The prevalence of Sexual Masochism disorder in the population is unknown, but the DSM-5 estimates 2.2% among males and 1.3% among females. Extensive use of pornography depicting humiliation is sometimes associated with Sexual Masochism Disorder.
Behaviors associated with Sexual Masochism Disorder can be acted out alone (e.g., binding, self-sticking pins, self-administration of electric shock, or self-mutilation) or with a partner (e.g., physical restraint, blindfolding, paddling, spanking, whipping, beating, electric shock, cutting, pinning and piercing, and humiliation such as by being urinated or defecated upon, being forced to crawl and bark like a dog, or being subjected to verbal abuse). Behaviors sometimes include being forced to cross-dress or being treated like an infant.
In extreme cases, accidental deaths can occur, such as from engaging in self-application of electric shock. One of the most extreme cases of masochism was Bernd Brandes, who answered a person ad from Armin Meiwes, who was seeking someone who wanted to be slaughtered and eaten.
Following a phenomenological study of individual involved in sexual masochistic sessions, Sexual Masochism was described as an addiction-like tendency, with several features resembling that of drug addiction: craving, intoxication, tolerance and withdrawal. It was also demonstrated how the first masochistic experience is placed on a pedestal, with subsequent use aiming at retrieving this lost sensation, much as described in the descriptive literature on addiction. The addictive pattern presented in this study suggests an association with behavioral spin as found in problem gamblers. A behavioral spin is described as a process one goes through that is characterized by a behavior growing in frequency and magnitude, as indicated by the Criminal Spin theory. As it develops, it gains its own momentum which the individual finds almost impossible to terminate even when faced with known unwanted outcomes. For the participants in sexual masochistic sessions, the behavioral spin is manifested as a continuously reinforced process leading the masochist to engage in masochistic activity, perpetuating itself, and binding the addict to his/her behavior.