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Dr. Saltzman:

I am 17 and live in New Zealand.

Ever since I was little I've had what I guess you could call 'fantasies' about hurting people. When I was 5-8 yrs old I used to torment my classmates by not letting them go to the bathroom. After arriving home from school I would sit and think about it and how much pain they were in. I remember this so clearly and enjoyed doing it and thinking about it. As I got older I started to have more violent thoughts. When I was 13 I had urges to strangle my stepsister to death. One morning before school I attempted it and I enjoyed doing it. She was trying to scream but couldn't and just before she went unconscious, I stopped, as I knew I had no plan of what to do after the death.

When I was 14 I attacked my mother with an iron, hoping to physically scar her (which I did). Also around this time I went back to my old ways and started depriving people (my stepsister) of the bathroom when she needed to go.

When I was 15 I chased my neighbours friend down the road with a large knife, hoping to stab him and watch him bleed to death. He was a fast runner so he got away. On the walk back home I threatened 2 strangers and said if they told anyone what had happened, I'd play jump rope with their intestines.

Everyday when I see my mother I can mentally see myself leaning over and pushing her to the ground, stabbing her and listening to her screams, laughing as she dies. I have thoughts like this about anyone and everyone, even mashing up my mothers ex boyfriend with a giant potato masher.

When I recently bought a knife, I was choosing which one to buy on the basis of how easy it would be to kill someone with it.

I realise that killing people is wrong and in fact, I am a vegan so I don't know why I can love animals so much yet want to destroy all people and feel nothing towards them.

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I don't want to kill someone as likely I would not get away with it. Prison would be worse than death. How do I get rid of these thoughts and why do I think this way?


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Hello, Brittany--

The thoughts and behaviors you describe technically would be considered a paraphilia known as sadism. Paraphilias are frequent, intense, sexually arousing fantasies or behaviors that involve inanimate objects, children or non-consenting adults, or suffering or humiliation of oneself or another person. Sadism, is the paraphilia in which a person experiences sexual excitement from inflicting physical or psychological suffering on another person, exactly as you have described in your letter, and is just one of many paraphilias.

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Some other common paraphilias are these:

  1. Fetishism, which is the use of a physical object (the fetish) to produce sexual arousal.

  2. Pedophilia, which is a preference for sexual activity with young children.

  3. Exhibitionism, which involves exposing the genitals in order to become sexually excited and/or feeling a strong desire to be observed by other people during sexual activity.

  4. Voyeurism, which involves becoming sexually aroused by watching someone who is disrobing, naked, or engaged in sexual activity.

  5. Masochism, in which a person experiences sexual excitement from being humiliated, beaten, bound, or otherwise abused.

  6. Frotteurism, which involves sexual excitement and gratification by touching or rubbing a non-consenting person. This behavior often occurs in busy, crowded places, such as on busy streets or on crowded buses or subways.

  7. Bestiality, which involves sexual feelings or behaviors involving animals.

  8. Necrophilia, which involves sexual feelings or behaviors involving corpses.

  9. Transvestism, which is characterized by heterosexual males who dress in women's clothing to achieve a sexual response.

The tendency towards sadistic behavior normally begins in adolescence or early adulthood; yours began earlier. Usually sadism begins with obsessive thoughts and sexual fantasies together with a desire to inflict physical or psychological torment or humiliation on another person such as you did by preventing your classmates from going to the bathroom. Sadism tends to be chronic in nature and usually increases in severity over time.

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There are various theories about the possible etiology (causation) of sadism, but in my opinion none of these has been backed up by sufficient evidence to be considered a satisfactory explanation for the kind of thoughts and feelings you describe. Some theorists believe that the essential causation of sadism is biological (genetic). This point of view imagines that some people are simply born with the tendency to be sadistic, and offers evidence for this idea in abnormal findings from neurological examinations of sex offenders. However, it is a long jump from observing some neurological abnormalities in a group of offenders to saying that the abnormalities caused their sadistic behavior.

Another idea involves the tendency in humans gradually to learn to take pleasure in activities which at first seem unpleasant or difficult to enjoy—to enjoy, in other words, the kinds of things that human beings seem programmed from birth to avoid. For example, babies are born with a very strong fear of falling, and this fear persists into adulthood. Nevertheless, people can learn to enjoy such falling-based activities as skydiving, high diving, and bungee jumping, and eventually even become addicted to the thrill of these pastimes--addicted, actually, to the powerful chemical messengers such activities release into the brain--so that more ordinary activities seem pale in comparison. According to this theory, the first time that a child inflicts harm, he or she might feel the normal human distaste at such actions, but as the child continues over time to commit such actions, a taste for them may develop in the same way that one can learn to love high diving or parachute jumping. This theory has the advantage of explaining how certain people can learn to enjoy inflicting pain, or even killing, despite the powerful inhibitions against such actions which seem to be a part of the normal human genetic program, but there is little direct evidence for this idea. In other words, perhaps this explanation for sadism makes sense, but little or no research can be educed to demonstrate it. In evaluating this theory, Miller (2005) asks why more people do not become sadists. His conclusion is that even if a certain level of sadism would be enjoyable, a sense of guilt prevents most people from admitting that they might take pleasure in inflicting harm on others. Pointing to the faculty of conscience which operates in most people (but not, of course, in psychopaths and sociopaths), Miller says that, "even if they started to experience . . . visceral pleasure . . . in the course of harming someone, they would not allow themselves to enjoy it, let alone to pursue it." (page 97)

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Sadger (1926) proposed that children might develop a tendency to sadism when their caretakers both bring sexual pleasure and also deny sexual pleasure while carrying out toilet training or when preventing masturbation. In other words, the parents might be guilty of a kind of unconscious sadism when they prevent a child from defecating when he or she needs to (which was one of your early tortures of your classmates), or when they prevent a child from enjoyment of his or her own genitals which is a natural action on the part of children. According to Sadger's explanation, this unconscious sadism is then passed on to the child as a learned behavior.

