Atypical Sexual Variations
Chapter 17
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Copyright 2008 Allyn & Bacon
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Atypical Sexual Variations
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Normal Versus Deviant Sexual Behavior
The Paraphilias
Theoretical Perspectives
Treatment of the Paraphilias
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Normal Versus Deviant Sexual
Behavior
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Defining Normal Sexual Behavior
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Frequency of the behavior
Cultural considerations
Persistent preference for nongenital sexual
outlets
Atypical variations
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Unusual patterns of arousal or behavior
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The Paraphilias
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Paraphilia
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A diagnostic category used by the American
Psychiatric Association
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Used to describe atypical patterns of sexual arousal or
behavior that become problematic to the individual or
society
Urges are recurrent and are either acted on or are distressing
to the individual.
Milder forms of these behaviors may be practiced by
many people, however.
Mostly occur among men
Some are harmless and victimless, while others can
have serious effects on others
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The Paraphilias
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Fetishism
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Inanimate object elicits sexual arousal
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Common objects are articles of clothing and
materials made of rubber, leather, silk, or fur.
Partialism
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Related to fetishism in which sexual arousal is
exaggeratedly associated with a particular body
part
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Such as feet, breasts, or buttocks
Most fetishes and partialisms are harmless.
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The Paraphilias
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Transvestism
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Person repeatedly cross-dresses to achieve sexual
arousal or gratification or is troubled by persistent,
recurring urges to cross-dress
Almost all transvestites are men.
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Both gay and heterosexual males report transvestism.
It is not the same as transsexualism.
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Transsexuals cross-dress because of discomfort with their
anatomic sex and desire to be the other sex
However, some transvestites and some transsexuals may be
motivated by autogynephilia
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A fetish in which men are sexually stimulated by fantasies that
their own bodies are female
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The Paraphilias
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Exhibitionism
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Urges and fantasies involving exposing one’s genitals
to unsuspecting strangers
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Exposure to exhibitionism is common.
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Provides sexual arousal or gratification
Urges are either acted upon or are disturbing
A sample of college women found that one-third had been
approached by a “flasher.”
Exhibitionists usually are not physically threatening.
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Victims may experience negative psychological consequences.
Often lonely and sexually repressed
Some progress to more serious crimes of sexual aggression
Copyright 2008 Allyn & Bacon
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The Paraphilias
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Obscene Telephone Calling
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Sexual arousal results from shocking victims
Telephone scatologia
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A DSM label for a paraphilia characterized by the making of
obscene telephone calls
Usually socially inadequate heterosexual men
Voyeurism
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Characterized by observing unsuspecting strangers
who are naked, disrobing, or engaged in sexual
relations
Most, but not all, voyeurs are nonviolent.
Often feel inadequate and lack social & sexual skills
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The Paraphilias
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Sexual Masochism
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Characterized by the desire or need for pain or
humiliation to enhance sexual arousal
Bondage
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Ritual restraint, as by shackles
Although some masochists are women, it is much
more common among men.
Masochists may form relationships with sexual
sadists, people who become sexually aroused by
inflicting pain or humiliation.
Copyright 2008 Allyn & Bacon
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The Paraphilias
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Hypoxyphilia
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Person seeks to enhance sexual arousal, usually
during masturbation, by becoming deprived of
oxygen
Sexual Sadism
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Characterized by the desire or need to inflict
pain or humiliation on others to enhance
sexual arousal
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The Paraphilias
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Sadomasochism (S&M)
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A mutually gratifying sexual interaction
between consenting sex partners
Sexual arousal is associated with the
infliction and receipt of pain or humiliation.
Occasional, mild S&M is common among the
general population.
S&M subculture exists in the U.S.
S&M fantasies likely begin in childhood.
