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Paraphilia

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Paraphilia (in Greek para παρά = besides and -philia φιλία = love)—in psychology and sexology, is a term that describes a family of persistent, intense fantasies, aberrant urges, or behaviors involving sexual arousal to nonhuman objects, pain or humiliation experienced by oneself or one's partner, children or other nonconsenting individuals or unsuitable partners. Paraphilias may interfere with the capacity for reciprocal affectionate sexual activity. [1] Paraphilia is also used to imply non-mainstream sexual practices without necessarily implying dysfunction or deviance (see Clinical warnings section). Also, it may describe sexual feelings toward otherwise non-sexual objects.

Contents

[edit] Clinical views of paraphilias

There is much debate about what (if anything) should constitute a paraphiliac, and how these should be clinically classified (see Controversy, below).

[edit] Clinically recognized paraphilias

Clinical literature discusses eight major paraphilias individually.[2] According to the Diagnostic and Statistical Manual of Mental Disorders, the activity must be the sole means of sexual gratification for a period of six (6) months, and either cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning" or involve a violation of consent to be diagnosed as a paraphilia.[3]

  • Exhibitionism: the recurrent urge or behavior to expose one's genitals to an unsuspecting person.
  • Fetishism: the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement. Partialism refers to fetishes specifically involving nonsexual parts of the body.
  • Frotteurism: the recurrent urges or behavior of touching or rubbing against a nonconsenting person.
  • Pedophilia: the sexual attraction to prepubescent or peripubescent children.
  • Sexual Masochism: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer for sexual pleasure.
  • Sexual Sadism: the recurrent urge or behavior involving acts in which the pain or humiliation of the victim is sexually exciting.
  • Transvestic fetishism: a sexual attraction towards the clothing of the opposite gender. (Compare to autogynephilia.)
  • Voyeurism: the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or may not be sexual in nature at all.
  • 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), necrophilia (corpses), partialism (exclusive focus on one part of the body), zoophilia (animals), coprophilia (feces), klismaphilia (enemas), urophilia (urine), emetophilia (vomit).
Literature also documents many other paraphilias, both common and rare.

[edit] Intensity and specificity

Clinicians distinguish between optional, preferred and exclusive paraphilias, though the terminology is not completely standardized. An "optional" paraphilia is an alternative route to sexual arousal. For example, a man with otherwise unremarkable sexual interests might sometimes seek or enhance sexual arousal by wearing women's underwear. In preferred paraphilias, a person prefers the paraphilia to conventional sexual activities, but also engages in conventional sexual activities. For example, a man might prefer to wear women's underwear during sexual activity, whenever possible. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia.

Optional paraphilias are far more common than preferred paraphilias, which are, in turn, far more common than exclusive paraphilias.

Optional paraphilias sometimes disrupt stable relationships when discovered by an unsuspecting partner. Preferred paraphilias often disrupt otherwise stable relationships. Open communication and mutual support can minimize or prevent such disruption in both of these cases. Exclusive paraphilias often preclude normal courtship and committed romantic relationships, even when the person in question desires such a relationship. Loneliness or social isolation are common consequences. In extreme cases, preoccupation with a preferred or exclusive paraphilia completely displaces the more typical desire for loving human relationships.

[edit] Psychology of paraphilias

[edit] Behavioral imprinting

Observation of paraphiliac behavior has provided valuable scientific information on the mechanisms of sexual attraction and desire, such as behavioral imprinting. Careful investigation has also led to the tentative conclusions that normal biological processes may sometimes be manifested in idiosyncratic ways in at least some of the paraphilias, and that these unusual manifestations are frequently associated with unusual (and especially traumatic) events associated with early sexual experience. They tend to be caused by classical conditioning in that a sexual stimulus has been paired with stimuli and situations that do not typically result in sexual response and has then been perpetuated through operant conditioning because the sexual response is its own reward or positive reinforcement.

