What Is Paraphilia?
Paraphilia is defined as sexual attraction and behavior that is recurrent, extreme, and out of the norm. The focus of the paraphilia is typically on objects, animals, non-consenting adults, sadism, masochism, or children.
Paraphilias are most commonly found in men with an onset during early puberty.
Paraphilias often have emotional, social, and legal ramifications.
If the paraphilia does not interfere with daily life or relationships, result in criminal activity, or harm the self or others, the behavior may not be classified as a mental illness.
What Are the Types of Paraphilia?
The DSM-IV TR lists seven of the most commonly observed paraphilias, but there are a large number of variations. Any unconventional sexual proclivity can be seen as a paraphilia if it is disruptive to development of healthy relationships or interferes with daily life.
Paraphilias are not diagnosed as psychiatric disorders unless they cause significant impairment or harm to self or others (as in pedophilia).
Exhibitionism – Also known as ‘flashing,’ this is the recurrent urge to expose one's genitals to an unsuspecting person. Sexual contact is rare, although the exposed may masturbate while exposing or fantasizing about exposing himself. This act is illegal and have can have legal consequences for the exposed.
Fetishism - The use of non-sexual objects as a means of sexual excitement and/or gratification. The objects may be used with a willing partner or alone. If the fetish becomes the primary object of desire, the individual may avoid sexual relationships.
Partialism - A fetish involving non-sexual body parts.
Fetishistic Transvestitism – The practice of heterosexual males dressing in women's clothing for sexual arousal. Cross-dressing is not a psychiatric issue unless it becomes necessary for sexual arousal or gratification.
Sexual Masochism – Involves sexual fantasies or acts intended to inflict pain or humiliation on the self. The pain can be emotional, verbal, or physical. Bondage and spanking are common masochistic acts that occur between consenting adults. Autoerotic partial asphyxiation is a type of masochism involving partial strangulation to enhance orgasm. This can be dangerous and potentially fatal.
Sexual Sadism – Involves sexual fantasies or acts that inflict psychological or physical pain and/or humiliation on a victim. Although sexual sadists are sometimes able to find willing partners, this disorder often involves illegal acts such as rape, torture, or murder. Rape is typically related to wielding power over a victim, whereas sadism would be related to sexual gratification from the pain and suffering of perpetrating a rape. Serious legal consequences often result from acts connected to this disorder, and intense treatment is required.
Voyeurism – Also called ‘peeping,’ this disorder involves obtaining sexual arousal and/or gratification from watching unsuspecting people getting undressed or engaged in sexual activity. The voyeur does not try to initiate contact with the observed person but sometimes gets caught, which can lead to legal issues.
Frotteurism – Involves sexual arousal and/or gratification from rubbing the genitals on an unsuspecting stranger, often in crowded locations. This disorder has legal repercussions due to the illegal nature of the contact.
Pedophilia – Involves having strong, recurrent feelings of sexual attraction and fantasies about pre-pubescent individuals, usually children under the age of 13. There is often a tremendous amount of shame involved in the onset of these fantasies, which can lead to concealment that in turn can lead to the individual not receiving treatment at an early enough age to prevent acting out. This has extreme legal ramifications due to the illegal nature of the contact.
Read more about pedophilia.
How Are Problematic Paraphilias Treated?
There is no effective cure for paraphilias, which are notably difficult to treat. Treatment can only be successful with individuals who are motivated to work on controlling their impulses. The most effective treatment for those motivated people is a combination of cognitive behavioral therapy and medications including SSRIs or those that reduce sex drive. Group therapy with a focus on relapse prevention is another common component.
Related Resource Pages on Band Back Together
How to Help Someone Heal From Sexual Assault or Rape
Additional Resources for Paraphilia:
Forensic Psychiatry.ca provides an overview of paraphilias.
National Association for Sexual Freedom has information and resources addressing the rights of individuals to engage in safe sexual activities.
Association for the Treatment of Sexual Abusers is an international, professional organization for those who are involved in the assessment, treatment, and management of individuals who have sexually abused, or are at risk for sexually abusive behavior.
The Federal Bureau of Investigation (FBI) provides links to the National Sex Offender Public Website as well as individual state, territory, and tribal registries.