Copyright 2008 Allyn & Bacon
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The Paraphilias
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Frotteurism
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Characterized by rubbing against or touching
a nonconsenting person
Often takes place in crowded places such as buses,
subways, or elevators
 Also known as “mashing”
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Reported exclusively among males
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Toucherism
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Related to frotteurism and characterized by the persistent
urge to fondle nonconsenting strangers
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The Paraphilias
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Other Paraphilias
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Zoophilia
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Characterized by urges and fantasies involving sexual contact
with animals
Bestiality
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Involves actual sexual contact with an animal
Necrophilia
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Characterized by desire for sexual activity with corpses
3 types
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Regular: has sex with a dead person
Necrophilic homicide: person commits murder to obtain corpse for
sexual purposes
Necrophilic fantasy: person only fantasizes about sex with corpse
Rare paraphilia & necrophiles are seriously disturbed
Copyright 2008 Allyn & Bacon
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The Paraphilias
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Less common paraphilias
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Klismaphilia
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Coprophilia
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Sexual arousal is attained in connection with feces
Urophilia
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Sexual arousal is derived from the use of enemas
Sexual arousal is associated with urine
These paraphilias may have childhood origins.
Copyright 2008 Allyn & Bacon
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Theoretical Perspectives
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Biological Perspectives
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Examines factors such as the endocrine system
and the nervous system
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Electroencephalograph (EEG) data show that
paraphilic men’s brains respond differently to sexual
stimuli and paraphilic stimuli compared to control
subjects.
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Theoretical Perspectives
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Psychoanalytic Perspectives
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Paraphilias are psychological defenses.
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Usually against unresolved castration anxiety due to the Oedipus
complex
Suppressed or repressed feelings of sexual guilt and shame
Learning-Theory Perspectives
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Paraphilias are learned behaviors acquired through
experience.
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An object or situation may be associated with sexual arousal,
fantasies, or orgasm
Modeling or observational learning also may play a role.
Copyright 2008 Allyn & Bacon
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Theoretical Perspectives
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Sociological Perspectives
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Focus on the social context, the effects of the group, and
society in general
An Integrated Perspective: The “Lovemap”
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Acknowledges the multiple origins of paraphilias
Money (2000) proposes that childhood experiences
create a lovemap
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A mental representation of the idealized lover and the idealized
erotic activity with the lover
Lovemaps can become distorted by early traumas.
Copyright 2008 Allyn & Bacon
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Treatment of Paraphilias
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Issues in treatment
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Many people with paraphilias don’t want
treatment & don’t seek it voluntarily
Ethical issues arise when providers are asked
to contribute to judicial processes
Providers realize they are likely to not be
successful with resistant clients
Perceived responsibility
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Treatment of Paraphilias
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Psychoanalytic Psychotherapy
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Focuses on resolving unconscious conflicts, typically
Oedipal, believed to lead to pathologies such as
paraphilias
Cognitive-Behavioral Therapy
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Focuses directly on changing behavior
Systematic desensitization
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A method for terminating the connection between a stimulus
and an inappropriate response
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Relaxation replaces sexual arousal
Copyright 2008 Allyn & Bacon
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Treatment of Paraphilias
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Aversion therapy
A method for terminating undesirable sexual
behavior in which the behavior is paired repeatedly
with an aversive stimulus such as electric shock so
that a conditioned aversion develops
 Covert sensitization
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A form of aversion therapy in which thoughts of engaging in
undesirable behavior are paired repeatedly with imagined
aversive stimuli
 Used with pedophiles, a paraphilia involving sexual
interest in children
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Treatment of Paraphilias
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Social skills training
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Behavior therapy methods for building social skills
that rely on a therapist’s coaching and practice
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Used to help individuals relate to the other gender
Orgasmic reconditioning
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A method for strengthening the connection between
sexual arousal and appropriate sexual stimuli by
repeatedly pairing the desired stimuli with orgasm
Copyright 2008 Allyn & Bacon
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Treatment of Paraphilias
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Medical Approaches
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Selective serotonin reuptake inhibitors (SSRIs)
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Used to treat exhibitionism, voyeurism, and fetishism
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May treat the obsessive-compulsive quality of paraphilias
Anti-androgen drug
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A chemical substance that reduces the sex drive by lowering
the level of testosterone in the bloodstream
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Depo-Provera is used in the treatment of sex offenders
 Suppresses, but does not eliminate, sexual desire in men
Unlike surgical castration (removal of the testes), the effects of
this treatment can be reversed.
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