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Medical Encyclopedia:

Sexual Perversions

Definition

Sexual perversions are conditions in which sexual excitement or orgasm is associated with acts or imagery that are considered unusual within the culture. To avoid problems associated with the stigmatization of labels, the neutral term "paraphilia," derived from Greek roots meaning "alongside of" and "love," is used to describe what used to be called sexual perversions. A paraphilia is a condition in which a person's sexual arousal and gratification depend on a fantasy theme of an unusual situation or object that becomes the principal focus of sexual behavior.

Description

Paraphilias can revolve around a particular sexual object or a particular act. They are defined by DSM-IV as "sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning." The nature of a paraphilia is generally specific and unchanging, and most of the paraphilias are far more common in men than in women.

Paraphilias differ from what some people might consider "normal" sexual activity in that these behaviors cause significant distress or impairment in areas of life functioning. They do not refer to the normal use of sexual fantasy, activity or objects to heighten sexual excitement where there is no distress or impairment. The most common signs of sexual activity that can be classified as paraphilia include: the inability to resist an impulse for the sexual act, the requirement of participation by nonconsenting or under-aged individuals, legal consequences, resulting sexual dysfunction, and interference with normal social relationships.

Paraphilias include fantasies, behaviors, and/or urges which:

  • involve nonhuman sexual objects, such as shoes or undergarments
  • require the suffering or humiliation of oneself or partner
  • involve children or other non-consenting partners

The most common paraphilias are:

  • exhibitionism, or exposure of the genitals
  • fetishism, or the use of nonliving objects
  • frotteurism, or touching and rubbing against a nonconsenting person
  • pedophilia, or the focus on prepubescent children
  • sexual masochism, or the receiving of humiliation or suffering
  • sexual sadism, or the inflicting of humiliation or suffering
  • transvestic fetishism, or cross-dressing
  • voyeurism, or watching others engage in undressing or sexual activity

A paraphiliac often has more than one paraphilia. Paraphilias often result in a variety of associated problems, such as guilt, depression, shame, isolation, and impairment in the capacity for normal social and sexual relationships. A paraphilia can, and often does, become highly idiosyncratic and ritualized.

— David James Doermann


 
 
Dictionary: per·ver·sion  (pər-vûr'zhən, -shən) pronunciation
n.
    1. The act of perverting.
    2. The state of being perverted.
  2. A sexual practice or act considered abnormal or deviant.
perversive per·ver'sive (-sĭv, -zĭv) adj.
 
World of the Body: perversion

Sexual perversion is usually implicitly assumed to mean some kind of unnatural, abnormal form of sexual behaviour. As such, its meaning is particularly fluid, depending on the position of the person using it, and their assumptions about the natural and the normal. While there would probably be a fairly broad consensus in favour of declaring necrophiliac cannibalism to be a perversion, very few forms of sexual practice have not been defined by someone, somewhere, as perversion.

Act versus object

Perversity can be broken down into two categories: perverse acts and perverse objects. Acts which involve some other use of the genitals beyond the insertion of the penis into the vagina followed by ejaculation have often been categorized as perversions. Masturbation, either mutual or solitary, comes into this category, as does oral sex. The use of contraception to thwart the reproductive purpose of intercourse has also been defined as perverted. It might be supposed that the one act which can always be defined as the normal, natural thing is sexual intercourse intended for the begetting of children (or at least, without the deliberate interposition of means to prevent this happening) between two persons of opposite sexes married to one another. At least in the abstract this is the case, but when it comes down to the practical, even the most reproductively intentioned married couple may be engaging in something which someone could define as perversion. The very position which one society regards as almost too natural even to think about may be regarded by another as an obscene variation calculated to inflame sensuality.

