BDSM Play For Clinicians: The BDSM Scene

What Is A Scene?

A BDSM “scene” is a negotiated event that may involve bondage, discipline, and sadomasochism, and/or power exchange behaviors. The length, type, number of participants, and other factors involved with play can vary dramatically from scene to scene. Traditionally, all elements are negotiated verbally or via written contract prior to each and every scene.

Why Do People Scene?

I cannot stress enough that as every person is unique, so are their BDSM experiences and reasons for participation. The following data is based upon reports from clients, community literature, clinical research, and interviews.

As noted in previous blogs, there is a distinct series of potential neurochemical responses related to BDSM activity. If this hypothesis holds true, the participants report sceneing due to the pleasurable altered state they experience. Supporting this theory, Sagarin (n.d.) reports that in one study where switches, BDSM practitioners who can take either the Top or bottom roles, were randomly assigned a role in a scene (Ambler et al., 2016).

The results revealed that both Tops and bottoms entered altered, though different, states of consciousness. Bottoms entered “transient hypofrontality,” which is associated with reductions in pain and feelings of floating, peacefulness, and living in the here and now as well as time distortions (Dietrich, 2003). Tops, in contrast, entered the altered state known as “flow” which is associated with focused attention, a loss of self-consciousness, and optimal performance of a task (Csikszentmihalyi, 1991). It is believed that these pleasurable altered states of consciousness might be one of the motivations that people have for engaging in BDSM activities.

Kelment et al. (2016) speculate that the act of participation in BDSM is similar to the act of other intense rituals such as fire-walking or body modification. They report that despite the motivations, such as religion, to participate in these activities they represent a desire for social bonding.

The team performed a study of the 160-person ritual Dance of Souls within the context of BDSM and found that: through hormonal assays, behavioral observations, and questionnaires administered before, during and after the Dance, we examine the physiological and psychological effects of the Dance, and the themes of spirituality, connectedness, transformation, release, and community reported by dancers. From before to during the Dance, participants showed increases in physiological stress (measured by the hormone cortisol), self-reported sexual arousal, self-other overlap and decreases in psychological stress and negative affect. Results suggest that this group of BDSM practitioners engage in the Dance for a variety of reasons, including experiencing spirituality, deepening interpersonal connections, reducing stress and achieving altered states of consciousness. (2016)

Thus, showing that there may be other positive therapeutic and social factors to BDSM and kink activities that need further study. Baumeister (1997) reported that masochism has been described as a set of techniques to lose one’s awareness of their “normal” identity, disrupting meaningful thought, and enhancing focus on sensation. It offers an escape from the stressors of the normal world and thwarts efforts to maintain control.

Pain Management

There is empirical data showing that BDSM Sceneing can be used in the practice of pain management. I have had a number of clients that suffer from conditions such as rheumatoid arthritis, fibromyalgia, and various chronic pain syndromes who have reported using sceneing in lieu of opioids or cannabis for pain relief. Working off the neurochemical hypothesis, that we get high from these activities and that is why we participate in them, of the pleasure/pain response and the brain’s response to stress, one can extrapolate that sceneing could indeed be a source of pain relief for someone struggling with chronic pain. Building endurance and desensitizing the body to severe pain can be an alternative source of pain relief rather than using pain medications that can be addictive and dangerous.


As this manual continues to work off of the neurochemical hypothesis of BDSM, the release of endorphins and dopamine are known to help in the reduction of anxiety and improvement of mood. Currently, The Alternative Sexuality and Health Research Alliance (TASHRA) is funding research that is exploring the use of sceneing as an alternative form for self-harm and I have had a number of clients report that they have eliminated those behaviors once they discovered sceneing.

Trauma Recovery

There is a popular myth, that participants must have a history of trauma or abuse, thus making their behavior pathological, yet while some participants may have abuse or trauma in their past research shows that for most of the population this myth is unfounded. Working from the hypothesis of the subconscious reframing trauma into triumph, some participants do report that BDSM activities are empowering for them. I have worked with many clients who used a combination of BDSM, role-play, and psychodrama to reframe and repair their trauma history. For example, I have had several survivors of sexual violence who enjoy the concept of power exchange as a form of sexual empowerment. As a therapist, I would not use this as a tool for trauma repair, however, I will support it if and only if the client is participating safely and is having positive results.

Types of Play

It is nearly impossible to enumerate the multiple forms of play that we see in BDSM, however, there are a number of categories that are commonly seen.


