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Classification according to ICD-10
F65.5 Sexual preference disorder
ICD-10 online (WHO version 2019)

As sadism in the medical sense is called when a human pleasure or satisfaction experienced by humiliating other people to oppress or inflict pain. To a certain extent, sadism can also be expressed through acts of cruelty to animals.

The term sadist is now used in common parlance to refer to people who can enjoy the suffering of others. The opposite of sadism - the gain in pleasure through suffering pain or humiliation - is called masochism .

Origin of the term

The term sadism was first used scientifically in 1866 by the German psychiatrist and coroner Richard von Krafft-Ebing . Sadism is named after Donatien Alphonse François Marquis de Sade , whose novels mixed pornographic content with violent fantasies.

Medical classification

Sadistic practices are no longer generally viewed as a disorder of sexual preference. The ICD-10 F65.5. still makes this classification, but is not particularly detailed with regard to the diagnosis of sadism. According to ICD-10 , sadomasochism is a "disorder of sexual preference" (Code F65.5), which is described there as follows: Sexual activities with the infliction of pain, humiliation or restraints are preferred. If the person concerned experiences this type of stimulation, it is masochism; when she inflicts it on someone else for sadism. Often times, the person concerned experiences sexual arousal during both masochistic and sadistic activities. The American Psychiatric Association (APA) (American Psychiatric Association) has with the appearance of the DSM IV published broader diagnostic criteria in 1994, after which BDSM is clearly no longer viewed as a disorder of sexual preference.

The diagnosis of sadism or masochism may therefore only be made with regard to the sexually motivated manifestation of these disorders if the person concerned cannot obtain sexual satisfaction other than through the exercise of sadistic or masochistic practices, or if he himself rejects his own sadistic or masochistic sexual preference and feels restricted or otherwise suffers from his living conditions. Consensual or even secret sexual preferences for sadistic practices in the sense of BDSM usually do not meet the criteria for diagnosing sadism in today's medical sense and are a sociologically different, but not uncommon expression of individual sexuality. However, the transitions between individually pronounced sexuality and disorder of sexual preference cannot be reliably defined in all cases.

Expressions of sadism

In the medical sense, one can essentially distinguish between two forms of sadism:

Not predominantly sexually motivated sadism

Erich Fromm analyzed this form of sadism in his work Anatomy of Human Destructiveness and there portrayed Heinrich Himmler as a clinical case of anal hoarding sadism (for an analysis of sadism / masochism in Fromm see also his work Die Furcht vor der Freiheit ). In his work The Art of Loving, Erich Fromm describes sadism as the desire of people to know themselves and those around them. This could happen on the one hand through love, on the other hand through cruelty and lust for destruction. An example of this is breaking objects in small children in order to get to know them.

Sexually motivated sadism

Exercising power or violence over other people or animals is a source of sexual arousal for the affected patient. Sadistic acts often represent the foreplay for intercourse, or intercourse itself is practiced in a way that demeans, humiliates, or causes pain for the partner. A special form of sexually motivated sadism is compensatory sadism , in which the sadistic act completely replaces sexual satisfaction.

Sexually motivated sadism and compensatory sadism can lead to serious (sexual) crimes, in particularly serious cases up to acts of killing. These occur in the context of the very rare, severe, progressive paraphilias in which sadistic fantasies and desires determine behavior. Extreme cases can develop over decades, lead to serial murder and also make children into victims.

These extreme cases strongly shaped the image of the sex offender and the mentally disturbed lawbreaker in public under the pressure of the media and led to a criminal law reform in Germany in 1998, which made it more difficult to release from prison and imprisonment.


Treatment of sadism is often lengthy and difficult; experimentally with psychotherapy .


  • About morality, sadism and related things. In: Andreas Dorschel : Thinking about prejudices. Felix Meiner, Hamburg 2001, ISBN 3-7873-1572-1 , pp. 129-174.
  • Erich Fromm: Anatomy of human destructiveness . Deutsche Verlags-Anstalt, Stuttgart 1974, ISBN 3-421-01686-0 . (Orig. 1973)
  • Erich Fromm: The fear of freedom . 6th, unchanged. Edition. European Publishing House, Frankfurt am Main 1973, ISBN 3-434-00009-7 . (orig. Escape from Freedom. 1941)
  • Walter Lennig: Marquis de Sade. Rowohlt, Reinbek near Hamburg 1977, ISBN 3-499-50108-2 .
  • Eberhard Schorsch, Nikolaus Becker: Fear, Pleasure Destruction - Sadism as social and criminal action. On the psychodynamics of sexual killings . Psychosozial-Verlag, Giessen 2000, ISBN 3-89806-048-9 .

Web links

Wiktionary: Sadism  - explanations of meanings, word origins, synonyms, translations
Wiktionary: Sadist  - Explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ICD-10-GM Version 2005.