Atypical Sexual Behavior
Common Versus Atypical Sexual Behavior
I. General points about atypical sexual behavior
A. In many instances, there are gradations of a sexual behavior existing on a continuum
1. Most people enjoy looking at other people, but, if someone spends many hours each day just looking at others, we would probably assume that a person has a problem
B. When is behavior obsessive (individual does not freely choose the behavior); when is it associated with emotional distress or with inability to interact satisfactorily with others
C. Many of us recognize some degree of atypical behaviors or feelings in ourselves, perhaps as in private fantasies
D. It is common not to know a lot about atypical sexual behaviors; since it is not common & is usually performed in private, it is difficult to study
II. Atypical sexual behaviors often occur in combination – Marv Albert did cross-dressing along with group sex & violence
The Most Common Paraphilias
I. Unusual or problematic sexual behaviors are scientifically known as paraphilias – philia means love; para means beyond the usual —> paraphilia is love beyond the usual
A. ~30 different paraphilias; each exists in fantasy & reality
B. Generally accepted that prevalence & variety of paraphilias are greater in males than in females; in most instances, little is known about them
II. Exhibitionism (usually called flashing or indecent exposure) – occurs when an individual achieves sexual gratification by exhibiting the genitals to observers
A. Amer. Psychiatric Assn. (1998) – officially defined it as:
1. "Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges or behaviors involving the exposure of one's genitals to an unsuspecting stranger"
B. Good example of sexual behavior that is difficult to classify as one that causes problems but…..
C. It has its origins in the primate courtship or the allurement ritual of displaying the genitalia as an invitation to copulation
D. No definite support for any theory that explains its cause; studies of exhibitionists characterize them as having:
E. Marshall (1991) – exhibitionists have important deficit in the capacity for intimacy; stated that this feature must be addressed in treatment
F. Silverstein (1996) – said genital exhibitionism is motivated by need for attention & admiration as well as a wish to overcome shame & feelings of inadequacy
G. Facts about exhibitionists that might put the behavior in perspective
1. Exhibitionist receives sexual gratification through victim's (observer's) response
2. They might achieve orgasm by the very act of exposure, but more likely they will masturbate either while exhibiting or later
H. Some think that they are violent & aggressive, but they usually are not
1. Extremely rare for them to do anything more than display the genitals
III. Voyeurism – also known as scopophilia (love of viewing); means obtaining sexual pleasure from watching unsuspecting people undress & engage in sexual activity
A. Amer. Psychiatric Assn. (1998) official definition – over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges or behaviors,
1. involving the act of observing an unsuspecting person who is naked, in the process of disrobing or engaging is sexual activity
B. Peeping Tom is a voyeur; voyeur learns from experience where to find people to watch
C. They are often shy & lonely & lack social skills; they commonly fantasize about having sexual relations with people they are watching; they often masturbate while fantasizing
D. Some degree of voyeurism probably exists in everyone; society even condones some forms of it
IV. Obscene communication – most common & traditional form is the obscene phone call; through years, many examples of obscene letter writing & now obscene e-mails
A. Erotic phone calling is a form of erotic distancing; obscene caller or writer gets sexual pleasure from a distance & not from direct contact with another person
1. Phone callers get sexual gratification by making obscene remarks over phone
B. Smith & Morra (1994) – national survey of Canada; 83.2% of females had received obscene or threatening phone calls at some time in their life
1. Divorced & separated females, young females & those living in major metropolitan areas were most likely to have been victims of this harassment
C. Katz (1994) – found that in 6 months preceding national survey in US, 16% of women had received at least one call
D. Obscene callers have counterparts in those who se primary turn-on is not genital sexual activity with a partner but erotic narrations or readings
