Scoptic Syndrome

By | June 10, 2022

Patients with scoptic syndrome self-harm in the genital area. They find the self-injury liberating or even arousing. The scoptic syndrome is therefore described by many scientists as a form of masochism.

What is Scoptic Syndrome?

Various disorders of the psyche are summarized as behavioral disorders. In addition to sexual disorders, the collective term includes disorders of gender identity, for example. One of the sexual disorders, or more precisely the disorders of sexual preference, is masochism, in which those affected derive pleasure or satisfaction from experiencing pain or humiliation of themselves. For what does kss mean, please visit

Delusional disorders such as dysmorphophobia, in which patients perceive their own body as disturbed, must be distinguished from sexual disorders and gender identity disorders. According to the DSM IV, scoptic syndrome is a gender identity disorder. Since the recent past, however, the syndrome has also been assigned to disorders in sexual preference by some scientists and regarded as a form of masochism.

Still others consider Scoptic Syndrome to be a form of dysmorphophobia. The main reason why the disease is so difficult to classify is that it is a rather rare disease that has not been researched very well to date. Patients suffer from a need for genital self-mutilation. The syndrome got its name from the Russian sect Skopzen, whose rituals included genital mutilation.


The cause of the scoptic syndrome has not yet been finally clarified. If the illness is actually a sub-form of masochism, psychodynamic and learning-theoretical explanations are available. In this case, depth psychology assumes a defensive behavior that suppresses fears and remorse about detachment from the mother.

Learning theorists, on the other hand, see the cause more in classical and operant conditioning, as occurs, for example, in the form of masturbation fantasies. If, on the other hand, the scoptic syndrome is a form of dysmorphophobia, biological and sociocultural factors probably play a role in its development. In this case, the causes would be understood in a similar way to the causes of obsessive -compulsive disorders.

If it is a gender identity disorder, the cause is probably the social expectations of the behavior of both sexes, men and women. In this context, the primary cause of the Scoptic syndrome would be the need for freer personality development.

The primary aim is to become independent of expectations that often already exist to a large extent on the part of the parents. As a classification-independent explanation, psychiatrists assume causes such as sexually induced feelings of guilt in scoptic syndrome.

Symptoms, Ailments & Signs

The scoptic syndrome manifests itself in various clinical pictures. Most patients are plagued by a need for genital self-mutilation, such as a need for castration, penectomy, or clitoridectomy. Those affected initially only suffer from the desire for mutilation, but they usually become active as the disease progresses and actually carry out the self-mutilation.

After the act of mutilation, many patients speak of liberation. Others describe feelings of sexual excitement. Under certain circumstances, these are actually two different clinical pictures. These differ not only in the claim, but also in the cause of each other. Patients who experience pleasure in self-mutilation are more likely to suffer from a form of masochism.

Patients with feelings of liberation, on the other hand, can be better described as having a gender identity disorder. Some of the patients do not perform full castrations, penectomies or cliterodectomies, but only injure themselves in the genital area. Other patients injure themselves as part of a more or less professionally planned operation.

Diagnosis & course of disease

The diagnosis of scoptic syndrome is made by a psychiatrist or psychotherapist. In general, a relatively high number of unreported diseases is assumed to be associated with the syndrome. Presumably many of those affected do not like to turn to the doctor or psychiatrist, especially with something as intimate as genital self-harm. Since the scoptic syndrome has not yet been researched in depth, the prognosis is relatively poor.


People who act out the scoptic syndrome and injure themselves in the area of ​​the genitals can suffer a wide variety of complaints as a result. If, for example, there is heavy bleeding, this can lead to anemia and possibly even to bleeding to death. The injury can also become infected and cause sepsis.

In individual cases, self-mutilation is practiced until the loss of the genitals – impotence, incontinence, serious infections and other complications can be the result. In addition, the mental illness on which the scoptic syndrome is based can cause further disorders that limit the affected person in their everyday life. Treatment of scoptic syndrome usually proceeds without complications.

If there is an acute risk of self-harm, however, the person concerned must be admitted to a closed facility, which sometimes worsens the mental state. Prescribed antipsychotics can result in changes in the blood count, blood pressure disorders and muscle cramps. Undesirable side effects such as weight gain, restlessness in sitting and moving, and fatigue can also occur.

Interaction with other medications or existing diseases can lead to further complications, for example cardiovascular problems, heart, kidney and liver damage as well as neurological deficits.

When should you go to the doctor?

