Paraphilic Disorder and Sexual

Variants

1
 What are normal sexual interests?
 “Normal” varies according to who you and
where you are.
– Statistical approach – unconventional behaviors are
labeled “sexual minorities.”
– Sociological approach – is the behavior customary
in a given society?
– Psychological approach – focus is on the mental
health of the individual; does it make him feel
distressed or cause problems in ordinary social
functioning?

2
 Paraphilic Disorders

 Characterized by recurrent, intense sexually

arousing fantasies, sexual urges, or behaviors
that generally involve:
– Abnormal targets of sexual attraction (shoes,
children)
– Unusual courtship behaviors (watching others
undress without their knowledge)
– The desire for pain and suffering of oneself or
others

3
 Paraphilic Disorders

 Not all unusual behaviors will be diagnosed as

paraphilic; the distinguishing feature of a
paraphilia is that the person’s sexual arousal
and gratification depends almost exclusively on
acting or fantasizing about the behavior.
 In nearly all cases, the paraphilia will either
cause or reveal harm done to the individual or
to others, and there is generally an obsessive-
compulsive quality to the behavior/fantasy.
4
 Paraphilic Disorders

5
 Voyeurism
 Watching others do sexual things is
a normal sexual variant.
 Voyeurs seek to observe people
without their consent or knowledge
and find this to be their preferred
form of sexual arousal and
gratification even if consenting
sexual partners are available.
 Most begin by age 15, have low
self-esteem, feelings of
inadequacy, poor social skills.
6
 Are voyeurs dangerous?

 Generally not, unless he tries to draw attention

to the fact that he is watching you or tries to
enter your building. Most prefer to stay hidden.
 Most have a history of great difficulty in
heterosexual relationships. They are
emotionally immature; this is a behavior for an
ill-behaved 12-year-old, not a 24 year old.
 Scoptophilia differs from voyeurism in that the
persons being watched have consented.
7
 https://www.youtube.com/watch?
v=0kG_dF2e6Gc&ab_channel=GMAPublicAffairs

8
 Exhibitionism

 “Streaking” or “mooning” represent playful

deviance. Doing a strip-tease for your lover is
a normal variant.
 Exhibitionists engage in showing their genitals
to unsuspecting strangers (“flashing”)
compulsively; sexual arousal from the fearful,
angry or surprised response is their preferred
means of gratification.
 Most flasher victims are women and children.
9
 Exhibitionists – Who are they?
 Almost all are men (nobody is
scared when a woman shows her
genitals) who began exposing
themselves in their late teens or
early 20s; half or more have been or
are married.
 They are emotionally immature, feel
inadequate, fear rejection and have
trouble forming intimate
relationships.
 Most are have normal or above
normal intelligence.

10
 Are they dangerous?
 A small number of rapists engaged in
exhibitionism when younger, but for the most
part, they are a different group of men.
 Because their erotic turn-on is directly related
to the victim’s expression of shock, disgust and
fear, the best way to avoid reinforcing this
behavior is to give no facial or verbal response;
just leave quietly and report the incident
immediately.

11
 Telephone scatologia
 Making an obscene phone call is a verbal form
of exhibitionism; like exhibitionism, it is a
disorder of the affiliative phase of courtship.
 Sexual arousal is proportionate with the
victim’s negative reaction. Even slamming
down the phone is reinforcing to him.
 Different types: shock caller, ingratiating
seducer, and trickster.
 It is rare that they would approach or molest
their victims; most prefer total anonymity.
12
 Frotteurism
 Rubbing one’s genitals against
unconsenting people in public
while fully clothed (tactile phase
disorder).
 Although many men have tried this
a time or two, the behavior is only
considered paraphilic if engaged in
repeatedly as the preferred form of
sexual behavior.
 Frotteurists seek out crowded
buses or other places where
bumping into strangers is not likely
to cause them to be arrested.
13
 Pedophilia
 The adult’s sexual arousal and
gratification depends primarily or
exclusively on having sexual
relations with children;
 It is usually first recognized in
adolescence
 An isolated case of child
molestation will not warrant the
diagnosis of pedophile; this must be
repeated and preferred behavior.
 Pedophilia is often comorbid with
the other courtship disorders.

14
 Pedophilia
 Nearly all individuals with
pedophilia are male and about two-
thirds of victims are girls
 Homosexual pedophilic sex
offenders tend to have more
victims than heterosexual
pedophilic sex offenders
 Not all men with pedophilia molest
children

15
 Fetishism, transvestism
and related paraphilias
 Erotic fetishism – achieving
sexual arousal and gratification
almost exclusively by handling or
fantasizing about an inanimate
object (i.e., rubber boots, high-
heeled shoes, panties, leather,
stockings, etc.).
 Partialism – sexual arousal
focusing exclusively on a specific
part of the body, such as the feet.
 Classical and/or operant
conditioning may be the cause of
these fascinations.
16
 What if I enjoy leather teddies?

