Paraphilia 23592 224432460 2008-07-08T20:38:07Z The Haunted Angel 1052195 Sorry to ignore the comment, but there is no justification for the spacing, defies MoS {{Redirect|Parasexual|parasexuality in microbiology|bacterial conjugation}} A '''paraphilia''' (in [[Greek language|Greek]] ''para'' παρά = besides and ''[[-philia]]'' φιλία = love)&mdash; is any of several persistent, intense sexual interests, fantasies, or urges involving nonhuman objects, pain or humiliation, children, or nonconsenting individuals. Paraphilias may interfere with the capacity for sexual activity with consenting adult partners.<ref>American Psychiatric Association (2000). ''Diagnostic and statistical manual of mental disorders'' (4<sup>th</sup> ed., text revision). Washington, DC: Author.</ref> See also [[List of Paraphilias]]. ==Early descriptions== Eulenburg (1914) noted a commonality across the paraphilias, using the terminology of his time, "All the forms of sexual perversion...have one thing in common: their roots reach down into the matrix of natural and normal sex life; there they are somehow closely connected with the feelings and expressions of our physiological erotism. They are...hyperbolic intensifications, distortions, monstrous fruits of certain partial and secondary expressions of this erotism which is considered 'normal' or at least within the limits of healthy sex feeling."<ref>Eulenburg (1914). ''Ueber sexualle Perversionen. Ztschr. f. Sexualwissenschaft,'' Vol. I, No. 8. translated in Stekel W. (1940). ''Sexual aberrations: The phenomena of fetishism in relation to sex.'' New York: Liveright, p. 4.</ref> ==Clinical definition== The clinical literature contains reports of many paraphilias, only some of which receive their own entries in the diagnostic taxonomies of the [[American Psychological Association]] or the [[World Health Organization]].<ref>[http://psyweb.com/Mdisord/DSM_IV/jsp/Axis_I.jsp psyweb.com "Axis I. Clinical Disorders, most V-Codes and conditions that need Clinical attention". Retrieved: 23 November, 2007.]</ref><ref>World Health Organization, International Statistical Classification of Diseases and Related Health Problems, (2007), [http://www.who.int/classifications/apps/icd/icd10online/ Chapter V, Block F65; Disorders of sexual preference.] Retrieved 2007-11-29.</ref> There is disagreement regarding which sexual interests should be deemed paraphilic disorders versus normal variants of sexual interest. The [[Diagnostic and Statistical Manual of Mental Disorders|DSM]] provides clinical criteria for these paraphilias: *[[Exhibitionism]]: the recurrent urge or behavior to expose one's genitals to an unsuspecting person. (Can also be the recurrent urge or behavior to perform sexual acts in a public place, or in view of unsuspecting persons.) *[[Sexual fetish|Fetishism]]: the use of inanimate objects to gain sexual excitement. ''[[Partialism]]'' refers to fetishes specifically involving nonsexual parts of the body. *[[Frotteurism]]: the recurrent urges of behavior of touching or rubbing against a nonconsenting person. *[[Pedophilia]]: the sexual attraction to [[puberty|prepubescent or peripubescent]] children. *[[Sadism and masochism as medical terms|Sexual Masochism]]: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer for sexual pleasure. *[[Sadism and masochism as medical terms|Sexual Sadism]]: the recurrent urge or behavior involving acts in which the pain or humiliation of a person is sexually exciting. *[[Transvestic fetishism]]: a sexual attraction towards the clothing of the opposite gender. (Compare to [[autogynephilia]].) *[[Voyeurism]]: the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or may not be sexual in nature at all. Under ''Paraphilia NOS'', the DSM mentions [[telephone scatalogia]] (obscene phone calls), [[necrophilia]] (corpses), [[partialism]] (exclusive focus on one part of the body), [[zoophilia]] (animals), [[coprophilia]] (feces), [[klismaphilia]] (enemas), [[Urolagnia|urophilia]] (urine), [[emetophilia]] (vomit). The DSM's Paraphilia NOS is equivalent to the ICD-9's ''Sexual Disorder NOS''. The literature includes single-case studies of exceedingly rare and idiosyncratic paraphilias. These include an adolescent male who had a strong fetishistic interest in the exhaust pipes of cars, a young man with a similar interest in a specific type of car, and a man who had a paraphilic interest in sneezing (both his own and the sneezing of others).