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Paraphilia
A paraphilia is
a condition in which a person's sexual arousal and gratification depend
on fantasizing about and engaging in sexual behavior that is atypical
and extreme. A paraphilia can revolve around a particular object (e.g.,
children, animals, underwear) or around a particular act (e.g.,inflicting
pain, exposing oneself). Most of the paraphilias are far more common in
men than in women. The focus of a paraphilia is usually very specific
and unchanging. For example, for someone who derives sexual pleasure
from exposing his genitals, watching others engaging in sexual activity
will not generally provide sexual gratification.
A paraphilia is
distinguished by a preoccupation with the object or behavior to the
point of being dependent on that object or behavior for sexual
gratification. In most cases, types of sexual activity outside the
boundaries of the paraphilia lose their arousal or satisfaction
potential unless the person fantasizes about the paraphilia at the same
time.
Although many of the
paraphilias seem so foreign or extreme that one could not imagine how
the object or behavior can be arousing to anyone, they are easier to
understand if one thinks of those behaviors that, in less extreme
versions, are quite common and not considered abnormal. For instance,
having a partner "talk dirty" occasionally may be a
"turn-on" for some people, but when talking dirty is the only
way that sexual arousal or satisfaction can occur, it would be
considered a paraphilia. Others want to be bitten, scratched, or
spanked, or find that watching their partner undress is highly arousing.
Viewing a nude person or watching sexually explicit videos can be
arousing for most people. Each of these acts is innocuous unless
magnified to the point of psychological dependence.
There are numerous
paraphilias. Some of the major types will be briefly defined here.
Fetishism is a fixation on an object or body part that is not primarily
sexual in nature, and the compulsive need for its use in order to obtain
sexual gratification. The fetish object is almost invariably used during
masturbation and may also be incorporated into sexual activity with a
partner in order to produce sexual excitation. Fetishists usually
collect the object of their favor, and may go to great lengths,
including theft, to acquire just the "right" addition for
their collection. Some of the more common objects that have served as
fetishes include women's undergarments, high-heeled shoes, or specific
materials, like silk, leather or fur. Some people have a fetish for
particular body parts such as feet, hair or legs. Refer
fetishism
for a more complete explanation.
Transvestism is a
paraphilia in which heterosexual males repeatedly and persistently get
sexual pleasure from dressing in women's clothing. Transvestism is not
simply dressing up in the other sex's garments for fun or for temporary
effect. The transvestite needs to cross-dress to achieve full sexual and
emotional release. This is very different from the female impersonator
or the drag queen (male homosexuals who occasionally dress in women's
clothing), both of whom are usually playing social roles rather than
expressing sexual needs.
Voyeurism is deriving
sexual satisfaction from watching people undressing or nude, or
observing them during sexual acts without their knowledge or consent.
Voyeurs (from the French verb meaning "to see") or Peeping
Toms are usually unmarried males in their 20s and 30s. They generally
prefer to peep at women who are strangers and they are often most
sexually excited when the risk of being discovered is high. Many voyeurs
confine their sexual activity to masturbation while peeping or while
fantasizing about previous peeping escapades.
Exhibitionism is the
compulsive act of inappropriately exposing one's sex organs to
unsuspecting strangers for the purpose of sexual arousal and
gratification. Also known as "indecent exposure" and
"flashing," this paraphilia is found almost exclusively in
males and the peak age of occurrence is reported to be in the twenties.
Many exhibitionists have erectile difficulties in other forms of sexual
activity and seem to be pushed by an uncontrollable urge that leads to
their impulsive behavior. For some, the primary intent of exhibitionism
is to evoke shock or fear in their victims, not necessarily to achieve
an erection or to ejaculate. They derive their pleasure from the visible
reaction of their victims. It is generally agreed that the exhibitionist
is unlikely to rape or assault his victims, but there are exceptions to
this rule, especially when an exhibitionist is unsatisfied with his
victim's response. Police catch more exhibitionists than any other
category of paraphiliacs. The risk of being caught may be an important
element of the turn-on, leading some exhibitionists into behavior almost
guaranteed to result in arrest, such as repeatedly performing at the
same street corner.
Sadomasochism is a
paraphilia that combines sadistic and masochistic roles in sexual
interaction. Sadism is the intentional infliction of pain on another
person or the threat to do so, for sexual excitement. Masochism is a
condition in which a person derives sexual gratification from being
subjected to pain or to the threat of pain. A sadomasochist is a person
who can derive sexual pleasure from either role.