Play Spaces

A BDSM scene can be performed anywhere depending on the elements involved. Many individuals prefer exploration and experiment in their bedrooms, privately, whereas others love the concept of public play and community. Play parties are common amongst lifestyle enthusiasts as well as those who identify as 24/7. These invitation-only parties are generally held at a private home and participants are generally vetted prior to attending. Membership dungeon clubs are also a common space for public play. One of the most common ways that interested individuals first explore Kink outside of the bedroom is by attending conventions which have classes and play areas reserved for experimentation. For the Kinky vacationer, there are now a number of resorts, such as Desire and Hedonism II, catering to these needs. Additionally, the recently launched website caters to the Kinky client by allowing individuals to rent dungeon rooms, Kinky hotels, and other themed rooms.

Sex Toys

Kinky people can use almost any object as a sex toy. In the community, an ordinary object which is used as a tool for play is known as a “pervertable.” In fact, there have been “Iron Dom” competitions where D/s couples compete to create the most erotic and interesting BDSM scene with a mystery box of ordinary household items. However, there are a number of tools that are standard in the community. See Appendix L for images of common sex toys.

Therapist Nicki Talks About What to Look For in Sex Toys

Safety Protocols

Safety is a huge topic of concern for those in the BDSM community and some fairly universal precautions are often part of any introduction. There are a couple of safety standards recognized by the BDSM community including SSC and RACK. While these two acronyms, as described in the previous chapter, are similar RACK allows for informed consent to higher risk activities such as edge play as these are not always seen as safe (Talon et al., 2008).

“Dungeon Monitors” (DM) are considered the safety officers of most play parties. It is standard procedure to have at least two if not more of these safety officers who are trained and have very specific protocols and rules they enforce. DMs are typically CPR-certified and have been trained in proper scene intervention. The ultimate role of the DM is to ensure that the play area and the participants are safe and the rules are followed. Though the role of the Dungeon Monitor is to remain present while keeping a reasonably low profile each play party or dungeon will have different boundaries and guidelines. Below is a list of some typical Dungeon Monitor responsibilities.

Example set of rules and responsibilities of a dungeon monitors


  • Familiarize yourself with the space, furniture layout, and equipment prior to the opening of the play space.
  • Check all furniture and equipment to make sure they are secure and safe.
  • Avoid anything that can impair your judgment or ability to function as Dungeon Monitor.
  • Dungeon Monitors should not “stalk” the play area or appear to be judgmental, superior, or disapproving.
  • Be courteous to and respectful of all participants.
  • Do not play when acting as Dungeon Monitor.
  • Watch for over-obtrusive voyeurs, drunkenness, and over-aggressive come-ons.
  • Yelling, screaming, and sounds of equipment breaking or collapsing should be investigated immediately.
  • Watch for violations of house rule and etiquette and ask for compliance to the rules if they are broken.


Safety Officer: Stay Calm!

Be Diplomatic, Discrete, Fair, and Assertive Monitor, Intervene or Stop as needed Do NOT intervene simply because you would “do it a different way.”

If participants are having difficulty or appear inexperienced, ask politely if you may make a suggestion. Try to avoid shouting matches or any physical altercations.

Always try to resolve matters as amicably as possibly in order to avoid any possible liability and/or legal action. If a participant is acting irresponsibly, dangerously, or abusively, stop the scene as quietly as possible and ask the offending participant(s) to join you outside the play area to discuss the matter.

If a participant needs to be ejected for any reason, get the support of other Dungeon Monitors and explain why the participant is being ejected, referring to the house rules regarding conduct. Do not allow any drunk or visibly impaired person to drive.
Communication, Intervention, and Direction: Provide direction (to restrooms, cleaning supplies, house rules, smoking area, etc.) Provide aid (answer questions, stalker complaints, and enforce rules). Mark broken equipment. Fire: Extinguish fire with an extinguisher and remember P.A.S.S.

Escort Service: • Whenever a person, male or female, feels uncomfortable walking out to their car, it is the DM’s job to escort them, if asked.

Traffic Control: • Direct the crowd as needed; this is especially important when there is a higher number of play participants and the crowd can endanger individual scenes.

Important safety equipment for play parties and dungeons

  • Ammonia Inhalants
  • First Aid Tape
  • Latex and non-Latex Gloves Band-Aids
  • EMS Scissors
  • Steri-Strips
  • Clear Dressings
  • Honey Packets
  • Sugar Gel
  • Applicator Swaps
  • Tongue Depressors

  • Clean Blankets and Towels Fire Extinguisher Flashlight
  • Bottled Water
  • Telephone Paper Towels
  • Bolt Cutters Hacksaw
  • Assorted Lubricant
  • 4×4 Gauze
  • Sharps Container
  • Activated Charcoal
  • Hydrogen Peroxide
  • Sterile Saline


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