The Leather Couch: Clinical Practice with Kinky Clients

The Leather Couch: Clinical Practice with Kinky Clients

by Stefani Goerlich
The Leather Couch: Clinical Practice with Kinky Clients

The Leather Couch: Clinical Practice with Kinky Clients

by Stefani Goerlich


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Winner of the 2021 AASECT Book Award!

Winner of the SSTAR Professional Book Award 2021!

Winner of the SASH Media Award 2022!

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.

Product Details

ISBN-13: 9780367439927
Publisher: Taylor & Francis
Publication date: 09/09/2020
Pages: 260
Product dimensions: 6.00(w) x 9.00(h) x (d)

About the Author

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.

Table of 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

3 Power-Exchange Relationships 71

What Is Power Exchange? 71


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

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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