I've found, fairly randomly through links on some other web pages, a couple of interesting things recently.
'I’m Gonna Need You to Fight Me On This: How Violent Sex Helped Ease My PTSD' - an article by a female journalist whose personal experiences, along with her experiences of interviewing many women who'd been raped, led to the onset of a stress disorder. Her way to deal with it was essentially a ritualistic baptism of fire: she asked an ex-lover to rape her, as realistically as possible. By going through the experience, and proving to herself that she could live through the experience, she cleared all the emotional blockages that had caused her stress.
It's hardly a textbook clinical approach to her problem but it worked for her. That's not to say it would work for everybody, but I''m certainly aware of others who have used bdsm play ritualistically in the same way, to the same ends, and with success. The enactment of the scene reinforces the intent to sort out emotional responses, perhaps. It's a private ritual that relies on much the same psychological mechanisms that religious (or magical) ceremonies employ. Not all such approaches might involve violent sex; not all bdsm is done for such purposes. But there does seem to be a link, and the author of the article was brave enough to describe and discuss her problem and how she dealt with it successfully.
'BDSM’s Dirty Secret – The Real Risk of Kinky Sex' by Midori is another equally interesting thinkpiece. Midori, if you haven't come across her, is one of the foremost bdsm gurus in the US. The article notes that bdsm is indeed potentially dangerous, though of course many everyday activities carry equally health-threatening risks - you can fall walking down stairs, burn yourself while cooking, and so forth.
The interesting risk, she argues, is intimacy. Often, bdsm scenes are relatively technical: a dominant does whatever they do to a submissive, who gets off on having it done rather than on who's doing it; the relationship is, ironically, almost a non-relationship in which each party gets off on the activity in a solitary way rather than relating to the other person in the scene. But it isn't always like that, and where there is communication and connection between people. it can be a massive emotional bond - the strong intimacy you get where people really give each other absolute trust and commitment.
Her argument is that the greater the level of technical skill involved in a scene, the more disconnect there is and the less such intimacy is built; conversely, simple non-technical scenes may enable much greater intimacy. Personally I can see where she's coming from, though as someone who does bondage suspensions and other 'technical' forms of play, I'd say that technical challenges aren't necessarily a bar to intimacy. Someone who's proficient enough to know exactly what they're doing and who keeps a good level of communication going with their sub before, during and after a scene is also able to build and experience the same intense level of connection.
Especially if the 'technical' form of play is actually part of a ritualistic scene, of the kind I described above...
My 2p or 2 cents' worth. Your opinions may vary.