Atypical Sexual
Variations
Chapter 17
Learning Objectives
• Normal versus Deviant Sexual Behavior
• The Paraphilias
• Theoretical Perspectives
• Treatment of Paraphilias
Normal vs. Deviant Behavior
Defining Normal Sexual Behavior
• Statistical norms
• Cultural considerations
• Persistent preference for non-genital
sexual outlets
• Atypical variations
• Unusual patterns of arousal or
behavior that individuals or society
view as problematic
Critical Thinking
Why is statistical rarity
an inadequate standard
for considering a sexual
practice to be normal
or abnormal?
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
• 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 crossdress
• 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”
• Victims may experience negative psychological consequences
• Exhibitionists usually are not physically threatening
• Often lonely and sexually repressed
• Some progress to more serious crimes of sexual aggression
Critical Thinking
Critical thinkers
pay closer
attention to
definitions.
Why are (most)
strippers and
nude sunbathers
not exhibitionists?
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
• Hypoxyphilia
• Person seeks to enhance sexual arousal, usually during
masturbation, by becoming deprived of oxygen
• 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
Sexual Sadism
• Characterized by the desire or need to inflict pain or
humiliation on others to enhance sexual arousal
• 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 US
• S&M fantasies likely begin in childhood
The Paraphilias
Frotteurism
• Characterized by rubbing against or touching a
non-consenting person
• Often takes place in crowded places such as
buses, subways, or elevators
• Also known as “mashing” or “groping”
• Reported exclusively among males
• Toucherism
• Related to frotteurism and characterized by
the persistent urge to fondle non-consenting
strangers
The 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 – sex with a dead person
• Necrophilic homicide – commit murder to obtain corpse for
sexual purposes
• Necrophilic fantasy – fantasizes about sex with corpse
• Rare paraphilia & necrophiles are seriously disturbed
The Paraphilias
Less common paraphilias
Klismaphilia
Coprophilia
• Sexual arousal is
derived from the use
of enemas
• 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
• Some studies show that many paraphiliacs have
higher sex drive
• 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
Critical Thinking
If people with paraphilias have
powerful urges to engage in
“deviant” behavior due to
biological forces or unconscious
fears, can they be expected to
control their behavior?
Theoretical Perspectives
Cognitive-Behavioral 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
•Social context
•Effects of the group
•Society in general
Theoretical Perspectives
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
Critical
Thinking
Is it ethical for
mental-health
professionals to
work with clients
who do not want
treatment?
Treatment of Paraphilias
Psychoanalytic
Psychotherapy
• Focuses on
resolving
unconscious
conflicts
CognitiveBehavioral Therapy
• Focuses directly
on changing
behavior
Cognitive-Behavioral Treatment of Paraphilias
Systematic
desensitization
• A method for
terminating the
connection between
a stimulus and an
inappropriate
response
• Relaxation replaces
sexual arousal
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
Cognitive-Behavioral 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
Medical Treatment of Paraphilias
Selective serotonin reuptake
inhibitors (SSRIs)
• Used to treat exhibitionism,
voyeurism, and fetishism
• May treat the obsessivecompulsive 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