Chronic Pain and BDSM

Whether or not you’re aware of it, you have a relationship with pain.

We all do. Everyone has suffered minor injury or illness; everyone has experienced a stubbed toe or a bitten tongue at least once.

If your experience is minimal, you probably can’t imagine the agony of a kidney stone, or what childbirth feels like, and this ignorance comes with its own brand of discomfort: fear.

I’ve already discussed how some of us control fear by eroticizing it. This is a pretty solid explanation for masochistic behavior: we can’t stop pain from happening, but we can make it happen intentionally, in a safe situation. In this way, the idea of suffering loses some of its power.

But why is there such a significant overlap between people with chronic pain and people who practice kink? If you’ve experienced more than your fair share of pain, the fear is likely less intense. You already know what you’re up against. You have strategies for dealing with it, and while it may seem counterintuitive, one of these strategies might be BDSM.

Since I’m not personally qualified to discuss this issue, I’ve cowritten this article with a friend, “MX,” who is a BDSM practitioner with a chronic pain condition. For readability, their contributions are offset with quotation marks, rather than block quotes.

Chronic Pain And Masochistic Pain

 Formatting this article was a masochistic endeavor.

Formatting this article was a masochistic endeavor.

“As the adage goes: no pain, no gain. And in the realms of BDSM, pain can be (but isn’t always) a tremendous gain. The distinction, for some, is around the type of pain.

There are euphoric kinds at the end of a bamboo cane, a fist or a flogger, and then there are the aches and gnawing, creeping, searing agonies of a life spent living with chronic pain.

For me, BDSM is vitally important, because it’s an opportunity to choose which kind it is. At its most reductive, it’s therapeutic; following the principle that a change is as good as a rest, then a healthy, controlled exorcism of nerve endings at the whimpering end of a cane is as good as a two week paid holiday in the sun.

 Rope burn is better than sunburn.

Rope burn is better than sunburn.

To give more context here: I’ve lived with chronic pain since some point in my teens. It started slowly, and progressed to something relentless.

My spine doesn’t move the way I need it to if I want to walk more than a few yards, and the nerves and muscles holding me together are constantly kicking up a fuss if I stand for too long, sit for too long, walk too quickly or too far, sleep too many consecutive hours…and so on. I walk with a cane, and I take a lot of painkillers.

The downside to this—one of them—is that it has played havoc with my pain tolerance. It varies wildly, from moderate to embarrassingly low.

Rather than embarking on the journeys oft portrayed in BDSM narratives, of expanding one’s limits to ever-intensifying levels of endurance, I’ve had to take a different route. It’s one that requires a lot of patience and understanding from a partner. If I can’t predict what my body is likely to do, I can’t dare expect anyone else to.

When the daily, bodily grievances reach a kind of screeching pitch—the kind where everything starts to form a hot-cold static; a full-body toothache—I can’t even handle being touched.

And yet, when that same pain manifests in warm glowing aches and twitching nerves and spasms, that’s when I’d gladly submit myself for an enthusiastic kicking, for knifeplay, for hot melted wax and elaborate ropework. It can be a lot to navigate, safely, and in a way that works for both partners.”

MX’s experience is unique, but by no means uncommon. Performance artist Bob Flanagan famously engaged in masochistic behavior to cope with his cystic fibrosis. He was the subject of a documentary, and wrote a book about the role of pain and kink in the final year of his life.

 He also starred as a torture victim in a banned Nine Inch Nails video, which is every masochist’s wet dream.

He also starred as a torture victim in a banned Nine Inch Nails video, which is every masochist’s wet dream.

Redditor adventureismycousin writes:

“I am both a sadist and a masochist. Consider for a moment: what is a deep tissue massage? It's actively hurting muscle to get it to relax. I have gotten bruises from massages. Now, pair that with how the body prioritizes pain: a new, sharp pain overrides the pain that is constant, making it distant. I need pain in the right places to make life stop hurting.”

An intense flogging session even provided one blogger with relief from a year-long fibromyalgia flare up. As far as we know, fibromyalgia is a disorder in how the brain processes pain signals. It follows, then, that mindfulness of a severe, intentional pain might be able to reset this mechanism under the right circumstances.

Intentional pain can help people with chronic pain, even without direct symptomatic relief. The reasons are multifaceted, but some of them have to do with how we process and contextualize pain.

Pain Processing

 What a lovely rendering of a nail embedded in flesh. Thanks, Wikipedia.

What a lovely rendering of a nail embedded in flesh. Thanks, Wikipedia.

We handle pain differently in different contexts. BDSMwiki has compiled an extensive list of the factors and coping strategies which can influence the experience of being hurt.

In a scene, the pain doesn’t come as a surprise, and intention to process can drastically affect pain tolerance. Though chronic pain ebbs and flows, and can sometimes be anticipated, the difference lies in consenting to be hurt. Asking for pain and enduring the consequences is an intentional act; the damage control which people employ when they feel a flare-up coming on is not.

A scene is also a shared experience. The sadist and masochist have similar intentions—suffering for pleasure, catharsis, sadistic satisfaction, sexual gratification, subspace—which sets masochism apart from daily pain, often suffered alone and in silence.

The top can also coach the bottom through the experience by encouraging them to breath, by verbally and physically guiding them through the scene, or even by verbally humiliating them, which can hasten the coveted release of control.