[edit] Non-clinical views on paraphilias

[edit] Religious views

Some religious adherents view various paraphilias as deviations from a divine plan for human sexuality, as understood through their religious tradition or laws. Depending in part on the nature of the paraphilia in question, judgements can differ as to whether religiously it should be considered a case of sexual sin, mental illness, or simply harmless sexual variation. Another variable is whether it is the acting out, or (less commonly) just the desirous thought alone, which is critically viewed in such cases. In any event, several paraphilias, as with many other behavior patterns outside the mainstream, are viewed negatively by various religions.

Some religious traditions include forms of extreme asceticism, such as whipping , which, when practiced as sexual activities, would usually be considered masochism and popularly viewed as paraphilias. When practiced for non-sexual reasons, they are usually valued by the religious groups concerned as a part of their religious observance and submission to God.

[edit] Legal views

Main article: Sex and the law

As a general rule, the law in many countries often intervenes in paraphilias involving young or adolescent children below the legal age of consent, nonconsensual deliberate displays or illicit watching of sexual activity, consensual sex with animals, illegal manipulation of dead people, harassment, nuisance, fear, injury, or assault of a sexual nature. Separately, it also usually regulates or controls censorship of pornographic material.

Exhibitionism, in cases where people who have not previously agreed to watch are exposed to sexual display, is also an offense in most jurisdictions, as is voyeurism when unarranged (see indecent exposure and peeping tom).

Non-consensual sadomasochistic acts may legally constitute assault and therefore belong in the list below. Some jurisdictions criminalize some or all sadomasochistic acts, regardless of legal consent, and impose liability for any injuries caused. For these purposes, non-physical injuries are included in the definition of grievous bodily harm in English law. (See Consent (BDSM), Operation Spanner)

The paraphilias listed below may carry a condition of illegality in some areas, even when they are performed between consensual partners.

The paraphilias listed below, that cannot involve consent since they involve non human animals or objects, may carry a condition of illegality in some areas:

  • Necrophilia: sexual attraction to corpses
  • Zoosadism: sexual attraction to torturing or killing animals
  • Zoophilia: emotional or sexual attraction to animals

[edit] Paraphilia in popular culture

In the late twentieth and early twenty-first century, previously censored or stigmatized images of many paraphilias became more prevalent in the popular culture of Western countries.

  • Zoophilia: Sex with animals has been a theme in a number of popular comedies, including Bachelor Party, Clerks II, and The 40-Year-Old Virgin. All these movies present the paraphilia as funny rather than erotic,[citation needed] as something ordinary young men are curious about but in the end find disgusting;[citation needed] in a minority of films and documentaries, the subject is given serious or thoughtful treatment.[citation needed] In all three movies the animal involved is an equine. In an episode of The Simpsons, Troy McClure acknowledges being sexually attracted to fish; his career had been damaged following an unspecified incident at an aquarium.

[edit] Controversy over the term

The definition of various sexual practices as paraphilias has been met with opposition. Advocates for changing these definitions stress that there is nothing inherently pathological about non-criminal paraphilic practices, and they are stigmatized by being lumped together with crimes. Those who profess such a view hope that, much as with the removal of homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (see homosexuality and psychology), future psychiatric definitions will not include most of these practices, or that consensual paraphilias will be clearly separated from nonconsensual paraphilias.

[edit] Drug treatment of paraphilias

The treatment of men with paraphilias and related disorders has been challenging for patients and clinicians. In the past, surgical castration was advocated as a therapy for men with paraphilias, but it was abandoned because it is considered a cruel punishment and is now illegal in most countries. Psychotherapy, self-help groups, and pharmacotherapy (including the controversial hormone therapy sometimes referred to as "chemical castration") have all been used but are often unsuccessful. Here are some current drug treatments for these disorders.

[edit] Hormone drug treatments

In humans, testosterone has a crucial role not only in the development and maintenance of male sexual characteristics but also in the control of sexuality, aggression, cognition, emotion, and personality. Testosterone is a major determinant of sexual desire, fantasies, and behavior, and it increases the frequency, duration, and magnitude of spontaneous and nocturnal erections. The deviant sexual fantasies, urges, and behavior of men with paraphilias also appear to be triggered by testosterone. Therefore, reducing testosterone secretion or inhibiting its action is believed to control these symptoms.

