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Paraphilias

 
, medical expert
Last reviewed: 23.04.2024
 
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Talk about the existence of paraphilia can be if:

  • sexual fantasy or sexual behavior are directed at a person who disagrees with such intentions or an inanimate object;
  • these fantasies or behavior are of a permanent nature or represent a dominant sexual interest for a given person.

Paraphilias were previously defined as perversions (perversions). The diagnosis of paraphilia suggests that this type of fantasy lasts at least six months and that they are re-realized or cause suffering.

Paraphilias include:

Exhibitionism. The exhibitionist exposes his sexual organs to unknown strangers. Some exhibitionists during this demonstration masturbate or try to touch their victim.

Frothturism. So the desire to touch a person and rub off on him is indicated, if this person does not agree with such behavior. These actions are usually carried out in crowded places - in a train, bus or elevator.

Fetishism. In this disorder, sexual stimulation is carried out with inanimate objects, most often with women's clothing (bras, tights, stockings, shoes) or with a part of the body (for example, with a foot). Most often it is accompanied by masturbation with the use of a favorite object. In transvestion fetishism, the clothes of the opposite sex are used as a fetish.

Masochism. Individuals with this kind of paraphilia experience sexual arousal when they are beaten, tied up or shackled, humiliated, or cause suffering in another way. Sometimes they require these actions from their sexual partner or hurt themselves, masturbating while doing so. Masochism can be extremely dangerous. At its one form (gipoksifilija) the person independently or by means of the partner causes at itself suffocation during the sexual certificate or act.

Sadism. This is a strong sexual desire, which occurs when another person is subjected to mental or physical suffering. Sexual behavior, which includes lashing, beating or mutilation, is sometimes extremely dangerous for victims, regardless of whether they are involved in such relationships voluntarily or under compulsion. Cruelty of behavior, as a rule, increases with the passage of time.

Pedophilia. Pedophiles experience a strong sexual attraction to children and often use them as sexual objects. Some pedophiles have a sexual attraction to those children who have distinctive features, such as blond hair or a certain age. Others stick to both boys and girls, regardless of their somatic symptoms. Unfortunately, in our society pedophilia is widespread, although not every case of sexual abuse of children is known. Such acts are often encountered in asocial personality disorders.

Voyeurism. The main sign of this disorder is a strong sexual impulse, which occurs when watching people who are either exposed or have sexual intercourse. The voyeur does not seek any contact with his victim. Sexual arousal is caused by the act of peeping, which usually accompanies or ends with masturbation.

Rare variants of paraphilia include necrophilia (the desire for sexual actions with the dead), zoophilia (beasts), coprophilia (excrement), urofily (urine), enema (enema) and telephone sex (obscene phone conversations).

Sexual actions between adults and children (pedophilia) or adults and dissenting "partners" (exhibitionism, voyeurism, frotteurizm) are unacceptable for society, illegal and potentially dangerous for their victims.

The true extent of paraphilia and its dynamics in our society are unknown. It seems that its growth is taking place, however, this may be not so much an increase in the number of cases as the number of reports of such incidents.

Causes

The majority (about 90%) of all persons with paraphilias are men, many of whom have two or more kinds of such disorders. In most of these men, these disorders occur during adolescence, up to 18 years. Unfortunately, paraphilias are most definitely diagnosed for the first time only after their arrest.

It is unclear how paraphilia occurs. Some researchers believe that the biological factor, possibly a brain defect, takes part in the development of paraphilia. Others see as a cause a metabolic disorder due to an excess of testosterone. There is an opinion that the origins of such disorders originate in the early childhood fear of castration, hostility against women, or may be caused by the brutality and heartlessness of parents. There is a theory that explains paraphilia acquired reaction to early sexual arousal. When a small boy, for example, is sexually aroused while he is dressed in women's clothing, it is possible that dressing clothes belonging to the other sex will communicate with him with sexual feelings and when he becomes an adult.

Diagnosis and treatment

Firstly, we will delimit paraphilia from variants of normal sexual behavior. It is likely that the couple for a change in sexual life sometimes uses bonding, clothing exchange, etc. Subject to mutual agreement. The diagnosis of paraphilia is valid only if this behavior is of a lengthy nature or is the sole and exclusive means of sexual stimulation leading to orgasm, and if such sexual activity is realized without mutual consent.

If there is a suspicion of paraphiliia, a thorough questionnaire is needed regarding the sexual history, including an unusual way of behavior and the power of sexual fantasies. The psychotherapist (sexologist) should exclude such causes of unusual behavior as psychosis or dementia.

The diagnostic process consists in examining all the false attitudes and beliefs that may be associated with the patient's behavior. Many rapists, for example, believe in what a woman likes when she is incited to sex by violence. Pedophiles often say that sex with children is permissible if it is not accompanied by physical damage. The exhibitionists claim that they show their naked penis to women because they like it. The therapist seeks to correct such self-deception of his patients, developing instead appropriate patterns of behavior and social skills.

In the treatment of paraphilias a number of measures are used from relatively mild to radical. In some countries, repeated violations of the law resort to castration. It is believed that after castration, the concentration of hormones released into the blood from the testicles will decrease and will restrain unacceptable sexual behavior. The results of such surgical interventions, however, are contradictory.

Another method of treatment is to change the concentration of hormones with medications, which suppresses sexual attraction (the so-called chemical castration). Such pharmacological treatment is better to be carried out together with psychotherapy.

For the treatment of paraphilia successfully used and behavioral therapy, which seeks to replace the anomalous type of excitation with acceptable patterns of behavior. With this form of therapy, the level of excitation is monitored by measuring the erection. The patient compares the stimulating effect of paraphilic and non-paraffinic stimuli (slides, video films, tape recordings). In this case, the degree of erection is recorded.

Due to the fact that some patients paraphilia break the law and involve helpless victims in communication, it is important that they are treated for their sexual deviations. They should know that paraphilia, as a rule, can not by itself disappear and that they need professional help.

  • Most people with paraphilia do not have the motivation for treatment. Motivate them should be around.
  • In most cases, effective treatment can be carried out. To get help, contact the psychotherapeutic department of a nearby hospital and contact doctors and psychotherapists who specialize in the treatment of paraphilias. When meeting with an expert, ask if he has experience with such problems, and find out in what framework such therapy should be carried out.

trusted-source[1], [2], [3], [4], [5],

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