Acts which may in themselves be regarded as either perverse or bordering upon perversity may, however, be considered permissible if they conduce to better reproductive sex between married couples. Catholic confessional manuals, and twentieth century works on marriage advice, have licensed practices such as clitoral titillation or oral sex, or variations in sexual position, provided these were performed with the intention of rendering intercourse either more likely to be fertile, or (in the latter example) to induce better bonding between the couple thus improving the stability of the institution of marriage. The manifesto for such attitudes was proclaimed by the Dutch gynaecologist Theodor Van de Velde in his Ideal Marriage (1926): ‘Ideal Marriage permits normal, physiological activities the fullest scope, in all desirable and delectable ways’, while banishing ‘All that is morbid, all that is perverse’. The ‘full range of contact and connection between human beings, for sexual intercourse’ was clearly marked as pertaining ‘exclusively to normal intercourse between opposite sexes’. Thus Van de Velde was able to provide detailed instructions for preliminary ‘love-play’ and for variant positions suitable for different occasions, while firmly closing the door on ‘the Hell-gate of the Realm of Sexual Perversions’.

While this does open up the possibility of acts being (perversely) indulged in for their own sake as a means of selfish gratification rather than the enhancement of a relationship, it also moves the question from the issue of the acts to that of the object. Perversity thus becomes not merely a matter of using the genitals in a ‘wrong’ way, but also of experiencing sexual feelings towards some object considered to be unnatural: for example, the body of an individual of the same gender, an animal, or some item of apparel, which are, under the rubric of ‘the natural’, not supposed to be endowed with erotic allure. However, even this became an area open to finesse: with the rise of the notion of ‘congenital inversion’ (an inborn homosexual tendency), sexologists made a distinction between ‘inverted sexual practices’ innately normal to those engaging in them, and ‘perversions’ indulged in for sensual variety by those who had no such excuse. Some cultures permit certain forms of homosexual interaction, and even ritualize these to some extent, while not having any category for homosexual relationships outside those bounds. This can be seen, for example, in societies where there is an accepted role of effeminate male homosexual, or which accept age-differentiated relationships between men and adolescent boys with an assumed pedagogic purpose. Behaviour which transgresses these structural norms, however, may be stigmatized.

The perverse and ‘normality’

A perhaps more ‘modern’ way of considering perversion has been to place the defining barrier around the quality of the relationship. Something which leads to a reciprocal and mutually meaningful relationship between two individuals (whatever their gender and practices) may be regarded as natural and healthy. Impersonal acts and those unlikely to result in the formation of a pair-bond are thus still assigned to the realm of the perverse. The implicit model remains, of course, heterosexual matrimony.

Early sexologists both created and tried to defuse the question of the perverse by differentiating practices which were a distortion or a corruption of the sexual instinct from those which were (however deplorable), an exaggeration of ‘natural’ tendencies. This latter category could include manifestations of excessive sexual desire, exhibitionism and voyeurism, and the milder forms of fetishism and sadomasochism (particularly where the latter fitted received notions of male aggression and female passivity). However, as pioneer British sexologist Havelock Ellis pointed out, nearly all so-called perversions were capable of being interpreted as exaggerations of some tendency within ‘normal’ sexuality.

Most of the practices defined as perverse have been and are still found either exclusively or much more commonly among men. This may represent women's lack of opportunities, since, in most societies throughout history, if not confined to marriage and motherhood, their only other role has been that of prostitute, indulging male quirks of desire rather than manifesting their own. Some female ‘perversions’, such as desire for clitoral stimulation, have been quite clearly defined by male assumptions about the appropriate form of female sexual satisfaction: indeed active sexual desire in the female has been interpreted as ‘perverse’. Since discussions of sexuality have often focused on women, it is therefore interesting to note that descriptions of ‘perversion’ are more likely to deal with men.

— Lesley A. Hall

See also fetishism; sadomasochism; sexual orientation.