Forms of sadism run the
gamut from the fairly common carefully controlled play-acting with a
willing partner, in which the mild forms of pain that result from such
acts as spanking or biting are not actually experienced as painful
(think of having one's back scratched - the same intensity can sometimes
feel good and sometimes hurt depending on the circumstances), to the
very rare assaultive behaviors that may include torture, rape, or even
murder. Some extreme sadists require an unwilling victim to derive
pleasure; others become sexually aroused only when they see their victim
suffering.
Likewise, masochism can
range from mild versions to extremes. In the mild renditions, activities
might include bondage (being tied up for the purpose of sexual arousal),
being spanked, or being overpowered by physical force. The crucial point
is that they are mainly symbolic enactments done under carefully
controlled conditions with a trusted partner. At the opposite end of the
spectrum are genuinely painful activities such as whippings,
semi-strangulation, being trampled and self-mutilation.
Although sadomasochistic
acts in their extreme forms can be physically and psychologically
dangerous, the majority of people engaging in these behaviors do so with
an understanding of the risks and stay within carefully predetermined
limits.
Pedophilia is a condition
in which an adult's preferred or exclusive method of sexual excitement
is fantasizing or engaging in sexual activity with prepubescent
children. About two thirds of the victims of pedophiles are girls, most
often between the ages of 8 and 11. Pedophilia predominately occurs in
males, but there have been documented cases of women who have repeated
sexual contact with children. The popular stereotype of the child
molester as a stranger who lurks around playgrounds with a bag of candy
to lure victims is not entirely correct. It is not uncommon that the
pedophile is a relative, neighbor, or acquaintance of the victim.
Pedophiles commonly fall into three distinct age groups: over 50, the
mid-to-late 30s, and the teens. Most are heterosexual and many are
married fathers. Strictly speaking, the person who has only isolated
sexual contact with children is not a pedophile and may be
inappropriately expressing sexual frustration, loneliness, or personal
conflict. There is no single pattern of sexual activity that fits all
pedophiles.
Engaging in sexual
contact with animals is known as bestiality. When the act or fantasy of
sexual activity with animals is a repeatedly preferred or exclusive
means of sexual gratification, it is called zoophilia. Bestiality
usually involves curiosity, a desire for novelty, or a desire for sexual
release when a partner is unavailable. Zoophilia sometimes involves
sadistic acts that may harm the animal.
Making repeated obscene
telephone calls for the purpose of sexual excitement is considered a
paraphilia. The relative safety and one-sided anonymity of the telephone
provides an idealized setting for masturbatory fantasies with no worries
about face-to-face contact. There are three basic types of obscene phone
calls. In the first, the caller boasts about himself and describes in
detail his masturbatory act. In the second type, the caller directly
threatens the victim ("I've been watching you" or "I'm
going to find you"). In the third type, the caller tries to get the
victim to reveal intimate details about her life. Sometimes the obscene
phone caller repeatedly calls the same victim, but more often, unless
the victim shows a willingness to stay on the phone and play his game,
he'll move on to others.
There are some
paraphilias that are relatively rare. Apotemnophilia refers to the
sexual attraction to amputations. Coprophilia and urophilia refer
respectively to sexual excitement deriving from contact with feces and
urine. Klismaphilia is sexual excitement resulting from the use of
enemas. Frotteurism is sexual arousal resulting from rubbing the
genitals against the body of a fully clothed person in crowded
situations, and necrophilia is sexual arousal derived from viewing or
having sexual contact with a corpse.
It is unclear what causes
a paraphilia to develop. Psychoanalysts theorize that an individual with
a paraphilia is repeating or reverting to a sexual habit that arose
early in life. Behaviorists suggest that paraphilias begin through a
process of conditioning. Nonsexual objects can become sexually arousing
if they are repeatedly associated with pleasurable sexual activity. Or,
particular sexual acts (such as peeping, exhibiting, bestiality) that
provide especially intense erotic pleasure can lead the person to prefer
that behavior. Although the origins of most paraphilias are not
understood, in some cases there seems to be a predisposing factor such
as difficulty forming person-to-person relationships.
Whatever the cause,
paraphiliacs rarely seek treatment unless an arrest or discovery by a
family member traps them into it. In most cases, the paraphilia results
in such immense pleasure that giving it up is unthinkable. Treatment
approaches have included traditional psychoanalysis, hypnosis, and
behavior therapy techniques. Research on the outcome of these therapies
has been incomplete, but often they have not be very successful. More
recently, a class of drugs called antiandrogens that drastically lower
testosterone levels temporarily have been used in conjunction with these
forms of treatment. The drug lowers the sex drive in males and reduces
the frequency of mental imagery of sexually arousing scenes. This allows
concentration on counseling without as strong a distraction from the
paraphiliac urges. Increasingly, the evidence suggests that combining
drug therapy with cognitive behavior therapy can be effective.
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