<ref>{{cite journal|journal=Psychiatry|volume=6|issue=3|date=March 2007|pages=130&ndash;134|title=Sexual disorder and psychosexual therapy|author=Padmal de Silva|doi=10.1016/j.mppsy.2006.12.009|publisher=Elsevier Ltd|url=http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B82Y7-4N0GJN5-6&_user=10&_coverDate=03%2F31%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0e747196d9865801e85db7b1c2942c5b}}</ref><ref>{{cite journal|author=King, M.B.|title=Sneezing as a fetish object|journal=Sex Marital Therapy|volume=5|date=1990|pages=69&ndash;72|doi=10.1016/j.mppsy.2006.12.009}}</ref> See also [[List of Paraphilias]]. ===Intensity and specificity=== Clinicians distinguish between optional, preferred and exclusive paraphilias, though the terminology is not completely standardized. An "optional" paraphilia is an alternative route to sexual arousal. For example, a man with otherwise unremarkable sexual interests might sometimes seek or enhance sexual arousal by wearing women's underwear. In preferred paraphilias, a person prefers the paraphilia to conventional sexual activities, but also engages in conventional sexual activities. For example, a man might prefer to wear women's underwear during sexual activity, whenever possible. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia.{{Fact|date=June 2008}} Optional paraphilias are far more common than preferred paraphilias, which are, in turn, far more common than exclusive paraphilias.{{Fact|date=November 2007}} Optional paraphilias sometimes disrupt stable relationships when discovered by an unsuspecting partner. Preferred paraphilias often disrupt otherwise stable relationships. Open communication and mutual support can minimize or prevent such disruption in both of these cases. Exclusive paraphilias often preclude normal courtship and committed romantic relationships, even when the person in question desires such a relationship. Loneliness or social isolation are common consequences. In extreme cases, preoccupation with a preferred or exclusive paraphilia completely displaces the more typical desire for loving human relationships.{{Fact|date=June 2008}} ===Drug treatments=== The treatment of paraphilias and related disorders has been challenging for patients and clinicians. In the past, surgical [[castration]] was advocated as a therapy for men with paraphilias, but it was abandoned because it is considered a cruel punishment and is now illegal in most countries. Psychotherapy, self-help groups, and pharmacotherapy (including the controversial hormone therapy sometimes referred to as "chemical castration") have all been used but are often unsuccessful.{{Fact|date=April 2008}} Here are some current drug treatments for these disorders.<ref name=Williams1>M. Williams. [http://www.brainphysics.com/paraphilias.php Sexual Compulsivity: Defining Paraphilias and Related Disorders "Psychoactive Drug Treatments"]. Retrieved 23 November, 2007</ref> ====Hormone drug treatments==== In humans, [[testosterone]] has a crucial role not only in the development and maintenance of male sexual characteristics but also in the control of sexuality, aggression, cognition, emotion, and personality. Testosterone is a major determinant of sexual desire, fantasies, and behavior, and it increases the frequency, duration, and magnitude of spontaneous and nocturnal erections. The deviant sexual fantasies, urges, and behavior of men with paraphilias also appear to be triggered by testosterone. Therefore, reducing testosterone secretion or inhibiting its action is believed to control these symptoms. Antiandrogenic drugs such as medroxyprogesterone (also known as the long-acting contraceptive [[Depo Provera]]) have been widely used as therapy in these men to reduce sex drive. However, their efficacy is limited and they have many unpleasant side effects, including breast growth, headaches, weight gain, and reduction in bone density. Even if compliance is good, only 60 to 80 percent of men benefit from this type of drug. Long-acting gonadotropin-releasing hormones, such as Triptorelin (Trelstar) which reduces the release of gonadotropin hormones, are also used. This drug is a synthetic hormone which may also lead to reduced sex drive.