Antiandrogenic drugs such as medroxyprogesterone (also known as the long-acting contraceptive Depo Provera) have been widely used as therapy in these men to reduce sex drive. However, their efficacy is limited and they have many unpleasant side effects, including breast growth, headaches, weight gain, and reduction in bone density. Even if compliance is good, only 60 to 80 percent of men benefit from this type of drug. Long-acting gonadotropin-releasing hormones, such as Triptorelin (Trelstar) which reduces the release of gonadotropin hormones, are also used. This drug is a synthetic hormone which may also lead to reduced sex drive.

[edit] Psychoactive drug treatments

Selective serotonin reuptake inhibitor (SSRI) class of antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and paroxitine (Paxil), have all been used to treat paraphilias and related disorders by reducing impulse control problems and/or sexual obsessions with some success. SSRIs work by selectively inhibiting presynaptic serotonin reuptake with minimal effect on levels of norepinephrine or dopamine.

Tricyclic antidepressants (TCA), such as imipramine (Tofranil) and desipramine (Norpramin), inhibit the reuptake of serotonin and noradrenaline, and can also modify the activity of glutamatergic neurons. This effect is caused by blocking the reuptake pumps in monoamine nerve synapses, extending the length of time neurotransmitters remain in the synapse and increasing their concentration. OCD responds preferentially to the TCA clomipramine (Anafranil), which is relatively selective for serotonin reuptake. Concern about these medications, however, persist as a result of their extensive side-effects, drug interactions, and toxicity when taken in excess.

Lithium, the mood-stabilizing drug also known as Eskalith is typically used for the treatment of mania in bipolar disorder. There are some reports of reduced sexual compulsive behavior and a reduction in obsessive sexual thoughts in patients, which they attribute to the drug's enhancement of serotonergic functioning.

Anxiolytics are not considered a typical treatment for these type of disorders, however the efficacy of buspirone (BuSpar) has been clinically demonstrated.

Psychostimulants have been used recently to augment the effects of serotonergic drugs in paraphiliacs. In theory, the prescription of a psychostimulant without pretreatment with an SSRI might further disinhibit sexual behavior, but when taken together, the psychostimulant may actually reduce impulsive tendencies. Methylphenidate (Ritalin) is a type of amphetamine used primarily to manage the symptoms of attention deficit hyperactivity disorder (ADHD). Recent studies imply that methylphenidate may also act on serotonergic systems; this may be important in explaining the paradoxical calming effect of stimulants on ADHD patients. Amphetamine is also used medically as an adjunct to antidepressants in refractory cases of depression.

(Source: BrainPhysics About Sexual Compulsions)

[edit] List of paraphilias

Also see article -philia for "-philias" in other fields

Used in a sexual context, terms with the -philia suffix refer to conditions in which the person's primary sexual interest involves the stimulus or situation mentioned (the suffix is also used for non-sexual interest in or admiration of a subject). Terms with the -lagnia suffix refer to an action involving the stimulus or situation. For example, someone who is consistently sexually excited by feces would have coprophilia; any sexual act involving feces, even by someone for whom that is not a primary interest, would be coprolagnia.

The following terms mostly represent combinations of Greek or Latin words or roots, but few qualify as clinical paraphilias. Some of the following sexual interests are fairly common, while others are very rare.

