The body knows what words have not yet said
Co-written with Justine Lefèvre, a psychologist
We’re going to talk about a topic that nobody really talks about—and when people do talk about it, it’s viewed negatively. Let’s talk about BDSM. The purpose of this article is not to shock or titillate. We’re writing to share what science and psychology have been showing for quite some time now, but which collective shame prevents us from hearing: these practices, when properly guided, can serve a deeply healing purpose.
So, let's get started.
Shame as a Gateway
Before we even get into neurochemistry or attachment, let’s call out what’s in the room: shame.
According to Kaufman (1989), it is defined as «an inherent feeling of being a bad person, an experience accompanied by the fear of being exposed as well as protective rage.».
This shame is overwhelming for many who engage in these practices. That feeling of having a desire that’s «weird,» «too much,» or «deviant.» But it’s interesting to note that this shame can become a real therapeutic springboard. Not because one must suffer to heal, but because the moment one chooses to face one’s shame head-on—to name it in a safe space, with someone one trusts—that moment is already an act of healing. A willing act of vulnerability.
BDSM requires knowing yourself, defining yourself, and presenting yourself in the way you desire. And for many people, the first time they truly do this is when they walk through the door of the dungeon.
This involves both psychological and physical exposure.
How it affects the body
In BDSM, the body is not an object. It is both the instrument and the subject.
During intense practice, the first thing that happens is a deep grounding in the present moment. It’s very difficult to get lost in rumination or anxiety when the body is fully engaged. It’s mindfulness, but with your hands tied—literally or figuratively.
BDSM involves emotional expression in situations where words fail. Many practitioners describe an ability to access deep emotions—fear, trust, vulnerability, anger—in a space where these emotions are contained, expected, and welcomed. The body speaks where language falls short.
And then there’s something more complex. For some people with self-destructive tendencies, BDSM can offer a path to sublimation. It is not meant to replace therapy, nor does it say «enough is enough» to an overflow of unspeakable emotions. On the contrary: it provides a non-pathological framework where an impulse finds a channeled, consensual outlet, experienced within the safety of a relationship.
How It Affects the Brain
The undesirable becomes desirable through a mechanism that is both relational and chemical.
During intense practice, the brain enters an altered state of consciousness similar to hypnosis (subspace/domspace), deep meditation, or the flow state.
Those who practice it regularly describe it as a form of letting go. There is no more mental noise—just presence.
On a neurochemical level, several things happen simultaneously. Endorphins and adrenaline surge: euphoria, pain tolerance, a temporary sense of invincibility—what we feel after an intense run or during a live performance. Cortisol levels drop, and with them, stress. Oxytocin, the hormone associated with attachment, security, and trust, surges. And dopamine, the neurotransmitter associated with pleasure and reward, is strongly activated.
For people with dopaminergic underactivation—such as those with ADHD or certain autism spectrum conditions—BDSM can provide the neurological regulation that many seek elsewhere, particularly in addictive behaviors. Hyperfocus, the sensation of being fully present in one’s body and in the moment: it’s no coincidence that a large part of the BDSM community identifies with these profiles.
How It Affects the Psyche
BDSM isn't necessarily linked to trauma. This common misconception should be discarded. It can be practiced from a place of inner security, curiosity, and desire—and that is often the case.
That said, for those who have experienced trauma, this practice can serve as a means of physical reintegration. Reenacting certain dynamics of power, vulnerability, and control in a safe space—but this time with explicit consent, within a chosen framework, and with the option to stop at any time—can help transform these experiences. Not erase them. Transform them. They are no longer a source of shame to be hidden, but a part of oneself to be reclaimed.
Beyond trauma, we also observe the reenactment of attachment patterns within a safe environment. How do we behave when we’re in a position of total vulnerability with someone? How do we cope with dependence? How do we receive care? These are questions that therapy explores through words, while BDSM poses them through action—and sometimes enables a form of healing that words alone could not achieve.
The catharsis of play is real. It’s a channeled emotional release, a way of working through fear in a safe space. It’s similar to what children do naturally—re-enacting difficult experiences to process them. And play has a therapeutic function.
Finally, the framework. The discussion before a scene bears a striking resemblance to the initial assessment at the start of therapy: we set boundaries, identify vulnerabilities, and create conditions for safety. The rituals that open and close a scene play the same role as the rituals at the beginning and end of a session with a therapist—they signal the transition into a different space and help us process what happened there.
The quality of the relationship between the top and the bottom—trust, communication outside of play—resembles what therapists call the therapeutic alliance. And just as in therapy, this is often what determines whether the experience is transformative or destructive.
Negotiation as a School of Life
Learning to say what you want, what you don’t want, what scares you, and what you need—that’s hands-on practice in real-life communication. Many people who practice this attest to it: by consistently expressing themselves in this context, they learn to do the same in their romantic lives, in their relationships, and in their relationship with themselves. They learn to set boundaries—which is, after all, the goal of many forms of therapy.
Regaining control over your desire, your body, and your voice: that is one of the most therapeutic things there is. Whatever form it takes.
And what's the best part of all this?
We often talk about the effects of BDSM on bottoms. Rarely do we discuss how it feels for those who are tops. And yet.
Being a top in a BDSM setting means constantly and carefully reading the other person’s body—their tension, their breathing, their nonverbal cues. It’s a form of physical and emotional empathy taken to the extreme.
Being a top also requires emotional stability and constant self-improvement. You can’t hold space for someone else if you don’t know what’s going on inside yourself. Sublimation transforms a drive for domination or control into an act of care… and sometimes into true love. The state of flow that bottoms experience is also experienced by tops: that absolute concentration, that hyperfocus, that total presence in the scene.
Being a top means taking responsibility for the setting. Managing safety, the pace, and the descent. When consciously embraced, this responsibility serves as a lesson in emotional regulation for the person who takes it on—a way of leading a session that would be familiar to any good psychologist.
The Risks: Because We Need to Talk About Them
We can't talk about all this without being honest about what could go wrong.
A poorly supervised BDSM setting can lead to retraumatization, dissociation, manipulation, and emotional dependence. These are not abstract risks. They exist, and they happen—just as they can happen with a therapist who doesn’t know what they’re doing. Recognizing that BDSM can have therapeutic effects also means recognizing the risks associated with any form of care, whether explicitly therapeutic or not.
What protects them is exactly what we’ve described: self-awareness, communication, boundaries, the partnership, and the willingness of the participants to learn how to engage in these activities as healthily as possible, both physically and mentally. Structurally, a healthy BDSM space resembles a healthy therapeutic space. And just like in therapy, it takes time to find the right partner, find the right words, and build the right kind of trust.
BDSM is not a form of therapy. It is no substitute for psychological counseling, especially when trauma is involved. But it can serve as a complementary support. An outlet. A space where something is released, acknowledged, and worked through.
And sometimes, what you go through in a scene brings to light things you wouldn't have been able to put into words otherwise. So you go to see your therapist, and this time, you have something to say.
If you're looking for a kink-friendly therapist, Here is a list for your reference.
I do not recommend, evaluate, or guarantee the quality of their services. It is up to you to do your own research to determine whether a practitioner is a good fit for your needs, values, and situation.
