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The Leather Couch
The Leather Couch provides a comprehensive overview of the BDSM and kink community and guides clinicians on how to meet the unique relational and mental health needs of its members.
The text offers a 101-style introduction to BDSM before delving into topics ranging from intersectionality within the kink community, to conducting a kink-affirming risk assessment and how to discern between domestic violence and consensual power-exchange. The author explores differential diagnoses and clinical concerns that are relevant to health care providers including social workers and therapists as well as primary care physicians and sex educators. Interwoven throughout with real-world case studies, each chapter presents practical suggestions, tools, and handouts the reader can use to inform their practice and serve clients in ways that meet the needs of each individual, couple, or partnership.
Written in a conversational, accessible style for clinicians and members of the BDSM community alike, The Leather Couch is the go-to resource for any mental health professional or educator looking to transform their practice from kink aware to kink affirming.
The text offers a 101-style introduction to BDSM before delving into topics ranging from intersectionality within the kink community, to conducting a kink-affirming risk assessment and how to discern between domestic violence and consensual power-exchange. The author explores differential diagnoses and clinical concerns that are relevant to health care providers including social workers and therapists as well as primary care physicians and sex educators. Interwoven throughout with real-world case studies, each chapter presents practical suggestions, tools, and handouts the reader can use to inform their practice and serve clients in ways that meet the needs of each individual, couple, or partnership.
Written in a conversational, accessible style for clinicians and members of the BDSM community alike, The Leather Couch is the go-to resource for any mental health professional or educator looking to transform their practice from kink aware to kink affirming.
250 pages, Paperback
First published September 9, 2020
33 people are currently reading
304 people want to read
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Displaying 1 - 14 of 14 reviews
August 24, 2020
The Leather Couch is a much needed addition to any clinician’s bookshelf, especially those who have an interest in serving folks in the kink community. Stefani goes straight to the source and conducts in-depth interviews that are invaluable in providing insight into the importance of kinks in our clients’ lives.
March 1, 2023
I am not a clinical psychologist, so this book was not aimed at me, but from what I can tell this was not especially tailored at psychologists / psychiatrists / therapists; it is more a general introduction to various kink subcultures aimed at open-minded people. The most relevant part is the part on therapist ethics and disclosure, which mostly made me sad, since it recommends that kinky therapists specializing in kink basically shouldn't be part of their local kink community in order to keep professional distance from their clients. That seems kinda unfortunate, since the kind of people who would be most interested in specializing in kink for therapy would be people already in the communities; this is kind of a problem because I imagine the "subculture watershed"¹ for specific kinks is probably pretty wide — if you're 0.1% of the population and your interest requires other people, you either need to be in a big city or you need to be willing to travel pretty widely to find it. I guess this is an argument for more legal and logistical support for telemedicine — probably desirable in general for kinksters seeking mental health treatment, where the barrier is lower and the fear of stigmatization seems likely to be way lower with a stranger living far away.
With regards to the bulk of the book: I think I was somewhat familiar with some of what goes on in kink subcultures, but some of it was pretty new to me. Non-sexual age play and caretaking relationships, pony-play, that kind of thing, all seemed pretty new to me.
I find it hard to grok the way some of the power play and role-playing can be as non-sexual as some people say it is, which is a cool sensation for me. I think probably some of the "oh no pretending to be a child and submitting to my 'daddy' is totally non-sexual" and "oh no pretending to be an animal is totally non-sexual, it's just what I like" is a way to divert normies from thinking that you want to have sex with children or animals. In some ways this "oh it's not sexual" pose doesn't seem like a good diversion, since people will find this kind of thing even weirder than if you get off on it. In reality I think they're trying to achieve what gay people achieved over the last few decades, which is "It's about sex, but it's not just about sex in the same way that you live with your opposite-gender spouse because you are sexually attracted to them, but also for practical reasons and because you like their company." In the distant past people would complain that two men kissing or holding hands in public was somehow profane because it made you think of the weird sex they were having, but eventually the message got through to the wider culture that sex is just one part of these relationships. I'm curious to know how much of the "oh it's not really about sex for me" contingent of some of these kinks is actually in the "it's not just about sex for me" camp, which is way more comprehensible to me. I think the reason I find it a bit hard to understand is that sexual attraction is the way most people experience "aesthetic performance" most directly, and they are familiar with the way that sexual desire can create a sort of temporary insanity; it's easy to map that experience onto "oh wait what if instead of being really into touching genitals, I was really into pretending to be a pony". When someone says, "Yeah I'm really into pretending to be a pony and I wear a collar 24/7 because of it, but it's not like sex at all", people are baffled because they have no reference point for what it's like to experience that.