  • Abasiophilia: love of (or sexual attraction to) people who are lame or crippled and/or who use leg braces or other orthopaedic appliances
  • Acomophilia: sexual attraction to baldness (also hairless genitalia)
  • Acousticophilia: sexual arousal from certain sounds
  • Adolescentilism: sexual pleasure from acting or dressing like an adolescent; not to be confused with ephebophilia, which is sexual attraction towards adolescents.
  • Ailurophilia: a form of zoophilia—sexual attraction to cats
  • Algolagnia: sexual pleasure from pain
  • Amaurophilia: sexual arousal by a partner whom one is unable to see due to artificial means, such as being blindfolded or having sex in total darkness (see sensory deprivation)
  • Amputee fetishism: divided to acrotomophilia (sexual attraction to amputation or amputees) and apotemnophilia (sexual arousal from having a healthy body part amputated)
  • Anaclitism: sexual arousal from wearing or using baby objects
  • Andromimetophilia (also gynemimetophilia): sexual attraction towards women dressed as men or who have had a sex change operation
  • Anesthesia fetishism: sexual arousal by the idea of anesthesia and the equipment related to its use
  • Apodysophilia: desire to undress (see nudism)
  • Aquaphilia: arousal from water and/or in watery environments, including bathtubs and swimming pools
  • Aretifism: sexual attraction to people who are without footwear, in contrast to retifism
  • Autoabasiophilia: sexual attraction to oneself being lame or crippled
  • Autogynephilia: love of oneself as a woman (see Blanchard, Bailey, and Lawrence theory for discussion on controversy)
  • Autoassassinophilia: sexual arousal from fantasizing about or staging one's own murder
  • Biastophilia: sexual pleasure from committing rape (cf. raptophilia)
  • Blastophilia: sexual pleasure from explosions
  • Blood fetish (also haematophilia): sexual attraction involving blood (either on another person or the liquid itself); not to be confused with haemophilia (a genetic disorder of the blood)
  • Breast expansion fetish: sexual arousal to the gradual or sudden enlargement of breasts
  • Breast fetishism: sexual arousal by a certain size or shape of the breasts or nipples
  • Celebriphilia: pathological desire to have sex with a celebrity
  • Chrematistophilia (also harpaxophilia): sexual arousal from paying for sex or being robbed by one's sexual partner
  • Chronophilia: sexual attraction to a partner of the same chronological age, but whose sexuoerotic age is discordant with that chronological age
  • Cock and ball torture (also phalloorchoalgolagnia): sexual arousal by the administration of painful stimuli to the male genitals
  • Coprophilia: sexual attraction to (or pleasure from) feces
  • Covert incestiphilia: arousal from non-contact sexual behavior with a child
  • Crush fetish: sexual arousal from seeing small creatures being crushed by members of the opposite sex, or being crushed oneself
  • Dacryphilia: sexual pleasure in eliciting tears from others or oneself
  • Dendrophilia: sexual attraction to trees and other large plants
  • Diaper fetishism (also autonephioplia): sexual arousal from diapers
  • Doll fetish (also pediophilia): sexual attraction to dolls
  • Emetophilia (also vomerophilia): sexual attraction to vomiting
  • Endytophilia: preferring to have sexual activity while fully clothed
  • Ephebophilia (also hebephilia): sexual attraction towards adolescents
  • Erinaceuannephilia: sexual arousal from hedghehog Annes
  • Erotic asphyxia: sexual attraction from asphyxia (also called "breath control play" or "strangulation"), including autoerotic asphyxiation (see medical warnings).
  • Erotic lactation (also galactophilia or lactophilia): sexual attraction to human milk or lactating women
  • Eproctophilia: sexual attraction to flatulence
  • Exhibitionism (also autagonistophilia or peodeiktophilia): sexual arousal by engaging in sexual behavior in view of third parties (also includes the recurrent urge or behavior to expose one's genitals to an unsuspecting person)
  • Faunoiphilia: sexual arousal from watching animals mate
  • Fecophilia: sexual arousal from defacation or watching a partner defecate, particularly on oneself
  • Fetishism: the use of non-sexual or inanimate objects or part of a person's body to gain sexual excitement. Examples include:
