Kink Aware Therapist: How to Tell Consent From Coercion
with Dr. Lisa Marie Bobby and AJ Greer, Greer Research and Consulting
A note before we start: this conversation includes discussion of sexual violence and homicide. Nothing graphic, but you know your own bandwidth.
Is This Their Sex Life, or Is This Abuse?
The difference is never the behavior. It is whether coercion was in the room, and coercion does not announce itself.
There is a half second that happens in sessions and almost nobody talks about it. A client is describing something intense that happened in their relationship, and for a moment you genuinely do not know what you are hearing. You cannot stop and ask. Nothing in graduate school prepared you to sort it. I have had that half second, I would guess you have too, and I would also guess you have never said so out loud in front of colleagues, because saying it out loud feels like admitting something. It is not. It is a hole in our training, and we are all carrying a map of them.
My guest is AJ Greer, who runs Greer Research and Consulting. She trains law enforcement, prosecutors, victim advocates and clinicians on sexual violence and domestic violence, she consults on live cases for agencies around Texas, and she spent years as a research specialist at the Texas Department of Criminal Justice. Her specialty is sexual sadism and psychopathy. She is a researcher and a trainer rather than a treatment provider, and she volunteers that distinction rather than blurring it, which is a large part of why I trusted everything else she told me.
We got into the four questions that made a prosecutor tell her she had just solved a case, why strangulation is a lethality indicator rather than a preference, what sexual sadism actually means and why consensual kink does not meet the diagnostic threshold, how coercion hides as ten extra minutes just under the line where anyone would name it, and how a therapist actually becomes a kink aware professional, including why the directory people list themselves in is a visibility tool and not a credential. She also walked me through original research she is early into on where serial homicide and intimate partner violence overlap, which she is careful to call preliminary every single time it comes up.
Being affirming is necessary, and it was never sufficient. That is the part of this conversation I have not been able to put down.
"Coercion negates consent." — AJ Greer
Moments from this episode
Episode transcript
The episode opens with a short clip taken from later in this conversation. It appears in context below rather than twice.
Dr. Lisa: Back here at APA, and it has been such a good time talking to fascinating people about fascinating things, and I think I found the winner of the whole deal. I am sitting down right now with AJ Greer, who has the most fascinating career in our space. AJ, why don't you tell our friends listening with us just a little bit more about what you do?
AJ Greer: Yes. So I run my own LLC. I do consulting, training, and independent research, and it's centered around sex offenders, domestic violence, sexual violence, and lots and lots of serial killers.
Dr. Lisa: Serial killers. Oh my gosh. Okay. So, if it's okay to ask, I feel like there's a story. How did you get into this specific niche in our profession?
AJ Greer: Oh, because I'm so short and we're closer to hell, so we have to be evil. I actually don't have a good answer for that. I've always been interested in human behavior in general. I grew up with a mother who was a psychologist, and growing up, violence seemed like the oddest thing. I was like, that doesn't make any sense. And so I just ran with it. As I went through my undergrad and my master's program, I stuck to this very niche area, specifically looking at sexual sadism and psychopathy, because those are such outlying and extreme behaviors that I'm like, what is going on there? I need to know. Now I interpret that and turn it into practical applications for people in the criminal justice system.
Dr. Lisa: Because you're right, it is interesting. There's this, why is that even happening? And for you it's driven by this curiosity. We were just chatting earlier, and, I mean, is it fair to say, the word that's coming up for me is not the right word, but underrepresented, or a part of our field where maybe there isn't as much information. Is that right?
AJ Greer: Yes. I would say it's pretty understudied, which is kind of interesting, because everyone is a little bit interested in serial killers. But when I've been talking to people, normally people hear what I do and they say, oh, I'm a true crime person. I'm like, that's a little different. Because then you get into the true crime and it gives you only so much, and then there's a cutoff point. And people do tend to have a hard stop when I'm talking about things. So if I'm looking at articles and I'm talking about them, I have some friends that are like, you cannot tell me more details about this particular one. So if it's like a sexual cannibal case, people are like, that's too much for me, I don't want to hear it. That tends to happen a lot with serial killers. There's only so much information people want to hear, and then they're like, nope, no more.
Dr. Lisa: Dissociate.
AJ Greer: Yeah. Which is totally fair, because it's scary and it's hard, and it's not for everyone, which is fine. But it is understudied because most people don't really want to deal with that particular type of offender.
Dr. Lisa: Yeah, I hear that. So your background is research psychology in forensics, and you have had many interesting chapters in your career as you've been exploring different aspects of this. We were chatting and you mentioned that you worked in the prison system for a period of time. You're exploring sexual sadism, BDSM, and healthy kink versus abusive relationships. I don't even know where to start with you.
AJ Greer: Where do you think we should start? Well, I was a research specialist for the Texas Department of Criminal Justice. That was an interesting job. I did some research on their batterer intervention programs. Way back when I first got into criminal justice, about eight years ago, I started on a program for law enforcement that does trainings around the state, the sexual assault and family violence investigators course. So that's how I got started. I moved through working in advocacy areas, and then I worked in rural Texas improving systems response to domestic violence.
AJ Greer: And then I went on, got my master's, focused on sex offender behavior. Once I started really focusing on sexual sadism, I started looking at the kink community. If I'm going to tell people what is non-consensual sexual sadism and what is violence, I need to show them what is a consensual act. And so now I do a lot of training for law enforcement, prosecutors, advocates. I think I actually have a law enforcement training at the end of the month this month. Either that or advocates. I really like my trainings. They're very fascinating.
Dr. Lisa: What about them? What's fascinating?
AJ Greer: So I get a lot of questions. When I'm speaking about it, I do it in a way that makes them really comfortable to ask questions. I don't know why. I think it's the energy. But I get people who will come up to me and ask questions like, I don't understand this, can you tell me more? I had a prosecutor come up to me one time, and I had some information in there about questions that you could ask on scene, or ask to verify consent in a relationship or determine if it's abuse.
AJ Greer: And she was like, oh my goodness, I think you just solved my case. I have been riding that high for a month.
Dr. Lisa: What shifted for this person?
AJ Greer: So a lot of criminal justice entities don't know anything about kink. So the rough sex defense can get used. They're like, oh, it's just rough sex, and it was all fine. But when you dig a little bit more, it's like, well, was there a safe word, which is key in kink. Was there aftercare? Do they know how kink works? Who has been in the kink community the longest? What kind of education is there? So knowing to ask those questions is going to reveal, okay, is this a consensual kinky relationship, or is this violence? And so then I'll get called by various places around the state, and they'll be like, hey, can you look at this case and give us some idea of what's going on? That really brings me a lot of joy. But for that prosecutor in particular, she was like, I have this information, and this is awesome.
