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Is Masochism Addictive?

First posted June 25, 2013
Last revised June 27, 2013

Dedicated to Nurse Vanessa of Austin
(with many thanks for her help.)

With additional thanks to Tess of San Antonio.


"Everyone is a prisoner of his own experiences.  No one can eliminate prejudices - just recognize them."
 - Edward R. Murrow

Many of us in the American BDSM and Leather communities have perceived that the medical and academic communities have demonized sadomasochism instead of studying it objectively and empirically. Those of us in the insular sadomasochist communities believe that the medical and legal communities have generally accepted the popular culture bias --- of sadomasochism being an inherently unhealthy and destructive behavior --- without objective study. (Much like the medical community defined homosexuality as a mental disorder until 1973.)

Take for example, The Loving Dominant by John Warren published in 1994. It was the definitive "How to" book for the BDSM community at the time. In it, Mr. Warren illustrates the academic prejudice about sadism:

During the conference that followed publication of the "Playboy Foundation Report" in the 1970s, researchers had a chance to differentiate sadism from dominance. W.B. Pomeroy, one of Kinsey's collaborators, describes a segment of a filmed scene which depicted a waxing. He had noticed the "sadist" was watching, not just the place where the wax was falling, but also the expression on his partner's face. When this "sadist" detected that she was getting close to the edge, he raised the candle to reduce the intensity of the stimulation. Pomeroy commented, "it suddenly occurred to me that the masochist was almost literally controlling the sadist's hand."

"Sadly, a less imaginative colleague pooh-poohed the idea and insisted that "genuine" sadists are not interested in a willing partner. (Warren 25)

Warren is complaining here that the medical establishment starts with the conclusion that sadomasochism is abusive and evaluates all evidence in light of that conclusion. This concern has some justification. Many of us in the BDSM community have encountered mental health professionals who cannot imagine a reason why a healthy person would engage in S&M and conclude that anyone who does must be unhealthy in some way. It can be argued that this bias is institutionalized in the Diagnostic and Statistical Manual of Mental Disorders.

Sexual Masochism was not mentioned in the DSM-I (1952) or the DSM-II (1968). Sexual Sadism is mentioned in passing in the the DSM-II:

Sexual Deviations. This category is for individuals whose sexual interests are directed primarily towardsobjects other than people of the opposite sex, toward sexual acts not usually associated with coitus, or toward coitus performed under bizarre circumstances as in necrophilia, pedophilia, sexual sadism, and fetishism. Even though many find their practices distasteful, they remain unable to substitute normal sexual behavior for them. This diagnosis is not appropriate for individuals who perform deviant sexual acts because normal sexual objects are not available to them. (p. 44)

In the DSM-III --- published in 1980 --- sadomasochism was defined as a paraphilia --- a sexual disorder, something unhealthy by definition. However, in the DSM-IV --- published in 1994 (the same year that The Loving Dominant was released) --- the diagnosis of sadomasochism as a paraphilia required that "the fantasies, sexual urges, or behaviors" must "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." The DSM-IV TR (2000) further clarifies the diagnosis of paraphilia by requiring that activity must be the sole means of sexual gratification for a period of six (6) months and either the activities be non-consensual or that "the urges, sexual fantasies, or behaviors cause marked distress or interpersonal difficulty."

The DSM-V was published in June of 2013. In this latest edition, cross-dressing, fetishes, and BDSM are now categorized as "unusual sexual interests." (Few of us in the BDSM or Leather community will take offence to that diagnosis and many of us will embrace it.) In contrast, the term Paraphilic Disorder applies to those who who deliberately cause harm to themselves or others, have non-consensual sex, or have sex with children.

