Sadism and masochism, in the original sense, describe psychiatric disorders characterized by feelings of sexual pleasure or gratification when inflicting suffering or having it inflicted upon the self, respectively. Sadomasochism is used in psychiatry to describe either the co-occurrence of sadism and masochism in one person as separate disorders, or as a replacement for both terms, depending on the theory used. The definitions of sadism and masochism in medicine have been modified repeatedly since they were introduced by the Austrian psychiatrist Richard Freiherr von Krafft-Ebing in the 19th century (Krafft-Ebing 1901).
The results of the newer studies have led to calls to abolish sadism and masochism as disease categories completely, arguing that the truly pathological forms are adequately covered by other diagnoses. The sadomasochistic subculture added a political dimension to this drive with claims of discrimination and by pointing to the precedent of removing of homosexuality from the list of mental disorders [5].
In response, the American Psychiatric Association modified the criteria for sadism and masochism in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) in 1994 so that consensual sadomasochistic behavior alone is not considered a sexual disorder anymore. However, in the DSM-IV TR, published in 2000, sadomasochistic behavior can be diagnosed if the patient acts on these sexual urges, even if it is consensual [citation needed]. In 1995, Denmark became the first country to completely remove sadomasochism from its classification of diseases [6].
How sadism and masochism develop and why some people find these practices pleasurable remains unclear. Various current theories include childhood experiences, endorphin-based mechanisms, learned behavior, genetic dispositions, and simple conscious choice. Why consensual BDSM and pathological sadomasochism as defined by DSM IV share some of the same superficial characteristics is also unknown.