1. Obscene letter writer or computer message sender is hoping for sexual gratification as well
E. What is recommended if person gets an obscene communication?
1. People advised to remain calm & not reveal shock or fright, which would reinforce the message sender & increase likelihood of repeated contact
2. Recommended response is to say nothing & end communication
V. Masochism & sadism – sacrificial paraphilias are those in which one or both partners atone for wicked acts by undergoing an act of penance or sacrifice
A. Penalty ranges from humiliation & hurt to blood sacrifice & death – self-sacrifice is masochism; partner sacrifice is sadism; either may be voluntary or forced
B. Amer. Psychia. Assn. (1998) – defines sexual masochism as "over a period of at least 6 months, recurrent, intense, sexually arousing fantasies, sexual urges or behaviors involving the act (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person"
C. Sexual masochism is sexual gratification that results from experiencing pain; might include scratching, biting, beating & the use of various devices
D. Sexual sadism occurs when an individual gets sexual gratification from inflicting pain on another person
1. Hallmark of sadism is intentional torture of victim to sexually arouse offender
E. Domination & degradation are important to both sadist & masochist – some psychiatrists feel sadism is expression of anger & hostility
F. Sadomasochism is paraphilia that combines both sadistic & masochistic sexual behavior; main characteristic is eroticizing of pain
1. What appears to outsider to be painful is experienced as somewhat painful but mostly pleasurable & very sexually arousing to sadomasochist
G. More info on masochism & sadism than on most other paraphilias
1. Weinberg, Williams & Moser (1984) – reported that although some persons engage in nonconsensual sexual violence (rape, lust murders)…..
2. Glickauf-Highes (1991) - masochists' relationships are characterized by masochists' loving objects who give nonlove in return
3. Nakakuki (1994) – proposed concept of "normal masochism" seeming to imply that it does not have to be viewed as a negative behavior or psychological problem
4. Shainess (1997) – noticeable masochism symptoms include:
5. Burmeister (1997) – masochism fosters temporary escape from stressful awareness of one's ordinary identity
6. Litman (1997) – suggested sexual masochism is more widespread & can be more dangerous than literature currently indicates
H. Sexual masochism is more common in males, but incidence in females is rising
I. Some sadists also require pain or humiliation of a partner to function sexually; as long as partner is consenting, sadism is not considered to be a psychological disorder
J. People who engage in masochism & sadism must be especially careful about diseases transmitted by body fluids (hepatitis, HIV)
K. Sadism & masochism are good examples of sexual behaviors in which we need to differentiate between fantasy & behavior
VI. Transvestism – sometimes confused with transsexualism & homosexuality; transvestite takes pleasure in wearing clothing of other sex & likely gets sexual gratification by doing it
A. However, a transvestite may have no interest in having a sex-change operation or in relating sexually to members of the same sex
B. Some transvestites cross-dress only periodically; use of female clothes (most transvestites are males) may approximate a fetish
C. No one knows for sure why some people are transvestites & it is interesting to note that most of them have quite normal heterosexual relationships
D. Anonymous survey of 1032 periodic cross dressers
E. Most begin to experiment with cross-dressing when they are children or adolescents
1. Some feel guilty & uncomfortable about this preference; others do not
VII. Fetishism - a paraphilia in which an inanimate object elicits sexual arousal; articles of clothing & materials made of rubber, silk, fur or leather are common fetishistic objects
A. Amer. Psych. Assn. (2000) – defines symptoms of fetishism as "over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects."
1. "The fantasies, sexual urges or behaviors cause clinically significant distress or impairment in social, occupational or other important areas of functioning."
B. Fetishist may masturbate while engaging in fetishistic behaviors or may just enjoy stimulation from the objects
C. In related paraphilia, partialism, people are aroused by a particular body part (breasts, muscular chests, feet, etc.)
D Generally, a person who has fetishism must have the fetish present to become sexually excited
F. Most fetishisms & partialisms are harmless
Other Paraphilias
I. Beastiality (zoophilia) – sexual contact with animals
A. Kinsey (1948, 1953) - ~8% of males & 4% of females reported having had sexual experiences with animals at some time
B. Such relationships with animals have been interesting topic for some people for hundreds of years
C. Historically, taboos against human-animal contact have been severe – laws in many states treated bestiality as a felony
D. Sexual experience with animals is usually only a transitory experience for young people who do not have acceptable sexual partners
E. True zoophilia exists only when sexual contacts with animals are preferred even when other forms of sexual contact are readily available
II. Frottage – act of getting sexual pleasure from rubbing or pressing against a nonconsenting person
A. Official definition – "over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving touching & rubbing against a nonconsenting person."