AJ Greer: I also get the honor of individuals who are kinky. They'll come up to me after my sessions in criminal justice and they'll be like, hey, this was really wonderful, thank you. And they'll also give me suggestions to improve it, and I love that. I'm like, yes, give me all of the information.
Dr. Lisa: What was the suggestion you got?
AJ Greer: So I was describing the concept of a drop. A drop is after a scene in a kink or BDSM play takes place, and it's this big flooding of emotions. The way I was describing it was like a flooding of emotions. And I had a nice woman come up and say, it's kind of like that drop after a runner's high, or like a balloon filled with water popping. And I was like, that's so much better than what I was saying. I was so excited. And so talking about all of that, I'm getting all of these perspectives coming up, and people are being more open to learning. That's super important to me, because now we can really get rid of the rough sex defense, which I hate.
AJ Greer: It's really just very annoying, especially when it comes to strangulation, because there's no safe way to strangle someone. Both the kink community says that, and strangulation is a huge lethality indicator in intimate partner violence. So it's one of those big red flags where it's like, you can't do it. There are so many ways you can possibly die. You can die up to a couple of years later, depending.
Dr. Lisa: That's wild. I didn't know that.
AJ Greer: Yeah. If anyone's interested, check out the Strangulation Training Institute. They have a lot of interesting things. They have a timeline of the process of being strangled. Incredibly dangerous. Please don't do it. That's my soapbox.
Dr. Lisa: But this is so interesting, because you're saying that without this education the rough sex defense is really kind of minimizing things that happen. And having some sort of metric around what is healthy and consensual versus what it looks like when it's not, so that they can understand it. And just out of curiosity, you talked about doing trainings on this topic for law enforcement. Do you do anything with other therapists who might be seeking to understand this in client populations? Because I could also see a therapist sitting down with a client, and maybe a client is telling them a story about something they're experiencing in their relationship, and a therapist really not knowing. Is this person being abused? Is this a trauma? What's going on here?
AJ Greer: Yeah. So I do talk to therapists as well. I just presented at a conference the other week that was for trauma support services, based in Texas, and most of their attendees are clinicians, therapists, LCSWs, social workers, that particular group.
AJ Greer: And they love attending, because then they learn more, and they will then go on to the National Coalition for Sexual Freedom's website. They can look at all of the resources there and become a kink aware professional. And that can get added into a database. So now they have this knowledge and these resources and some base level information, so they can be like, this is a better way to approach this. And kind of open their mind and be like, this is just something that's fun for somebody to do, and that's okay. They also have resources on NCSF's website for helping to determine if it's intimate partner violence versus consensual kink.
Dr. Lisa: Oh, that's such a good resource. That's one of the things that I love doing the most on this show, is just bringing this up into the light, because I would say 99.9% of the therapists who are here with us right now listening to this conversation are like, wait, what? What was the website again? There's a trustworthy source to go and learn more. So say it one more time, and of course we'll put it in the show notes for any providers wanting to learn more.
AJ Greer: Awesome. Yeah. It's the National Coalition for Sexual Freedom. I believe it's, I don't remember the website name, because it's a little different off the top of my head.
Dr. Lisa: National Coalition for Sexual Freedom. We got it. We will look up the website and put it in the show notes.
AJ Greer: Yes. I normally have it written down everywhere. So that's the best resource for that. They're wonderful, and they also provide free education on cultural competency. They can come out and teach. I've seen them teach probation departments. I've seen them teach therapists. I've seen them teach all sorts of people, and they're really wonderful.
Dr. Lisa: Interesting. You know what? Just the way that you said that, that actually shifted something for me, AJ. It's a kind of cultural competence. And I think I hadn't framed it that way in my own mind, but then when you said that, I was like, yeah, it is.
AJ Greer: That's full credit to NCSF for that, because that's how they address providing information. They call it their cultural competency course.
Dr. Lisa: Cool. Well, thank you so much for taking us into that one dimension of your fascinating career. And we haven't really even started talking about serial killers. Or your guillotine earrings, which I am so obsessed with.
AJ Greer: Highly recommend. Love presenting with them. You get up on stage, people are like, oh, this is serious. People really like it. I wear these when I'm doing the presentations on consensual and non-consensual sexual sadism. People like it. They're like, oh, that's so fun. I'm like, yeah, yes it is. It's awesome.
Dr. Lisa: So then, well, wait, is there anything else that I should ask you in that realm? I mean, even just sexual sadism, what you just said. What do you know about that?
AJ Greer: That's a good segue into the serial killers as well. So sexual sadism is kind of my really special thing. I love sexual sadism. Not, I do not practice it.
Dr. Lisa: We don't care if you did. I don't care.
AJ Greer: But non-consensual sexual sadism has always been something I've been interested in.
AJ Greer: And a lot of your serial rapists and your serial killers, your sexually sadistic serial killers, obviously sexual sadists. It's basically where someone receives sexual gratification by inflicting harm on another person, whether that's physical, psychological, or whatever. It only qualifies as a disorder in the DSM if it causes significant distress or they're actually harming another person. So therefore kink does not qualify under that. And actually NCSF did a lot of work to get that removed from the diagnostic, to make sure that kink couldn't be diagnosed like that.
Dr. Lisa: Good.
AJ Greer: Love them for that. And it's mostly studied in forensic populations, because unfortunately we don't really have a way to study non-consensual sexual sadists in the wild, because they won't turn themselves in. They're in hiding. It doesn't work. And it's a lot of looking at sexually sadistic homicides. That's a big one. So that's where we pick up the various things. So in a sexually sadistic homicide scene you might see something like biting, object insertion. I don't know how deep you want me to go on this, because I know it can get dark very quickly.
Dr. Lisa: Hey, wait. Are we wearing our stickers?
AJ Greer: We are.
Dr. Lisa: We are. Too deep, too dark, too fast. I mean, we might as well. So for listeners here, one of the things we have is sassy therapist stickers at APA Conference. So, I am emotionally available but only during business hours. And we have our sorry, too deep, too dark, too fast, because I'm a therapist. You guys know. I know psychologists do not get our jokes, but all counseling psychologists, they come up and they're like, me too.
AJ Greer: I love that.
Dr. Lisa: So yeah, what should we know?
AJ Greer: Oh my gosh, we could talk about sexual sadism forever. It's so fascinating because, again, much like psychopathy, it's understudied. And it's thought that it's almost like a sliding scale of violence. So you can start somewhere and move down into more sadistic things. And psychologists, I mean, you've met psychologists, we don't like to define anything clearly. Like the definition for psychopathy? Our definition depends on the day. I'm trained in the PCL-R, so I normally will just reference parts of the PCL-R.
Dr. Lisa: PCL-R.