 
Columbia Encyclopedia: sexual perversion,
in psychology, sexual behavior deemed pathological by its deviation from “normal” sexual desire. The definition of sexual perversion has shifted considerably over time: indeed, it has never been an uncontested category of meaning. For example, homosexual desire has long been stigmatized as sexual perversion among many segments of Western society (and remains so among some), but within the field of psychology, it is no longer considered pathological. Use of the term perversion itself has come under wide criticism in recent years. Today, psychologists generally refer to nontraditional sexual behavior as sexual deviation or, in cases where the specific object of arousal is unusual, as paraphilia. There are a number of recognized disorders of this type. In fetishism, the object of sexual desire is either an inanimate object or a nongenital part of the human anatomy. Voyeurism involves the covert viewing of other individuals who are naked, undressing, or engaged in sexual activity, as the primary means of sexual arousal. Sexual arousal as a result of physical contact with prepubescent children is described as pedophilia. Other forms of sexual deviation include exhibitionism, incest, transvestism, necrophilia, sadism, and masochism. Many of these behaviors, when they involve the participation of nonconsenting adults (or children, consenting or not), are punishable by law. Although rape is not classified as a paraphilia, it is a serious sexual deviance, and perhaps the most highly reviled form of sexual gratification. Most forms of sexual deviance are accompanied by any number of other psychological disorders.

Bibliography

See V. Bullough, Sexual Variance in Society and History (1980).

 
Psychoanalysis: Perversion

To posit a "perverse" sexuality is to imply the existence of a "normal" variety with reference to which certain acts and object-choices are deemed deviant. In the Three Essays on the Theory of Sexuality (1905d), Sigmund Freud stated that the aim of adult sexuality was to reach orgasm by means of genital penetration, but he tempered this rather normative statement by observing that "the disposition to perversions is itself of no great rarity but must form a part of what passes as the normal constitution" (p. 171).

This was the basis of Freud's celebrated formula according to which "neurosis is the negative of perversion" (pp. 165, 231). In his turn—or perhaps rather his return—to Freud, Jacques Lacan followed up by underlining the importance of the absence of the father in cases of perversion, and at the same time claimed that perversion was above all attributable to the mother's putting her child in the place of the phallus (2002 [1955-56], p. 188). The pervert-to-be was thus chained to the desire/demand of the mother. It should be borne in mind, however, that Lacan was chiefly interested in the form of a "third structure" between the psychotic structure and the neurotic, so that for him perversion was a specific structural category rather than a class of sexual behavior to be set against an established norm.

It is difficult, from the psychoanalytical perspective, to frame a satisfactory definition of what, among adult sexual activities and object-choices, might constitute a symptom. Should homosexuality, for example, always be looked upon as a symptom? Or should it be viewed simply as a variation of male or female sexuality? Psychoanalysts are sharply divided on this clinical question.

First of all, the polymorphous features of adult sexuality hardly need underlining. Countless patients, whether heterosexual or homosexual, describe an infinite variety of erotic scenarios, fetish objects, masquerades, sadomasochistic games, and so on, which constitute private areas in their love lives, and which they experience neither as compulsive nor as indispensable to their sexual gratification.

Since every psychological symptom constitutes an attempt at self-cure intended to spare the sufferer painful mental conflict, this may be said equally of symptomatic sexuality (inasmuch as we are able to define it). Such a constructive approach to the meaning and aim of sexual symptoms, and of the reason for their formation, invariably leads to the conclusion that they embody infantile solutions to the confusions and anxieties attending sexual difference and sexual identity. The need to reinvent the sexual act often turns out to be closely tied to the parents' unconscious, or to silent messages or deceptive communications from the parents concerning sexual identity, adult sexuality, and notions of "feminine" and "masculine."

If some patients can achieve sexual satisfaction only by recourse to fetishistic, sadomasochistic, or other scenarios, the analyst might well wish that their sex life were less constrained, less subject to rigid conditions; yet if such erotic rituals are indeed for them the sine qua non of sexual relations, there is no justification for wanting these patients to abandon their erotic practices, whether or not other people consider them perverse.

As for the primal scene and the troubling fantasies to which it is apt to give rise, these tend—apart from their genital aspects and the phallic-oedipal conflicts they arouse well before the oedipal crisis proper—to bear the stamp of the pregenital: the fantasies in question feature devoration, or erotic and sadistic exchanges of an anal or fecal kind. When such fantasies predominate, they often fail to be integrated into genital eroticism and thus lead to so-called perverse sexual solutions.

