https://ncadv.org/assets/2497/domestic_violence.pdf
  4. What is domestic violence? (2016). Domestic Violence Roundtable. Retrieved from http://www.domesticviolenceroundtable.org

Adult with short dark hair and beard sits on bench, hands steepled against face, looking downI believe infidelity is one of the most difficult challenges a couple can experience and attempt to recover from. In my work with people who have experienced infidelity—who may still be reeling from its effects—I’ve noticed some similarities between their varied experiences. While some come to me days after discovery and others may wait decades, many of those seeking help share one common experience, regardless of the amount of time that has passed: the pressure to forgive.

While many partners who have been unfaithful and want to salvage the relationship seek to be forgiven, sometimes almost immediately, many partners who have been betrayed are not ready to forgive until they are sure their partner understands the pain the act has caused.

Understanding Infidelity’s Impact

Infidelity can come in many forms, and it is not always characterized by a sexual relationship. Often infidelity occurs in the form of a new relationship outside the primary relationship. In some instances infidelity may be undetectable to all involved. Typically, an affair suggests that an individual was unfaithful over a period of time with an affair partner was an active, knowing participant. To some, infidelity also includes secret thoughts about a person other than a partner or the development of an emotional connection outside the primary relationship. A partner can also be unfaithful by hiding income or debt.

In most cases, infidelity is evidenced by: [fat_widget_right]

  1. Guilt over the crossing of relationship boundaries, even if one partner is not aware of what happened.
  2. Acts or thoughts kept secret by one partner because they know the other partner would not approve
  3. A feeling of betrayal when the acts or thoughts are discovered or revealed.

People who have been unfaithful may not be aware they have crossed the line into infidelity. They may also not have had the intention of harming their partner. In the aftermath of unfaithfulness, however, they often discover the pain experienced by the other person goes deeper than they could have imagined.

A betrayed partner may come to find their world view, sense of safety, and very identity has been shaken. Many people I treat experience both physical and emotional symptoms, such as intrusive thoughts that creep in over the course of their day, difficulty sleeping or eating, or depression symptoms, among others. These effects, and the pain experienced as a result, may heal in time. But time does not automatically heal the wounds of infidelity; therefore, there is not a specific timeline for forgiveness. Couples who want to recover from the trauma of infidelity generally find it necessary to invest significant time and effort into rebuilding the relationship.

What Forgiveness Can Signify—and What It Doesn’t

After infidelity comes to light, the person who was unfaithful may hope to be forgiven right away. While forgiveness may be a necessary part of infidelity recovery, it generally does not occur at the beginning of the recovery process. In my experience, forgiveness more often comes near the end of the process.  To the partner who was betrayed, forgiveness often means the end of the journey. Why? Because forgiveness can feel dangerous.

Forgiveness can feel dangerous because, to some, it may indicate certain beliefs they may not necessarily support. Let’s consider a few of those.

1. I can never feel hurt or upset again.

When an affair is discovered, couples who are trying to reconcile may fall into opposite roles. The partner who was betrayed is the “good” partner while the partner who was unfaithful is the “bad” one. They remain in these roles until the “good” partner sees the “bad” partner begin to understand the hurt they experienced as a result of the “bad” partner’s actions.

Hurt stemming from a breach of trust such as infidelity may cause emotions and symptoms that affect activities of daily life. In this case, the betrayed partner may feel it’s better to forgive for the good of the relationship, but that doing so will remove the pain from the experience. By forgiving, they might feel, they can never try to heal from the pain or learn what is needed to prevent it from happening again.

But forgiveness does not wipe away or invalidate the pain or trauma resulting from an act of infidelity, nor does it indicate the person who was betrayed no longer experiences those emotions.

2. I am excusing or accepting your behavior.

Many partners I’ve worked with struggle with the idea that forgiving infidelity does not mean the behavior is acceptable. Some equate it to raising children: if there are no consequences to deter behavior, then the behavior is excused. Partners who have been betrayed may feel by forgiving, they are offering the partner who was unfaithful a “get out of jail free” card.

After infidelity, most couples struggle to find a way to ease the pain, and forgiveness may seem like a less-painful way out. Unfortunately, when a partner who has been betrayed is rushed to forgive, increased pain and distance is often the result.