B. Likely to occur in crowds, on elevators & in buses & subways
III. Necrophilia – rather rare behavior in which a person receives sexual pleasure from viewing or having sexual relations with a dead person
A. Sometimes necrophiliacs (almost all of whom are men) pay women to pretend to be dead in order to provide sexual pleasure
B. Necrophiliacs are usually severely emotionally disturbed & sexually & socially inept & hate & fear women
C. Although local newspapers do not report instances, law enforcement officers indicate that bodies are sometimes stolen for this purpose
IV. Troilism – having sexual relations with another person while a third person watches
A. In one respect, troilism combines elements of exhibitionism & voyeurism
B. Example – husband invites another man to have intercourse with his wife
C. It is clearly not a safe sexual activity; with multiple partners involved, it is a high-risk activity
V. Asphyxiophilia – desire for a state of oxygen deficiency in order to enhance sexual excitement & orgasm
A. Also called erotic or autoerotic suicide, sexual suicide, autoerotic strangulation, autoerotic asphyxiation, hypoxophylia, autoerotic accident
B. Most information about it is found in reports from police or doctors of forensic medicine who examine people who have died during this behavior
C. O2 deficiency can be induced in many ways; since circumstances /features of autoerotic deaths are not commonly known, they are often misinterpreted as homicides or suicides
1. Death can easily result since cutting off blood flow to brain can produce unconsciousness in as little as 5 – 10 seconds
E. There are several theories to account for life-threatening autoerotic behaviors:
VI. Klismaphilia – sexual arousal is obtained from enema use
A. Klismaphiles usually prefer the receiving role; less commonly arousal may be associated with administering an enema
B. Their background often indicates that as infants or young children, they were frequently given enemas by concerned & loving mothers
C. Since it involves anal contact, it is not a safe sexual activity unless latex gloves are used & there is great attention to cleanliness
VII. Coprophilia – sexual pleasure is associated with feces; people with it reach high levels of sexual excitement by watching someone defecate or by defecating on someone
A. Connection of feces with sexual arousal may also go back to childhood
B. Since it appears that HIV can be present in any body tissue or fluids, coprophilia is not a safe sexual activity
VIII. Urophilia – sexual pleasure is associated with urine
A. Similarly to coprophilia, person may want to urinate on someone or be urinated on
B. There may be childhood beginnings
Treatment of Paraphilias
I. A number of issues surface when one considers treatment for paraphilias
A. People with paraphilias often do not want treatment
B. They often feel that they cannot control their urges, so they cannot accept personal responsibility for their actions
1. However, personal responsibility is usually a prerequisite for successful behavior change
C. Some helping professionals think it is not their responsibility to provide treatment for paraphilias; they believe it is the responsibility of the criminal justice system
D. Possible treatments fall into 3 categories: psychotherapy, behavior therapy, pharmacological approaches (drug therapy)
II. Psychotherapy – not much info available about successful treatment of paraphilias by psychotherapy
A. Purpose of psychoanalysis is to discover unconscious conflicts that are believed to originate in childhood
B. If conflicts can be drawn to surface & resolved, the hope is that the particular behavior can be changed
III. Behavior therapy – applies learning principles to help people change their behavior; many techniques have been used to help change paraphiliac behavior
A. Systematic desensitization – therapist tries to break the link between a sexual stimulus (leather for fetishist) & inappropriate response (sexual stimulation)
B. Aversion therapy – undesirable behavior (masturbation for voyeur) is paired repeatedly with negative stimulus, such as a painful (but harmless) electric shock
C. Social training – individual is helped to improve his or her social skills
D. Orgasmic reconditioning – goal is to increase sexual arousal by socially appropriate stimuli
IV. Drug therapy – no drug can eliminate such behavior…..
A. But some chemicals can sometimes be helpful in reducing intensity of sexual drives & establishing environment for more successful treatment using one of other approaches
B. Prozac (commonly used for treating depression) has been used to help some people reduce obsessions & compulsions
C. Antiandrogen drugs (chemicals that reduce sex drive by lowering testosterone level in bloodstream) can reduce sexual desire & erections in males
Sexual Addiction
I. Some people might have very strong, or even insatiable, sexual needs
A. Nymphomania – excessive, insatiable sexual drive in women; satyriasis or Don Juanism – same condition in men
B. Some experts believe that sexual addiction is mainly a male abnormality caused by childhood trauma that usually requires intense psychotherapy
C. Sexual addiction can involve a wide variety of practices – sometimes addict has trouble with just one unwanted behavior, sometimes with many
D. Patrick Carnes outlines 10 practical & useful indicators of compulsive sexual behavior
E. Main way to identify any addictive behavior is to consider whether it is causing negative or unwelcome problems & yet the person continues it anyway
1. Sex addicts are often unable to make & keep commitments to themselves & others about stopping or changing particular sexual behaviors over the long term
F. Recently, cybersexual addiction has become prominent; symptoms are:
G. Organizations formed to help people deal with activities if they feel there is problem; no agreement on how to deal with compulsive sex activity (if it can be done at all)
H. Initial process of treatment can be divided into 3 major stages
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