1. Atypical and Paraphilic Sexual Behaviors

2. What are typical sexual behaviors? People tend to have low tolerance for sexual diversity, considering it deviant or perverted Most modern views of sexuality see it as a continuum, not “deviant” vs. “normal” Sexual behaviors come in and out of popularity Social value judgments, not science, typically define what is “normal” in a society People who deviate may not see the behavior as a problem, or may be troubled by it

3. Paraphilias Sexual behaviors that involve a craving for an erotic object that is unusual or different DSM IV-TR essential features: recurrency and intensity of the sexual behavior that involves a nonhuman object or the suffering or humiliation of oneself or one’s partner, a child or a non- consenting person The behavior causes significant distress and interferes with the ability to work or interact

4. Paraphilias continued Movement to differentiate consensual from coercive paraphilias (Paraphilic Coercive Disorder) No classic profiles, but majority are male and come from every socioeconomic bracket, ethnic/racial group and sexual orientation

5. Paraphilias continued Related factors: dysfunctional family while growing up, poor social skills, distorted views of intimacy Paraphiliacs often try to suppress their behaviors, but are unable to do so A prime characteristic of a paraphilia is that it replaces complex human sexual contact with undemanding sexuality of an inanimate object, scene or single action

6. Paraphilias continued Motivations: provides meaning and a sense of self, relieves depression and loneliness, allows expression of rage Research is not representative: primarily clinical and incarcerated samples Are attempts to distinguish between behaviors of “normal” people and those whose behaviors can be dangerous or threaten others Classifying and labeling paraphilias is a controversial issue among professionals

7. Theories about Paraphilias

8. Biological Theories Many physical conditions have been linked to the development of paraphiliac behavior –Temporal lobe epilepsy –Brain tumors and lesions Brain structure and chemistry differences have been linked to paraphilias in some people

9. Psychoanalytic Theory Paraphilias are related to the Oedipal crisis and castration anxiety –E.g., exhibitionists cope with castration anxiety by showing the power of their masculinity Boys must painfully separate from their mothers –Why most paraphiliacs are male

10. Developmental Theories We are born with a general erotic potential that can be attached to almost anything We learn what are sexual objects Courtship disorders – paraphiliac’s behavior is fixated at an early stage of mating Lovemaps – stimuli experienced during child sex play form a template that defines our ideal lover and sexual situation

11. Developmental Theories Childhood trauma or punishment for curiosity may disrupt the lovemap in 1 of 3 ways: –Hypophilia – genitals impaired from full functioning –Hyperphilia – overly sexually active –Paraphilia develops – new elements are placed into the lovemap and erotic energy is directed toward other objects Once a lovemap is set, it is very stable

12. Behavioral Theories A behavior or object is associated with sexual pleasure through conditioning Behaviors become positively reinforced and are continued in order to experience more sexual pleasure

13. Sociological Theories Women are treated as sexual objects so it is natural to replace the woman with another sexual object Some men feel the need to reinforce their masculinity by exposing themselves and evoking fear American society is saturated by media and we experience things vicariously, rather than experiencing things directly

14. TYPES OF PARAPHILIAS

15. Types of Paraphilias Some of the more common paraphilias: –Fetishistic Disorder –Transvestic Disorder –Sadism and Masochism –Exhibitionism and Voyeurism –Pedophilia –Other Paraphilias and Sexual Variations

16. Fetishistic Disorder An inanimate object or body part not usually associated with sex becomes the main focus of sexual arousal and orgasm Often responses are to: –Objects: shoes, boots, bras, panties –Fabrics: rubber, leather, silk, fur –Body Parts: feet, hair, buttocks A fetishist needs the presence or fantasy of the item for arousal, sometimes with a partner

18. Transvestic Disorder Recurrent and intense sexual arousal from the cross-dressing, typically causing distress or impairment in functioning Possibly develops from an early childhood experience, such as –Masturbating with female clothing –Being punished or humiliated by women & forced to dress as a woman

19. Transvestic Fetishism Most transvestites not anxious to seek therapy or stop behavior Transvestic Disorder firmly fixed in a man’s personality Goal of therapy is to help transvestite cope with anxieties and guilt and help him relate to his partner and family