Even more inhibiting than fantasies originating in the pregenital psychosexual stage are archaic fantasies involving vampirism, implosion, and fears of the loss of identity or of the sense of the boundaries of the body. When such fantasies, characteristic of early infancy, play a predominant part in the mental reality of adult individuals, sexual and love relationships are liable to be experienced as a threat of castration, annihilation, or death.

In order to achieve a gratifying sexual or love life, individuals inhabited by such terrifying fantasies find themselves obliged by the force of their unconscious to invent means whereby their castration anxiety and fear of annihilation—to which may be added feelings of confusion as to sexual identity, of emptiness, and of inner death—can be transformed into eroticized games. As an absolute prerequisite to sexual relations, adults in this situation commonly require complex theatrics: constraining conditions, disguises of all sorts, pregenital sexual behavior including the exchange of excrement, and so on—all meticulously stage-managed.

Most patients who re-enact the primal scene in this way feel that their erotic acts and object-choices are conflict-free and consonant with their desires, even if other people adjudge them perverse. The specific form assumed by a person's sexual predilections becomes a clinical problem in need of solution only if it causes that person to suffer. The real question is not whether particular acts or preferences should be judged deviant, but when a given deviation should be considered a variation from adult sexuality within the context of a significant object-relationship and therefore be treated as symptomatic.

A good many authors continue to us the term "perversion" in a pejorative way, but only inasmuch as it connotes a proclivity towards evil. Thus Robert Stoller (1975) confines the use of the word, which he defines as "the erotic form of hatred," to any sexual act whereby a person seeks deliberately to hurt someone else. Joyce McDougall (1995) uses the term "neosexual" to qualify the kind of scenarios described above and suggests that "perverse" be applied exclusively to specific relations, notably sexual relations, imposed by one individual on another who does not consent thereto (as for instance a child or a mentally disturbed person): in other words, sexual relationships in which one of the partners is utterly indifferent to the vulnerability or the desire of the other. It is worth noting that these same acts belong more often than not to the class of behavior that is condemned by the law: sexual abuse of minors, rape, exhibitionism, and so forth. The sexual activity of consenting adults, whether or not it is considered deviant with respect to supposed norms, tends not to be treated as illegal.

In short, where neosexual practices do no harm to either partner, nor seem to display a relentless compulsiveness of which the subject him or herself complains, the analyst has no cause to wish another erotic perspective upon the patient. It should be remembered that neosexualities serve not only to repair breaches in the sense of sexual and subjective identity but also, unconsciously, to protect their internal objects from the subject's hate and destructiveness, which derive in part from the unworked-out oral and anal impulses characteristic of incorporative infantile love. In the course of an analysis, the meaning of the love relationships of sexual innovators is revealed. It transpires in fact that their "choices" represent the best solution that the sometime child was able to find in response to messages from the parents. The feeling of choice is nonexistent, whether the individual is heterosexual, homosexual, autosexual, and/or neosexual.

Thanks to the uncovering of neosexual scenarios, what had been nonsensical becomes significant and meaningful, and a feeling of vitality prevails, at least momentarily, over inner death. These same problems might otherwise have produced graver outcomes of a psychotic or psychopathological order. Despite the often constraining conditions imposed by patients' compulsions and anxiety, which so often define the repertoire of sexual deviations, the underlying self-curative intent in face of conflicts of a neurotic or psychotic kind means that Thanatos is bound and that Eros triumphs over death.

Bibliography

Freud, Sigmund. (1905d). Three essays on the theory of sexuality. SE, 7: 123-234.

Lacan, Jacques. (2002 [1955-56]). On a question prior to any possible treatment of psychosis. InÉcrits: A selection. (Bruce Fink, Trans.). New York: Norton.

McDougall, Joyce. (1995). The many faces of Eros: A psychoanalytic exploration of human sexuality. New York: W.W. Norton.

