I was driving home when I thought about this thread...
Whatever the sub and her Dom do is founded on a relationship of trust and respect. The submissive trusts her Master in what they do, He knows best and knows his girl well enough to gauge reactions and difficulties. Some might think that the abuse is continuing, but if the submissive of her own free will allows this, then it is her choice and safe words are always there in the back of her mind. But with time and trust, while the word is there, it is seldom used, unless during a play session there are cases of flashbacks or sudden fear to escape the situation - which I can relate to and thankfully I have a Dom who understands this and knows how to reassure and change the mind set.
The difference is the person abused didn't let what happened to them happen with free will or because they wanted it....it was done to them against their beliefs against their will, or done to them without even realising it was abuse when they confided in others.
That is why it can work, if you have a partner who you can trust with your heart and mind to take these steps, then it isn't abuse because it is willing on both sides.