John Edward Robinson, a 56 year old Kansas native who has led a life of heretofore upstanding appearance, is charged in the deaths of at least 11 women. The married grandfather also trolled the internet under the name “Slavemaster”, and lured women from a variety of states seeking fulfillment of sexual fantasy. Two of those women, including a Texas psychologist, experienced him as going “too far” in their encounter.

Studies of serial killers have noted the prevalence of sadistic and controlling behaviors in their modus operandi. With sadomasochistic fantasy as common as it is, why is it that only a small portion of those with this sexual proclivity become homicidal? In Part 2 of this installment, we explore the psychological and biological factors that distinguish sadomasochists from violent sexual offenders. The Forensic Panel assembled a group of noted experts in alternative lifestyles and deviant sexual behaviors in an attempt to answer this and other questions.

What psychiatric diagnosis or psychosocial characteristics and background distinguish those who are drawn to practice sadomasochistic sex?

Bartlik: The cause of paraphilias (sexual deviance) is not known. This is an inherently difficult area to research and few causal studies have been done. Some psychoanalysts have theorized that maternal attachment problems are almost always present. Others view peculiar sexual inclinations as coping mechanisms that develop in reaction to a particular traumatic event or painful set of circumstances in childhood. Thus, the paraphiliac weaves a sexual fantasy around painful experience to help him to come to terms with it. This is commonly the case with individuals who were brutalized as children, or who grew up in homes in which family members were brutalized. In adulthood, such individuals are prone to develop either sadistic or masochistic sexual fantasies.

Berlin: In my opinion, the major factor that leads an individual to engage in sadomasochistic sex is the fact that such behaviors are erotically arousing for him. In growing up, a person does not decide voluntarily what sorts of behaviors (or what sorts of partners) will cause him/her to become sexually aroused. Rather, in growing up, an individual discovers what kinds of behavior excite him sexually. For some, sadomasochistic behaviors may be a turn-on, whereas for others, they may be a turn-off.

Moser: The only difference between "normal" heterosexuals and sadomasochism practitioners is that S/M practitioners engage in S/M sex. They otherwise seem to be quite normal and do not have any characteristic psychological traits or diagnoses.

Bartlik: Persons with paraphilias also develop other non-paraphilic sexual disorders, such as erectile disorder and hypoactive sexual desire disorder, particularly when their paraphilic desires are thwarted. About half of the men with paraphilias are married. Many of these men give up having sex with their wives, unless their wives participate in their paraphilia. Men with paraphilias may resort to hiring prostitutes when their needs go unmet within their relationship. Paraphilias rarely occur in women, with the exception of sexual masochism, for which the male to female ratio is 20:1.

Why are some with sadistic sexual fantasy homicidal or severely assaultive as part of the sexual fantasy?

Hucker: Studies of criminal sadists have generally described those with serious psychopathology in addition to sadistic sexual preferences. Features such as substance abuse and personality disorder (especially psychopathy) are prominent in these individuals.

Moser: Why is anyone homicidal? Most of us have had a murderous fantasy about someone we know (boss, spouse, parent), but very few of us ever act on this. Substance abuse and isolation are factors, but it can happen to anyone.

Hucker: Ressler, a former FBI agent, and his colleagues in their work on sexual homicides have argued that among their subjects early childhood abuse and other dysfunctional family behaviors are prominent and various behavioral indicators, largely antisocial, emerge quite quickly.

Quinsley: I doubt that there is a causal link between the parent-child relationship or Post Traumatic Stress Disorder and serial sexual homicide, although there may well be a correlation.

Berlin: Little is known about why some individuals seem capable of limiting sadomasochistic sexual activities to fantasy alone or to non-harmful actions, whereas others seem to be either unwilling or incapable of doing so. Clinically, individuals are seen who are driven to act in a destructive and even murderous way, and who, like the severe alcoholic, seem to be quite out of control. Indeed, the issue here is analogous to alcoholism. Why can some drink socially in a way that seems to cause little if any harm, whereas for others their ability to do so safely and moderately seems to be so compromised and impaired?

Hucker: Sexually sadistic killers are driven by fantasies, which develop at a very early age and often are expressed quite early as well. Researchers also identify a number of antecedent factors which immediately precede acting on the behavior and this includes conflict with females, conflict with parents, financial and employment problems, marital problems and various other stressors.

What is the relationship between harmless sadomasochistic sexual fantasy and sadomasochistic murder or assault?

Moser: There is no known relationship. Sadomasochism is not the same as rape. The difference between "normal" heterosexual intercourse and rape is consent. The difference between S/M and sexual violence is consent. What is the difference between the fantasies of rapists and "normal" heterosexual men? Both have rape and non-rape fantasies.

