Paraphilia

Sexual feelings or behaviors that may involve sexual partners that are not human, not consenting, or that involve suffering by one or both partners.

To diagnose an individual with a paraphilia, the psychologist or other diagnostician must confirm recurrent, intense, sexually arousing feelings, fantasies, or behaviors over a period of at least six months. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), it is not uncommon for an individual to have more than one paraphilia.

Bestiality

Bestiality is a term that describes sexual feelings or behaviors involving animals. Termed zoophilia by the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), this is a relatively uncommon disorder. The disorder does not specify an animal or category of animals; the person with zoophilia may focus sexual feelings on domesticated animals, such as dogs, or farm animals, such as sheep or goats.

Exhibitionism

Exhibitionism is the exposure of genitals to a nonconsenting stranger. In some cases, the individual may also engage in autoeroticism while exposing himself. Generally, no additional contact with the observer is sought; the individual is stimulated sexually by gaining the attention of and startling the observer.

Masochism (Sexual)

Masochism is a term applied to a specific sexual disorder but which also has a broader usage. The sexual disorder involves pleasure and excitement produced by pain, either inflicted by others or by oneself. It usually begins in childhood or adolescence and is chronic. Masochism is the only paraphilia in which any noticeable number of women participate—about 5 percent of masochists are female. The term comes from the name of a nineteenth century Austrian writer, Leopold von Sacher-Masoch, whose novels often included characters who were obsessed with the combination of sex and pain.

In the broader sense, masochism refers to any experience of receiving pleasure or satisfaction from suffering pain. The psychoanalytic view is that masochism is aggression turned inward, onto the self, when a person feels too guilty or afraid to express it outwardly.

Pedophilia

Pedophilia involves sexual activity with a child, generally under age 13. The Diagnostic and Statistical Manual of Mental Disorders describes a criterion that the individual with pedophilia be over 16 years of age and be at least five years older than the child. Individuals with this disorder may be attracted to either males or females or both, although incidents of pedophilic activity are almost twice as likely to be repeated by those individuals attracted to males. Individuals with this disorder develop procedures and strategies for gaining access to and trust of children.

Sadomasochism

Sadomasochism applies to deviant sexual behavior in which an individual achieves gratification either by experiencing pain (masochism) or inflicting it on another (sadism).

In psychoanalytic theory, sadism is related to the fear of castration, while the behaviorist explanation of sadomasochism is that its constituent feelings are physiologically similar to sexual arousal. Separate but parallel descriptions are given for sexual sadism and sexual masochism in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The clinical diagnostic criteria for both are recurrence of the behavior over a period of at least six months, and significant distress or impairment of the ability to function as a result of the behavior or associated urges or fantasies. Either type of behavior may be limited to fantasies (sometimes while one is engaged in outwardly nondeviant sex) or acted out with a consenting partner, a non-consenting partner, or in the case of masochism, alone. Sadomasochism occurs in both males and females, and in both heterosexual and homosexual relationships.

Sadistic activities, which may express dominance or inflict pain and /or humiliation on the other person, include restraint, blindfolding, whipping, burning, rape, stabbing, strangulation, and even death. Masochists may seek to be the object of some of these acts as well as other types of humiliation, including forced cross-dressing. A particularly dangerous and fatal masochistic practice is hypoxyphilia, which consists of deliberately cutting off one's oxygen supply through mechanical or chemical means. Both sadistic and masochistic fantasies usually begin in childhood, and the disorders usually manifest in early adulthood. When associated with anti-social personality disorder, it may result in serious injury to others or death.

Voyeurism

Voyeurism is a paraphilia in which a person finds sexual excitement in watching unsuspecting people who are nude, undressing, or having sex. Voyeurs are almost always male, and the victims are usually strangers. A voyeur may fantasize about having sex with the victim but almost never actually pursues this. The voyeur may return to watch the same stranger repeatedly, but there is rarely physical contact.

Voyeurs are popularly known as "peeping Toms," based on the eleventh-century legend of Lady Godiva. According to the story, Tom was a tailor who "peeped" at Lady Godiva as she rode naked through the streets of Coventry, England, in a sacrificial act to get her husband to lower taxes. Tom was struck with blindness for not looking away like everyone else did.

Incidence and treatment

Psychologists estimate that a greater percentage of people experience sexual deviance than is officially reported. This is because many people who carry out sexual deviations do not consider their activities to be deviant. For instance, sadomasochists have group meetings, workshops, and large gatherings and have become something of a subculture. They do not typically think of themselves as needing therapy or treatment.

People who seek treatment for paraphilias often do so because they have been cited for illegal activity or because they are afraid they may do something illegal and be caught for it. Many different treatments have been tried with paraphilias, from medication to group therapy, to eliminate the behavior. Psychologists report low success rates, especially among criminally charged child molesters. Behavior modification is most likely to succeed when a combination of therapy, aversion technique (using electric shock or visualization to change pleasure experience), and medication is employed.