 Most heterosexual men are aroused by

women’s panties, and many men and women
have favorite sexy outfits or favorite body parts,
but these are only tools for arousal and not
their primary sexual focus.
 For the truly paraphilic fetishist, the woman
wearing the panties or high heels is only a
vehicle for the fetishistic object.
 Fetishists rarely seek treatment on their own.
17
 Transvestism
 There are several reasons a person may choose
to cross-dress, but for the transvestite the
purpose is sexual arousal and gratification.
 The large majority of transvestites are
heterosexual and most are married.
 Autogynephilia refers to a paraphilic sexual
arousal by the thought or fantasy of being a
woman
 Reasons vary and may include -
– Escape from the confines of the masculine role
– Finding comfort in the fantasy of being female
– Reaction to being punished as a child by being made to
dress as a girl; or being encouraged to dress as a girl.
18
 Fetish-like paraphilias
 Urophilia – arousal by urination
 Coprophilia – arousal by excrement
 Mysophilia – arousal by filth (sweaty socks, tampons)
 Beastiality – arousal through sexual contact with
animals; most who have done this have done so only a
few times as adolescents
 Zoophilia – when beastiality is preferred; usually
horses or dogs; oral-genital sex is most common,
vaginal sex 2nd, masturbating the animal 3rd, receiving
intercourse from the animal 5th.
19
20
 Sexual Sadism
 Sadism – arousal from infliction of pain
on another person
– Derived from the name of Marquis
de Sade (1710-1814)
 Sadistic fantasies include themes of
dominance, control, and humiliation
 Bondage and discipline may include
tying a person up, hitting or spanking to
enhance sexual excitement
 Victim is nonconsenting
 Sexual sadism have comorbid disorders
21
 Sexual Masochism
 Masochism – arousal from being
dominated and made to experience
pain
– Derived from the name of Leopold
Sacher-Masoch (1836-1895)
 Sexual stimulation and gratification
from the experience of pain and
degradation in relating to a lover

22
 Sadomasochism (S&M)
 In its extreme (paraphilic) form,
masochism is more common
than sadism, and male sadists
far outnumber female sadists.

 Dominatrixes- women who wear

tight leather or rubber outfits and
are paid to inflict pain and
humiliation in a sexually charged
sense

23
 Dominance and submission (D&S)
 In their milder forms S&M are very common as
sexual variants between consenting partners.
 Rather than extreme pain, the distinctive
feature of this role-playing sex game is
domination (or discipline) and submission. Pain
is erotically arousing only as part of the
agreed-upon ritual or “script.”
 Mutual consent, trust, concern for each other’s
safety, sexual and emotional pleasure are
characteristics of healthy S&M (D&S) “play.”
24
 Who plays these “games?”

 Most are socially well adjusted but close to 1/3

report extreme nervous anxiety.
 Ratio of men to women is 2:1; heterosexual,
well educated (often with prominent careers),
and also enjoy “ordinary” sexual activities.
 Dominators – master/mistress, top
 Submissives – slave, bottom
 Role play that is contradictory to social norms.
25
 Other paraphilias
 Necrophilia – arousal from having sex with dead
bodies
– Most are men; most are believed to be severely emotionally
disturbed or psychotic
 Autoerotic asphyxiation – individuals deprive
themselves of oxygen when highly sexually aroused in
hopes of intensifying orgasm.
– Unfortunately 500 – 1000 deaths occur annually.

26
 What causes paraphilias?

 Freudian theorists – arrested psychosexual

development early in childhood; defense
mechanisms develop to reduce anxiety.
 Learning theorists – classical conditioning
(association of an object with sexual arousal)
or operant conditioning (early unusual sexual
experiences are reinforced by orgasm).
 Paraphilias and obsessive-compulsive disorder
have many similarities.
27
 Why are they so often male?
 Attitudes about and expectations of men and
women are different; consider women
“flashing” or cross-dressing.
 Most paraphiliacs are heterosexual, but
generally have poor social skills, low self-
esteem, history of childhood abuse or neglect
(or were raised in families where sex was
thought to be evil and normal erotic
development was inhibited), and anger at
women.
28
 Understanding paraphiliacs
 Men in our culture are expected to be the
sexual initiators but conventional sexual
relationships are too complex and threatening
for most paraphiliacs, who need to have a
great deal of control in order to become
aroused.
 In a social systems perspective, the need for
some men to dominate women might
encourage unusual means for becoming
aroused in order to ensure against failure.
29