Quinsley: There is evidence (albeit based on small numbers of cases) that a substantial proportion of serial sexual murderers have deviant sexual interests and entertain deviant sexual fantasies. This evidence comes from information concerning behavioral tryouts or rehearsals prior to the murders, elements of the offenses themselves (such as bondage, humiliation, fetishistic acts, multiple sexual acts, and so forth) that are sexually deviant or suggestive of paraphilic interests, as well as post-arrest disclosures of the offenders regarding their sexual fantasies. We can therefore be confident that most serial sexual killers have sadistic sexual interests but that most sadists are not serial killers.

Bartlik: It is noteworthy that violent sex offenders do not appear to suffer from schizophrenia or other major mental disorders with greater frequency than that of the general population. When confined to special prisons for sex offenders which are comprised mostly of sexual sadists, rapists and pedophiles, these inmates have a higher socioeconomic status and educational level than the general prison population. It has long been known that periods of stress and substance abuse exacerbate paraphilias. Sobriety is an important element of recovery in specialized treatment centers for sex offenders.

Are there any particular qualities that distinguish dangerous sexual sadists from those who engage in sadomasochistic sex, who are not dangerous?

Berlin: The primary factor that distinguishes dangerous and non-dangerous individuals who practice a sadomasochistic lifestyle is that the dangerous ones often find that fantasy and pretend activities alone may fail to cause an adequate degree of sexual excitement.

Bartlik: More often than not, individuals who commit rape and murder lead solitary, isolated lives. Often acquaintances are shocked to learn of their crimes because they viewed these individuals as unusually quiet and socially withdrawn, with no outward signs of aggressivity. Though usually solitary individuals, some are married and live with their wives and children. Often their family serves as a cover for their secret double life. This type of sex offender may go to great lengths to conceal his activities, However, on some level, his wife may be aware that something is dreadfully wrong. A man with this problem may show little to no sexual interest in his wife. He may possess relics or keepsakes of his crimes, which he may use during masturbation while fantasizing about past violent acts. He may have an extensive collection of pornography and sadomasochistic materials. And he may disappear all night long or for days at a time without explanation.

Quinsley: With respect to sex offenders generally, the combination of psychopathy (as measured by Hare’s Psychopathy Checklist) and sexual deviance, as measured by phallometric examination, is associated with particularly high rates of sexual reoffending. This combination, therefore, is a very bad prognostic sign. It is very likely, therefore, that men with sadistic interests who are also psychopathic are those that represent the greatest danger.

Berlin: For some, fantasy and non-dangerous sexual activities may lead to temporary satiation of sexual drive and desire. For others their sexual appetite is only further whetted in a way that may lead to escalation and danger. Conversely, some persons who are aroused by low levels of pain, or by simulated pain and suffering, may actually be less sexually aroused by the real thing.

Moser: I often ask sexual violent perpetrators if the "victim" was willing and turned on by the acts, would it increase or decrease their interest? The S/M practitioner would be turned on and the sociopath would not. This is not a standardized response backed by research, but does seem helpful in deciding who would benefit from treatment and what that treatment might be.

Berlin: The degree to which conscience and a sense of concern for the well being of others plays a role in all of this also needs to be further understood. However, it is clear that, some persons of conscience can feel so driven to act in a sadomasochistic fashion that, in spite of ongoing efforts to resist, they may not be able to succeed in doing so.

Is there evidence for biological predisposition to dangerous sexual expression, or is this solely mediated by environmental triggers?

Moser: That is a great debate. Probably some complex interaction of both.

Quinsley: It is certain that there is something different about the brains of individuals who are repetitive aggressive sex offenders. It is not yet clear exactly what this difference is or how it arises.

Hucker: A small number of studies, including some that I was involved with some years ago, point to damage in the right temporal lobe in the brains of sexually sadistic killers and other sexual attackers. Others have suggested various hormonal or chromosomal abnormalities.

Bartlik: There is evidence, however minimal, that paraphilias run in families, but little research has been done to prove this association. For example, the sons of pedophiles are known to be at increased risk of becoming pedophiles themselves. However, this could be due to either biological or environmental factors, since these boys may have been molested by their fathers. In studies on the sons of pedophiles who were adopted by other families, the sons also show an increased risk of developing pedophilia, but this does not prove a genetic link. Adoption itself may influence the outcome.

Berlin: Just as there have been some theories and some data suggesting a biological predisposition to homosexuality, there has been some data suggesting a possible biological predisposition towards sexual sadism. However, at this point in time, no firm answers are possible.

Next in Part 3: The role of the internet, and recommendations to professionals

Check back for Part 3!