But both partners need to work to find a way to separate the pain of the breach from the freedom of forgiveness. The reality is, forgiveness is for the forgiver. It can help to think of forgiveness as taking the weight of your own hurt and pain and tossing it into the ocean. By forgiving, you are saying “I do not want to carry this burden of pain any longer.” A person can still experience hurt as a result of a behavior but choose to forgive—because they want to begin to heal.

3. Now I have to want to restore the relationship.

A partner who has been unfaithful may believe once they are forgiven, the relationship will return to the way it was or be automatically repaired. But this may not be the case. Even when a person is able to forgive, they may still not be ready to repair the relationship, at that time or at any time.

Restoration is not always the goal of infidelity recovery, and infidelity recovery does not have to involve both partners. Sometimes one or both partners may choose to heal alone. Forgiving a partner who was unfaithful may, to some, mean moving on from the relationship. Some partners who were unfaithful may similarly choose to move on from the relationship.

I teach the people I work with that there are levels to recovery.

In most cases the first level is sufficient for individuals who choose to recover on their own. Reconciliation is necessary to rebuild trust, but it is important to remember forgiveness does not automatically mean reconciliation will follow.

4. Now I must be ready to trust completely.

I’ve heard partners who have been unfaithful say, “If you forgive me, then you have to trust me.” I work diligently to teach them forgiveness and trust are two separate events. Forgiveness can mean a partner wants to trust again at some point, but it may not yet be possible. Forgiveness helps the person forgiving find release from pain, while trust can allow the person who was forgiven to find release from guilt. The act of rebuilding trust also requires the participation of both partners.

After infidelity, most couples struggle to find a way to ease the pain, and forgiveness may seem like a less-painful way out. Unfortunately, when a partner who has been betrayed is rushed to forgive, increased pain and distance is often the result. While in some cases, forgiveness may not be possible, in other cases being unable to forgive may prolong pain.

Finding the place where forgiveness is beneficial can be a delicate process, and patience, with both the self and with one’s partner, is more likely to aid recovery than forcing the process. No recovery has a timeline or a shortcut. Recovering is hard work, whether partners choose to end a relationship or attempt to rebuild it. In either case, recovering from infidelity can present an opportunity for both partners to find strength and grow, and couples counseling can be a helpful step in this process.

Photo of black leather handcuffs, blindfold, flogger, and rope on flower petal backgroundYou consider yourself an open-minded therapist. As such, you feel ready to accept and understand almost anyone who walks through your office doors, whatever concern or issue they bring in with them. But what happens when a person you are working with mentions a practice you are unfamiliar with? Your natural tendency may be to ask the individual to elaborate and help you understand the nature of what they have brought up, until you get the chance to do some research of your own.

Individuals who practice BDSM may be able to help you better understand both what the practice means to them and any impact, positive or negative, it might have on their relationship and/or life, but each person and couple’s experience is unique. One individual cannot, of course, help you understand what the practice means to others you might see in therapy.

Of course, while people may seek therapy for reasons related to BDSM practice and/or its effects on their relationship, they are just as likely to seek therapy for unrelated reasons. The purpose of this article is to help you become familiar with what to look for when working with BDSM-practicing couples or individuals—and to help you avoid assumptions and stereotypes.

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What Exactly Is BDSM? 

BDSM serves as an umbrella term or combined abbreviation that refers to “bondage and discipline,” “dominance and submission,” and “sadism and masochism.” It can describe a wide variety of erotic practices and/or roleplaying involving one or more of these or related interpersonal dynamics between consenting adults.

Some individuals and their partners might incorporate BDSM into everyday life or live a BDSM lifestyle 24/7, while others maintain BDSM practices only in the bedroom. Some might also practice certain behaviors typically identified as being part of a BDSM lifestyle, such as collaring (putting a collar on one’s partner) or practicing sexual dominance and submission, without fully identifying with BDSM culture. There are many subgenres of BDSM, and individuals may choose to practice in any number of ways.

Distinguishing Intimate Partner Abuse from BDSM

When a person’s information about BDSM is primarily limited to sources outside the BDSM community—movies, books, news, and pornography that may or may not be thoroughly researched–it may be difficult to understand the difference between consensual and safe BDSM practices and “BDSM play” that is in actuality abuse.

What’s often left out in media and popular culture depictions of BDSM is the single most important aspect of BDSM culture: consent. Therefore, in order to truly understand the dynamics of a BDSM relationship, or a relationship characterized by the practice of some aspects of BDSM, one must have the curiosity to look “behind the scenes,” or past what is readily apparent, and seek to truly understand what is happening.