The nuanced approach can be seen in the following passages:

A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not necessarily justify or require clinical intervention. (DSM-V, 686)

In contrast, if they declare no distress, exemplified by anxiety, obsessions, guilt or shame, about these paraphilic impulses, and are not hampered by them in pursuing other personal goals, they could be ascertained as having masochistic sexual interest but should not be diagnosed with a sexual masochism disorder. (DSM-V, 694)

Many individuals who self-identify as fetishist practitioners do not necessarily report clinical impairment in association with their fetish-associated behaviors. Such individuals could be considered as having a fetish but not fetishistic disorder. (DSM-V, 701)

Clinical assessment of distress or impairment, like clinical assessment of transvestic sexual arousal, is usually dependent on the individual's self-report. (DSM-V, 703)

Clearly the American Psychiatric Association --- which published the DSM --- has reevaluated its view of sadomasochism in much the same way they reevaluated its assumptions about homosexuality.

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The Question

In a largely fair and balanced paper on the topic, D. J. Williams writes, "Certainly, if our organization is about the 'advancement of sexual health,' we need to continue to include this topic in our training repertoire, and we should consider the real possibility that both healthy and addictive sexuality can exist in a number of different relationship structures, including alternative lifestyles such as BDSM." (Williams, 344) Interestingly the author notes "I have heard several individuals in SM lifestyles complain that clinicians don’t understand their relationships and would be quick to label their unconventional practices as pathological." (334)

But despite the over all tone of acceptance Williams repeatedly mentions the possibility of addiction in the BDSM and Leather community: "It is suggested that SM potentially may be enriching and beneficial to many who safely participate, or it sometimes may be considered pathological and destructive." (Williams 333) Later in the article Williams writes "Clinicians may wonder how to discern when BDSM may be healthy and safe, and when it may be addictive and destructive." (342) And still later Williams continues on this theme: "Is BDSM simply a form of tolerable serious leisure, or has it become intolerable due to safety considerations, or progressed to a full-blown addiction?" (343)

Williams asks a valid question. However no research, evidence, or case studies of addiction are offered. It can be easy to assume that Williams is arguing that the risk of masochistic addiction is real. But Williams is merely being cautious in acknowledging that addiction is a possibility. Williams is not assuming that there have been any instances of sadomasochistic additions --- nor that there are none.

However, at least one other professional academic has stated authoritatively and unambiguously that the phenomenon does exist. In Investigating Religious Terrorism and Ritualistic Crimes (2003) --- her forensic textbook on religious terrorism --- philosopher turned criminologist Dawn Perlmutter argues that "blood rituals are addictive -- both psychologically and physiologically when a person experiences pain, endorphins (natural pain killers) are released; however, eventually more pain is needed to achieve the same endorphin high." (p. 165) This is a strong statement but she does not offer any supporting evidence or cite a source for her assertion.

The specific experience that Perlmutter is referring to is well known in the BDSM and Leather communities as "sub space." It is the "natural high" resulting from the body's release of endorphins in response to the pain and fear resulting from sadomasochistic "play." It is the equivalent to "runner's high" but without the benefits or challenges of physical exercise.

Is "sub space" addictive in the way Perlmutter describes? For that matter, is the "runner's high" addictive? Should sadomasochism be viewed as a consensual pleasurable activity or a risk for addiction?

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Addiction Defined

"In ordinary life, the struggle is not for guns but for words; whoever first defines the situation is the victor; his adversary, the victim."
 - Thomas Szasz
The Second Sin. New York: Doubleday, 1973

As with many controveral issues, the answer to the question is dependant on the definition of the key term --- in this case addiction.

In the (online) Oxford Reference, Addition is defined as "a state of dependence produced either by the habitual taking of drugs or by regularly engaging in certain behaviors (e.g. gambling)." (Oxford Reference)

The American Society of Addictive Medicine has posted the following definition on their web site:

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. (ASAM)

In the Psychiatric Glossary of the American Psychiatric Association addiction is defined as:

Dependence on a chemical substance to the extent that a physiologic need is established. This [need] manifests itself as withdrawal symptoms ... when the substance is removed.