Skoptic syndrome is a serious mental illness. If there is a suspicion that the rare syndrome could be present, a sex therapist or a specialist in sexual disorders must be consulted in any case. People who have an acquaintance who shows signs of the syndrome should seek medical advice and raise the suspicion with the affected person in consultation with the professional. Because it is a rare condition, only a sexual dysfunction therapist can definitively diagnose the condition. If self-injurious behavior has already occurred, a doctor must be consulted quickly.

Injuries to the intimate area can cause serious infections and other health problems. For this reason, medical advice is required after self-mutilation. In the case of serious injuries, it is best to go to a hospital immediately. The wounds can be treated there. The psychological suffering requires long therapy by a sex therapist. If people feel an increasing desire to self-mutilate, they should inform the therapist. Adjunctive drug treatment may be necessary.

Treatment & Therapy

The treatment of people with scoptic syndrome differs from case to case. It is important to research the causes and to correctly classify the disease in the individual case. The treatment of masochism takes the form of psychotherapy on an experimental basis. However, the treatment of masochists is usually lengthy and difficult.

Cognitive – behavioural therapy, on the other hand, seems to be worthwhile in patients with dysmorphophobia. Serotonin reuptake inhibitors in combination with antipsychotics have also been shown to be effective in these patients. The earlier psychotherapy is started, the greater the chances of recovery in the case of auto-aggressive behavior.

In addition to depth psychological treatment attempts, psychoanalytic and behavioral therapy steps can be taken to treat the patient. One therapy for treating patients with borderline personality traits is Marsha M. Linehan’s dialectic-behavioural therapy. With this type of therapy, the patient is given strategies to cope with acute suffering.

For example, offering alternative ways to behavior that is harmful to the body, such as holding ice cubes or chewing chili peppers. If there is an acute risk of self-harm, patients with scoptic syndrome are usually treated in a closed facility.

If there are already injuries, the care and treatment of the injured areas is the priority for the time being. In this case, the actual therapy of the scoptic syndrome is neglected.


Since the causes of scoptic syndrome are still largely unclear, there are no promising steps for prophylaxis.


The aftercare measures for scoptic syndrome can be very diverse. As a rule, the cases of illness are not comparable with one another. The extent of the follow-up care is determined by the form of the disease and the severity of the individual need for self-mutilation in the person concerned. If the self-mutilation has not yet been carried out, the focus of the aftercare treatments is to prevent it.

In the case of masochism, the psychotherapy that was started therapeutically is continued in the follow-up care. The person concerned must continue to be closely monitored and cared for by depth psychology. In those affected with dysmorphophobia, therapy with antipsychotics (combined with serotonin) that may have been started is continued. In addition, the medication prescribed by a doctor must be checked regularly and adapted to the current clinical picture.

The aim of the follow-up examinations is to regulate the side effects (e.g. fatigue, weight gain, restlessness in movement and sitting) of the prescribed antipsychotics for the affected person as best as possible. For this purpose, the person concerned must be presented regularly on an outpatient basis or in hospital for blood tests to be carried out to examine the complete blood count. If the acute risk of self-injury cannot be ruled out therapeutically, the closed facility is responsible for aftercare.

The follow-up measures are then limited to the renewed attempt at therapy. If self-mutilation has already been carried out, the aftercare focuses on the postoperative care of the person concerned. The healing of the self-inflicted wounds is observed and sometimes supported by antibiotic therapy. The therapy of the scoptic syndrome follows immediately after the healing process.

You can do that yourself

Since self-injury to the genitals is part of a form of lust, it is often not possible to alleviate the symptoms by self-banning. On the other hand, it is helpful to reflect on the emotional state of the person concerned and to question their motivation.

The person affected often suffers from strong emotional pressure, fears or other psychological impairments. These are in collaboration with a therapistor to find out on their own responsibility so that the situation can improve. In everyday life, it is advisable to deal openly with the masochistic tendency, especially with your partner. The communication about the existing desires but also an exchange about states of mental stress is essential for maintaining one’s own health. An exchange with other affected persons or contact with a sex therapist can be perceived as helpful. It is important to set limits and stick to them. Otherwise, irreversible damage or a life-threatening condition may result from the self-injurious actions. It must be avoided at all costs.

There are often stressful relationships with other family members that are the triggers for the actions. Unprocessed situations and experiences can also be the cause of scoptic syndrome. In order to experience relief, it is important that the causal trigger is clarified.

Scoptic Syndrome