AJ Greer: The Psychopathy Checklist Revised.
Dr. Lisa: Right. Thank you. Yes.
AJ Greer: That is my baby. I love that. It was originally used as a research tool, or created to do research. And it's a good way to describe various facets of psychopathy. And some research has been looking at different parts of it and looking at crime scene behaviors. So specifically also with your sexual sadists, they tend to be more forensically aware, because they've got that psychopathic component to them. And again, this is non-consensual sexual sadists. My consensual sexual sadists? Nerds. Absolute nerds. They play RPG games, Renaissance festival, all of the things. And they're very delightful, and they're not hurting anyone. They're also less likely to use strangulation compared to my non-consensual sexual sadists. They actually love using strangulation. When the target is a woman, a sexual sadist's preferred method of homicide is strangulation.
Dr. Lisa: Interesting. Well, and you also just said a really interesting detail, that because they are higher in psychopathy, they have more awareness of the forensic system. What did you mean by that?
AJ Greer: So there are some studies looking at, I believe it's either psychopathy or sexual sadism or both. So forensic awareness means that they're taking care to make sure they don't leave DNA, but they're also investigatively aware, which basically means they understand police procedure enough to avoid certain things. Which makes them really hard to catch. And additionally, when you're linking serial killer crimes, one of the weakest links to have to link up two different crime scenes is a sexual assault. Strangulation is actually a better way to link crimes together. There are some sexually motivated serial killers who don't actually need to use penetration or anything directly sexual in order to get the sexual gratification they're looking for. It could also be that they're getting off on power and control. It could be a mix of a bunch of different things. But the actual sexual assault itself is not always the best way. There's more data coming out on that, because investigative psychology in general is kind of a new up and coming thing. But that's kind of what I mean by all of that. Like I said, I'm very fun at dinner parties.
Dr. Lisa: I want to hang out with you all day. This is an area that I know nothing about, and I'm sure that many therapists are as well, right? This is probably way oversimplifying it, but I am curious to know. So you've done a lot of research and exploration around serial killers, people who commit multiple murders. Would you say that sexual sadism is really at the core of most of these, or is it sometimes motivated by different things?
AJ Greer: So when I talk about serial killers, I'm specifically talking about the sexually motivated ones. Technically, hit men would be serial killers. Gang violence could, by the FBI's standard definition. I don't mess with those. Those don't come into my research, because that's not usually what I'm looking at. I have some exceptions for some separate research, but that's neither here nor there. Sadism is a specific motivator in sexually motivated homicide, especially if it's got multiple series. Additionally, they tend to target sex workers the most. A non-consensual sexual sadist will either target exclusively sex workers, or they'll do both sex workers and non-sex workers, but you rarely see one that just targets non-sex workers. And often they are practicing on sex workers. So the sex workers are surviving, but they can't report to law enforcement because of all of the stigma, because they might be arrested. I know where I'm from, they have a good chance of being arrested, and they're like, I don't want to talk about that. I actually spoke to a trafficking survivor who had survived a serial killer as well. Tough as nails. Absolutely lovely woman.
Dr. Lisa: What a vulnerable population, though, because sometimes awful things are happening to them and they feel like they need to conceal it.
AJ Greer: Yeah. And they have so many other things to worry about that it's just another thing they're checking off on their trauma box, and it's awful. It's not addressed, and then the offenders are not being held accountable and they're going on to offend more. And we're really bad at catching serial killers in general, just because the original concept of profiling that came out in the seventies, great foundation, but now we're starting to do stuff with more data and actually being able to use that, because you can now incorporate that into court. So like an expert witness testimony or something like that.
Dr. Lisa: So interesting. Well, I have so many questions, but you know your work. You have been living in this space all day, every day for a long time. So what do you think is the most interesting thing to talk about next? Because I don't want to make an assumption here.
AJ Greer: Ooh, okay. So I'm working on some research right now. I'm looking at the overlap of serial killing and intimate partner violence. Because there's this little small space that we're missing. When you hear those two things, you don't really put them together. And even in my line of work I don't see it talked about a ton. Maybe a little bit. And there was a case I saw out of England where this man was horrible. I will not get into the details, but if you're curious, his name is Peter Tobin. He is no longer with us, thank goodness. But he did some really horrendous things to both strangers as well as his wives. And I'm like, that's a really interesting thing. And he was absolutely a sexual sadist. I don't know if he was ever officially evaluated on the PCL-R, but I've heard some psychologists say they're pretty sure he was a psychopath.
AJ Greer: So I started digging, and I started looking at individuals by the FBI standard of, I believe it's two or more homicides. And I started tracking if they had any accusations of intimate partner violence against them. And I'm finding a pattern, and again, this is very early on, so we're not all the way there, but there's a pattern of, okay, I'm seeing sadism is present, and I'm seeing strangulation is present in a lot of these. And I'm like, okay, that means something. Especially when we talk so much about strangulation in the domestic violence and sexual violence world. So that's been really, really interesting to me, because it's this new kind of area. But really, anything about serial killers. I love talking about psychopathy and sexual sadism in general, especially for law enforcement if they're investigating that, because psychopaths are really hard to interview. Classical techniques don't always work. My best theory and best suggestion is to just let them talk, because they will talk. Half of it will be lies probably, but you might get some truths in there.
Dr. Lisa: Can I ask you a question? You know so much about psychopathy, and this is something that I'm interested in. I came across, I think it was a study, of course I can't remember details, but it seems increasingly evident that a lot of psychopathic traits are actually genetic in nature, to a variance of like 60 to 70%. Now of course, the way that manifests, I'm sure, has a lot to do with nature versus nurture. But the things around the callousness, being less reactive, the sensation-seeking, it's a heritable trait. Have you found that in your work as well?
AJ Greer: No. Not necessarily. That's not something I look at specifically. I'm not looking at their genes.
Dr. Lisa: Well, of course.
AJ Greer: And also we're in this era where I try not to look at the older serial killers, because the newer ones are using new predatory methods. So I'm trying to look at their history, and typically they have a history of experiencing child abuse, so there is a chance that there is that happening. I also firmly believe that it's like a lock and key mechanism. You can have the predisposition for it, or genetics, but if you don't have that environment, nothing will manifest.
Dr. Lisa: Absolutely.
AJ Greer: And I also think that there can be pro-social psychopaths. I think you can have someone who has psychopathy, or not full-blown psychopathy, but has that lack of emotion, and they don't harm people.
Dr. Lisa: Right. And I think I've even heard some studies, when you look at certain professions and people that are successful in some, like law enforcement. Who else is going to run towards the person shooting the gun? You know what I mean? There can be a light side to all of this as well.
