Let’s start by saying that there is a wide berth of understanding when it comes to sexual masochism. It is a practice that sometimes goes along with BDSM, but doesn’t necessarily have to. For the sake of writing a dissertation on the subject, I’m going to stick strictly to the sexual practice of self-harm, not to those who are simply “cutters”.
Many people may ask what can possibly make hurting one’s self arousing, but the answers aren’t always black and white. Yes, it’s listed in the Diagnostic and Statistical Manual of Mental Disorders as a paraphilia, or otherwise known as intense and recurrent sexually arousing urges, fantasies, or behaviors. But isn’t that all sex, really? Don’t we all have fantasies somewhere deep down which manifest in someway in our approach to sex?
In the research I’ve done, literature points out that self-harmers are not suicidal, or even attention seekers. Quite the opposite, actually. People who self-harm tend to use this means as a coping method for something in their past, anxiety, depression, post-traumatic stress, or a multitude of other disorders. Sexual masochism is slightly more prevalent in males and it is interesting to note that more people consider themselves masochistic rather than sadistic.
Some of the more popular acts of masochism are spanking, whippings, cutting, burning and hitting, and can occur in the context of role-playing. In the explosion of erotica romance, these practices are sometimes written about, in detail, and with a HEA ending. BDSM themed books are in demand and usually top the best-seller lists. But writing a believable book is important...and difficult if one doesn't truly understand or "get" the culture. It is important to relate the emotion in masochism, to make the reader feel the power behind it.