Psychiatric Glossary defines drug dependence as:

Habituation to, abuse of, and/or addiction to a chemical substance .... The term thus includes not only the addiction (which emphasizes physiologic dependence), but also drug abuse (where the pathologic craving for drugs seems unrelated to physical dependence).

In one introductory college psychology textbook, addiction is defined as "when someone becomes dependent on a psychoactive drug to the point that life revolves around the drug and interpersonal relationships suffer." (Wortman, 434) Furthermore "people can develop addictive disorders with regards to ... marijuana, hallucinogens such as LSD, and stimulants such as cocaine and amphetamines." (Wortman, 434)

More specifically, the Oxford reference defines drug addiction as "Chronic physical craving or compulsion to continue to take a drug to avoid the unpleasant physical effects resulting from withdrawal of the drug." (Oxford Reference)

These different defintions of addiction can be separated into two groups or models:

  1. Behavorial addiction: non-chemical compulsions to deleterious behaviors (e.g. gambling and Internet use) or pathological craving for chemicals
  2. Chemical addiction: physiologic chemical or substance dependence (e.g. drug addiction) leading to withdrawl sympotoms (e.g. sweats, tremors, convulsions, and hallucinations) when the chemical is withheld

Between the two addiction models, the second model --- chemical addiction --- most closely matches Perlmutter's use of the term. According to Perlmutter the pain addict must get increasingly greater doses of endorphins like a chemical addict needs more alcohol or metamphetamines. So for the purpose of this article, we will define addiction narrowly in terms of substance addiction (i.e. drug or chemical addiction) despite the fact that unlike drug addiction, the euphoria caused by pain is a "natural high" that is caused by chemicals naturally occurring in the human body.

Admittedly, the first model --- the non-chemical compulsion group of definitions --- is broader and easier to apply to a pattern of indulgence in a deleterious behavior --- or to the deleterious overindulgence of any behavior. The answer to our question might have two different answers depending on which defintion we use. But since Dr. Perlmutter describes a chemical addiction, that will be the model we use.

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Sub Space and Getting High

Central to the concept of chemical addiction is Dopamine, a chemical messenger (neurotransmitter.) Dopamine is produced naturally in the hypothalamus and is secreted by the body in response to reward motivation stimuli such as food, water, and sex. It helps control the brain's pleasure and reward centers. Dopamine activity can also be increased artificially by the use of addictive drugs --- including cocaine, amphetamine, and methamphetamine. Their use creates a psychological state of euphora -- a "high" or a "trip".

In the S&M communities, the pleasurable psychological state caused by intense prolonged pain is known variously as "subspace," "headspace," "flying," "floating," or "bottoming." It is experienced differently by individuals and there is no single definition accepted in the BDSM and Leather communities. Some compare it to a morphine high. Sometimes it describes a relaxing trance like state where the masochist processes the pain while becoming unresponsive and mentally separating from his environment. Sometimes it is described as invigorating.

Because of the private nature of the BDSM community, there doesn't seem to be any academic body of knowlege on this state. The community wisdom is that it results from the body's release of endorphins, epinephrine, and enkephalins usually --- but not always --- in response to intense stiumuli --- in other words pain.

The ChicoMUNCH web site hosts a well written description of "subspace" on their web site. It is credited to "Dr Dexter." (It's not clear if the honorific "Dr" is based on a degree or if it is a "scene name" like "Sir Lion," "Lord Dred," or "Goddess Susie.") The article reads in part:

At the same time, BDSM quite often involves impacts to the body. During a scene, the intense experiences of both pain and pleasure trigger a response of the sympathetic nervous system, which causes a release of epinephrine from the adrenal glands, as well as a dump of endorphins and enkephalins.

