Treatment of an unusual case of masochism

Masochistic sexual activity is potentially dangerous, rarely reported voluntarily, and hard to treat. This article describes a masochist patient who received sexual gratification from being burnt or crushed. Antiandrogen medication, serotonin uptake inhibitor, and psychodynamic psychotherapy along with sexual education and social-skills training and aversive behavior therapy were all tried over a period of 9 months. The response was measured by effects of treatments on the frequency of erotic fantasies and masturbation. Antiandrogens and aversive behavior therapies may be the most effective treatments for such cases, at least in the short term, although the underlying social deficits and the need to reshape the sexual behavior ought to be addressed in the long term.