learn and explore the world of Paraphilia and its dysfunctions

1. Abnormal
Psychology
Welcome
Introduction Of
Paraphilia

2. Abstract
There is a great deal of controversy concerning
paraphilia, and defining what is normal versus deviant or
disordered, given that this is to some degree dependent
on cultural views of acceptability.
In this topic, we will outline the issues and describe
recent progress in contributing factors and other
sociological issues that affect generally in PARAPHILIA.

3. Paraphilia

4. Definition and classification According to the
Diagnostic and Statistical Manual Disorder,
Fourth Edition, Text Revision (DSM IV-TR) or
to the International Classification of Mental
Diseases (ICD-10th), paraphilias are defined as
sexual disorders which are characterized by
“ recurrent, intense, sexually arousing
fantasies, sexual urges or behaviours, generally
involving called “ paraphilia not otherwise
specified ” .

5. GENERALLY involving;
(1) non human objects,
(2) the suffering or humiliation of oneself or one’
s partner, or
(3) children or other non-consenting persons
that occur over a period of 6 months ”
(criterion A), which “ cause clinically
significant distress or impairment in social,
occupational, or other important areas of
functioning ” (criterion B).

6. The term paraphilia comes from the Greek prefix
“ para ” meaning AROUND OR BESIDE and “
philia ” an ancient Greek word for love.
The term paraphilia first appeared in the third
version of the DSM classification. In the first
version of the DSM published in 1952, sexual
deviations were conceptualized as a subclass of
sociopathic personality disturbance.

7. PARA meaning “abnormal” and PHILIA
meaning “attraction”, Literally, “Abnormal
Attraction”

8. A paraphilia is distinguished by a preoccupation
with the object or behaviour to the point of being
dependent on that object or behaviour for sexual
gratification.
In most cases, types of sexual activity outside
the boundaries of the paraphilia lose their
arousal or satisfaction potential unless the
person fantasizes about the paraphilia at the
same time.

9. It is unclear what causes a paraphilia to
develop. Psychoanalysts theorize that an
individual with a paraphilia is repeating or
reverting to a sexual habit that arose early in
life. Behaviourists suggest that paraphilias
begin through a process of conditioning.
Nonsexual objects can become sexually arousing
if they are repeatedly associated with
pleasurable sexual activity.

10. Most paraphilias emerge during adolescence
although there is usually a connection with
events or relationships in early childhood.
Once established, they tend to be
chronic, although some research has
indicated that the behaviors will reduce as the
individual ages.
Most individuals with paraphilias are
MEN.

11. Although biological factors play a role in some
paraphilias, researchers have yet to identify a specific
biological or biochemical cause. Instead,
psychological factors seem to be central. In most
cases, one or more events occurred during childhood
that led the individual to associate sexual pleasure
with that event (or object) thus resulting in the
development of a paraphilia.

12. A content analysis of these materials would
likely provide a reasonably accurate indication
of the prevalence of these paraphilias—at least
the legal ones. With the exception of those who
are in legal trouble, most, but not all, persons
with paraphilia probably do not seek treatment.
Indeed, it has been argued that the impact of the
mandatory reporting laws enacted for certain
sexual crimes has further decreased the number
of individuals seeking voluntary treatment.

13. Simply having paraphilia is, obviously, not illegal.
Acting in response to paraphilic urges, however, may be
illegal and in some cases subjects the person with
paraphilia to severe sanctions. The distinguishing
phenomenological characteristic of paraphilias is an
intense craving or urge to fantasize or engage in some
form of sexual expression that most people would not
find erotic. Most people simply do not experience such
cravings. These urges are often difficult and, in some
cases, may even be impossible to control. It is this
putative lack of impulse control that underlies the
insanity defense in trials alleging sexually criminal
behavior. Such defenses are based on impaired mental
capacity and are sometimes, although infrequently,
successful.

14. While DSM-IV-TR does not classify paraphilias
other than by erotic focus, it is clear from
clinical practice that they may be either
exclusive or nonexclusive as well as egosyntonic
or egodystonic. Patients with the exclusive form
of a paraphilia may not be able to be sexually
aroused by anything other than their paraphilic
imagery or behavior. By contrast, patients with
the nonexclusive form may be aroused by other
sexual fantasies, stimuli, and behaviors,
although their paraphilias may interfere with
their overall sexual experiences.

15. The paraphilias do not always occur in the
absence of other psychopathology. Many
paraphilic patients show evidence of major Axis
I mental illnesses including affective disorders,
substance abuse disorders, schizophrenia, other
psychotic disorders, dementia, and other
cognitive disorders. Paraphilias can occur
within the context of Axis II disorders such as
borderline or antisocial personality disorders
and mental retardation, and Axis III disorders,
such as temporal lobe epilepsy or brain trauma

16. Prevalence rates for paraphilias are difficult to
obtain due to changes in criterion over time and
between cultures. surveyed a sample of 1,915
German men aged 40-79 and found 62.4%
reported at least one paraphilia-associated
sexual arousal pattern, and that this caused
distress in only 1.7% of cases.