AJ Greer: Yeah. And that's one thing I also like to talk about, the two sides of the coin. You can have someone who does something really bad, but also can do good things. And vice versa. It's the complexity of humans.
Dr. Lisa: Right. And they're wonderful. They're always fascinating. So in your work, have you found any evidence to suggest, and I know you've also done a lot of work in prison systems, so for offenders, and I know another dimension is working with sex offenders. To what degree is there the potential for, I don't know, redemption, but actually to convert somebody who has been operating in the world in a very destructive way to have them not be dangerous?
AJ Greer: I wish I knew.
Dr. Lisa: Ah.
AJ Greer: I would love to know.
Dr. Lisa: Me too.
AJ Greer: So I'm not a treatment provider, but based on the things that I've seen, we sort of have these sex offender therapy type situations for sex offenders coming out of prison, but they're starting to get referred to mental health systems instead of going to prison, because a lot of the prisons are being overcrowded. So everybody's at a loss as to what to do with sex offenders. And because nobody wants to look and study them, and if we don't study them, we can't treat them, and we can't prevent sex offenders from occurring in the future. So that one's really, really tough, and I wish I had a good answer for it, because it's so complicated. And depending on the state you're in, the treatment looks different, and the psychoeducation looks different. Some of the psychoeducation I've reviewed in places that I shall not name out loud have not been great. Made me very worried. Not particularly with my job. It was something else. It was not related to anything I've done professionally, but it was something I reviewed, and I was like, that's really not great. They never mentioned the concept of consent in the psychoeducation part for sex offenders. Which, I feel like that's important.
Dr. Lisa: Important.
AJ Greer: Important to talk about. And I admire the people who really want to get into treatment and find a way to do the best that they can.
Dr. Lisa: So interesting. It really is.
AJ Greer: And as far as my sexually sadistic sex offenders, we don't really have good treatments for antisocial personality disorder. So that one's really, really tough. But there was a study done in Australia, I believe it was 2017 or 2018, that was looking at children with the callousness traits. And I believe that if the caregiver was able to provide more eye contact to the child, it helped reduce those callousness traits in those individuals. So that's only the one study. I haven't seen it replicated, but I was like, that's cool. So that's the one I talk about, and I'm like, this is something. We have something. It's small, but it is important.
Dr. Lisa: Well, and so the other thing, and I know you're a researcher, you're not a clinician, and so I don't want to put you on the spot in that way. But I guess what I would be curious about is, what would you want boots-on-the-ground therapists to know? So people who are day in, day out talking with individuals, couples, families, where some of these things could potentially be present, but they are unlikely, typically, for people to be talking about unless or until something usually pretty regrettable has happened. What comes from your research that you would want a therapist to know about, or even just have in the back of their mind while they are moving through the world talking to all kinds of people?
AJ Greer: Consent. Knowing about consent is probably the biggest one. And I know that's kind of an odd thing to say, but what is going to distinguish your non-consensual sexual sadist, or your psychopath, or someone with antisocial personality disorder, versus someone who is in a kinky relationship, is going to be consent. And so having that in the back of your mind when you're listening to somebody talk. Okay, where was consent present in this particular action? And you can apply that to various things. So maybe they've set a fire at some point. Well, was it something that they were planning? Were they burning a brush pile, something that would be a consensual thing with the city? Or did they start a wildfire? I was just reading an article about a guy who started a wildfire. That's why that popped up. So it's keeping that in the back of your mind, and looking out for this interesting concept of boundary pushing.
AJ Greer: So when I'm working supervised visitation in particular, my job is to just observe the person who's on supervision. I don't interfere unless the child might be in danger, but I document all of their behaviors. And the ones that tend to have more antisocial traits, in my personal opinion, are the ones that will push the boundaries in very subtle ways. So they push the boundaries like time. We have a strict time schedule, but they'll push it just far enough to where it's not enough for them to get fully in trouble, but it's still a significant amount of time. So like 10 to 15 minutes, and they'll do that consistently across visits, and it's just enough plausible deniability that it's hard to hold them accountable for it. So small things like that are what you'll see, those very subtle boundary pushings. And then, you know, the classical gaslighting behaviors, that's the kind of thing you can see. Questioning reality. No, that never happened. And it's hard for people to take accountability in general, so working on that. But if it really just comes to the point where it's that boundary pushing and you're not seeing any willingness for accountability, then okay, let's look at some other things that might be going on. Doesn't necessarily mean antisocial personality disorder, but it means there's some other factor going on.
Dr. Lisa: Yeah. Those are great indications to look for. And then, before we end, AJ, this has been so fascinating. And I also want to remember to just get more resources for you to load people up before we end. But going back to, for a therapist to even just do some light exploration around consent, if you could design your ideal questions, what are some questions that might be asked to get a sense of consent, and what should it look like, and to be able to sort of filter through, like, problem, not problem? Because that's a differential that therapists need to make all the time. What would be your ideal?
AJ Greer: My number one question would be, is everybody in a space that they're able to consent? Is coercion present? Because coercion negates consent. And that's a really big one.
Dr. Lisa: I would think coercion could be subtle.
AJ Greer: Coercion can be very subtle. That's the thing. It's very insidious, and it's very hard to prove, and it's that little bit of boundary pushing. That's what that is. And so keeping an eye out for that, and learning about coercion to the best of your ability, is really the best way to approach it.
Dr. Lisa: Yeah. Coercion. Consent. Is everybody having a good time?
AJ Greer: Is everyone feeling safe to. Because one thing I see a lot in cases is, I didn't feel safe enough to use my safe word. And I'm like, okay, that's coercion. That makes me worried. I'm like, okay, what are our next steps? And so I'll see things like that, or I'll see someone who claims to be a dom or a top, and they tell their sub they're not allowed to use their safe word. This is a target at Christian Grey, by the way, from Fifty Shades of Grey. I hate that book.
Dr. Lisa: I got like three sentences into it and I couldn't even.
AJ Greer: He's just an abuser. Straight up an abuser. Don't read it. It's not worth it. Terrible book. There are better books. But that immediately is my red flag in a kinky situation. I'm like, okay, there's coercion going on. Let's go from there.
Dr. Lisa: Wow. Yeah. So good. Okay. Well, we talked about some resources. Where else? A therapist who's like, oh my God, this is so interesting, I want to learn more, I want to be AJ's best friend, we're going to go shopping together for guillotine earrings, it's going to be so fun. How would they connect with you? Hop in with your trainings, or if they want to bring you in to local law enforcement or other agencies in their community?
