Power exchange relationships, whether Dom/sub, Master/slave, or other BDSM-based structures, require a different approach to relationship therapy. Yet, many traditional therapists lack the training to support these relationships without imposing their own biases.
According to Georgie Blewett, a Somatic Sex and Relationship Practitioner, there is still a troubling amount of stigma in therapy spaces when it comes to BDSM.
"There’s this outdated idea that BDSM is a form of self-harm, a way to facilitate violent tendencies, or a punishment inflicted on oneself," she explains.
Because of these misconceptions, it is essential for power exchange partners to seek out kink-aware therapists who understand the difference between consensual and non-consensual play, as well as the deeper emotional and psychological aspects of these dynamics.
"Power exchange couples need a space where they’re not pathologised—where their dynamic is understood in context rather than judged," she says.
This is why it is crucial to vet therapists carefully and ensure they do not impose their own assumptions onto a relationship that is built on mutual consent and trust.
Common Challenges in Power Exchange Relationships
All relationships evolve over time, but in BDSM dynamics, these shifts can feel particularly intense. Blewett highlights two key relationship stages where challenges often arise:
Navigating the Challenges of Power Exchange Relationships
All relationships evolve over time, but in BDSM dynamics, these shifts can feel particularly intense. The nature of power exchange means that trust, communication, and self-awareness must be continually reassessed to ensure both partners’ needs are being met. According to Blewett, there are two key stages where couples often encounter difficulties: the limerence stage and the long-term relationship stage.
The limerence stage, often referred to as new relationship energy, is a time of heightened excitement, where partners see each other through rose-tinted glasses. This period is filled with intense emotional and physical connection, making it easy to overlook potential red flags. In power exchange relationships, this can lead to an incomplete or biased vetting process, particularly when selecting a Dominant or submissive.
Blewett explains that people in this stage should take a step back and ask themselves critical questions. Are safe words respected? Do boundaries hold firm over time? Does the submissive struggle with people-pleasing to the point of overriding their own limits? While chemistry and excitement can drive a strong connection, true compatibility in a power exchange relationship requires conscious reflection beyond initial attraction.
As the relationship deepens and attachment solidifies, new challenges can emerge. In long-term BDSM dynamics, partners may fall into habitual roles without regularly reassessing their needs. Without ongoing communication, a Dom or sub may begin to feel stifled or disconnected from the initial excitement of their dynamic. This is the stage where old wounds and behavioural patterns can resurface, sometimes leading to resentment, avoidance, or difficulty in expressing evolving desires.
Regular check-ins become essential to ensure both partners remain aligned and fulfilled. This means asking: Is this dynamic still working for us? Do we need to adjust anything? Are we satisfied with our communication? These conversations allow couples to renegotiate boundaries, refine expectations, and ensure that both parties still feel empowered by their roles.
Power exchange relationships are not static—they evolve as the individuals within them grow. A kink-aware therapist can help partners navigate these transitions, offering an objective perspective on what is working well and what may need adjustment. Having a safe, non-judgemental space to discuss concerns can make the difference between a relationship that deepens over time and one that struggles under unspoken tensions. Understanding these natural relationship shifts and proactively addressing them is key to maintaining a healthy, satisfying power exchange dynamic.
Signs That a Power Exchange Dynamic Needs a Reset
Blewett believes the body often recognises when something in a relationship needs to shift before the mind does.
Physical signs to look out for include:
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A tight chest
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An accelerated heart rate
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A growing sense of resentment, anger, or irritation
"If you’re people-pleasing, overriding your own boundaries, or feeling unable to express concerns, those are clear signals that something needs to change," she explains.
Regular communication is key. It is important to ask:
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Am I allowed to communicate openly?
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Do I feel safe expressing a change in preference?
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Am I afraid I will be abandoned or rejected if I ask for an adjustment?
If communication feels strained or unsafe, it is time to reassess and reset the dynamic.
Navigating Mismatched Desires in a Kink Relationship
One of the most common challenges in both vanilla and BDSM relationships is when one partner wants to explore more than the other.
Blewett introduces the idea of Core Erotic Themes—the emotional needs people seek to fulfil in intimacy.
