ASD Sensory-Seeking, Pain Stimming, and Participation in BDSM

This Literature review examines the concept of pain-stimming as a self-regulatory behavior as it applies to neurodiversity. Historically, society, psychology, and medicine have pathologized common ASD behaviors like stimming, framing them as a malady or symptomology that needed to be controlled or eliminated entirely. This review seeks to challenge this paradigm by analyzing historical evidence, contemporary research, and neurobiology to reframe stimming, such as pain stimming, as a potential regulatory and adaptive mechanism. Additionally, this review examines the pathologization of ASD from the demonization in ancient beliefs and changeling children, to historical interventions aimed at the suppression or elimination of stimming through physical, psychological, and chemical intervention. Finally, this review then explores contemporary theories positing that sensory stimming is a response to processing aberration and atypical neural pruning, all in service to regulating an overstimulated nervous system. This review introduces pain stimming, not as a symptom, but as a response with a neurobiological framework that differentiates it from classical non-suicidal self-injury. Additionally, this review investigates the practices of BDSM, not as a sexual proclivity, but a historical expression of adult pain stimming that offers structure, sensory regulation, coregulation, and potentially a form of exposure therapy that may serve to inoculate neurodivergents against anxiety and stress. The conclusions of this review suggest that seeking pain in a regulated and controlled environment is not a deviant pathology but an evolved practice built for achieving homeostasis, regaining sensory control, and flow states. Finally, this review advocates for a fundamental shift in research away from the pathology-centric model toward a sensory-affirming paradigm that utilizes neuroimaging to better understand the regulatory functions that these behaviors serve.