Balloon fetishismBike fetishDental braces fetishismFoot fetishism (podophilia) – Fur fetishismHand fetishismLeather fetishismLipstick fetishismPanty fetishismRubber fetishismShoe fetishismSilk/Satin fetishismSmoking fetishismSneezing fetishismSpandex fetishismSpitting fetishismUniform fetish
  • Fat fetishism (also lipophilia): sexual attraction towards overweight or obese people
  • Food play: sexual arousal from food
  • Formicophilia: sexual attraction to smaller animals, insects, etc. crawling on parts of the body
  • Forniphilia: sexual objectification in which a person's body is incorporated into a piece of furniture
  • Frotteurism: sexual arousal from the recurrent urge or behavior of touching or rubbing against a non-consenting person
  • Garment fetishism: sexual arousal from a type of garment (clothes, uniforms, gloves, leather, socks, etc.)
  • Gastergastrizophilia: sexual arousal derived from the sight of or sensations associated with someone (usually female) receiving punches in the stomach; also known as "bellypunching".
  • Geisiphilia: sexual arousal associated with tasting an unfamiliar flavour; especially a theoretical "original flavour".
  • Gerontophilia: sexual attraction towards the elderly
  • Hebophilia: sexual attraction to adolescents (those who are no longer children, but have not completed puberty)
  • Heterochromophilia: sexual attraction towards people of a different skin colour
  • Homeovestism: sexual arousal by wearing the clothing of one's own gender
  • Human animal roleplay: sexual arousal by having oneself or a partner taking on the role of real or imaginary animal
  • Hybristophilia: sexual arousal to people who have committed crimes, in particular cruel or outrageous crimes
  • Hypephilia: sexual attraction to fabrics
  • Hypnofetishism: sexual arousal to being hypnotized, hypnotizing others or viewing others being hypnotized (usually directed in a popular cultural depiction of mind control, hypnosis or brainwashing)
  • Impregnation fetish: sexual arousal to the possibility or risk of impregnation through unprotected vaginal sex
  • Incestophilia: sexual attraction to a member of one's own family
  • Jock sniffing: sexual arousal from sniffing unlaundered jockstraps
  • Katoptronophilia: sexual arousal from having sex in front of mirrors
  • Kattyphilia: sexual arousal from young, beautiful Greek women
  • Kleptophilia: sexual arousal from stealing things
  • Klismaphilia: sexual pleasure from enemas
  • Koumpounophilia: sexual arousal from buttons
  • Ludophilia: sexual attraction to games (or, in more recent years, video games).
  • Lust murder (also homicidophilia or erotophonophilia): sexual arousal from committing (or trying to commit) murder
  • Macrophilia: sexual attraction to giants or giant body parts (such as breasts and genitalia)—the opposite of microphilia
  • Masochism: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer
  • Medical fetishism: sexual arousal to medicine related objects or activities
  • Microphilia: sexual attraction to miniature people or miniature body parts—the opposite of macrophilia
  • Mysophilia: sexual attraction to soiled, dirty, foul or decaying material
  • Narratophilia: sexual arousal in the use of dirty or obscene words to a partner
  • Navel fetishism: sexual attraction to the human navel
  • Necropedophilia: sexual attraction to the corpses of children
  • Necrophilia: sexual attraction to corpses
  • Nepiophilia (also infantophilia): sexual attraction to children three years old or younger
  • Nyotaimori (Japanese term): sexual arousal by eating sashimi or sushi from the body of a (usually naked) woman
  • Nose fetishism (also nasophilia): sexual attraction to the sight and touch of human noses
  • Oenophilia Sexual arousal from wine
  • Olfactophilia: sexual stimulus with smells or odors
  • Omorashi (Japanese term): sexual arousal to one's or a partner's feeling of having a full bladder
  • Paraphilic infantilism: sexual pleasure from dressing, acting, or being treated as a baby
  • Parthenophilia: sexual attraction to virgins
  • Pecattiphilia: sexual arousal from committing sins or from feeling guilt (also includes stygiophilia—the specific thought of going to hell)
  • Pedophilia: sexual attraction to prepubescent children (British spelling: paedophilia)
  • Pictophilia: sexual attraction to pictorial pornography or erotic art
  • Plushophilia: sexual attraction to stuffed animals