17. In terms of more standardized studies,
most data are based on criminal reports or
studies using clinical populations referred
for legal reasons, rather than for self-help
in the general population.
However, prevalence rates are still
difficult to report with any certainty, and
this is further underpinned by the
contentious nature of paraphilia
definitions.

18.  Usually lasts for 6 months.
 Always thinking to carry out their unusual
behavior.
 Overly obsessed that if the individual cannot get to
their desired object, they get stressed.
 The individual will lose sight of other goals and
concentrate of the fulfillment of their sexual
desires if worse.
 It causes intense personal distress or impairment
in social, work and other areas of life functioning.
 Except for Sexual Masochism, almost all cases of
Paraphilia Involve MEN.

19. Paraphilias are not fleeting whims or
daydreams about unusual sexual
practices but are conditions that last at
least 6 months.

20. Both the ICD-10 and DSM-IV include eight
specific paraphilias outlined with additional ‘not
otherwise specified (DSM-IV), unspecified (ICD-
10), other specified paraphilic disorder and
unspecified paraphilic disorder (DSM-5)’
categories. Table 1 outlines paraphilias included
in the DSM-IV and subsequent changes in DSM-
5.
There are numerous paraphilias. Some of
the major types are:

21.  Fetishism is where a person feels a strong
recurrent sexual attraction to a nonliving
object.
 People with this are always preoccupied with
the object of desire, and they become
dependent to it as an object for sexual
gratification.
 Objects include shoes, gloves, underwear,
stockings, swimsuits, etc.

22.  Another variant of Fetishism.
 People with Partialism are solely
interested in the sexual gratification from
a specific body part, examples are feet,
neck, underarms, back, etc.

23.  They do unusual actions to the desired
object, like sucking, smelling, fondling,
rubbing, burning and cutting.
 Have no desires to intercourse with the
partner with the desired object, rather, they
would masturbate to the desired object.
 It involves compulsive rituals that are
beyond the control of the individual, which
can cause distress and interpersonal
problems.

24.  A syndrome found only in males.
 A disorder in which a man has an
uncontrollable urge to wear a
woman’s clothing, as primary means
of achieving sexual gratification.
 This sexual gratification has a
compulsive quality, and consumes a
lot of emotional energy.
 Sometimes accompanied by
masturbation.

25.  Has recurrent urges and desires to wear
woman’s clothing or cross dressing to achieve
sexual gratification.
 The fantasies and sexual urges cause
significant distress and/or impairment.

26.  The word comes from the term VOIR,
meaning “To See”
 A sexual disorder where an individual
compulsively seeks sexual
gratification from observing nudity or
sexual activity of others who are
unaware that they are being watched.
 This disorder is more common in
men.
 The term “Peeping Tom” usually
refers to voyeur.

27.  The person has intense sexual urges and
arousing fantasies involving the exposure
of genitals to a group of stranger/s.
 He/she does not expect a sexual reaction
from the stranger but finds the shock or fear
in the onlooker to be arousing
 Have the fantasy that the onlooker will be
sexually aroused.

28. CONT…
Compulsive act of inappropriately exposing
one's sex organs to unsuspecting strangers for
the purpose of sexual arousal and gratification.
Also known as "indecent exposure" and
"flashing," this paraphilia is found almost
exclusively in males and the peak age of
occurrence is reported to be in the twenties.

29.  Sexual Masochism
 Comes from the name of an Austrian
Writer Leopold Baron von Sacher-Masoch.
Who is known for his novels about men
being sexually humiliated by women. A
Masochist is someone who seeks pleasure
from being subjected to pain.
 Sexual Sadism
 The term Sadism comes from the name of
French author Marquis de Sade, who
wrote extensively about obtaining sexual
enjoyment from inflicting cruelty.
 Both terms were coined by Krafft-Ebing, a
german physician.

30.  Disorder marked by an attraction to
achieving sexual gratification by having
painful stimulation applied to one’s own
body, either alone or with a partner.
 Men and women with this disorder achieve
sexual satisfaction by such means like
binding, ropes, whips, or injuries.

31.  The converse of Sexual Masochism. It involves
deriving sexual gratification from activities that
harm, or from urges to harm, another person.
Seeing or imagining another’s pain excites the
sadist. In contrast to Sexual Masochism, which
does not require a partner, sexual sadism clearly
requires a partner to enact sadistic fantasies.
 Sadomasochist is the term where in a person
does both Sadist and Masochist roles, or
inflicting and receiving pain.

32. A paraphilia that combines sadistic and
masochistic roles in sexual interaction.
Sadism is the intentional infliction of pain
on another person or the threat to do so,
for sexual excitement. Masochism is a
condition in which a person derives sexual
gratification from being subjected to pain
or to the threat of pain

33.  Sadists
 Have the urge and desire, and recurrent sexual
fantasies of inflicting pain, seeing physical pain
and humiliation of another person
 Masochists
 Have the urge and desire and recurrent sexual
fantasies of receiving pain, submissive to
punishments, and other acts of humiliation.