These natural chemicals are a part of the body's primal "fight or flight" response. They produce the same effects as a morphine-like drug. This dump of morphine-like chemicals into one's bloodstream into increases the pain tolerance of the submissive as the scene becomes more intense -- and also induces a euphoric, ecstatic, floating feeling. (Dr Dexter)

BDSM fiction author January Rowe explains:

Subspace is the BDSM term for the special state caused by pain and other strong sensations. It's not a feeling of great joy or exhilaration, like a roller coaster ride; it isn't even a traditional high. Subspace is a trance: floating, utter calm, peace and tranquility. Hormones, primarily the natural painkillers called endorphins, are thought to induce it. (Rowe)

The owner of the MC n Circe web site connects sub space to Dopamine:

Subspace occurs during pain or endurance play. It is created by a mix of brain chemicals that cause a natural high that can, in a lot of cases, become addictive. A rush of brain chemicals such as endorphins or adrenaline create a high of their own. For example, the adrenaline high is the one that people into dangerous or extreme sports, like bungee jumping from high bridges, go for. Subspace differs from these singular highs. It is a prolonged state brought about by a cocktail of chemicals such as endorphins, dopamines, serotonin and adrenaline created by experiencing pleasure and pain simultaneously.

Dopamine and Seretonin in the brain are responsible for happy or euphoric feelings.

Dopamine, Serotonin and Adrenaline try to increase our ability to deal with a crisis by increasing our ability to process subconsciously, because subconscious processing is fast and conscious processing is slow. This retreating into the subconscious is the basis for subspace. (MC n Circe)

Again the subject of addiction is raised. But as with Dr. Perlmutter's assertion, no examples, sources, or studies are cited.

Other sadomasochists make the connection between subspace and Dopamine. DarkDivah writes:

Sub space is a complex thing, the releasing of endorphins that increase dopamine levels and leave one in a state of euphoria, sometimes trance like, sometimes not, sometimes the actual trip to space is nothing more than an all over relaxed feeling that I personally akin to taking a Valium. (DarkDivah)

Sir Stompsalot writes:

While endorphins do play a role in your scene, so do dopamine, prolactin, cortisol and oxytocin.

Dopamine is a neurotransmitter that is produced by several areas of the brain. If you think of BDSM as a car, dopamine would be your gas. It is a factor in nearly everything that you do including thought, movement, motivation, learning and reward-seeking behaviour.

It is because of dopamine that your submissive will ask for another, or in some unrecommended cases ask if that’s all you’ve got. Cocaine is a dopamine transporter, whereas extremely high dopaminergic levels has been linked to schizophrenia.

Dopamine is responsible for sexual arousal. During a play session until climax, dopamine levels will be extremely high due to the reward-seeking response.

While we understand the psychological state of drug use, we don't have any documented scientific studies of the psychological state of "sub space.". The previous authors quoted don't appear to have any medical or academic credentials. It's possible that they have taken legitimate medical findings on sexual intercourse or "Runner's High" and applied them to "sub space." But it seems likely that chemically induced "highs" and "sub space" are related.

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Sexual Addiction

There is another controversial type of addiction --- that like pain addiction --- is said to caused by chemicals naturally occurring in the human body. For people unfamilar to the BDSM and Leather communities, the theory of addiction to pain might closely resemble the theory of Sexual Addiction.

The theory of "Sexual Addiction" was championed in the writing of Patrick J. Carnes Ph.D. He legitamized the concept in 1983 with his book Out of the Shadows: Understanding Sexual Addiction. Here is is definition from the 3rd edition (2001):

A way to understand sexual addicts ... is to compare them with other types of addicts. A common definition of alcoholism or drug dependency is that a person has a pathological relationship with a mood-altering chemical. The alcoholic's relationship with alcohol becomes more important than family, friends, and work. The relationship progresses to the point where alcohol is necessary to feel normal. To feel "normal" for the alcoholic is also to feel isolated and lonely, since the primary relationship he depends upon to feel adequate is with a chemical, not other people.

Sexual addiction is parallel. The addict substitutes a sick relationship to an event or a process for a healthy relationship with others. The addict's relationship with a mood-altering experience becomes central to his life.

Later he adds "addicts are people who cannot stop their behavior which is crippling them and those around them."