This review has gone a bit long because the book induced me to think through some of these things, but I wouldn't say that I found the book amazingly insightful. Part of that is that I've been immersed in the generally liberal "blue tribe" world for long enough that "hey people like what they like" and "be open minded about people's sexual interests" is second nature to me. I imagine this could be very insightful for people who would be made uncomfortable by unfamiliar kinks, and particularly some extreme kink lifestyles.
3.5 of 5 stars
¹ "subculture watershed" is a term I'm inventing ad hoc here to refer to the geographical or possibly social-graph distance that defines a single subculture community.
With regards to the bulk of the book: I think I was somewhat familiar with some of what goes on in kink subcultures, but some of it was pretty new to me. Non-sexual age play and caretaking relationships, pony-play, that kind of thing, all seemed pretty new to me.
I find it hard to grok the way some of the power play and role-playing can be as non-sexual as some people say it is, which is a cool sensation for me. I think probably some of the "oh no pretending to be a child and submitting to my 'daddy' is totally non-sexual" and "oh no pretending to be an animal is totally non-sexual, it's just what I like" is a way to divert normies from thinking that you want to have sex with children or animals. In some ways this "oh it's not sexual" pose doesn't seem like a good diversion, since people will find this kind of thing even weirder than if you get off on it. In reality I think they're trying to achieve what gay people achieved over the last few decades, which is "It's about sex, but it's not just about sex in the same way that you live with your opposite-gender spouse because you are sexually attracted to them, but also for practical reasons and because you like their company." In the distant past people would complain that two men kissing or holding hands in public was somehow profane because it made you think of the weird sex they were having, but eventually the message got through to the wider culture that sex is just one part of these relationships. I'm curious to know how much of the "oh it's not really about sex for me" contingent of some of these kinks is actually in the "it's not just about sex for me" camp, which is way more comprehensible to me. I think the reason I find it a bit hard to understand is that sexual attraction is the way most people experience "aesthetic performance" most directly, and they are familiar with the way that sexual desire can create a sort of temporary insanity; it's easy to map that experience onto "oh wait what if instead of being really into touching genitals, I was really into pretending to be a pony". When someone says, "Yeah I'm really into pretending to be a pony and I wear a collar 24/7 because of it, but it's not like sex at all", people are baffled because they have no reference point for what it's like to experience that.
This review has gone a bit long because the book induced me to think through some of these things, but I wouldn't say that I found the book amazingly insightful. Part of that is that I've been immersed in the generally liberal "blue tribe" world for long enough that "hey people like what they like" and "be open minded about people's sexual interests" is second nature to me. I imagine this could be very insightful for people who would be made uncomfortable by unfamiliar kinks, and particularly some extreme kink lifestyles.
3.5 of 5 stars
¹ "subculture watershed" is a term I'm inventing ad hoc here to refer to the geographical or possibly social-graph distance that defines a single subculture community.
October 15, 2022
Clear, thorough, and compassionate; highly recommended.
"Over the last century, those working in medicine, biology, and social scientists have undertaken to better understand the nature of sex and sexuality. We have made remarkable progress and yet much is still unknown about the inner workings and interconnections of brain and body. We can offer explanations rooted in cognitive neuroscience and Freudian psychoanalysis. We can leverage medical models and organizational psychology. Regardless of the science, the theory, and the analysis, all we know for certain is that the heart wants what the heart wants. And that gap between heart and brain, between oxytocin and eroticism, is what makes this field such a fascinating one to work within."