34. “The most disturbing disorder
you will study in this book”
 Pedophilia is where an adult
(16 yrs. Above) has
uncontrollable sexual urges
to sexually immature
children (13 below)
 Persists from months to
even years.
 Forms of sexual acts against
children include
kidnapping, sexual abuse,
fondling, and penetration or
intercourse.

35.  Situational Molesters
 Normal Sexual development and interest. But when
stress calls for it, they sometimes want to become
sexual with a child
 Preference Molesters
 Pedophillic behavior is already ingrained in the
individual’s lifestyle, clear preference for children,
esp. Boys, and will do anything (even marry) to
hide his behavior, and clearly sees nothing wrong
with his unusual behavior.
 Child Rapist
 A violent childabuser whose behavior is an
expression of hostile sexual drives.

36. Engaging in sexual contact with animals. When
the act or fantasy of sexual activity with
animals is a repeatedly preferred or exclusive
means of sexual gratification, it is called
ZOOPHILIA.

37.  Derived from the word
‘Frotter’ meaning ‘To rub’
 Refers to the masturbation
that involves rubbing against
another person.
 Frotteur has recurrent sexual
desires on rubbing into
people. Targets of Frotteurs
are not consenting people,
rather they target strangers.

38.  Obsessed with the rubbing of selves to
unsuspecting strangers, finding it sexually
pleasurable.
 Often acts quickly, or undetected.
 Fantasizes that they are in an intimate
relationship with the stranger.
 Treatment includes extinction and covert
conditioning.

39.  Coprophilia- deriving sexual pleasure from
contact with feces.
 Klismaphilia- deriving sexual pleasure from the
use of enemas.
 Urophilia- deriving sexual pleasure from contact
with urine.
 Autagonistophilia- having sex in front of
others.
 Somnaphilia- having sex with a sleeping person.
 Stigmatophilia- deriving sexual pleasure from
skin piercing or a tattoo.
 Autonepiophilia- wearing diapers for sexual
pleasure.

40.  Telephone Scatologia- making obscene
phone calls, such as describing one’s
masturbatory activity, threatening to rape
the victim, or trying to find out the victim’s
sexual activities.
 Necrophilia- deriving sexual gratification
from viewing or having sexual contact with a
corpse.
 Zoophilia- having sex with animals or
having recurrent fantasies of sex with
animals.

41. Abnormal Psychology
Welcome
Continuation Of
Paraphilia
Treatment

42. There is an abundance of small studies and case
reports regarding a variety of pharmacological
and psychological treatments within sex
offender populations, as captured by the
researchers, such as pedophilia, exhibitionism
and rape. The research into treatment of other
‘non-criminal’ paraphilias is negligible, it is
reliant on voluntary disclosure, which is very
rare, and justification for treatment of such is
still very much debatable

43. Group therapy inthis setting isdesigned tohelp
paraphilic individuals break through the denial they
socommonly exhibit bysurrounding them with other
patients who share their condition. Once these
individuals begin to admit that theyhave asexual
divergence, thetherapist can begin to address
individual issues that mayhave led tothe sexual
disorder.

44. Cognitive-behavioral therapy (CBT) involves
applying behavioral therapy techniques to
modify sexual deviations by altering patients’
distorted thinking patterns and making them
cognizant of the irrational justifications that lead
to their undesirable sexual behaviors

45. 1. Aversive conditioning with ammonia or
(masturbatory) satiation
2. Confrontation of cognitive distortions (especially
effective in groups)
3. Victim empathy (showing videos of victims and the
consequences they experience from the patient’s act)
4. Assertiveness training (including social skills training,
time management, and structuring)
5. Relapse prevention (identifying antecedents to the
behavior [high-risk situations] and ways of disrupting
these antecedents)
6. Surveillance systems (family associates who help
monitor patient behavior)
7. Lifelong maintenance

46. Psychotherapy is not the most effective
form of treatment for pedophilia;
however, it still is important to teach
pedophiles what is at the root of their
problems.

47. Individual expressive-supportive therapy requires
a psychologically minded patient who is willing to
focus on the paraphilia.
The therapist should not set unrealistically high
goals but must break through the denial

48. Pharmacologic interventions may be used to
suppress sexual behaviour. These
treatments may offer genuine help to a
variety of patients with paraphilic disorders;

49. Psychosurgery using stereotaxic tractotomy and
limbic leucotomy may be performed. This is an
invasive, irreversible procedure that was used
on a small number of subjects, primarily in
Germany. Some success has been reported in the
treatment of pedophilia, hypersexuality, and
exhibitionism. Given its emotional, physical, and
intellectual adverse effects, as well as the
availability of suitable pharmacologic
interventions, this procedure is not likely to be
widely used.

50. Family systems therapy has been tried in homes
where incest has occurred and it is desired by all
family members to reunite or keep the family
intact.
This type of therapy needs to be insight oriented.

51. Empirical studies indicate that the most effective
treatment as far as physical sexual abuse is
concerned resides in the castration methods –
either physical, which is illegal, or chemical. The
reason these methods are effective, is not
because the illness is being cured, but rather
because the sexual desire of the male is being
inhibited.