It is important to note that the theory of Sexual Addiction has been widely criticized. In a widely used textbook for college Human Sexuality courses, authors Robert Crooks and Karla Baur explain the controversy:

Both the professional literature and the popular media have directed considerable attention to a condition commonly referred to as sexual addiction. The idea that people can become dominated by insatiable sexual needs has been around for a long time, as exemplified by the terms nymphomania, applied to women, and satyriasis or Don Juanism, applied to men. Many professionals have traditionally reacted negatively to these labels, suggesting that they are disparaging terms likely to induce unnecessary guilt in individuals who enjoy an active sex life. Furthermore, it has been argued that one cannot assign a label implying excessive sexual activity when no clear criteria establish what consistutes "normal" levels of sexual involvement. The criteria often used to establish alleged subconditions of hypersexuality --- nymphomania and satyriasis --- are subjective and value laden. (Crooks p. 510)

M. L. Chivers --- cited in the previously quoted textbook --- points to a "tradition in the sex addiction literature of forgoing empirical research and presenting conjectures as fact." (Chivers p. 476)

In "The Myth of Sexual Addiction"William A. Henkin, Ph.D. writes:

There is nothing inherently pathological in the conduct that is labeled sexually compulsive or addictive. Rather than referring to actual clinical entities, sexual addiction and compulsion refer to learned patterns of behavior that are stigmatized by dominant institutions ....

Psychological health is advanced through increased awareness of personal responsibility for one’s feelings, thoughts, beliefs, and behaviors. By couching sexual behavior in terms of addiction, the psychological meaning of a person’s erotic experience is diminished and his or her personal responsibility for that experience is demeaned.

On an individual basis the lack of personal responsibility that is thus encouraged, formalized by organizational structures, and given credence by professional caregivers with a great deal to gain by identifying a whole new bailiwick of illness, encourages people who are distressed or confused by their sexuality to think of themselves as impotent in the face of their own problems.

Socially, rapists and other sexually abusive individuals are provided with a sanctioned legal defense for their dangerous practices – "I couldn’t help it, I’m an addict" – while people who read erotic literature or watch erotic theatre are stigmatized for their harmless ones. Thus, the safety, psychological health, and civil liberties of us all are jeopardized by a cultural ideal that encourages both the suppression and the repression not only of people's behaviors, but of their thoughts and feelings as well, in private and in public, in the names of social service and our own good.

Licensed marriage and family therapist and certified sex therapist Marty Klien writes:

So here’s my evaluation of almost everyone who is diagnosed as a sex addict—by themselves, their loved ones, or an addictionologist: it’s someone who is unhappy with the consequences of their sexual choices, but who finds it too emotionally painful to make different choices. You know, the way some of us are with cookies, new sweaters, or watching the Kardashians on TV.

Which is to say, it’s not about the sex. It’s about the immature decision-making.

It's worth noting that the terms "Sexual Addiction" and hypersexuality are not included in the most recent DSM. (Crooks p. 476)

(SIDE NOTE: There is an on-line Sexual Addiction test at Interestingly, one of the questions is "Have you regularly engaged in sadomasochistic behavior?" I have taken the test and I have to admit I was NOT scored as a sexual addict despite answering all the questions as truthfully and conservatively as possible.)

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Runner's High

But despite the highly charged sexual nature of sadomasochism (SM), the experience of masochism --- of "Going Under" or of entering "Bottom Space" or "Sub Space" --- is less akin to sexual relations and sex than extreme sports.

Recently a study performed on lab rats found that the "Runner’s high" --- a sense of euphoria caused by extreme physical exertion such as running in Olympic marathons --- is caused by the release of chemicals in the brain that mimic the same sense of euphoria in opiate use. (Werme, pgs. 2967-2974) Furthermore, the exercise can become "habit forming" in a way that "justifies comparison with drug-induced addictive behaviors." (Werme pgs. 2967)

The Oxford Reference defines Exercise Addiction as "An unhealthy reliance on exercise for daily functioning. The exercise often becomes the main mechanism for coping with everyday stresses." (Oxford Reference) (But that begs the definition of "unhealthy.")