20. Sadism and Masochism Sadism – a recurrent and intense sexual arousal from the physical or psychological suffering of another person Common activities or fantasies: restraint, blindfolding, strangulation, beating, burning, pinching, whipping, spanking, electrical shocks, torture

21. Sadomasochists often use props, like leather clothes, studs, chains and nipple clamps.

22. Sadism and Masochism Sexual Masochism Disorder – a recurrent and intense sexual arousal from the act of being humiliated, beaten, bound or suffering Sadomasochism (S&M) - sadism and masochism are often practiced together; both associate sexuality and pain Kinsey and his colleagues (1953) found that 3% to 12% of women and 10% to 20% of men reported getting sexually aroused to S&M narratives.

23. Sadism and Masochism Most common activity: bondage & restraint; spanking, urine and feces may also be involved Bondage & discipline (B&D) may involve: flagellation, caning, birching, hot wax, ice, biting Psychological techniques: –Sensory deprivation – masks, ear plugs –Humiliation – verbal abuse, bootlicking, urolagnia, scatophagia, infantilism

24. Sadism and Masochism Pain is used to enhance sexuality, not that it is exciting in itself The BDSM encounter is carefully planned, a “safe word” is usually agreed upon to act as a signal of distress Masochism allows a person to avoid responsibility or anxiety, explore power Dominatrix – offers S&M services primarily to men with power

25. A dominatrix is paid by submissive clients to engage in bondage and discipline fantasy play.

26. Exhibitionism and Voyeurism Exhibitionism – recurrent and intense arousal from exposing one’s genitals to an unsuspecting stranger; non-consensual “flasher” The fear or shock from the non- consenting victim is what is exciting Usually have an erection during exposure and masturbate then or later Begins in teen years & decreases with age

27. Exhibitionism and Voyeurism “Indecent exposure” accounts for 1/3 of all sex convictions in U.S., Canada, and Europe Many exhibitionists have normal dating and sexual histories; majority are shy and withdrawn, many have borderline or avoidant personality disorders 40% to 60% of female college students report having been exposed to Exhibitionism Females have more legitimate ways to expose themselves to feel feminine and desired

28. Exhibitionism and Voyeurism Voyeurism – sexual gratification from watching unsuspecting persons undressing, naked or engaging in sexual activity; “peeping toms” Typical voyeur is a heterosexual male that begins before age 15; most are sexually frustrated and chronic masturbators Most are harmless and charged with trespassing, not a sex crime The non-consensual nature is what is exciting

29. Although female exhibitionism is rare, it is interesting how much more acceptable it is for a woman to expose her body in U.S. society. Few people would complain about this woman exposing her breasts in public.

30. Pedophilia Recurrent and intense sexual arousal from prepubescent or pubescent children, usually causing distress or impairment in important areas of functioning Are often 18 or older; at least 5 years older than victims Legally, its definition varies by society Illegal in every country; tolerance has varied over time and across cultures Pedophiles are often obsessive and predatory Paraphilia most likely seen in treatment due to its illegal & harmful nature

31. Pedophilia Girls are more likely to be victims –44% prefer only girls –33% prefer only boys –23% choose both girls and boys Boys are less likely to reject advances, involve violence, and report it to authorities Some pedophiles only look, while others engage in a variety of sexual acts –Most common behaviors are fondling and exhibitionism

32. Pedophilia –Most pedophiles believe its acceptance will increase in the future; North American Man-Boy Love Association (NAMBLA) supports the abolition of age-of-consent laws Pedophiles are often attracted to children of a certain age range, usually: –8-10 year old girls –Slightly older boys

33. Pedophilia Pedophiles usually lack empathy and don’t believe they are causing negative psychological or physical consequences Related factors: arrested psychological development, childish emotional needs, low self- esteem, poor social relations, alcoholism, exaggeration of the social male role –Victim of childhood sexual abuse for 35% Reasons they give for their behaviors: they didn’t fight, lacked sexual outlets, intoxication, victim- initiation Recidivism rates are high