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As one might expect given the lack of understanding of the causes of sadism, treatment for sadism is usually difficult and most often ends unsuccessfully with the sadist, even if he or she has abstained for a while during treatment, returning sooner or later to further sadistic activity. The fact that many sadistic fantasies are socially unacceptable often causes sadists to avoid treatment in the first place, or else to drop out of treatment once it has begun. The unwillingness of many therapists to deal with such an unpleasant or sensitive subject constitutes another impediment to treatment of sadism. In general, sexual sadism is difficult to modify with the kinds cognitive-behavioral techniques which work well for so many other problems. Chemical (pharmacological) intervention may be of some benefit, depending upon the individual. Some of the antidepressant drugs have been tried, but with only limited effect. Unfortunately, with or without treatment acts of sexual sadism tend to grow more violent or bizarre over time, so the outlook is not good.

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With that as background, Brittany, let me address your letter more specifically. Judging from what you have written, there is little doubt that you are a sadist, and that you have be suffering this paraphilia since early childhood. But unlike some sadists, you also lack all sympathy for your victims, and would like to begin killing people, although you state clearly that you know that "killing is wrong." This statement sounds to me, not just like sadism, but very much like quintessential psychopathy, or sociopathy as it also is known. Another bit of evidence of your psychopathic thinking is your statement that, "I had to fake concern for my mother because it's what was expected of the daughter of a surgical patient." This is classic psychopathy: the psychopath learns early to feign emotions which she or he does not really have so as to blend in better with more normal society—to slip through the cracks, that is. Now your psychopathy, even more than your rather cruel brand of sadism, is a frightening condition, both for you—since you dread the idea of the incarceration which probably will result eventually if you carry out your desires—as well as for the rest of us, for whom you are a danger and a menace. I know that it must feel terrible to you to be so out of control, and to be a danger to yourself, even though I know that being dangerous to others does not worry you, and may, in fact, bring you sexual pleasure.

In other terms, although you feel and understand what sympathy is—you feel it for animals—you have none for the humans you intend to victimize. This is because the idea of a human being suffering, particularly at your own hands, gives you pleasure and, most likely sexual release. You did not mention it in your letter, but I assume that you masturbate to orgasm while aroused by fantasies of hurting and killing, which also would be classic sadistic behavior.

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Unfortunately, as I have stated earlier, the outlook for treatment sadism is not particularly hopeful, at least insofar as I know. Nevertheless, in my opinion, you should and must, seek some kind of treatment, and you must do this right away. Your purchase of the knife and your criteria for choosing that particular weapon indicate that you intend to commit murder—perhaps murder of your mother—and soon. This is why I say that you must seek help, even if your condition is, according to what I know, difficult to treat. In the first place, new pharmacological treatments are being tried as I write this, and perhaps one of them could work for you. In the second place, your powerful fear of incarceration could work as a lever for an experienced psychotherapist, who, even if you cannot be relieved of your fantasies, might at least help you to get the worst of them under control so that they remain fantasies. Thirdly, my understanding of sadism and its treatment is limited and incomplete (I have interviewed but never actually treated any murderous sadists), whereas another therapist with more experience in this problem might be able to be both more hopeful and more helpful than I have been. Therefore, I advise that you try to find the best psychologist you can, and that you explain to that person exactly what you have explained to me. Perhaps you can be helped, Brittany. I certainly hope so, and I wish you the best.

Be well.

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Your reply to the sadistic 17 yr. old was in bad taste. All sadism isn't

of a sexual nature and it doesn't sound like hers is/was. After reading

your reply however she may have taken her desires to a new level. What

were you thinking? Explicit photos and all. I think you may be in need

of some counseling yourself. The girl is only 17. Seems to me you were

trying to "turn her out" with your explanation and those sexual images.

Why do you psychotherapist always feel the need to sexualize things? Many people have urges that offer no sexual release after the people follow through on them. That's LEWDacris for you to assume that she masturbates to orgasm while fantasizing about hurting people. That's quite an assumption. Sound more like a fantasy of yours doc.

Delisa R. Russell

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Your letter was not only disrespectful in tone, but also ignorant and incorrect. Yes, people do have urges that offer no sexual release after the people follow through on them, but sadism is not one of those urges. By definition, sadism includes sexual excitement, most often leading to orgasm either spontaneously during the act or afterwards by means of masturbation.

The images in my reply are intended to illustrate what sadism is, which apparently you do not understand, and, judging from your reply, do not wish to understand.

The intensity of your attack on my reasonable reply to this young woman, and particularly your saying that "psychotherapists always feel the need to sexualize things," leads me to wonder if you have problems in the area of sexuality and masturbation. I suggest you look into your own mind and try to see what is really there, including sexuality, instead of projecting your anxieties about sex and masturbation onto "you psychotherapists." Sexual excitement and masturbation are a normal part of human life, and it would be a very rare seventeen year old who does not masturbate. Furthermore, no competent psychologist could possibly reply to a letter from a sadist without mentioning sexuality.

Be well.

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