Paraphilias - Causes, Symptoms & Treatment

Paraphilias are sometimes referred to as sexual deviations or perversions. Paraphilias include fantasies, behaviors, or sexual urges focusing on unusual objects, activities, or situations. The act commonly is followed by arousal and orgasm, usually achieved by masturbation and fantasy. Paraphilias are considered deviant outside of acceptable patterns of behavior because they involve unusual objects, activities, or situations not considered sexually arousing to others. Paraphilias may interfere with the capacity for reciprocal affectionate sexual activity. Paraphilia is also used to imply non-mainstream sexual practices without necessarily implying dysfunction or deviance. Paraphilias are considered rare, affecting only a small percentage of the US population. Most patients are aged 15-25 years; this disorder rarely occurs in individuals older than 50 years. The information on paraphilia in older individuals is limited. Although many of the paraphilias seem so foreign or extreme that one could not imagine how the object or behavior can be arousing to anyone, they are easier to understand if one thinks of those behaviors that, in less extreme versions, are quite common and not considered abnormal. There are numerous paraphilias. Some of the major types. Paraphilias first is Fetishism- the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement. Fetishists usually collect the object of their favor, and may go to great lengths, including theft, to acquire just the "right" addition for their collection. Second is Transvestism - The male with this fetish usually has a variety of female clothes that he uses to cross-dress.

Transvestism is not simply dressing up in the other sex's garments for fun or for temporary effect. Paraphilias third types is Voyeurism is behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or may not be sexual in nature at all. Fourth is Exhibitionism- compulsive act of inappropriately exposing one's sex organs to unsuspecting strangers for the purpose of sexual arousal and gratification. Fifth is Sadomasochism- Sadism is the intentional infliction of pain on another person or the threat to do so, for sexual excitement. This disorder is different from minor acts of aggression in normal sexual activity; for example, rough sex. In some cases, sexual sadists are able to find willing partners to participate in the sadistic activities. The caused of Paraphilia is childhood trauma, such as sexual abuse. Others causes sexually arousing if they are frequently and repeatedly associated with a pleasurable sexual activity. In most cases, the individual with a paraphilia has difficulty developing personal and sexual relationships with others. Many paraphilias begin during adolescence and continue into adulthood. The intensity and occurrence of the fantasies associated with paraphilia vary with the individual, but usually decrease as the person ages. Paraphilias treatment modalities currently used fall into three categories: surgical castration, psychotherapy, and pharmacotherapy. Long-acting gonadotropin-releasing hormone (GnRH) agonist analogues are the most potent antiandrogens, and selectively abolish testosterone secretion in a totally reversible fashion.

Causes of Paraphilias

Common causes and Risk factors of Paraphilias

• Brain injury.
• Schizophrenia.
• Biological factors.
• Sexual hormones.

Signs and Symptoms of Paraphilias

Common Sign and Symptoms of Paraphilias

• Pain..
• Humiliation to another person.
• Bitten, or spanked.

Treatment of Paraphilias

Common Treatment of Paraphilias

• Treatment modalities currently used fall into three categories: surgical castration, psychotherapy, and pharmacotherapy.
• Pharmacological interventions consist of antiandrogens that either completely reduce testosterone secretion and/or antagonize the action of testosterone at the level of the receptor, and psychotropic drugs, namely antidepressants.
• Cyproterone and medroxyprogesterone acetates are the two antiandrogens more commonly used.
• Psychotropic drugs may be effective solely in men with a definite obsessive-compulsive disorder component.
• Long-acting gonadotropin-releasing hormone (GnRH) agonist analogues are the most potent antiandrogens, and selectively abolish testosterone secretion in a totally reversible fashion.
• Group therapy involves breaking through the denial so commonly found in people with paraphilias by surrounding them with other patients who share their illness.
• Cognitive therapies described include restructuring cognitive distortions and empathy training.
• Use social skills training to treat patients with these types of disorders. Many social skills training groups also teach basic sexual education, which is very helpful to this patient population.