34. OTHER PARAPHILIAS AND SEXUAL VARIATIONS

35. Other Paraphilias and SexualVariations People can be sexually attracted to almost anything Obscene Telephone Callers Frotteurism Zoophilia Necrophilia Sexual Addictions

36. Other Paraphilias and SexualVariations Obscene Telephone Callers (Scatolophilia): person becomes excited as the victim reacts to obscene suggestions –Masturbation occurs during the call or after –Excitement comes from the non- consensual reactions of fear, disgust or outrage –Most callers have relationship problems and other paraphilias –During call, he may describe sexual acts he will perform, threaten the victim, or try to get the victim to perform sexual acts or discuss her sexual life

37. Other Paraphilias and SexualVariations Frotteurism – a man rubbing his genitals against a woman’s thighs or buttocks in a crowded place –It can be explained as an accident; allows easy escape

38. Women-only passenger cars are subway and railway cars that do not allow male passengers. Problems with groping and frotteurism on public transportation has led to the establishment of women-only passenger cars in places such as Tokyo, Japan and Seoul, South Korea.

39. Other Paraphilias and SexualVariations Zoophilia/bestiality – sexual contact with animals –Most popular animal is the male dog –Some common behaviors: masturbating the animal, submitting to anal sex with the animal, active or passive oral sex with the animal

40. Other Paraphilias and SexualVariations Necrophilia – having sex with corpses –Desire unresisting and unrejecting partners –May seek professions near corpses –3 types: Necrophiliac fantasy Regular necrophilia – already-dead body Necrophiliac homicide – commit murder to obtain corpse Erotophonophilia – murder itself is exciting

41. Sexual Addictions Sexual Addiction/Hypersexuality: recurrent and intense sexual fantasies, sexual urges and sexual behavior; excessive time spent on these behaviors and inability to control these fantasies Typical sexual addict: married man who develops an obsession with pornography, cybersex, prostitute visits or multiple sexual affairs Double standard in terms used: –Women: nymphomaniacs, whores, sluts –Men: Don Juans, studs

42. Sexual Addictions Cycle repeated by sex addicts: –Preoccupation with thoughts of sex –Ritualization of preparation for sex –Compulsive sexual behavior –Despair Little systematic research on sexual addiction Estimates are that 3% to 5% of Americans have a sexual addiction; men outnumbering women five to one

43. Sexual Addictions Typical treatment involves individual or group therapy as part of a 12-step recovery process Many criticize treatment of hypersexuality, claiming “sexual addiction” better reflects really poor social judgment

44. Assessing and Treating Paraphiliasand Sexual Variations First step is to assess the nature & scope of the problem through: –Self-report – reliability problems –Behavioral observation – limited –Physiological tests Penile plethysmography measure erection when viewing various pictures –Personality inventories MMPI examines personality patterns

47. Assessing and TreatingParaphilias Most paraphiliacs don’t seek treatment; are content with balancing the pleasure and guilt of their behaviors Others find it disruptive to their lives –Relationship problems, legal problems, dominating preoccupation

48. Assessment Often a combination of treatments are used –Group, individual & family therapy –Medication, education, self-help groups Treatment is designed to reduce or eliminate symptoms, prevent relapse & increase victim empathy Therapy may try to: –Resolve childhood trauma or experiences –Increase self-esteem & social skills

49. Assessment Assessment methods –Self-report: of questionable reliability –Behavioral observation: cannot assess fantasies and desires –Physiological tests: penile plethysmograph (measuring blood flow to penis in response to stimuli) might be most reliable with male sex offenders –Personality Inventories: MMPI can help establish personality patterns and psychological disorders

50. Assessment Aversion therapy – used to suppress strong desires –An unpleasant stimulus (odor, nauseating drug, electric shock, shame) is linked with the undesired behavior –Effectiveness decreases over time

51. Variations or Deviations What criteria should decide what is “normal”? –Percentage that engage in the behavior –Religion –Popular opinion –Courts –Psychiatrists Most people are uncomfortable with sex for its own sake, separate from love, intimacy and attachment Paraphilias may be a part of human sexual diversity