The Leather Couch: Clinical Practice with Kinky Clients PDF
Preview The Leather Couch: Clinical Practice with Kinky Clients
The Leather Couch “Through sitting on the leather coach, Stefani Goerlich takes the therapist/ reader on a respectful and immersive journey. She helps us understand our kinky clients, and gives us the tools to be able to join them in their work— compassionately, positively, and well-informed. A must read for all clinicians.” Prem K. Pahwa, LCSW, CST, co-director, The Sexual Health Certificate Program, University of Michigan The Leather Couch provides a comprehensive overview of the BDSM and kink community and guides clinicians on how to meet the unique relational and mental health needs of its members. The text offers a 101-style introduction to BDSM before delving into topics ranging from intersectionality within the kink community to conducting a kink-affirming risk assessment and how to discern between domestic violence and consensual power exchange. The author explores differential diagnoses and clinical concerns that are relevant to health care providers, including social workers and therapists as well as primary care physicians and sex educators. Interwoven throughout with real-world case studies, each chapter presents practical suggestions, tools, and handouts the reader can use to inform their practice and serve clients in ways that meet the needs of each individual, couple, or partnership. Written in a conversational, accessible style for clinicians and members of the BDSM community alike, The Leather Couch is the go-to resource for any mental health professional or educator looking to transform their practice from kink aware to kink affirming. Stefani Goerlich is a sex therapist with over 15 years of experience in supporting clients with gender, sexuality, and relationship differences and issues related to these populations as well as the BDSM community around the country. Stefani Goerlich The Leather Couch Clinical Practice with Kinky Clients STEFANI GOERLICH First published 2021 by Routledge 52 Vanderbilt Avenue, New York, NY 10017 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2021 Stefani Goerlich The right of Stefani Goerlich to be identified as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. The purchase of this copyright material confers the right on the purchasing institution to photocopy pages which bear the photocopy icon and copyright line at the bottom of the page. No other part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission in writing from the publisher. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Goerlich, Stefani, author. Title: The leather couch : clinical practice with kinky clients / Stefani Goerlich. Identifiers: LCCN 2020014761 (print) | LCCN 2020014762 (ebook) | ISBN 9780367439910 (hardback) | ISBN 9780367439927 (paperback) | ISBN 9781003006961 (ebook) Subjects: LCSH: Bondage (Sexual behavior)–Psychological aspects. | Sexual dominance and submission–Psychological aspects. | Sex (Psychology) Classification: LCC HQ79 .G64 2021 (print) | LCC HQ79 (ebook) | DDC 306.77/5–dc23 LC record available at https://lccn.loc.gov/2020014761 LC ebook record available at https://lccn.loc.gov/2020014762 ISBN: 978-0-367-43991-0 (hbk) ISBN: 978-0-367-43992-7 (pbk) ISBN: 978-1-003-00696-1 (ebk) For the women who led the way: Emma Goldman RBG and Dr. Ruth Contents Acknowledgments x Introduction 1 1 What Does Kinky Look Like? 4 Key Terms 5 The Gender, Sexuality, and Relationship Diversities (GSRD) Carousel 6 Is BDSM a Sexual Orientation? 9 What Does the Kink Community Look Like? 10 Nonmonogamy in Kinkspace 12 Honorifics, Titles, and Roles 15 Fetishes 42 2 Intersectionality in BDSM 56 Race/Ethnicity 58 Culture/National Origin 59 Religion 60 Family 61 Age 62 Mental Health/Ability 64 Physical Ability/Disability 65 Income 67 Professional Role 69 viii Contents 3 Power-Exchange Relationships 71 What Is Power Exchange? 71 BDSM 72 Bondage 75 Discipline 79 Dominance 86 Submission 91 Sadism 94 Masochism 98 Power Exchange Within Therapy 106 4 Morals, Values & Ethics in Kink 109 Core Values 110 Safe, Sane, and Consensual 116 Risk-Aware Consensual Kink (RACK) 117 Okay … But Why? 119 5 Myths and Misconceptions 123 Clinician Bias 123 The Ick Factor Self-Assessment 124 6 Intimate Partner Violence, Sexual Assault, and Consent in Kink 138 Defining Concepts 139 Cycle of Abuse vs. Cycle of BDSM 141 Warning Signs 149 Sexual Assault: Kinksters as Victims and Perpetrators 152 Barriers to Prosecution 155 Barriers to Community Intervention 158 Effective Therapeutic Techniques for Kinky Survivors 159 7 Diagnostics, a Discussion 165 A Brief History of Erotic Minorities in the DSM 165 Overview of Diagnostic Criteria 167 Agolagnic Disorders 168 Anomalous Activity Preference 169 Anomalous Target Preference 172 Limitations of Diagnosing 174 8 Psychological Benefits 176 Stronger Relationships 177 Better Communication 177 Greater Open-Mindedness 179 Contents ix Increased Happiness 180 Lower Stress and Anxiety Levels 181 9 Clinical Considerations 183 Social Isolation 183 Relationship Changes 185 Changes in Power Dynamics or Needs 188 Changes in Kink/Fetish Practice 190 Shame 193 Relentless Hope 195 Body Image/Disability Concerns 198 General Mental Health Concerns 201 10 Best Practices 204 Strategies to Increase Disclosure 204 Considering Clinician Disclosure 207 Treatment Tools and Interventions 212 Day-to-Day Power: A Questionnaire 223 Conclusions 230 Recommended Resources 232 References 233 Index 240
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