"A submissive may want to feel completely taken care of, while a Dominant may crave a sense of power or control. But no one partner can meet 100% of someone’s desires," she explains.
When desires are mismatched, partners tend to respond in one of five ways:
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Outsourcing their needs ethically (e.g., through an open dynamic or external play partners)
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Outsourcing their needs unethically (e.g., through infidelity)
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Staying in the relationship and building resentment
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Staying and processing their disappointment through open discussion and compromise
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Leaving the relationship if desires are truly incompatible
Many people choose resentment or avoidance rather than working through disappointment, which can lead to frustration over time.
Blewett emphasises the importance of finding small, manageable ways to bridge the gap between each partner’s core desires through honest, non-judgemental conversation.
She also advises against discussing these matters in the bedroom.
"The best place to have these conversations, especially with a hesitant partner, is as far away from the bedroom as possible. Have a cup of tea, go for a walk, be physically close to each other, but do not bring it into the bedroom."
When a Power Exchange Relationship Becomes Unhealthy
Like vanilla relationships, not all kink dynamics are built on healthy foundations. Blewett highlights key warning signs that a power exchange relationship is veering into unhealthy territory.
Red flags to look out for
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Isolation from community – If a partner discourages you from seeing friends and family or insists that your entire identity should revolve around serving or being served, this is a warning sign.
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Lack of ongoing consent discussions – Consent and negotiation should be habitual and ongoing. If a partner refuses to revisit limits or renegotiate dynamics, that is a cause for concern.
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Being purposely misunderstood – If you express a kink or boundary and your partner constantly acts like they do not understand, this is a problem.
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Vague or unclear scene planning – Healthy dynamics involve specific negotiations (where, when, and how a scene will take place). If a partner is intentionally vague, this can lead to manipulation or coercion.
A kink-aware therapist can help partners determine whether their relationship simply needs adjustments or if there are deeper issues that need to be addressed.
Practical Tools to Strengthen a Kink Relationship
One of Blewett’s favourite exercises for reconnecting in a power exchange relationship is “Building Your Hottest Sexual Scene”. It’s helpful in understanding the direct pathways to getting your core erotic themes met.
How it works:
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Individually or as a couple, write out your ideal intimate experience—whether fantasy or real.
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Describe every detail: What do you smell? Hear? See?
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Consider the four key elements:
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Physicality – How do you want to touch or be touched?
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Words – What do you want to hear?
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Energy – What kind of dynamic do you want to feel?
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Gestures – Are there specific actions that bring intensity or meaning (e.g., collaring, kneeling)?
This exercise helps partners communicate their desires and boundaries, allowing them to understand what experiences feel most fulfilling.
How to Find a Kink-Friendly Therapist
Not all therapists are well-versed in kink relationships, so it is important to vet practitioners carefully.
Blewett suggests asking direct screening questions:
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What are your thoughts on BDSM being classified as a disorder in the DSM?
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How do you differentiate between self-harm and kink?
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What do you consider an ‘unhealthy coping mechanism’ in relationships?
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Have you worked with power exchange relationships before?
A competent therapist will see BDSM as a valid relational structure, not something to be cured or treated. If a therapist views BDSM as self-harm or assumes it is always linked to trauma, they may not be the right fit.
In conclusion…
Power exchange relationships require specialised, informed support, not judgment. By recognising when a dynamic needs adjustment, ensuring consent remains an ongoing conversation, and seeking kink-aware professionals, partners can build relationships that are both healthy and fulfilling.
"A good therapist won’t try to ‘cure’ kink," Blewett says. "They’ll help you navigate it with clarity, safety, and intention."
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About Georgie
Georgie Blewett, MSc is a Somatic Sex and Relationship Practitioner based in Edinburgh, specialising in sexual dysfunction, embodiment, and BDSM. With a deep commitment to supporting clients in cultivating fulfilling relationships and authentic self-expression, Georgie integrates evidence-based approaches with embodied practices.
In addition to their private practice, Georgie serves as the Research Coordinator for the Center for Positive Sexuality and is a reviewer for the Journal of Positive Sexuality. Their academic work includes a master's dissertation on stigma, identification, and well-being in the kink community, reflecting their dedication to advancing inclusive, sex-positive research and education.
