Neural Kinks: Talking Mental Wellness and Sexuality with Lilian Ostrovsky, LCSW

                   Lilian Ostrovsky, LCSW

                   Lilian Ostrovsky, LCSW

Written by Paige Fraker

What comes to mind when you hear the word kink? (If it’s Fifty Shades of Grey, go ahead and give yourself fifty lashes).  A mere two decades ago, thanks to long held beliefs of BDSM being linked to psychopathology, the answer may have been sexual deviance.  New generations are beginning to view the concept in a much more positive light. While the analysis of human sexuality is nothing new, recent studies reveal some surprising benefits to incorporating grownup playtime into the everyday.

Sigmund Freud famously stated, “A complete absence of sex is the only thing which can be properly considered sexual deviance. Everything else is just a matter of taste.” While some may not view Freud as a glowing pillar of sexual enlightenment, the man may have been onto something.  Kink and sexual openness have been steadily increasing in popularity alongside the open love movement, and researchers are beginning to take note of the correlation between erotic adventurousness and a healthy sex mentality. We sat down with Lilian Ostrovsky, a psychotherapist focusing on sexuality and its impact on personal fulfillment, to get all the kinky details on her practice, her clients, and the new view of sexual wellness.

PF: How did you get into this line of work?

LO: From the time I was a young child I was very much obsessed with the concept of freedom and was fascinated by the world around me.  At that age I would get lost in emotionally complex characters especially those a child would consider evil and would fantasize about their lives and what brought them to the brink of hurting others. You can imagine how delighted I was when Gregory Maguire’s wrote Wicked. The entire book felt like an unfolding my of childhood fantasy.  It was natural for me to have empathy for the pariah who seemed to bring nothing but harm to the people and communities around them.  This is probably where it all began for me. I continue to draw inspiration from taboos and the shadowy elements of the human experience both professionally and personally.    

PF: How many of your clients would you say focus their sessions on sexual reservations or deviances?

LO: Sex and sexuality is often the most challenging area for clients to unpack because of the continued social stigmas and judgmental language we use as a society when thinking and talking about sex.


PF: That plays exactly into my next question, which is how much do you perceive societal sexual norms play into your clients’ concerns?

LO: I’m so glad you asked. I think no one will disagree with me when I say that from birth we are initiated into a culture of dualism. Boy/girl, good/bad, angel/demon, black/white, and so on. By design these dual relationships have their limitations as children mature into adults and their impulses, desires, and fantasies become more complex outgrowing the binary narratives of childhood. As adults struggle with their experience in the world using these socially imposed belief systems, feelings of shame, embarrassment, inadequacy, fear, anger, and worthlessness can turn into anxiety, depression, and addiction. In all aspects of their lives including their sexual identities people often feel stuck in the developmental restrictions imposed by this kind of socialization.

The crux of my work with clients involves the discovery, acceptance, and integration of emotions, impulses, desires and fantasies as a sidestep from socially imposed suffering to a greater sense of freedom and personal authenticity. Clients with natural playful tendencies and a sense of wonderment toward personal development tend to have an enriching journey with fewer feelings of shame and fear. This is in large part due to the wonderful and well-documented effects of play on adult stress management and development. In the last two years I’ve also noticed a greater openness among my clients, both couples and singles, to engage in sexual play as a way of exploring different types of connection and trying on alternate personas.  The level of communication, trust, and safety that exists between participants largely informs the success of this kind of play. The one thing that stands out to me among clients who incorporate practices like tantra and BDSM into their sexual lives, is their general sense of wellbeing and connection to themselves as well as the highly present and non judgmental communication styles that spill over from their relationships with their partner(s) into the rest of their lives.    

PF: What would you say is the most common sex-related concern that your clients seem to have?