AJ Greer: So I have done trainings also for therapists, and they've been approved for CEUs before. So I'm not personally affiliated with the CEU board, but I know that other organizations have gotten that. You can find me at my website, which is greerresearchandconsulting.com. My email is aj@greerresearchandconsulting.com. I know it's very long. Too late now, I've already made the email. Or you can find me on LinkedIn. I post a bunch of my trainings all there. I travel everywhere to go do trainings. I love doing them. I like to joke I'm a professional yapper, and I will talk. I will customize trainings for pretty much anyone. If someone's interested in doing some applied research, or they have something specific they want to look at, I love collaboration. And you can find me in all those places.
Dr. Lisa: Amazing. Well, thank you for yapping with me today, AJ.
AJ Greer: Thank you for having me. This has been such a delight.
Dr. Lisa: Thank you.
What to take with you
The differential is never the behavior.
Two people can describe identical acts and one is a Saturday night, the other a felony. What separates them is whether everyone was in a position to freely agree.
Coercion negates consent, and it does not announce itself.
It shows up as ten to fifteen minutes over the schedule, every visit, just under the line where anyone would call it. The pattern is the finding, not any single instance.
Being affirming is necessary and it was never sufficient.
If the only skill you have is not reacting, you can sit across from someone describing serious harm and file it under lifestyle.
Kink competence is cultural competence, with the same obligations attached.
That reframe, which came from NCSF and landed live on tape, is the most portable idea in the episode.
Strangulation is a lethality indicator, not a preference.
Prior non-fatal strangulation is associated with seven-fold odds of a woman later becoming a completed homicide. Clients often mention it in passing.
The KAP directory is a visibility tool, not a credential.
NCSF states plainly that it does not endorse, verify, or screen anyone listed. Present it accordingly.
What we cover, in order
- How Do You Tell the Difference Between Consensual Kink and Abuse?
- Why Is Strangulation a Red Flag in Intimate Partner Violence?
- What Sexual Sadism Actually Means, and Why Consensual Kink Does Not Meet the Threshold
- What Does Coercion Look Like in a Relationship?
- What Questions Should a Therapist Ask to Assess Consent?
- How Does a Therapist Become a Kink Aware Professional?
- Why Reading This Article Probably Isn't Enough
- What I Am Taking Into My Next Session
What's in this article
Both, honestly, but the reason to listen is the clinical part. AJ's specialty is sexual sadism and psychopathy, so the forensic material is genuinely fascinating and it is in there. What you will actually use on Monday is the consent framework she built out of that work.
You probably do, and more to the point the framework is not really about kink. It is about locating consent underneath any behavior, and AJ applies it to things that have nothing to do with sex. If you do couples work or family work, it is relevant.
No, and I want to be careful here because the answer is easy to get wrong. NCSF publishes free educational resources and there is a directory you can list yourself in, but the directory involves no vetting and is not a credential. It is a way for clients to find you.
We talk about sexual violence and homicide. Nothing graphic, and AJ self-polices carefully about how deep to go, but you know your own bandwidth and it is worth knowing that going in.
Two questions. Was everyone in a position to consent, and was coercion present. Hold them underneath whatever a client is telling you.
Kink Aware Therapist: How to Tell Consent From Coercion
A client is telling you about something that happened in their relationship. Something intense. And somewhere in the middle of it there is a half second where you honestly do not know what you are hearing. Is this their sex life, or is this abuse? Nothing in graduate school prepared you to sort that, because becoming a kink aware therapist was never on anyone's syllabus, and you cannot stop a session to ask. Here is the answer I got from a forensic researcher who sorts exactly this question for prosecutors: the difference is never the behavior. It is consent, and specifically whether coercion was present, because coercion negates consent no matter what the act itself looked like.
I have done the half-second thing. I would guess you have too, and I would also guess you have never said so out loud in front of colleagues, because saying it out loud feels like admitting something. It is not. It is one of the most ordinary experiences in our profession, and it surfaces constantly in the Therapist Growth Collective, usually about ten minutes into a conversation that started somewhere else entirely.
I recorded this one live at APA with AJ Greer, who runs Greer Research and Consulting. She trains law enforcement, prosecutors, victim advocates and clinicians on sexual violence and domestic violence, she consults on live cases for agencies around Texas, and she spent years as a research specialist at the Texas Department of Criminal Justice. Her research specialty is sexual sadism and psychopathy. She is a researcher rather than a treatment provider, and she volunteers that distinction rather than blurring it, which is a large part of why I trusted everything else she told me.
I want to stay on that half second a little longer before we get into her material, because I think it matters more than the content does. That gap is not a flaw in you. It is a hole in our training, and every one of us is carrying a whole map of them. What I have watched over more than a decade of running a group practice is that the clinicians who close those holes fastest are not the ones who read the most. They are the ones who have somewhere to bring the half second afterward. An article can hand you a question to ask. It cannot be in the room on a Tuesday night when you are turning over a call you made at two in the afternoon and there is nobody to check it against. That part happens in conversation with other clinicians who take this as seriously as you do, and building that place for our profession is most of what I do now.
How Do You Tell the Difference Between Consensual Kink and Abuse?
You tell the difference by locating consent, not by cataloging behavior. Two people can describe acts that look identical written down, and one of them is a Saturday night and the other one is a felony. The variable that separates them is whether everyone involved was in a position to freely agree, and whether saying no was actually available to them.
AJ arrived at this from an unusual direction. Her specialty is non-consensual sexual sadism, and she realized early that she could not credibly teach investigators what violence looks like unless she could also show them what consensual practice looks like. So she went and learned it. That is a research decision, but it is also the same move any of us make when a case lands outside our scope of competence and we go get educated instead of quietly guessing.
Then she told me about the prosecutor. She had been running trainings for investigators and had included a set of questions you could ask on scene to verify consent in a relationship, or to determine whether you were actually looking at abuse. A prosecutor came up to her afterward holding a case file and told her she had just solved his case. Not with evidence. With questions.
Was there a safe word. Was there aftercare. Who has been in this community longer. What education does each person have. Knowing to ask those four things, AJ said, is what reveals whether you are looking at a consensual kinky relationship or at violence.
Those are not forensic questions. They are intake questions. They are the kind of thing we ask fifty times a week in other contexts without thinking twice, which is the part that stopped me cold. The skill is not exotic and it does not require a forensic background. Knowing to ask is the entire thing. Colleagues who do child and family investigation work will recognize the logic immediately, because observation-based assessment under uncertainty is the whole job there.
Most of the clinicians I talk with about this have been making this differential by instinct for years and have simply never had language for what they were doing. That gap, between doing something competently and being able to name it, is exactly where consultation earns its keep. It is also most of what a Collective conversation actually is: somebody describes a case, and three people who have seen a version of it help them find words for what they already sensed.
Why Is Strangulation a Red Flag in Intimate Partner Violence?
