I was surprised that these criteria did not specifically mention pain. I had thought that sadism and masochism were about wanting to hurt and be hurt. Reading these makes me think that it’s more about issues around control and humiliation than enjoying the sensation of pain.

This is word-for-word from the DSM-IV-TR, pages 573 and 574:

Diagnostic criteria for 302.84 Sexual Sadism

A. Over a period of at least 6 months, recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.

B. The person has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

Diagnostic criteria for 302.83 Sexual Masochism

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer.

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or important areas of functioning.

[First posted on Nathen’s Miraculous Escape, May 30, 2010.]