We are often only shown the provocative parts of BDSM, a strategy designed to keep our attention that is not dissimilar to the way pornographic films rarely show protection steps such as putting on a condom or flushing the bowels. When movies or TV portray BDSM practices, we do not often see a discussion of safe words, the amount of safety preparations necessary for activities such as rope-binding, or aftercare following a session of intense activity, in which partners reconnect and offer verbal, emotional, and/or physical support to each other.

Forms of mainstream media often inaccurately portray BDSM relationships, and misinformation about BDSM culture prevails in part due to the amount of attention these false depictions of BDSM culture receive.  Take, for example, the novel and movie series 50 Shades of Grey. The publication of the novel sparked interest in the BDSM community, but unfortunately the series doesn’t accurately depict BDSM culture. Thus, many consumers of the book and/or movie are left with a false representation of a BDSM lifestyle.

Christian Grey, the character who plays at being a dominant partner in the series, exhibits a number of abusive behaviors not condoned by the real-world BDSM community. For example, Christian engages in non-consensual stalking and threatening of the female character, Ana. In one scene, he does not stop when Ana says “no” to sex but continues his sexual advances. Not only does ignoring a partner who says no (unless this is an activity for which prior consent was obtained) go against BDSM culture, it is also rape. Another significant indicator of abuse in the series is the contract Ana signs at Christian’s behest, which states she cannot speak to anyone about what happens between her and Christian. If their relationship was one based on communication and mutual respect—as all relationships should be—there would be no need to silence and isolate Ana. Many partners who practice BDSM together do have written and/or verbal contracts, but these generally exist to outline hard limits and practices both partners have consented to.

Now that we have explored some ways BDSM culture has been misconstrued by outside sources, let’s discuss a few ways you, as a helping professional, can bring this awareness into your practice.

It’s important to remember that abuse can still happen within the context of an established BDSM relationship, and abuse assessment is still an essential step of intake when beginning to provide treatment to a new individual or intimate partners.

1. Bruises don’t always mean abuse

As therapists, we have most likely been trained to look for certain signs of abuse, such as long sleeves, a malnourished appearance, and particularly bruises. In some BDSM relationships, however, bruises are common and may even be cherished and/or displayed proudly by their wearers. If you notice bruises on a person you are working with, it is always important to assess where the bruises came from and whether their origin was consensual, accidental, or from unwanted physical violence.

2. Consent is key

You may be wondering about the line between an abusive relationship and a BDSM relationship, as they both involve what we may consider to be “abuse” in both mental and physical forms (striking, paddling, insulting, belittling, or controlling another person). As mentioned above, the key difference here is consent. In a healthy BDSM relationship, there is open communication between partners about what they want, and a contract outlining what is permissible and consented to as well as any limits, commonly exists between willing participants.

The following examples provide further clarification on communication and consent:

3. Assess for Abuse Individually

I always advocate for individual abuse assessment with every couple. Couples who practice BDSM are no different. I believe it is a good idea to, during intake or shortly after, set time aside to see each partner individually in order to assess for abuse.

It’s important to remember that physical and sexual abuse can still happen within the context of an established BDSM relationship, and abuse assessment is still an essential step of intake when beginning to provide treatment to a new individual or intimate partners. The above example with Nikole and Terry could very well happen in an established BDSM relationship.

4. Seek to Understand

You may be feeling somewhat uncertain or at a loss when a couple who practices BDSM or lives a lifestyle characterized by BDSM practices walks into your practice for the first time. You may feel a flutter of nervousness when a person you are working with informs you they practice BDSM. Hopefully, the topics discussed in this article have helped you feel better equipped to address this topic in the therapy room by providing you with some insight into what to expect and what follow-up questions to ask.

However, even if you consider yourself to be an all-around expert on BDSM culture, you still will not necessarily be familiar with exactly what BDSM means to each person you work with, as every individual and couple defines their relationship and the aspects of it that relate to BDSM differently. The only way to truly understand is to ask what BDSM means to them and how they incorporate BDSM practices into their relationship. Every answer will be different.

Reference:

  1. Kolmes, K. (2015). An introduction to BDSM for psychotherapists. The Society for the Advancement of Psychotherapy. Retrieved from http://societyforpsychotherapy.org/an-introduction-to-bdsm-for-psychotherapists
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