There is an exchange of power that happens in SM that I have yet to find in many other places. Some SM activity may be understood as a ritual "sacrifice," the person being tortured sacrificing their power, pain or blood to the person doing the beating, cutting or piercing. Some people are in SM for the endorphins and the "high" produced by the person on the bottom (the one being beaten or whatever), which is empathed by the top, who then gets a contact high.
From here, an interesting article.
This is true, not only the 'pain' element in S/M, but also in the acts of dominance or submission themselves.
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