The most relevant processing technique is perhaps expressive behavior. In a scene, the submissive is free to express their pain by screaming, fighting, snarling, crying, laughing, moaning. It can be liberating to know that one’s partner not only accepts these expressions, but revels in them.

Submission and Vulnerability

 I’m not totally sure what’s happening here. Submission and vulnerability, I guess.

I’m not totally sure what’s happening here. Submission and vulnerability, I guess.

Someone with a chronic pain condition might be suffering a majority of the time, yet they’re expected to hide their pain in daily life, lest it make others uncomfortable. In a scene, the submissive is free to express not only the pain they feel in the moment, but also the pain which society implores them to keep bottled up every day.

“I have a habit of putting on a “brave face”. A lot of us folks with issues like this don’t like to share what’s really going on, and a lot of us have found ways to limit just how much vulnerability we broadcast.

Over the years, I have honed a more-or-less stoic expression. If the walk to the shop has left me feeling like I’ve done two straight hours on the cross trainer with a broken rib, I don’t want other people to see that when they look at me.

So, I keep it as buttoned in as I can. And that can be hard to maintain when you’ve got friends telling you about their Tough Mudder challenges, their half marathons, or those moments when they worked out so hard that they soaked through their gym clothes with cardio-sweat; I can’t really compare that to a particularly intense shuffle back from the top of the street that left me incapacitated for half a day and crying into my opiates. It can be emotionally and socially isolating.”

The expectation for disabled people to remain stoic is a catch-22. In a fantastic blog post about BDSM and disability, Amanda Forest Vivian writes:

“The most perfect disabled person receives emotional and physical discomfort and pain with a complete poker face, and this is in the service of a goal: appearing to experience the same amount of pain as non-disabled people, and for the same reasons. Which is to say that the most perfect disabled person appears non-disabled and is not admired by anyone for her stoicism because, if she’s doing it right, no one knows she has anything to be stoic about.”

So what does it mean to hurt, intentionally, in a context where pain is expected and valued? Where your suffering brings someone else pleasure?

“What BDSM can provide, and has done for me, is the setting in which the “brave face” can (and will) be destroyed. You can show how strong you are, but you can also allow yourself to display the full scope of your vulnerability to someone who wants to see you that way.”

Roadblocks and Lessons

 Not literally. Well, maybe.

Not literally. Well, maybe.

MX writes:

“When I was newer to these things, I was fumbling around wildly unsafe practises with partners who had less of a clue than I did. One partner would simply leave immediately after a scene ended, so as to avoid the messy aftermath. Pro tip: never accept that kind of nonsense behaviour from anyone!

Another partner saw my limited mobility as an advantage. I’m more easily overpowered than most, so from the offset the dynamic was set. That aspect of things worked; it felt as though the way my body worked (or didn’t) was complementary to what I wanted to happen—until it wasn’t, and the means to extricate myself weren’t in place. I’m still paying for new dental work, years after what my kindly dentist referred to as “repeated facial trauma,” because even my bones are terrible and at the time it didn’t occur to me that perhaps bits of my body could be worth protecting. I hear mouthguards are useful, if not aesthetically pleasing.

 Artist’s rendering of the kindly dentist, who happens to be aesthetically pleasing.

Artist’s rendering of the kindly dentist, who happens to be aesthetically pleasing.

Those experiences, confined to the past, serve as a salient reminder that while I have an imperative need to seek out vivid and cruel experiences, it’s important to do so with a whole lot of clear communication. There may be days—or longer—where engaging in heavy impact play is not a viable option, and it’s important that this is my partner can except this. Trust is integral here, as with all BDSM exchanges.

The extra complication that I bring to the table is that I am trusting this person to cause damage, but only the right kind of damage. And they need to trust me to tell them which is which.

Move me into the wrong stress position, and there is a strong chance that it will take an unfeasibly difficult length of time to then unmove me from it. A sense of humour is largely essential at this point.

Beyond that, if my body is feeling particularly contrary during a scene, there’s a chance that any repercussions from it will last far longer than the pleasing burn of a welt across the skin, and it can result in a huge flare-up of the chronic pain once the euphoria passes.

Personally, I can handle this just fine. A flare-up can be sparked by something as mundane as someone knocking the back of my chair, and it’s more a gradient than a spike. Being able to link it back to an experience that I enjoyed is a gift—I might be more of a walking wreck than usual for a week or so, but it’s not just because of my body. It’s something external, that I consented to. Someone else has done this to me, and done this for  me, and I wanted and welcomed it. That can make the chronic pain seem bearable.

When it’s been done by someone I truly love and trust, my own everyday, horrid pain is transformed into something I can own. It allows me to stop resenting my own body for a while.

 Take that, body!

Take that, body!

I’ve also learnt that it’s not easy for the person wielding the instruments. They’ve entered into this with a sincere desire to revel in at least some of the suffering caused, but when the after-effects of a scene draw into question about whether I need to speed up that referral to a specialist, or need to be signed off work for another week, it’s a lot.

I’ve been lucky in recent years that my partners have largely understood and embraced the comedy of it when things go awry. There were negotiations and check-ins throughout any kind of scene, though the more intense acts have often been parked in the interests of safety.

The exchanges of power were subtle things, woven into the everyday, more verbal than physical. The foundation was of nurturing, not cruelty. That the nurturing included hearty bouts of controlled brutality made it no less loving—and writing this out now, the chronic pain and disability seems almost incidental to everything else. These are the hopes and expectations of any healthy relationship.”

My most sincere thanks to MX for sharing their experience so eloquently.