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PARAPHILIAS

Paraphilias are problems with controlling impulses that are characterized
by recurrent and intense sexual fantasies, urges, and behaviors involving
unusual objects, activities, or situations not considered sexually arousing to
others.

Characterized by:

• Infliction of pain or humiliation to self, partner, children or other
nonconsenting individuals
• That has lasted for at least six months
• Has resulted in severe distress in impairment in normal functioning.

• These objects, activities or situations often are necessary for the
person's sexual functioning.
• Someone with a paraphilia may be referred to as "kinky" or
"perverted," and these behaviors may have serious social and legal
consequences.

Types of Paraphilias:
Exhibitionism ("Flashing")

• Exhibitionism is characterized by intense, sexually arousing fantasies,
urges or behaviors involving exposure of the individual's genitals to
an unsuspecting stranger.
• The individual with this problem, sometimes called a "flasher," feels a
need to surprise, shock or impress his victims.
• The condition usually is limited to the exposure, with no other harmful
advances made, (although "indecent exposure" is illegal).
• Actual sexual contact with the victim is rare. However, the person
may masturbate while exposing himself or while fantasizing about
exposing himself.

Paraphilias1

women's shoes. Frotteurism • With this problem. the focus of the person's sexual urges is related to touching or rubbing his genitals against the body of a non-consenting. often in a crowded public location. unless it is necessary for the individual to become sexually aroused or experience sexual climax. sexual relationships often are avoided. The person becomes sexually aroused by wearing or touching the object. the object of a fetish could be an article of clothing.Fetishism • People with this problem have sexual urges associated with non- living objects. or women's underwear or lingerie. rubber clothing. unfamiliar person. • In most cases of frotteurism. • The sexual arousal usually does not involve a real partner. Transvestism • Transvestism. involves becoming sexually aroused by a body part. • A related disorder. a male rubs his genital area against a female. such as underwear. but includes the fantasy that the individual is the female partner. • When the fetish becomes the sole object of sexual desire. • Some men wear only one special piece of female clothing. such as underwear. including hair style and make-up. such as the feet. while others fully dress as female. • The fetish may replace sexual activity with a partner or may be integrated into sexual activity with a willing partner. • This disorder also is a problem because the contact made with the other person is illegal. • For example. called partialism. or transvestic fetishism. • Cross-dressing itself is not a problem. breasts or buttocks. Pedophilia Paraphilias2 . as well. refers to the practice by heterosexual males of dressing in female clothes to produce or enhance sexual arousal.

" and actual pain and injury is avoided.such as cutting or piercing their skin.  This activity constitutes rape and is a felony offense punishable by imprisonment.  Age of pedophile is set at 16 years old or more  Age difference between the offender and the victim set at 5 years or more o When the victim is postpubertal. touching or fondling the child's genitals and forcefully performing sexual acts on the child. • Activities with a partner include bondage. Masochists may act out their fantasies on themselves -. Some pedophiles limit their activity to their own children or close relatives (incest). or burning themselves -. Health care providers are legally bound to report such abuse of minors. not simulated) of being humiliated. the humiliation and abuse are acted out in fantasy. • Predatory pedophiles may use force or threaten their victims if they disclose the abuse. • Some pedophiles are sexually attracted to children only (exclusive pedophiles) and are not attracted to adults at all. encouraging the child to watch the abuser masturbate. beaten or otherwise made to suffer in order to achieve sexual excitement and climax. • The participants are aware that the behavior is a "game. • Sadomasochistic fantasies and activities are not uncommon among consenting adults. while others victimize other children. • These acts may be limited to verbal humiliation. In most of these cases. urges or behaviors involving the act (real. Paraphilias3 . or may involve being beaten. • Pedophilic behavior includes undressing the child.or may seek out a partner who enjoys inflicting pain or humiliation on others (sadist). spanking. • People with this problem have fantasies. bound or otherwise abused. the disorder is labeled as child molestation or ephebophilia Sexual Masochism • Individuals with this disorder use sexual fantasies. urges or behaviors that involve illegal sexual activity with a prepubescent child or children (generally age 13 years or younger). and simulated rape. however.

in which a person uses ropes. • At its most extreme. • In some cases. rape involves a combination of sex and gaining power over the victim. nooses or plastic bags to induce a state of asphyxia (interruption of breathing) at the point of orgasm. These individuals need intensive psychiatric treatment and may be jailed for these activities. for example. Voyeurism ("Peeping Tom") • This disorder involves achieving sexual arousal by observing an unsuspecting and non-consenting person who is undressing or unclothed. rough sex. the infliction of suffering is not the motive for most rapists. but accidental deaths sometimes occur. Sexual Sadism • Individuals with this disorder have persistent fantasies in which sexual excitement results from inflicting psychological or physical suffering (including humiliation and terror) on a sexual partner. • A potentially dangerous. in which case the death of the victim produces sexual excitement. This is done to enhance orgasm." • Other rarer paraphilias are grouped together under Other paraphilias not otherwise specified (ICD-9-CM equivalent of "Sexual Disorder NOS") and include telephone scatalogia (obscene phone calls). and even murder. Paraphilias4 . sometimes fatal. Rather. sexual sadists are able to find willing partners to participate in the sadistic activities. masochistic activity is autoerotic partial asphyxiation. Other names for this behavior are "peeping" or "peeping Tom. sexual sadism involves illegal activities such as rape. The voyeur does not seek sexual contact with the person he is observing. • This disorder is different from minor acts of aggression in normal sexual activity. torture. and the victim's pain generally does not increase the rapist's sexual excitement. • This behavior may conclude with masturbation by the voyeur. It should be noted that while rape may be an expression of sexual sadism. and/or engaged in sexual activity.

only 60 to 80 percent of men benefit from this type of drug.reducing impulse control problems and/or sexual obsessions • Tricyclic antidepressants (TCA) Paraphilias5 . and personality. and magnitude of spontaneous and nocturnal erections. • The deviant sexual fantasies. duration. urophilia(urine). such as Triptorelin (Trelstar) which reduces the release of gonadotropin hormones. reducing testosterone secretion or inhibiting its action is believed to control these symptoms. partialism (exclusive focus on one part of the body). Psychoactive drug treatments • Selective serotonin reuptake inhibitor (SSRI) . aggression. Therefore. o Even if compliance is good. • Long-acting gonadotropin-releasing hormones. Hormone drug treatments • testosterone has a crucial role not only in the development and maintenance of male sexual characteristics but also in the control of sexuality. klismaphilia (enemas). o efficacy is limited and they have many unpleasant side effects (breast growth. cognition. and reduction in bone density). and behavior of men with paraphilias also appear to be triggered by testosterone. and it increases the frequency. necrophilia (corpses). coprophilia (feces). are also used. zoophilia (animals). urges. emotion. emetophilia (vomit). and behavior. This drug is a synthetic hormone which may also lead to reduced sex drive. Testosterone is a major determinant of sexual desire. fantasies. • Antiandrogenic drugs such as medroxyprogesterone (also known as the long-acting contraceptive Depo Provera) have been widely used to reduce sex drive. weight gain. headaches.

the mood-stabilizing drug also known as Eskalith is typically used for the treatment of mania in bipolar disorder. o There are some reports of reduced sexual compulsive behavior and a reduction in obsessive sexual thoughts in patients Etiology: a. • Lithium. temporal lobe disorders. Biologic Factors: destruction of the parts of the limbic system. abnormal levels of androgens b. meimom ongan Paraphilias6 . Psychoanalytic theory: failure to resolve oedipal conflict. identification with parent of the opposite sex or selection of inappropriate object for libidinal cathexis.