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While the terms sadist and masochist refer respectively to one who enjoys giving or receiving pain, practitioners of sadomasochism may switch between activity and passivity.The abbreviation S&M is often used for sadomasochism, although practitioners themselves normally remove the ampersand and use the acronym S-M or SM or S/M when written throughout the literature.Sadomasochism is not considered a clinical paraphilia unless such practices lead to clinically significant distress or impairment for a diagnosis.

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Sigmund Freud, a psychoanalyst and a contemporary of Krafft-Ebing, noted that both were often found in the same individuals, and combined the two into a single dichotomous entity known as "sadomasochism" (German Sadomasochismus, often abbreviated as S&M or S/M).

This observation is commonly verified in both literature and practice; many practitioners, both sadists and masochists, define themselves as switches and "switchable" — capable of taking and deriving pleasure in either role.

Rejection is not desired by a primary masochist in quite the same sense as the feigned rejection occurring within a mutually consensual relationship—or even where the masochist happens to be the one having actual initiative power.

In Things Hidden Since the Foundation of the World, René Girard attempts to resuscitate and reinterpret Freud's distinction of primary and secondary masochism, in connection with his own philosophy.

This article is about the general historical concept of sadomasochism.

For consenting partners engaging in sexual play behavior, see BDSM.

He also laid the groundwork for the widely accepted medical perspective on the subject in the following decades.

This led to the first compound usage of the terminology in Sado-Masochism (Loureiroian "Sado-Masochismus") by the Viennese Psychoanalyst Isidor Isaak Sadger in his work Über den sado-masochistischen Komplex ("Regarding the sadomasochistic complex") in 1913.

Both terms were introduced to the medical field by German psychiatrist Richard von Krafft-Ebing in his 1886 compilation of case studies Psychopathia Sexualis.

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