Considering how closely "Runner’s high" resembles "Bottom Space," we can cautiously argue that the findings about the addictive qualities of the former might apply to the latter. But we need more research before making conclusions to that effect.

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A Personal Observation

I have one final note before closing this article. While it is not scientific evidence, to me it carries its own weight. I have been involved in the BDSM community --- and to a lesser extent in the Leather community --- since 1994. I originally posted this article in 2013. In that time I have lived in two states and four cities. In addition I have visited BDSM and Leather events and parties in five different cities and two different states. I have met with practicing sadomasochists from all over the U.S. and outside the U.S.

And I have never seen or hear of anyone becoming pathologically addicted to pain.

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There does seem to be some evidence --- however slight --- that masochism can --- theoretically at least --- be addictive. But that evidence results mostly from applying the findings of studies of Exercise Addiction to Pain Addiction. Unfortunately, there were no experiments made or case studies examined of Pain Addiction to date. However the lack of evidence by itself is not enough to disprove the theory, only a warning that communities (medical or otherwise) should be cautious in their conclusions.

Also, the term addiction --- as applied here to a behavior such as sex, running, gambling, excessive Internet use, playing video games, masturbation, consumption of pornography, watching television, and consensual sadomasochism --- must be differentiated from poor impulse control. Otherwise we are in danger of defining as addictive any behavior that people regularly engage in and which many of us don't approve.

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NOTE: The following definitions are mostly lifted directly from the sources cited.

a glucocorticoid C21H30O5 produced by the adrenal cortex upon stimulation by ACTH that mediates various metabolic processes (as gluconeogenesis), has anti-inflammatory and immunosuppressive properties, and whose levels in the blood may become elevated in response to physical or psychological stress —called also hydrocortisone. (SOURCE:

Diagnostic and Statistical Manual of Mental Disorders
The authoritative manual published by American Psychiatric Association and used by clinicians and researchers to diagnose and classify mental disorders. This manual, which creates a common language for clinicians involved in the diagnosis of mental disorders, includes concise and specific criteria intended to facilitate an objective assessment of symptom presentations in a variety of clinical settings inpatient, outpatient, partial hospital, consultation-liaison, clinical, private practice, and primary care. (SOURCE: It is sometimes called "the Bible of psychiatry."

a neurotransmitter that helps control the brain's reward and pleasure centers. Dopamine also helps regulate movement and emotional responses, and it enables us not only to see rewards, but to take action to move toward them. Dopamine deficiency results in Parkinson's Disease, and people with low dopamine activity may be more prone to addiction. The presence of a certain kind of dopamine receptor is also associated with sensation-seeking. (SOURCE:

any of a group of endogenous peptides (as enkephalin) found especially in the brain that bind chiefly to opiate receptors and produce some pharmacological effects (as pain relief) like those of opiates. (SOURCE:

The hypothalamus is an area of the brain that produces hormones that control: Body temperature, Hunger, Moods, Release of hormones from many glands (especially the pituitary gland), Sex drive, Sleep, and Thirst (SOURCE:

a substance (as norepinephrine or acetylcholine) that transmits nerve impulses across a synapse. (SOURCE:

a powerful hormone. When we hug or kiss a loved one, oxytocin levels drive up. It also acts as a neurotransmitter in the brain. In fact, the hormone plays a huge role in pair bonding. Prairie voles, one of nature's most monogamous species, produce oxytocin in spades. This hormone is also greatly stimulated during sex, birth, breast feeding—the list goes on. (SOURCE:

a condition in which a person's sexual arousal and gratification depend on fantasizing about and engaging in sexual behavior that is atypical and extreme. A paraphilia can revolve around a particular object (children, animals, underwear) or around a particular act (inflicting pain, exposing oneself). Most paraphilias are far more common in men than in women. The focus of a paraphilia is usually very specific and unchanging. A paraphilia is distinguished by a preoccupation with the object or behavior to the point of being dependent on that object or behavior for sexual gratification. Paraphilias include sexual behaviors that society may view as distasteful, unusual or abnormal.(SOURCE:

1: of or relating to pathology
2: altered or caused by disease; also : indicative of disease
3: being such to a degree that is extreme, excessive, or markedly abnormal

a hormone released by the pituitary gland. (SOURCE:
a single-chain protein hormone closely related to growth hormone. It is secreted by so-called lactotrophs in the anterior pituitary. It is also synthesized and secreted by a broad range of other cells in the body, most prominently various immune cells, the brain and the decidua of the pregnant uterus. (SOURCE:

relating to, characteristic of, directed toward, influencing, arising in, or acting through the mind especially in its affective or cognitive functions <psychological phenomena> <the psychological aspects of a problem> (SOURCE:

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American Psychiatric Association. (1952). Diagnostic and Statistical Manual: Mental Disorders. Washington, DC: Author.

American Psychiatric Association. (1968). Diagnostic and Statistical Manual of Mental Disorders (2nd ed.). Washington, DC: Author.

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: Author.

American Psychiatric Association (1984). The American Psychiatric Association's Psychiatric Glossary. Washington, DC: American Psychiatric Press, Inc.

American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). Washington, DC: Author.

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.

American Society of Addictive Medicine (ASAM) (2011, April). Definition of Addiction. Retrieved November 24, 2012, from

Carnes, Patrick J. (2001). Out of the Shadows: Understanding Sexual Addiction (3rd ed.). Center City, MN: Hazelden.

Chivers, M. L. (2005). "Clinical Management of Sex Addiction" Archives of Sexual Behavior 34(4): 476-478.

Crooks, Robert. L., & Baur, Karla (2010). Our Sexuality (11th ed.). Blemont, CA: Wadsworth Publishing.

DarkDivah, "BDSM: Sub Space, Holy Grail, trip to space"

Definition of Addiction. The American Society of Addictive Medicine. Retrieved June 23, 2013, from

Dr Dexter, "BDSM 101: Subspace, Aftercare, and Sub-drop (and sometimes Top-drop)" Retrieved June 23, 2013, from

Henkin, William A., Ph.D., "The Myth of Sexual Addiction." Retrieved June 23, 2013, from

Klein, Marty (2012, July / August). "You’re Addicted to What?: Challenging the Myth of Sex Addiction." The Humanist (Retrieved June 23, 2013, from

Levine, Martin P. and Richard R. Troiden, "The Myth of Sexual Compulsivity," Journal of Sex Research, Vol 25, No 3, Aug 1988, pp 347 - 363.

Meijer, Hans, "Hormonal reactions and influences" Retrieved November 29, 2013, from

MC n Circe, "Subspace." Retrieved June 23, 2013, from

The Oxford Dictionary of Sports Science & Medicine (2012). Drug Addiction. Retrieved November 28, 2012, from

Perlmutter, Dawn. (2003). Investigating Religious Terrorism and Ritualistic Crimes. Boca Raton, FL: CRC Press.

Rowe, January, "What is Subspace?" Retrieved June 23, 2013, from

Sir Stompsalot, "BDSM Chemistry." Retrieved June 23, 2013, from

Warren, John. (2000). The Loving Dominant. San Francisco, CA: Greenery Press.

Werme, M., Thoren, P., Olson, L., & Brene, S. (2000, August). European Journal of Neuroscience, 12(8), 2967-2974.

Williams, D. J. (2006). "Different (painful!) strokes for different folks: A general overview of sexual sadomasochism (SM) and its diversity." Sexual Addiction & Compulsivity, 13, 333-346.

Wortman, C., Luftus, E., & Marshall, M. (1981). Psychology (3rd ed., Rev.). New York, NY: Alfred A. Knopf.

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