Because there is no physiologically safe way to do it, and because it is one of the strongest single predictors of later homicide in an abusive relationship. It is treated as a lethality indicator in the domestic violence field for that reason, and the kink community treats it as off limits for the same underlying reason.
AJ said it plainly and without any drama, which is how it should be said. There is no safe way to strangle someone. The danger also does not end when the incident does. People can die from the consequences up to a couple of years later, which she noted almost in passing and which I did not know.
The research supports how seriously she treats it. Glass and colleagues (2008) compared 506 attempted and completed homicides against 427 abused controls and found that prior non-fatal strangulation was associated with roughly six-fold odds of a woman becoming an attempted homicide and over seven-fold odds of becoming a completed homicide. Strangulation appeared in about 10 percent of the abused control group and in 43 to 45 percent of the homicide and attempted homicide cases. Those numbers reframe a disclosure that clients very often deliver casually, in passing, on their way to something they think is the real story.
This is also where the rough sex defense does its damage. AJ's frustration with it is specific: it lets serious violence get reclassified as a lifestyle, and it works precisely because the people evaluating the case do not know enough about consensual practice to challenge it. For the clinical detail on strangulation itself she points people to the Training Institute on Strangulation Prevention, which publishes a timeline of the physiological process.
What Sexual Sadism Actually Means, and Why Consensual Kink Does Not Meet the Threshold
Sexual sadism involves deriving sexual gratification from inflicting harm on another person, whether physical or psychological. It only rises to a diagnosable disorder when it causes significant distress or when another person is genuinely being harmed. Consensual kink, by definition, does not clear that bar.
AJ credits the National Coalition for Sexual Freedom with a great deal of the advocacy work that got the diagnostic language to a place where consensual practice cannot be pathologized by default. She is warm about them and she is right to be. That work is the reason the diagnostic threshold now does the sorting for us instead of leaving it to individual clinical taste.
Then she drew the distinction I have not been able to stop repeating. Her consensual sexual sadists, in her words, are absolute nerds. They play RPG games, they go to Renaissance festivals, they are delightful, and they are not hurting anyone. They are also less likely to use strangulation. Her non-consensual sexual sadists are the inverse on every count, and when the target is a woman, strangulation is the preferred method of homicide.
The empirical picture on consensual practice is not ambiguous either. Wismeijer and van Assen (2013) compared 902 BDSM practitioners with 434 controls across personality, attachment, rejection sensitivity and subjective wellbeing, and the BDSM group scored more favorably on most measures. Less neurotic, more extraverted, more open to experience, more conscientious, less rejection sensitive, higher subjective wellbeing. The authors concluded it looked more like recreational leisure than the expression of psychopathology.
If reading that produced a small internal flinch, that is worth noticing rather than suppressing. Most of us trained in a period when this material was framed as pathology by default, and that residue does not clear on its own just because the DSM language moved. Noticing your own reaction is real clinical work, not a detour from it, and it is the kind of thing that gets easier to do out loud with colleagues than alone in your office. It is also the same muscle we use when a case is too close to home.
What Does Coercion Look Like in a Relationship?
Coercion usually looks like small boundary violations that stay just underneath the threshold where anyone would name them, repeated consistently, paired with a refusal to be accountable when they finally are named. It rarely looks like force. That is what makes it so hard to see and so hard to prove.
AJ does supervised visitation observation, where her job is to watch the person on supervision and document behavior without interfering unless a child is in danger. The people who show more antisocial traits, in her experience, push boundaries in very subtle ways. Time is the cleanest example. There is a strict schedule, and they run ten to fifteen minutes over. Every visit. Never enough to get them in real trouble, always enough to matter, and always with just enough plausible deniability that holding them accountable becomes genuinely difficult. This is boundary-pushing as clinical data, and once you have the frame you cannot unsee it.
Alongside that she watches for the classical gaslighting behaviors. Questioning reality. That never happened. And a general unwillingness to take accountability, which she is careful to say is hard for most people, so it is the combination that matters rather than any single instance. Boundary pushing plus no movement toward accountability is the pattern that tells her something else is going on. She is equally careful to say it does not necessarily mean antisocial personality disorder. It means there is another factor in play and it is worth looking.
The practical implication for us is about documentation. Any one of those ten-minute overruns is nothing. You would never write it up, and if you did it would look petty on the page. The pattern is the finding, which means the pattern has to actually exist somewhere you can see it. That is a case notes problem before it is a clinical one, and it is worth thinking about how your documentation practices would or would not surface a fifteen-minute drift repeated across four months.
Here is the part I keep coming back to. Patterns are exactly what a clinician sitting alone with a case is worst at seeing, because we are inside the sequence rather than looking at it. That is not a competence problem and it is not fixable by trying harder. It is structural, and the only real answer to it is another set of eyes. It is a large part of why the case consultation conversations inside the Collective are worth the hour, and why I have never regretted bringing a case I thought I already understood.
What Questions Should a Therapist Ask to Assess Consent?
Start with two. Is everyone in a position where they are able to consent? Is coercion present? Everything else follows from those, because coercion negates consent regardless of what was said or agreed to on the surface.
Those are AJ's number one and number two, in that order. Underneath them sit the four she gave the prosecutor: was there a safe word, was there aftercare, who has been in this community longer, and what education does each person have. The tenure and education questions do more work than they look like they do, because a significant experience differential is one of the quieter places power hides. All of this is a reminder that assessment is continuous rather than an intake event, and that the answers can change across the course of a relationship.
Then AJ said the thing that stopped me. She sees it constantly in cases, and it is almost always phrased the same way.
"I didn't feel safe enough to use my safe word."
The safe word existed. The permission to use it did not. There is no behavior checklist in the world that catches that, and it is not a subtle distinction once you have heard it once. Her immediate red flag in a kinky context is the same shape: someone who claims to be a dom or a top and tells their partner they are not allowed to use their safe word. She named Fifty Shades of Grey directly on this point and said Christian Grey is just an abuser, which I found clarifying, and which I suspect a lot of clients would too.
The consent question is also not limited to sexual contexts, and this is the part I think is most portable. AJ's own example was fire. Somebody set a fire: was it a permitted burn coordinated with the city, or was it a wildfire? Same question, entirely different domain. Once you are holding consent as the operative variable rather than behavior, it works on money, on family decisions, on caregiving, on anything involving power inside a relationship.
A word about how to actually use this, because two questions on a page and two questions in a live session are different animals. The reason it is hard is not that the questions are complicated. It is that asking them requires you to have already decided you are allowed to go there, in the moment, with a real person who is watching your face. That decision is easier to make when you have made it before with somebody in your corner. It is the sort of thing our members practice on each other before they try it on a caseload.
How Does a Therapist Become a Kink Aware Professional?
