Chapter 14 Paraphilias and Sexual Variants Defining Normal

Chapter 14 Paraphilias and Sexual Variants

Defining “Normal” Statistical approach Sociological approach Psychological approach

Historical Perspectives Mid 11 th century, Christian perspective • Missionary position only • All other positions “unnatural” Freud • Only penile-vaginal sex is “mature”

Today’s DSM-IV-TR Definitions: Paraphilia and Sexual Variants Paraphilia: from Greek, “para” means other and “philia” means love § § Sexual arousal and gratification depends on engaging in or thinking about unusual behavior Lasts at least 6 months Sexual variants may be unusual but are not the preferred behavior

Paraphilia, Sexual Variant, or Normal? What do you think? Walking naked on beach and out of the view of others = q Paraphilia q Sexual variant q Normal or acceptable behavior

Multiple and Related Paraphilias • Over half in treatment for paraphilia report engagement in 3 or 4 types of paraphilias • Some types of paraphilias cluster together • Most developed fantasies by age 12 or 13 but fearful of disclosure or discussion

Courtship Disorders: Normal Phases What are these normal phases? • Finding potential partner • Affiliation • Tactile phase • Copulatory phase

Voyeurism: Disorder of “Finding” Phase of Courtship § Description § Symptoms and causes § Danger level

Exhibitionism: Disorder of Affiliative Phase of Courtship Description Symptoms Causes and sexual turn-on Consequences

Obscene Phone Calls: Another Affiliative Phase Disorder Telephone Scatologia: verbal form of exhibitionism • • • Description Types Causes and sexual turn-on Consequences Danger level

Frotteurism: Disorder of Tactile Courtship Phase Frotteurism: sexual arousal achieved primarily by rubbing one’s genitals against others in public places • Only considered paraphilic if engaged in repeatedly as preferred form of sexual behavior

Pedophilia: sexual arousal is achieved primarily and repeatedly through sexual activity with children who have not reached puberty Half or more of men diagnosed as voyeurs, exhibitionists, telephone scatologists, or frotteurists also meet criteria for pedophilia Pedophile is at least 16 years old and at least 5 years older than child

Fetishism, Transvestism and Related Paraphilias Erotic fetishism: sexual arousal and gratification almost exclusively by handling or fantasizing about inanimate object Partialism: sexual arousal focusing exclusively on specific part of body

But what if I really enjoy leather? Which is “normal”? Tools for arousal and not primary sexual focus Fetishistic object primary sexual focus and not partner

Transvestism Edward Hyde, governor of New York (1702 – 1709) and a modern transvestite.

Most Transvestites Secretly Cross-dress • • Purpose of crossdressing Reasons for crossdressing Marital status Transsexuals versus transvestites

Personal Reflections Do you believe that it is okay for consenting adults to engage in any sexual behavior in private as long as it does not cause physical and/or emotional injury and does not interfere with normal social and occupational activities? Why or why not?

Related Fetish-like Paraphilias Nonhuman objects are focus: • Urophilia • Coprophilia • Mysophilia • Klismaphilia

Bestiality vs. Zoopilia Beastiality: arousal through sexual contact with animals Zoophilia: beastiality is preferred over sex with human partners

Sadomasochism (S&M) Sadism: arousal from infliction of pain on another person Masochism: arousal from experiencing pain Paraphilic masochism more common than sadism Gender differences Sadists share many characteristics and behaviors with other sexual aggressors

S&M as a Sexual Variant Mild S&M behaviors common between consenting partners Distinctive feature of S&M/D&S roleplaying sex games is domination and submission, NOT extreme pain Pain is erotically arousing only as part of agreedupon ritual or fantasy “script” Involves power exchange

Other Paraphilias Necrophilia: arousal from having sex with dead bodies Autoerotic asphyxiation: individuals deprive themselves of oxygen when highly sexually aroused in hopes of intensifying orgasm

What Causes Paraphilias? Paraphilias and obsessive-compulsive disorder have many similarities • • Freudian theorists Learning theorists Which theory makes the most sense to you?

Understanding Paraphiliacs Can you fill in the blanks below? • Attitudes about and expectations of men and women are ______. • Most paraphiliacs are _____, but generally have history of other struggles.

Why are most paraphiliacs male? What did the text convey?

Therapy: Does it work? • The large majority of paraphiliacs do not want to change, stifling hopes of success in therapy • Recidivism is very high

Therapy: Approaches Traditional psychotherapy or group therapy Confrontational approaches Behavioral approaches Desensitization Social skills training Medical approaches and medications Multiple methods

Personal Reflections Do you engage in sexual practices that may be physically or psychologically harmful to yourself or others (e. g. , exhibitionism, obscene telephone calls, voyeurism, sadomasochism, pedophilia)? If so, have you sought therapy to help with your behavior? If not, why not?