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Atypical Sexual VariationsChapter 17
Learning Objectives
• Normal versus Deviant Sexual Behavior• The Paraphilias• Theoretical Perspectives• Treatment of Paraphilias
Normal vs. Deviant Behavior
Defining Normal Sexual Behavior
• Statistical norms• Cultural considerations• Persistent preference for non-genital
sexual outlets• Atypical variations• Unusual patterns of arousal or
behavior that individuals or society view as problematic
Critical Thinking
Why is statistical rarity an inadequate standard for considering a sexual practice to be normal
or abnormal?
The Paraphilias
Fetishism• Inanimate object elicits sexual arousal• Common objects are articles of clothing and
materials made of rubber, leather, silk, or fur• Partialism• Related to fetishism • Sexual arousal is exaggeratedly associated with a
particular body part, such as feet, breasts, or buttocks
• Most fetishes and partialisms are harmless
The Paraphilias
Transvestism• Person repeatedly cross-dresses to achieve sexual arousal or
gratification, or is troubled by persistent, recurring urges to cross-dress
• Almost all transvestites are men• Both gay and heterosexual males report transvestism
• It is not the same as transsexualism.• Transsexuals cross-dress because of discomfort with their
anatomic sex and desire to be the other sex• However, some transvestites and some transsexuals may be
motivated by autogynephilia • A fetish in which men are sexually stimulated by fantasies
that their own bodies are female
The Paraphilias
Exhibitionism• Urges and fantasies involving exposing one’s genitals to
unsuspecting strangers• Provides sexual arousal or gratification• Urges are either acted upon or are disturbing
• Exposure to exhibitionism is common• A sample of college women found that one-third had been
approached by a “flasher”• Victims may experience negative psychological consequences
• Exhibitionists usually are not physically threatening• Often lonely and sexually repressed• Some progress to more serious crimes of sexual aggression
Critical Thinking
Critical thinkers pay closer
attention to definitions.
Why are (most) strippers and
nude sunbathers not
exhibitionists?
The Paraphilias
Obscene Telephone Calling
• Sexual arousal results from shocking victims
• Telephone scatologia• A DSM label for a
paraphilia characterized by the making of obscene telephone calls
• Usually socially inadequate heterosexual men
Voyeurism
• Characterized by observing unsuspecting strangers who are naked, disrobing, or engaged in sexual relations
• Most, but not all, voyeurs are nonviolent
• Often feel inadequate and lack social & sexual skills
The Paraphilias
• Characterized by the desire or need for pain or humiliation to enhance sexual arousal
• Bondage• Ritual restraint, as by shackles
• Hypoxyphilia• Person seeks to enhance sexual arousal, usually during
masturbation, by becoming deprived of oxygen• Although some masochists are women, it is much more
common among men• Masochists may form relationships with sexual sadists,
people who become sexually aroused by inflicting pain or humiliation
Sexual Masochism
The Paraphilias
• Characterized by the desire or need to inflict pain or humiliation on others to enhance sexual arousal
• Sadomasochism (S&M)• A mutually gratifying sexual interaction between consenting sex partners
• Sexual arousal is associated with the infliction and receipt of pain or humiliation
• Occasional, mild S&M is common among the general population
• S&M subculture exists in the US• S&M fantasies likely begin in childhood
Sexual Sadism
The Paraphilias
• Characterized by rubbing against or touching a non-consenting person• Often takes place in crowded places such as
buses, subways, or elevators• Also known as “mashing” or “groping”
• Reported exclusively among males• Toucherism
• Related to frotteurism and characterized by the persistent urge to fondle non-consenting strangers
Frotteurism
The Paraphilias
• Characterized by urges and fantasies involving sexual contact with animals
• Bestiality • Involves actual sexual contact with an animal
Zoophilia
• Characterized by desire for sexual activity with corpses• 3 types
• Regular – sex with a dead person• Necrophilic homicide – commit murder to obtain corpse for
sexual purposes• Necrophilic fantasy – fantasizes about sex with corpse
• Rare paraphilia & necrophiles are seriously disturbed
Necrophilia
The ParaphiliasLess common paraphilias
Klismaphilia• Sexual arousal is
derived from the use of enemas
Coprophilia• Sexual arousal is
attained in connection with feces
Urophilia• Sexual arousal is
associated with urine
These paraphilias may have
childhood origins
Theoretical Perspectives
Biological Perspectives
Examines factors such as the endocrine system and the nervous system• Some studies show that many paraphiliacs have
higher sex drive• Electroencephalograph (EEG) data show that
paraphilic men’s brains respond differently to sexual stimuli and paraphilic stimuli compared to control subjects
Theoretical Perspectives
Psychoanalytic Perspectives
Paraphilias are psychological defenses• Usually against unresolved castration
anxiety due to the Oedipus complex• Suppressed or repressed feelings of
sexual guilt and shame
Critical Thinking
If people with paraphilias have powerful urges to engage in “deviant” behavior due to
biological forces or unconscious fears, can they be expected to
control their behavior?
Theoretical Perspectives
Cognitive-Behavioral Perspectives
Paraphilias are learned behaviors acquired through experience• An object or situation may be associated with sexual arousal,
fantasies, or orgasm
Modeling or observational learning also may play a role
Theoretical Perspectives
Sociological Perspectives
Focus on • Social context• Effects of the group• Society in general
Theoretical Perspectives
An Integrated Perspective: The “Lovemap”
Acknowledges the multiple origins of paraphilias
Money (2000) proposes that childhood experiences create a lovemap• A mental representation of the idealized lover and the idealized erotic
activity with the lover• Lovemaps can become distorted by early traumas
Treatment of Paraphilias
Issues in treatment
• Many people with paraphilias don’t want treatment & don’t seek it voluntarily
• Ethical issues arise when providers are asked to contribute to judicial processes
• Providers realize they are likely to not be successful with resistant clients
• Perceived responsibility
Critical Thinking
Is it ethical for mental-health professionals to work with clients who do not want treatment?
Treatment of Paraphilias
Psychoanalytic Psychotherapy
• Focuses on resolving unconscious conflicts
Cognitive-Behavioral Therapy
• Focuses directly on changing behavior
Cognitive-Behavioral Treatment of Paraphilias
Systematic desensitization
• A method for terminating the connection between a stimulus and an inappropriate response
• Relaxation replaces sexual arousal
Aversion therapy
• A method for terminating undesirable sexual behavior in which the behavior is paired repeatedly with an aversive stimulus such as electric shock so that a conditioned aversion develops
Covert sensitization
• A form of aversion therapy in which thoughts of engaging in undesirable behavior are paired repeatedly with imagined aversive stimuli• Used with
pedophiles, a paraphilia involving sexual interest in children
Cognitive-Behavioral Treatment of Paraphilias
Social skills training
• Behavior therapy methods for building social skills that rely on a therapist’s coaching and practice• Used to help
individuals relate to the other gender
Orgasmic reconditioning
• A method for strengthening the connection between sexual arousal and appropriate sexual stimuli by repeatedly pairing the desired stimuli with orgasm
Medical Treatment of Paraphilias
Selective serotonin reuptake inhibitors (SSRIs)
• Used to treat exhibitionism, voyeurism, and fetishism• May treat the obsessive-
compulsive quality of paraphilias
Anti-androgen drug
• A chemical substance that reduces the sex drive by lowering the level of testosterone in the bloodstream• Depo-Provera is used in the
treatment of sex offenders• Suppresses, but does not
eliminate, sexual desire in men
• Unlike surgical castration (removal of the testes), the effects of this treatment can be reversed