Start with the National Coalition for Sexual Freedom, which publishes free educational resources including material specifically on distinguishing intimate partner violence from consensual kink, and offers a free cultural competency course. From there you can list yourself in the Kink and Polyamory Aware Professionals directory, which is how clients and referral sources find clinicians who work in this space.
AJ described the sequence exactly as she has watched it happen. Therapists attend one of her trainings, they go to the NCSF site afterward, they work through the resources, and they come out with base-level knowledge and a better way to approach the conversation. She has also seen NCSF go in and teach probation departments, therapists, and all kinds of other groups, and she speaks about them with real affection.
One thing to be honest about, because this audience notices. NCSF states plainly that it does not endorse, verify, or screen the professionals listed in the KAP directory. Inclusion involves no vetting of any kind. So it belongs in your practice as a visibility tool and a referral pathway, not as a credential and not as a line on your bio that implies review. Presenting it otherwise would be an ethics problem, and it would be an avoidable one.
The thing that genuinely shifted for me came in the middle of all that, and it was one word. AJ mentioned that NCSF frames their education as cultural competency, and hearing it said that way reorganized the whole category in my head. I had been holding kink competence as a stance. Do not pathologize, do not flinch, do not make the client feel strange. It is cultural competence in therapy, the same as any other, with the same obligations attached.
That distinction is not academic and I want to be precise about why. If the only skill I have is not reacting, then I have no way to tell the difference between a client describing a consensual part of their life and a client describing something that is hurting them. Affirming without being coercion-literate is not neutral. It means I can sit across from someone describing serious harm and file it under lifestyle, and feel good about myself while I do it. Being affirming is necessary. It was never sufficient.
If that landed somewhere specific for you, that is worth saying to another person rather than just filing away. That is genuinely what the first conversation with us is for. Not to enroll you in anything, and not to fix a deficiency you do not have, but to figure out together whether the thing you just noticed about your own practice is something worth building on.
Why Reading This Article Probably Isn't Enough
I want to be straight with you about something, because I would rather say it than let you close this page thinking the reading was the work.
Everything above is real and it is usable. AJ's two questions are good questions. The boundary-pushing pattern is a genuinely observable thing. But here is what almost always happens with an article like this one. Something clicks. You feel a little sharper than you did twenty minutes ago. You make a mental note to hold the consent question in the back of your mind next time. And then next time arrives, and it arrives at 3:40 on a Thursday when you are on your fifth session and the client says the thing in a tone that makes you not want to slow down, and you do exactly what you have always done.
That is not a motivation problem and it is not a character problem. You are trying to install new clinical behavior by yourself, in real time, during the exact moment when your existing habits are most active and your bandwidth is lowest. That is the hardest possible condition for new behavior, and we would never expect a client to pull it off alone. We ask ourselves to do it constantly. It is also why therapist imposter syndrome tends to bloom right after professional development rather than before it, which is backwards and which nobody warns you about.
What actually changes practice is having somewhere to take the aftermath. A place where you can say, I had a session on Tuesday and something in it did not sit right and I do not entirely know why, and have three colleagues who understand the work help you find the thread. Not a lecture. Not a recorded module you watch at 1.5 speed and forget. An ongoing set of relationships with people who know your caseload well enough to notice when you are off. This is the piece private practice quietly strips out, and most of us do not realize how much we relied on it until it has been gone for a couple of years.
That is what the Therapist Growth Collective is. It is where clinicians who take their own development seriously bring the half seconds. And you do not need to have failed at anything to come. The people who get the most out of it are almost always the ones who were already doing fine, which is precisely the group that tends to think they have not earned it.
If something in this article landed on a specific client or a specific moment, that is the signal. Come see what it actually looks like week to week, or send us a message and we will give you a real answer rather than a sales pitch. No pressure and no commitment attached to either one.
The lowest-friction version of the thing this section is about. New episodes, clinical material and CEU announcements, written for working clinicians, every Wednesday morning.
What I Am Taking Into My Next Session
Not the serial killer material, as fascinating as it was. What I am taking is one question, held underneath everything else a client tells me: could this person have said no? Was coercion in the room? Because coercion does not announce itself. It shows up as ten extra minutes, every single time, just under the line where anyone would call it. It shows up as I did not feel safe enough to use my safe word.
I am also taking something less comfortable, which is the recognition that I have been assessing this by instinct for a long time without the language for it, and instinct is not a system. It works until it does not, and you never find out which session was the one where it did not. If you sat with that sentence for a second longer than you wanted to, that is the same thing I did, and it is worth paying attention to rather than shaking off. Material like this also has a way of staying with you afterward, which is its own thing to manage, and carrying heavy clinical material is a skill nobody teaches us either.
AJ said one more thing I keep thinking about. She said the field is understudied because most people do not want to look at it, and if we do not study it we cannot treat it, and if we cannot treat it we cannot prevent it. She was talking about sex offender research. But the shape of that is familiar to every one of us, because it is also true of the parts of our own practice we avoid looking at directly.
So here is where I would leave it. Go work through the NCSF materials, which are free and genuinely good. Read the strangulation research if you have clients in violent relationships, because those numbers should change how you hear a disclosure. And then find some people to think about it with, especially if you are carrying a high-intensity caseload where this material is more than theoretical.
That last part is the one I would not skip. Everything in this article is information, and information is the cheap part. What is expensive, and what actually changes what happens in your room on a Thursday afternoon, is having colleagues who know your work and will tell you the truth about it. That is what my team built the Collective to be, and it is the honest next step if this landed. Come find out whether it fits how you already practice.
xo,
Dr. Lisa Marie Bobby
P.S. If you have a colleague who does couples work and has never once asked a client about a safe word, send them this. That is who it is for.
P.P.S. The guillotine earrings are real. She wears them when she presents on consensual and non-consensual sexual sadism, and she told me people love them. I do too.
About this episode's experts
AJ Greer
AJ Greer runs Greer Research and Consulting, a one-person consultancy doing training, consulting, and independent research on violence. Her specialty is narrow and genuinely dark: sexual sadism, psychopathy, sexual offending, domestic and sexual violence, and sexually motivated serial homicide. She got there by way of a psychologist mother and a childhood conviction that violence made no sense, and she has stayed there because the questions still have not been answered. She is trained in the PCL-R, which she calls her baby, and she is very funny about how she is at dinner parties.
Her track record is applied rather than academic. She was a research specialist at the Texas Department of Criminal Justice working on batterer intervention programs, she started in criminal justice about eight years ago on a statewide law enforcement training program for sexual assault and family violence investigators, she worked in victim advocacy, and she spent time in rural Texas improving systems response to domestic violence. Her master's focused on sex offender behavior, specifically sexual sadism and psychopathy. She now trains law enforcement, prosecutors, advocates and clinicians, consults on live cases for agencies around Texas, and does supervised visitation observation. Her trainings have been approved for CEU through third-party organizations, though she is not personally CEU-affiliated.