Stoller, Robert. (1975). Perversion: The erotic form of hatred. New York: Pantheon.

Further Reading

Bach, Sheldon. (1994). The language of perversion and the language of love. Northvale, NJ: Jason Aronson.

Goldberg, Arnold. (1995). The problem of perversion. The view from self psychology. New Haven, CT: Yale University Press.

Kernberg, Otto F. (1991). Sadomasochism, sexual excitement, and perversion. Journal of the American Psychoanalytic Association, 39, 333-362.

—JOYCE MCDOUGALL

 
Wikipedia: paraphilia
Sexual orientation
Part of sexology
Distinctions

Asexual
Bisexual
Heterosexual
Homosexual
Pansexual
Paraphiliac
Labels

Gay
Lesbian
Queer
Questioning
Methods

Kinsey scale
Klein Grid
Study

Biology
Demographics
Medicine
Animal

Homosexuality in animals
See also

Intersex
Transgender
Transsexual


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.

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).

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 (see Purple Aki).
  • 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.
  • Vincilagnia: Being sexually aroused by bondage
  • 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).

Homosexuality was previously listed as a paraphilia in the DSM-I and DSM-II. Consistent with the change in consensus among psychiatrists it was not included in later editions. A disorder of clinical distress caused by the repression of homosexuality is still listed. Literature also documents many other paraphilias, both common and rare.

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.

Psychology of paraphilias

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.

Non-clinical views on paraphilias

Religious views

Main article: Religion and sexuality

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.

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.

  • Raptophilia: sexual pleasure from being raped (when agreed upon beforehand but acted out in public).
  • Exhibitionism and voyeurism: sexual pleasure by exposing oneself or by being peeped on
  • Frotteurism: sexual arousal through rubbing oneself against an unknowing stranger in public
  • Lust murder: sexual arousal from committing (or trying to commit) murder
  • Pedophilia: sexual attraction to peripubescent or pre-pubescent minors
  • Telephonicophilia: being sexually aroused by making obscene telephone calls

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

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.

  • Sadomasochism: In the independent 1974 Italian film The Night Porter, Charlotte Rampling wore a hat from a Nazi uniform in a sadomasochistic sex scene. At the time, the image was startling and new, but over the following years the use of Nazi-tinged iconography in a sexual context became mainstream,[citation needed] appearing first in mass-marketed pornography like Playboy[citation needed] and Penthouse,[citation needed] and finally becoming so tame that teen queen Britney Spears wore a similar outfit to a primetime awards show in 2003.[citation needed] By 2006, sadomasochistic imagery had become mainstream enough[citation needed] for singer Justin Timberlake to have a hit song, SexyBack, with the lyric "You see these shackles baby, I'm your slave! / I'll let you whip me if I misbehave!"
  • 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.

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.

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.

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.

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)

