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This paper argues that some forms of sadomasochistic fantasy and enactments can represent a developmental and therapeutic advance for some patients. Playful fantasies of dominance and submission, when enacted, function to reassure the patient that the other can survive the full expression and power of his or her sexual desire. Sadomasochistic scenarios can mitigate guilt and worry and free the patient for an experience of sexual ruthlessness. The apparent differences in the manifest roles of the man and woman in this situation are belied in a paradoxical way by underlying commonalities. A woman can use her consensually scripted domination as a reassurance that the man can withstand the full force of her excitement, and the man can experience his partner's excitement in submission as a condition of safety for the consolidation of his phallic strength. Two clinical examples illustrate these paradoxes and the affirmative dimension of certain kinds of sadomasochistic play. The suggestion is made that blanket critiques of sadomasochism as either perversion or misogyny are misguided and potentially repressive.