She is early into original research on the overlap between serial homicide and intimate partner violence, tracking intimate partner violence accusations against individuals meeting the FBI's two-or-more-homicides standard and finding sadism and strangulation recurring across both. She is careful to say it is preliminary, repeatedly, unprompted. That care is exactly why I would have her back. If you want to bring her in for a training, or you are working on something in this space and want a collaborator, her consultancy is at greerresearchandconsulting.com and she is most active on LinkedIn, where she posts her training schedule.
Dr. Lisa Marie Bobby
Licensed psychologist, licensed marriage and family therapist, and board-certified coach. Founder and clinical director of Growing Self Counseling & Coaching. Author of Exaholics: Breaking Your Addiction to an Ex Love. Host of the Love, Happiness & Success podcast and Love, Happiness & Success for Therapists. More than two decades of clinical practice and group practice ownership, with a focus on the professional development, leadership, and sustainability of mental health clinicians and the practices they build.
Questions therapists ask about consent, coercion and kink
A kink aware therapist is a clinician who has developed working knowledge of consensual kink and BDSM practice so they can respond to client disclosures without pathologizing them, and so they can distinguish consensual practice from abuse. It is not a licensed credential. It typically involves completing educational resources such as those published by the National Coalition for Sexual Freedom, and clinicians may choose to list themselves in the Kink and Polyamory Aware Professionals directory.
By locating consent rather than evaluating behavior. Identical acts can be consensual or violent, so the operative question is whether everyone involved was in a position to freely agree and whether refusal was genuinely available. Coercion negates consent regardless of what was outwardly agreed to.
Two primary questions: is everyone in a position where they are able to consent, and is coercion present. Four supporting questions come from forensic practice: was there a safe word, was there aftercare, who has been in this community longer, and what education does each person have. A significant tenure or education differential is one of the places power imbalance hides.
Coercion typically appears as small boundary violations kept just below the threshold where anyone would name them, repeated consistently over time, combined with a refusal to take accountability once named. It also appears as gaslighting, including denial that documented events occurred. Any single instance looks trivial. The pattern is the finding.
Because there is no physiologically safe way to perform it and because it is a strong predictor of subsequent lethality. Research by Glass and colleagues (2008) found prior non-fatal strangulation associated with roughly six-fold odds of a woman becoming an attempted homicide and over seven-fold odds of becoming a completed homicide. Deaths can also occur well after the incident itself.
Begin with the National Coalition for Sexual Freedom, which publishes free educational resources including material on distinguishing intimate partner violence from consensual kink, and offers a free cultural competency course. Clinicians may then list themselves in the Kink and Polyamory Aware Professionals directory maintained through NCSF.
No. NCSF states explicitly that it does not endorse, verify, or screen the professionals listed in the directory, and inclusion involves no vetting. It functions as a visibility tool that helps clients find clinicians and helps clinicians find referral partners. Presenting a directory listing as a qualification would be an ethics problem.
The evidence does not support that view. Wismeijer and van Assen (2013) compared 902 BDSM practitioners with 434 controls and found the BDSM group scored more favorably on most psychological measures, including lower neuroticism, greater openness and conscientiousness, lower rejection sensitivity and higher subjective wellbeing. The authors concluded BDSM better resembles recreational leisure than pathology.
Sexual sadism involves deriving sexual gratification from inflicting physical or psychological harm on another person. It only rises to a diagnosable disorder when it causes significant distress or when another person is genuinely being harmed, which means consensual kink does not meet the threshold. NCSF advocacy contributed substantially to that diagnostic clarity.
The rough sex defense is a legal argument that reclassifies violence as consensual sexual activity. It succeeds most often when the people evaluating a case lack working knowledge of consensual practice and therefore cannot challenge the claim. The same knowledge gap operates in a therapy room, where a clinician without kink literacy may accept a lifestyle framing for something that is actually abuse.
Yes, and that is one of its strengths. The question of whether everyone involved was in a position to agree applies to financial decisions, family decisions, caregiving arrangements and any situation involving a power differential. The framework sorts consent from coercion regardless of the domain.
No. An affirming stance without coercion literacy means a clinician can hear a description of serious harm and categorize it as a lifestyle. Affirming practice is necessary but not sufficient. Competence requires both the willingness not to pathologize and the assessment skill to recognize when consent was not actually possible.
Sources cited in this episode
- Dadds, M. R., Allen, J. L., McGregor, K., Woolgar, M., Viding, E., & Scott, S. (2014). Callous-unemotional traits in children and mechanisms of impaired eye contact during expressions of love: A treatment target? Journal of Child Psychology and Psychiatry, 55(7), 771-780. https://doi.org/10.1111/jcpp.12155
- Glass, N., Laughon, K., Campbell, J., Block, C. R., Hanson, G., Sharps, P. W., & Taliaferro, E. (2008). Non-fatal strangulation is an important risk factor for homicide of women. The Journal of Emergency Medicine, 35(3), 329-335. https://doi.org/10.1016/j.jemermed.2007.02.065
- Wismeijer, A. A. J., & van Assen, M. A. L. M. (2013). Psychological characteristics of BDSM practitioners. The Journal of Sexual Medicine, 10(8), 1943-1952. https://doi.org/10.1111/jsm.12192
Third-party resources mentioned in the recording: National Coalition for Sexual Freedom (ncsfreedom.org), the organization AJ names on air in Chapter 6, which publishes free educational resources including material on distinguishing intimate partner violence from consensual kink, and a free cultural competency course, and which AJ credits with advocacy on the DSM diagnostic language; the Kink and Polyamory Aware Professionals Directory (kapprofessionals.org), the listing AJ describes therapists joining in Chapter 6, a self-listed visibility and referral resource that NCSF does not endorse, verify or screen, and which is never framed as a credential; Greer Research and Consulting, LLC (greerresearchandconsulting.com), AJ's consultancy for trainings, consulting and applied research collaboration, stated on tape in Chapter 10; the Training Institute on Strangulation Prevention, which AJ recommends in Chapter 5 for the physiological detail including a timeline of the process of being strangled, named here without a link because no URL was supplied in the handoff package and none has been constructed; and the Psychopathy Checklist-Revised (PCL-R), the instrument AJ is trained in and references in Chapters 8 and 9, named for accuracy with no outbound link needed.
Intentionally omitted: the offender AJ names in Chapter 8 as the case that prompted her current research. She explicitly declines to describe the details on tape, and the recommendation is to keep it that way. Naming an offender adds nothing clinically and moves the piece toward true crime.