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. Also called hebophilia.
  • 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 an adult wearing/using baby objects.
  • Andromimetophilia (aka gynemimetophilia): love of women dressed as men or have had a sex change
  • Anesthesia fetishism: sexual arousal to the idea of general anesthesia and the equipment related to its use
  • Apodysophilia: desire to undress, also see nudism
  • Aquaphilia: arousal from water and/or in watery environments, including bathtubs or 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 (also 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; see also raptophilia
  • Blood fetish (aka 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 breasts or nipples
  • Celebriphilia: pathological desire to have sex with a celebrity
  • Chrematistophilia: sexual arousal from paying for sex or being robbed by one’s sexual partner (aka harpaxophilia)
  • 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 (aka Phalloorchoalgolagnia): sexual arousal by the experiencing of painful stimuli being administered 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, popularized by the 1999's movie Superstar with Molly Shannon
  • Diaper fetishism (aka Autonephioplia): sexual arousal from diapers
  • Doll fetish (aka Pediophilia): sexual attraction to dolls
  • Emetophilia (aka. vomerophilia and emetophilia): sexual attraction to vomitting
  • Endytophilia: preferring to have sexual activity while fully clothed
  • Ephebophilia (aka. hebephilia): sexual attraction towards adolescents
  • Erotic asphyxia: sexual attraction to asphyxia; also called breath control play (or being strangled); including autoerotic asphyxiation; see medical warnings.
  • Erotic lactation (aka Galactophilia and lactophilia): sexual attraction to human milk or lactating women
  • Eproctophilia: sexual attraction to flatulence
  • Exhibitionism (aka Autagonistophilia and peodeiktophilia): sexual arousal through 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
  • Fecophile: sexual arousal from defacation or watching a partner defecate, particularly on oneself
  • Fetishism: the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement. Examples include:
Balloon fetishism -- Bike fetish -- Dental braces fetishism -- Foot fetishism (podophilia) -- Fur fetishism -- Hand fetishism - Leather fetishism -- Lipstick fetishism -- Panty fetishism -- Rubber fetishism -- Shoe fetishism -- Silk/Satin fetishism -- Smoking fetishism --Sneezing fetishism -- Spandex fetishism -- Spitting fetishism -- Uniform fetish
  • Fat fetishism: sexual attraction to oneself or one's partner being overweight or obese (aka Lipophilia)
  • 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 nonconsenting 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; AKA, "bellypunching."
  • Gerontophilia: sexual attraction towards the elderly
  • Heterochromophilia: sexual attraction towards people of different skin colour
  • Homeovestism: sexual attraction towards 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
  • Katoptronophilia: sexual arousal from having sex in front of mirrors
  • 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 (aka Homicidophilia and 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 (referred to as belly button)
  • Necropedophilia: sexual attraction to the corpses of children
  • Necrophilia: sexual attraction to corpses
  • Nepiophilia (aka infantophilia): sexual attraction to children three years old or younger
  • Nyotaimori (a Japanese term): sexual arousal by eating sashimi or sushi from the body of a (usually naked) woman
  • Nose fetishism (aka Nasophilia): sexual attraction to the sight and touch of human noses
  • Olfactophilia: sexual stimulus with smells or odors
  • Omorashi (a 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: sexually attracted to the idea of being raped; see also 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
  • Shoe fetishism (aka 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) is a fetishistic attraction to humanoid or non-humanoid robots
  • 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 (aka Acarophilia): sexual pleasure from being tickled or itching
  • Tightlacing: sexual arousal by wearing or having a partner wear a tightly-laced corset
  • Tamakeri (a Japanese term): sexual arousal from having a male kicked in the testicles by a woman
  • Total enclosure fetishism: sexual arousal by having an entire body enclosed in a certain way
  • Transformation fetish: sexual arousal from depictions of transformations of people into objects or other beings
  • Transvestic fetishism (aka transvestitism): sexual attraction towards 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 (aka Gynophagia): sexual attraction to being eaten by, and/or eating, another person or creature. It also 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 (a 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 angels/demons
  • Xenophily: sexual attraction to foreigners (in science fiction, can also mean sexual attraction to aliens)
  • Zelophilia: sexual arousal from jealousy
  • Yeastiality: sexual arousal from intercourse with bread
  • Zoophilia: emotional or sexual attraction to animals
  • Zoosadism: the sexual enjoyment of causing pain and suffering to animals. Necrozoophilia(aka necrobestiality) is when it reaches the level of killing.

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

See also

External links

Paraphilias and fetishes
Abasiophilia · Amaurophilia · Amputee fetishism · Andromimetophilia · Anesthesia fetishism · Autogynephilia · Biastophilia · Blood fetish · Bondage (BDSM) · Breast expansion fetish · Breast fetishism · Chronophilia · Coprophilia · Crush fetish · Dacryphilia · Diaper fetishism · Doll fetish · Emetophilia · Erotic asphyxiation · Erotic lactation · Exhibitionism · Fat fetishism · Food play · Foot fetishism · Frotteurism · Garment fetishism · Hand fetishism · Homeovestism · Human animal roleplay · Hybristophilia · Hypnofetishism ·