Atypical Sexual Variations • • • • Normal Versus Deviant Sexual Behavior The Paraphilias Theoretical Perspectives Treatment of the Paraphilias Normal Versus Deviant Sexual Behavior • Defining Normal Sexual Behavior – Frequency of the behavior – Cultural considerations – Persistent preference for nongenital sexual outlets – Atypical variations • Unusual patterns of arousal or behavior The Paraphilias • Paraphilia – A diagnostic category used by the American Psychiatric Association • 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 The Paraphilias • Fetishism – Inanimate object elicits sexual arousal • Common objects are articles of clothing and materials made of rubber, leather, silk, or fur. – Partialism • Related to fetishism in which sexual arousal is exaggeratedly associated with a particular body part – Such as feet, breasts, or buttocks – Most fetishes and partialisms are harmless. The Paraphilias • Transvestism – 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. • Both gay and heterosexual males report transvestism. – It is not the same as transsexualism. • 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 – A fetish in which men are sexually stimulated by fantasies that their own bodies are female The Paraphilias • Exhibitionism – Urges and fantasies involving exposing one’s genitals to unsuspecting strangers • Provides sexual arousal or gratification • Urges are either acted upon or are disturbing – Exposure to exhibitionism is common. • A sample of college women found that one-third had been approached by a “flasher.” – Exhibitionists usually are not physically threatening. • Victims may experience negative psychological consequences. • Often lonely and sexually repressed • Some progress to more serious crimes of sexual aggression The Paraphilias • Obscene Telephone Calling – Sexual arousal results from shocking victims – Telephone scatologia • A DSM label for a paraphilia characterized by the making of obscene telephone calls – Usually socially inadequate heterosexual men • Voyeurism – 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 The Paraphilias • Sexual Masochism – Characterized by the desire or need for pain or humiliation to enhance sexual arousal – Bondage • 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. The Paraphilias – Hypoxyphilia • Person seeks to enhance sexual arousal, usually during masturbation, by becoming deprived of oxygen • Sexual Sadism – Characterized by the desire or need to inflict pain or humiliation on others to enhance sexual arousal The Paraphilias • Sadomasochism (S&M) – 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. The Paraphilias • Frotteurism – 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” – Reported exclusively among males • Toucherism – Related to frotteurism and characterized by the persistent urge to fondle nonconsenting strangers The Paraphilias • Other Paraphilias – Zoophilia • Characterized by urges and fantasies involving sexual contact with animals • Bestiality – Involves actual sexual contact with an animal – Necrophilia • Characterized by desire for sexual activity with corpses • 3 types – 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 The Paraphilias – Less common paraphilias • Klismaphilia – Sexual arousal is derived from the use of enemas • Coprophilia – Sexual arousal is attained in connection with feces • Urophilia – Sexual arousal is associated with urine • These paraphilias may have childhood origins. Theoretical Perspectives • Biological Perspectives – Examines factors such as the endocrine system and the nervous system • Electroencephalograph (EEG) data show that paraphilic men’s brains respond differently to sexual stimuli and paraphilic stimuli compared to control subjects. Theoretical Perspectives • Psychoanalytic Perspectives – Paraphilias are psychological defenses. • Usually against unresolved castration anxiety due to the Oedipus complex • Suppressed or repressed feelings of sexual guilt and shame • Learning-Theory Perspectives – Paraphilias are learned behaviors acquired through experience. • An object or situation may be associated with sexual arousal, fantasies, or orgasm – Modeling or observational learning also may play a role. Theoretical Perspectives • Sociological Perspectives – Focus on the social context, the effects of the group, and society in general • An Integrated Perspective: The “Lovemap” – Acknowledges the multiple origins of paraphilias – Money (2000) proposes that childhood experiences create a lovemap • A mental representation of the idealized lover and the idealized erotic activity with the lover • Lovemaps can become distorted by early traumas. Treatment of Paraphilias • Issues in treatment – 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 Treatment of Paraphilias • Psychoanalytic Psychotherapy – Focuses on resolving unconscious conflicts, typically Oedipal, believed to lead to pathologies such as paraphilias • Cognitive-Behavioral Therapy – Focuses directly on changing behavior – Systematic desensitization • A method for terminating the connection between a stimulus and an inappropriate response – Relaxation replaces sexual arousal Treatment of Paraphilias – 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 – 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 Treatment of Paraphilias – Social skills training • Behavior therapy methods for building social skills that rely on a therapist’s coaching and practice – Used to help individuals relate to the other gender – Orgasmic reconditioning • A method for strengthening the connection between sexual arousal and appropriate sexual stimuli by repeatedly pairing the desired stimuli with orgasm Treatment of Paraphilias • Medical Approaches – Selective serotonin reuptake inhibitors (SSRIs) • Used to treat exhibitionism, voyeurism, and fetishism – May treat the obsessive-compulsive quality of paraphilias – Anti-androgen drug • A chemical substance that reduces the sex drive by lowering the level of testosterone in the bloodstream – 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.