Most discussion of BDSM focuses on the scene itself: rope, blindfolds, power, surrender. Hormonal research points elsewhere. The relationship outcome may be decided in the minutes after the scene ends, in what the kink community calls aftercare. I have seen in my practice how much weight it carries for both partners.
Aftercare is the set of soothing behaviours that follow a scene: holding, a blanket, water, quiet talk, and the simple question of how the other person is doing. It brings both partners down from intense arousal to ordinary safety. Both partners need it, not only the one who received.
The kink community uses the terms sub drop and top drop for what may arrive hours or a day or two later: low mood, guilt, emptiness, or doubt about having harmed the partner. Sub drop refers to the receiving partner, top drop to the dominant one. [Needs further research: sub drop and top drop are community terms and have not yet been directly measured in any controlled study.]
A 2024 qualitative study interviewed 40 people in the United States who take the dominant role. They described using aftercare to manage the impression they leave in the partner’s mind and in their own. The 2024 study was qualitative, and only the dominant side was heard.
Rope becomes intimacy only when the hands that tied it stay to care afterwards. — Photo: Alexander Krivitskiy / Pexels
What happens in the body during and after a scene?
During a scene, the receiving partner’s body shows a stress response while reward systems activate at the same time. After a scene that went well, stress hormone falls and felt closeness rises. This double movement is what makes the minutes afterwards so consequential.
Two studies with 58 BDSM practitioners in total measured saliva cortisol before and after scenes. Cortisol rose significantly in people who were bound, receiving stimulation or following orders, but not in those giving stimulation or orders. Afterwards, in those same 58 practitioners, people who said the scene went well showed lower cortisol and higher closeness to their partner.
A 2020 study in Belgium compared 35 BDSM couples during a real interaction with 27 non-BDSM control participants in an ordinary social interaction. Submissives showed rises in cortisol and in endocannabinoids, molecules linked to pleasure and reward. Dominants showed endocannabinoid rises only when the play centred on power rather than pain. The 2020 Belgian study was small and drawn only from the Flanders region of Belgium.
A qualitative analysis of accounts from 227 people who prefer the receiving role found that one of three main reasons for the practice was reaching an altered state of mind. My clinical reading of this is simple: coming back from such a state to ordinary life needs a bridge, and aftercare is that bridge.
Why do some couples grow closer after play, and others drift apart?
What shapes the relationship is the quality of the experience and what happens afterwards, not BDSM itself. Two partners can share the same act and end up in different places, depending on whether the minutes after the scene are held or abandoned. In the same 58-person research, among people who described a scene as having gone badly, closeness fell for some and rose for others, and the data do not explain why. My interpretation is that talking and repair after the scene can turn even an unpleasant experience into intimacy.
A national online sample in Norway of 4,148 participants found that more than one in three reported at least one BDSM interest or behaviour. BDSM behaviour was associated with higher sexual satisfaction and showed no significant association with relationship closeness. The 4,148-person Norwegian sample was cross-sectional, so it cannot show cause.
A 2025 UK survey of 470 people found that relationship satisfaction correlated with partners sharing these interests.
In my consulting room, especially with Iranian couples in Toronto, Vancouver and Los Angeles, the recurring pattern is that the play itself is rarely the problem; the silence afterwards is. One partner reaches for the phone without a word, and the other reads that silence as regret or contempt. In a culture that has tied desire to guilt, that silence weighs even more. My position is clear: a scene is over when both people have said they are okay, not when the rope comes off. Aftercare is not decoration; it is the continuation of the consent given before the scene.
Many couples do not come to therapy for the play itself; they come for the silence after it. — Image: AI-generated / Nano Banana 2 via fal.ai
What did Freud say about pleasure and pain?
In 1924 Freud admitted that enjoying pain was an economic problem for his theory because it does not fit the pleasure principle. He separated three forms of masochism: erotogenic, feminine and moral. He set moral masochism apart because it is tied neither to sexual pleasure nor to a love object.
Consensual BDSM with a specific partner, prior agreement and aftercare is a two-way play with power and sensation. Clinical concern arises when someone seeks punishment for their own guilt and feels worse after every scene. Psychoanalytically, aftercare is the moment the dominant partner becomes caring again, and the psyche experiences that power and tenderness can live in one person. [Needs further research: this is a psychoanalytic reading and has not been tested empirically.]
No standard duration exists in the research. The measure is how both partners feel, not the clock. A short message the next day is part of aftercare, because low mood can arrive later.
What is sub drop, and what helps?
Sub drop is a community name for low mood, fatigue or tears after play. It is not a sign that the desire is wrong. Rest, food, warmth and talking help; if it lasts several days, speak to a professional.
Does the dominant partner need aftercare too?
Yes. Dominants also show biological change when play centres on power, and they may doubt whether they harmed the partner. Hearing that the partner is okay matters for them as well.
When should a couple see a therapist about BDSM?
When one partner keeps feeling worse after play, when consent is given under pressure, or when the two cannot agree about these interests. The interest itself is not a reason to seek help; the suffering is.
Conclusion
The data remain small and mostly Western, and much of what the community knows has not been tested in controlled work. The message is still clear. A couple that learns to stay, ask and listen after play can draw deeper trust from the very experience that could have created distance. That possibility does not require certainty about the mechanisms; it requires attention to the other person in the minutes that follow.
Looking for professional support with your relationship or mental health?
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References 1 to 6 were retrieved from PubMed.
Image Credits
The featured image and the therapy-session image are AI-generated (Nano Banana 2 via fal.ai) and depict no real person. Rope photo: Alexander Krivitskiy / Pexels (Pexels licence).
