[khorboth]

I've never used it in play. I've seen it go through what I call the "curiosity arc" many times, though. Inexperienced players put it on their sheet during a first-draft, read the description and then remove it once they understand what it really is.

In terms of using it as a punishment, I always thought of it as a last-ditch attempt at reform. If someone's neurology is so messed up that they are getting pleasure from all these terrible criminal acts and we can't redirect it, then the only recourse is to burn out their pleasure center. So sad, but better than killing them.