"Over the last century, those working in medicine, biology, and social scientists have undertaken to better understand the nature of sex and sexuality. We have made remarkable progress and yet much is still unknown about the inner workings and interconnections of brain and body. We can offer explanations rooted in cognitive neuroscience and Freudian psychoanalysis. We can leverage medical models and organizational psychology. Regardless of the science, the theory, and the analysis, all we know for certain is that the heart wants what the heart wants. And that gap between heart and brain, between oxytocin and eroticism, is what makes this field such a fascinating one to work within."
April 14, 2021
Ms Goerlichs writing style is easy to read, even while she is clinical in her specifics and presents a deep subject well. Highly recommend this book for anyone who is looking to gain a deeper understanding of kink, for whatever reason.
April 18, 2025
4.6/5
This isn’t written for the gen public, so this rating is for clinical lens only. It was educational, not too dry/boring info dumping, and it wasn’t trying hard to be likable/entertaining. Definitely educational and mindful for clinicians who want to be more open in regard to working with kink clients. It covers safety assessments, DMV, police/legal problems, disability, problematic areas, health/aging factors, case examples, and not pathologizing clients.
Some of the diagrams were poorly formatted (including ridiculously small text) and the end felt like a dump of tools like “here, bye”. Let’s not lean on Freud, he sucks. I definitely have mixed feelings, mostly not in agreement, on their “non disclosure” segment and that clinicians have to isolate from local kink/BDSM community, or practice states away, for the sake of clients.
This isn’t written for the gen public, so this rating is for clinical lens only. It was educational, not too dry/boring info dumping, and it wasn’t trying hard to be likable/entertaining. Definitely educational and mindful for clinicians who want to be more open in regard to working with kink clients. It covers safety assessments, DMV, police/legal problems, disability, problematic areas, health/aging factors, case examples, and not pathologizing clients.
Some of the diagrams were poorly formatted (including ridiculously small text) and the end felt like a dump of tools like “here, bye”. Let’s not lean on Freud, he sucks. I definitely have mixed feelings, mostly not in agreement, on their “non disclosure” segment and that clinicians have to isolate from local kink/BDSM community, or practice states away, for the sake of clients.
August 20, 2024
Okay, so I already knew about 90% of the book just from being in the kink space myself. However, I truly appreciate the author’s effort to assist someone like me with case conceptualization for clients. It’s easy to be on the other side of the couch with these experiences, but if you don’t know how to connect those experiences to your client, it’s not helpful. I can see this book benefiting many clinicians, regardless of their experience with kink and fetish-related backgrounds.
February 16, 2021
In-depth and useful, full of great examples and tools that are accessible and inclusive. This is a foreward thinking text that encourages helpers from all industries to be mindful, respectful, and informed for when they are working with kinky clients. I feel much more prepared as a counsellor and I hope many others invest in reading this mind-opening and informative text.
November 3, 2023
Fantastic, non-pathologizing overview of the practice and psychology of kink and how to effectively work with kinky clients. There are a few places that I thought the discussion could be more in depth or nuanced (kink and IPV; how kinky clinicians handle their own involvement in kink spaces while avoiding inappropriate disclosure/boundary confusion/dual relationships), but overall really good.
August 15, 2024
I was not the target of this book. Just a kinkster with a passing interest in psychology. But it fell in my lap and I checked it out and actually found it a really interesting read overall. I genuinely hope the people it IS targeted at, take the advice to heart.
April 22, 2025
I didn't quite know what to expect when starting this book, I was delightfully surprised. It is a wonderful overview of many different aspects of kink and BDSM, both de-pathologizing many aspects of the lifestyle and play, while also prioritizing safety and minimizing the chances for abuse as part of the conversation.
April 22, 2025
This was a really excellent overview of the subject matter with the lens of clinician overlaid. I found it very valuable and have been able to immediately put it into practice in my practice. I particularly appreciated the interviews the author included.
March 11, 2022
Decent kink 101 book. Not comprehensive and not for the average reader. Does it’s job.
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December 22, 2022Kink positive guide written by a clinician, for clinicians - a valuable resource for anyone practicing therapy, and a fascinating window if you want a more clinical perspective on Kink.
June 20, 2023
A good, basic introduction to understanding kink and BDSM for clinical providers.
Displaying 1 - 14 of 14 reviews