LO: In large part clients come with the kind of sexual preferences and tastes that you would expect but foot fetishes and fantasies around power play tend to be the most common. What gets people stuck and ultimately to seek help are feelings of shame and inadequacy that can lead to anxiety, depression, compulsion, and addiction. The goal of therapy with these clients is to create a safe space for them to explore their fantasies and to adopt an attitude of unconditional self-acceptance and positive personal regard. I’ve found as people begin to incorporate healthier attitudes about themselves, their impulses, and fantasies, their emotional and behavior tendencies tend to follow suit.    

PF: So what does a typical session look like?  I realize that it must differ a lot from patient to patient, but what is the general flow of it?

LO: For both individual clients and couples the first few sessions are focused on getting to know them and building rapport. This first step can take as long as clients need to feel safe before taking a deeper dive into their inner worlds. I offer clients therapeutic and explorative meditation in addition to traditional talk therapy with an intention of creating as much alignment as possible with my clients’ needs and personal goals. In couples therapy the goal is to get people to communicate and connect with one another as soon as possible. I use an eclectic mix of guided dialogue, meditation, and sensory exploration to help fulfill this goal.

PF: We’ve touched on this in all of your answers, but what would you say are some of the most important things to know with adult play and mental wellness?  Where does the need come from?  Why do those who participate benefit in their personal lives?

LO: I think we all know and understand the importance of play for children. Children learn and process the world around through play.  In recent years research in neuropsychology has supported the idea that human development occurs throughout a person’s lifespan and that play offers tremendous benefits for adult learning, processing, stress reduction, creativity, and greater authenticity.  I’ve also noticed that for my clients playful attitudes and activities help with depression and anxiety, and that couples who struggle with depressed relationships begin to experience a resurgence of connection and intimacy when they incorporate playful exploration and kink into their relationships.  The relationship blossoms from a depressed state into a beautiful energy that percolates into the rest of their lives as individuals.


PF: Lastly, how do people react when they find out about your line of work?

LO: (Laughs) A lot of times people express feeling intimidated or see it as an opening to tell me about their struggles. But recently, I’ve been getting a lot of great questions about vulnerability, which delights me. I believe that vulnerability is the holy grail of personal fulfillment and well being and seeing a sudden surge in interest on the topic makes me think that a greater number of New Yorkers are ready for deeper and sustainable connections. I should say that kink and other types of sex play can be a fun and low risk pathway to vulnerability and all of its wonderful benefits.

So ultimately, besides a few vanilla-leaning concerns, where’s the harm?  The estimated thirty seven percent of Americans who participate in BDSM would surely say that there is none. There are now multiple studies citing those who practice kink in the bedroom as experiencing less anxiety in their day-to-day lives, and more intimacy with their partners. As long as enthusiastic consent remains the number one priority, the ever-expanding climate of sexual openness seems to be making a positive impact on the lives of those who participate. After all, it was also Freud who said, “Everything that you do in bed is perfectly and absolutely acceptable. If only both sides enjoyed it.” Who can argue with that?


Interest piqued? Ready to dive in? Find below NSFW-approved picks for your BDSM starter kit. (click the image to visit the site):

Feather Nipple Clamps from Babeland

A perfect starting point for couples looking to experiment with the senses (without investing too much $$). Also a great way to gauge pain tolerance..

Mini Riding Crop from Babeland

Crops are an excellent beginners tool since they're easy to wield, intuitive to use, and deliver controlled impact. This one is lightweight and compact, great for travel or on-the-go use. (we don't know your life)

Flavored JO Lube from Body Candy

It may go without saying, but we'll say it anyway: Lubing up is a crucial part of making BDSM play comfortable and pleasurable for everyone involved. We're partial to this fun, flavored take.

Leather Pocket Paddle from Babeland

Pocket-sized pleasure on the go, what more could you need? We love this little guy for amping up couples' play. The shape also allows for a little creativity as far as placement is concerned..

Beginner's Bondage Fantasy Restraint Set from Adam & Eve

This affordable restraint set is a great introduction to the B in BDSM. Couples looking to toy with sensory deprivation, Dom/Sub play, and multiple, kinky positions will love how easy it is to slip on and off.