  • Pregnancy fetishism: sexual attraction to childbirth or pregnant women
  • Pyrophilia: sexual arousal through watching, setting, hearing, talking or fantasizing about fire
  • Raptophilia: sexual arousal at the idea of being raped (cf. biastophilia)
  • Robot fetishism: sexual attraction to machines, especially robots or androids
  • Sadism: deriving pleasure, or in some cases sexual arousal from giving pain
  • Salirophila: sexual arousal by ruining (only the appearance of) the object of one's desired partner
  • Savantophilia: sexual arousal to mentally challenged individuals
  • Schediaphilia (also toonophilia): love of (or sexual arousal towards) cartoon characters
  • Shoe fetishism (also retifism): sexual arousal from shoes
  • Sitophilia: sexual arousal by involving food in sex
  • Somnophilia: sexual arousal from sleeping or unconscious people
  • Spectrophilia: sexual attraction to ghosts
  • Statuephilia: sexual attraction to statues or mannequins or immobility
  • Sthenolagnia: sexual arousal from the demonstration of strength or muscles
  • Stigmatophilia: sexual focus on a partner who is tattooed or scarred
  • Symphorophilia: sexual attraction with stage-managing a disaster, such as a traffic accident
  • Robot fetishism (also ASFR or technosexuality): fetishistic attraction to humanoid or non-humanoid robots
  • Technophilia: sexual arousal from techno or technology.
  • Telephone scatologia: being sexually aroused by making obscene phone calls to strangers
  • Telephonicophilia: sexual arousal in explicit phone conversations
  • Teratophilia: sexual attraction to deformed or monstrous people
  • Tickling fetishism (also acarophilia): sexual pleasure from being tickled or the sensation of itching
  • Tightlacing: sexual arousal by wearing or having a partner wear a tightly laced corset
  • Tamakeri (Japanese term): sexual arousal from having a male kicked in the testicles by a woman
  • Total enclosure fetishism: sexual arousal by having the entire body enclosed in a certain way
  • Transformation fetish: sexual arousal from depictions of transformations of people into objects or other beings
  • Transvestic fetishism (also transvestism): sexual arousal by wearing the clothing of the opposite gender
  • Trichophilia: sexual arousal from hair
  • Troilism: sharing a sexual partner with another person while looking on
  • Urolagnia: sexual attraction to urine, including urinating in public, urinating on others, and being urinated on by others
  • Urophagia: sexual attraction to drinking urine or watching others drink urine
  • Vorarephilia (also gynophagia): sexual attraction at the thought of being eaten by or eating another person or creature. It includes endosomataphillia—a sexual fetish of being within someone (a sub-genre is partial unbirthing—a sexual attraction to inserting an adult head into a vagina).
  • Voyeurism: sexual arousal through secretly watching others having sex (also includes scoptophilia—the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities (see Peeping Tom)
  • Wakamezake (Japanese term): sexual arousal by drinking alcohol from a woman's body.
  • Wet and messy fetishism: sexual arousal by having substances deliberately and generously applied to the naked skin, or to the clothes people are wearing
  • Wing fetishism: sexual attraction to wings, often those of angels or demons
  • Xenophily: sexual attraction to foreigners (in science fiction, it can also mean sexual attraction to aliens)
  • Yeastiality: sexual arousal from intercourse with bread
  • Zelophilia: sexual arousal from jealousy
  • Zoophilia: emotional or sexual attraction to animals
  • Zoosadism: sexual gratification derived from causing pain and suffering to animals. Necrozoophilia (also necrobestiality) strictly applies to killing animals.

Note:

  1. Sadism and masochism are often grouped together, under "sado-masochism", as a clinical term; also see algolagnia (sexual pleasure from pain). As a lifestyle interest, see BDSM - divided to bondage (aka Vincilagnia), discipline, domination & submission and sadism & masochism

[edit] See also

[edit] External links

[edit] Notes

  1. ^ American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed., text revision). Pp. 566-567.
  2. ^ http://psyweb.com/Mdisord/DSM_IV/jsp/Axis_I.jsp
  3. ^ http://ajp.psychiatryonline.org/cgi/content/full/159/7/1249
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