Editing BDSM (section)

=== Clinical issues ===
Nichols (2006) compiled some common clinical issues: countertransference, non-disclosure, coming out, partner/families, and bleed-through.<ref name="a1" >{{cite journal | last1 = Nichols | first1 = M | year = 2006 | title = Psychotherapeutic issues with "kinky" clients: Clinical problems, yours and theirs | journal = Journal of Homosexuality | volume = 50 | issue = #2–3| pages = 281–300 | doi=10.1300/j082v50n02_14| pmid = 16803768 | s2cid = 37706751 }}</ref>

[[Countertransference]] is a common problem in clinical settings. Despite having no evidence, therapists may find themselves believing that their client's pathology is "self-evident". Therapists may feel intense disgust and aversive reactions. Feelings of countertransference can interfere with therapy. Another common problem is when clients conceal their sexual preferences from their therapists. This can compromise any therapy. To avoid non-disclosure, therapists are encouraged to communicate their openness in indirect ways with literature and artworks in the waiting room. Therapists can also deliberately bring up BDSM topics during the course of therapy. With less informed therapists, sometimes they over-focus on clients' sexuality which detracts from original issues such as family relationships, depression, etc. A special subgroup that needs counselling is the "newbie". Individuals just coming out might have internalized shame, fear, and self-hatred about their sexual preferences. Therapists need to provide acceptance, care, and model positive attitude; providing reassurance, [[psychoeducation]], and [[bibliotherapy]] for these clients is crucial. The average age when BDSM individuals realize their sexual preference is around 26 years.<ref name="a3" /> Many people hide their sexuality until they can no longer contain their desires. However, they may have married or had children by this point.{{Citation needed|date=January 2019}}