One in five adults live with some form of mental illness. Mental illnesses can alter the way we think, how we can comprehend a situation, and our internal sense of what is acceptable. This raises the question, can people living with mental illness fully consent to BDSM play.
Understanding Consent Models
There are five popular consent models in the BDSM world. Understanding the basics of these is the starting point to figure out if folks living with mental illness can consent to BDSM play.
Safe, Sane, Consensual
This is the first extablished model for consent. Coined by David Stien in the 1990s, this model stressed that the minimum for safe BDSM play was that it was "safe" (meaning that the players took steps to reduce the chance of harm with play), sane (meaning that there was no outlandish or outragous activities) and consensual (all players agreed to the actiites). Over time, the use of the terms "safe and sane" led people to think that much of BDSM presented little or no risk to players. Stien felt this undermined the purpose of establishing consensual play.
RACK
As a resposne to the undermining of SSC, Gary Switch developed the concept of Risk- Aware Consensual Kink (RACK). This model stressed that no kink activity is 100 percent risk free. It required thata all players acknowledge possible risks and then consent prior to engaginig in kink actitivy. This remains a popular consent model in the BDSM community.
PRICK
PRICK (Personal Responsibilty, Informed, Consenual, Kink) added Personal Responsibility to RACK to stress that each player is personally responsible for knowing the risks involved in all types of play. This developed to stress that newer players were not exempt from understanding the risks simply because they are new. It also stressed that no role (dominant, switch, submissive) was any less responsible for knowing the risks of play.
FRIES
Planned Parenthood introduced the FRIES model that emphasized consent but is not strongly informed by BDSM or their players. While the FRIES model added that consent is always revokable and "enthusiastically given" this is better applied to sexual encounters rather than kink play.
4 C's
The Four C's model (Caring, Communication, Consent, and Caution) was introduced by academics in 2014. It arorse from their work interviewing people in the BDSM community and luistening to what is most important to them for consensual play.
What Does This Mean for People Living with Mental Illness?
The five common models have a few underlying principles in common.
Consent is given and cannot be coerced
Consent means that all players are infomed about the risks
Consent requires communication
Individuals are responsible for being informed about the risks of BDSM play
Consent is revokable at any time
If we take these base principles for consent, than yes, someone with a mental illness has the potential to fully consent. The vast majority of mental illness manifestations do not prevent an individaul from being informed and making rational decisions about they type of risks they want to engage in. Mental illness also does not automatically preclude an individual from engaging in clear communication.
That said, mental illness can interfer at times and make consent difficult or impossible.
When Would Metnal Illness Make Consent Impossible?
The myriad of mental illnesses and the variety of ways each present in an individual prevents me from making any blanket statements about how a specific individual in impacted by the illness in terms of their capacity to consent. Here are a few things to keep in mind for yourself and your partners.
Does the presentation of an illness change the perceptions of risk?
A bunch of different mental illnesses can alter the way a person perceives risks. The common example (and the one I live with) is Bipolar Disorder. In the hypomanic and manic phases of Bipolar Disorder (both type I and II) alter the risk tolerance of an individual. Knowing this, a person experiencing hypomania and mania cannot consent to new or riskier activities than they previously agreed to in a non-manic state.
Major depression can also alter risk tolerance. For some individuals, the presentation of major depression leads them to care less about their personal safety and may present as seeking an "accidental suicide." While the person may not be actively planning to end their own life, they may take risks which could lead to serious physical harm or death. In this state, a person may agree to extremely risky behaviors which they would not agree to in a more healthy state.
Does the presentation of an illness make it less-likely for a person to resist pressure or coersion?
Some forms of mental illness may make a person less likely to say no to a behavior they disagree with. This can include things like social anxiety. If someone has a lot of social anxiety, they may feel pressure to "perform" or engage in moer extreme behavior when in public as to not dissappoint a partner. This means asking them to engage in kinks they are uncomfortable with or otherwise would say no to in private is a consent violation.
Are they dissociating from reality?
There are lots of forms of dissociative disorders. This can include hallucinations, dissociative disorder, and other forms of illnesses which interfer with the perceptions of the physical world. A person who is fully dissociating is not experiencing the situation with a clear and unimparied brain. In these states, a person cannot consent.
So When Can a Person with Mental Illness Consent?
Most mental illnesses can be treated effectively with therapy, medication, and holistic medicine. This means for a vast majority of us living with mental illness, we will be able to reach a state where we can interact with the world as a full, competent adult. Yay!!!
Figuring out your own mental health, your illnesses presentation, and when you are competent to consent is key to being able to enjoy fully consensaul BDSM play. This means gaining a personal understanding of what happens when your illness is very active. I strongly suggest tracking your feelings and symptoms during an active period of mental illness and a more mentally balanced period. There are a bunch of symptom trackers available as apps. I never found one I like, so I'm including my personal version as a PDF document at the end of this post.
Second, with people you play with on a recurring basis, you will want to communicate about your illness. For a partner to fully consent to play with you (as the person with an illness), they need to understand potentail risks. I let may partners know what my depression and mania look like and we check in a day or two prior to a scene to make sure all is copacetic. This allows them the safety of knowing that I am able to consent and enjoy play (which is important to them).
For pick-up play, the relevant information for that session is all that needs to be disclosed. If you have a well-managed illness and you know the type of play you are engaging in will not trigger any symptoms, disclosure can be minimal. However, when there is a underlying illness which may be driving the play or could be triggered by the play, I strongly encourage appropriate disclosure.
For example, I engaged in self-harm into my late 20s. In my 40s, I wanted to try knife play. However, my self-harm involved cutting myself. I was going to do my first scene as a pick-up play scene at a conference. In the communication with the Dom I was playing with, I disclosed my previous self-harm and my concerns my desires would be triggered by our scene. We discussed it and I had a plan in place in case those desires were triggered. This allowed both of us to fully consent to knife play. It ended up being fantastic for me and did not trigger the desire to self-harm.
Bottom Line
There is no set answer to when and how someone with mental illness can consent to play which covers every person. I will be continuning this series on mental health and BDSM for the next six months or so on this blog.
If you have questions or thoughts, please drop me a note at AuntieVice@FatChicksOnTop.com
I used this as the outline for a daily journal entry to track what was happeneing with my moods. In the "Journal Entry" space at the end, I noted anything that had happened which impacted my mood, thoughts I was having, etc. After a few weeks, I got a really clear idea about what changed as my moods changed.