Kink: What Is Pathology Vs. Healthy Exploration?

What is Considered Healthy Exploration?

Healthy exploration of your sexuality is a fluid and controversial topic. The Diagnostic and Statistical Manual (DSM) is considered the universal authority in the United States for classifying mental health disorders. It is important to note that the DSM is not only a tool that is a collaborative effort among various mental health professionals and psychiatrists in the community, but that pathology criteria are augmented based upon clinical research and the changing culture. For example, there was once a time when the DSM considered homosexuality to be a disorder, and as we have come to find through clinical research and better understanding of the human sexuality, this has since changed. However, these augmentations do not happen overnight and trying to evaluate a hidden population is next to impossible. The more we are able to discover that these behaviors are more commonplace, and as a scientific community the more we provide further clinical research, the better we as a healthcare providers can evaluate disease vs. health and reduce stigma to these practices.

Culture is Important

Cultural considerations must be taken into account when assessing a client. If someone identifies as part of the BDSM subculture, it is malfeasant to assess their desire to be spanked as a disorder. According to the DSM-5, there are three criteria for Fetishistic Disorder, and four specifiers that can be applied. The criteria are:

  1. Over a six-month period, the individual has experienced sexual urges focused on a non-genital body part, or inanimate object, or other stimuli, and has acted out urges, fantasies, or behaviors.
  2. The fantasies, urges, or behaviors cause distress or impairment in functioning.
  3. The Fetishistic object is not an article of clothing employed in cross-dressing, or a sexual stimulation device, such as a vibrator.

Specifiers for the diagnosis of Fetishistic Disorder include the type of stimulus, which is the focus of attention:

  1. Body Part(s) (non-genital or erogenous areas of the body – e.g., feet or hair) this is also referred to as Partialism- preoccupation with a part of the body rather than the whole person.
  2. Non-living object(s) e.g. shoes or boots
  3. Other- situations or activities- e.g.- smoking during sex.

Other specifiers are:

  1. In a controlled environment where Fetishistic Disorder cannot readily be engaged in, such as an institutional setting.
  2. In remission: No distress or impairment of functioning for a five-year period, exclusive of a controlled environment. (American Psychiatric Association, 2013)

Conclusion Explore Kink

In short, fetishes are normal healthy parts of the human sexual experience until they begin to impair your ability to function


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Association.

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