<ref name=Williams1 /> ====Psychoactive drug treatments==== [[Selective serotonin reuptake inhibitor]] (SSRI) class of antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and paroxitine (Paxil), have all been used to treat paraphilias and related disorders by reducing impulse control problems and/or [[sexual obsessions]] with some success. Tricyclic antidepressants (TCA), such as imipramine (Tofranil) and desipramine (Norpramin), are also used. [[Lithium]], the mood-stabilizing drug also known as Eskalith is typically used for the treatment of mania in bipolar disorder. There are some reports of reduced sexual compulsive behavior and a reduction in obsessive sexual thoughts in patients, which they attribute to the drug's enhancement of serotonergic functioning. Anxiolytics are not considered a typical treatment for these type of disorders, however the efficacy of buspirone (BuSpar) has been clinically demonstrated. Psychostimulants have been used recently to augment the effects of [[serotonergic]] drugs in paraphiliacs. In theory, the prescription of a psychostimulant without pretreatment with an SSRI might further disinhibit sexual behavior, but when taken together, the psychostimulant may actually reduce impulsive tendencies. Methylphenidate (Ritalin) is an amphetamine like stimulant used primarily to manage the symptoms of attention deficit hyperactivity disorder (ADHD). Recent studies imply that methylphenidate may also act on serotonergic systems; this may be important in explaining the paradoxical calming effect of stimulants on ADHD patients. Amphetamine is also used medically as an adjunct to antidepressants in refractory cases of depression.<ref name=Williams1 /> ==Religious views== {{main|Religion and sexuality}} Various religious adherents view various paraphilias as deviations from a divine plan for human sexuality, as understood through their religious tradition or laws. Depending in part on the nature of the paraphilia in question, judgements can differ as to whether religiously it should be considered a case of sexual [[sin]], [[mental illness]], or simply harmless sexual variation. Another variable is whether it is the acting out, or (less commonly) just the desirous thought alone, which is critically viewed in such cases. In any event, several paraphilias, such as bestiality or pedophilia, are viewed negatively by various religions. Some religious traditions include forms of extreme [[asceticism]], such as [[flagellation|whipping]] , which, when practiced as sexual activities, would usually be considered masochism and popularly viewed as paraphilias. When practiced for non-sexual reasons, they are usually valued by the religious groups concerned as a part of their religious observance and submission to [[god]]. ==Legality== {{main|Sex and the law}} As a general rule, the law in many countries often intervenes in paraphilias involving young or adolescent children below the legal [[age of consent]] and sex with animals due to [[duty of care]] issues and general public abhorrence of the practice. There is also legal intervention concerning nonconsensual deliberate displays or illicit watching of sexual activity, illegal manipulation of dead people, harassment, nuisance, fear, injury, or assault of a sexual nature. Separately, it also usually regulates or controls [[censorship]] of [[pornography|pornographic]] material. ''Exhibitionism'', in cases where people who have not previously agreed to watch are exposed to sexual display, is also an offense in most jurisdictions, as is [[voyeurism]] when unarranged ''(see [[indecent exposure]] and [[peeping tom]])''. ''Non-consensual'' sadomasochistic acts may legally constitute assault and therefore belong in the list below. Some jurisdictions criminalize some or all sadomasochistic acts, regardless of [[consent (criminal)|legal consent]], and impose liability for any injuries caused. For these purposes, non-physical injuries are included in the definition of [[grievous bodily harm]] in [[English law]]. ''(See [[Consent (BDSM)]], [[Operation Spanner]]'') ==References== {{Reflist}} ==See also== *[[List of paraphilias]] *[[-philia]] (list of philias) *[[Sexual fetishism]] *[[Kink (sexual)]] *[[Psychosexual development]] *[[Human sexuality]] *[[Developmental psychology]] *[[Human development]] *[[Sex and the law]] *[[Dorian Gray syndrome]] *[[Hebephilia]] *[[John Money]] *[[Richard Freiherr von Krafft-Ebing]] for history of classifying sexual object choice as a disease ==External links== *[http://www.behavenet.com/capsules/disorders/paraphilias.htm DSM-IV and DSM-IV-TR list of paraphilias] {{paraphilia}} {{sex}} [[Category:Paraphilias| ]] [[Category:Human sexuality]] [[bs:Parafilija]] [[bg:Сексуално отклонение]] [[ca:Parafília]] [[cs:Parafilie]] [[cy:Paraffilia]] [[da:Parafili]] [[de:Paraphilie]] [[et:Parafiilia]] [[es:Parafilia]] [[eo:Parafilio]] [[fr:Paraphilie]] [[ko:성도착]] [[hr:Parafilija]] [[it:Parafilia]] [[he:פאראפיליה]] [[lt:Lytinis nukrypimas]] [[hu:Parafília]] [[nl:Parafilie]] [[ja:性的倒錯]] [[no:Parafili]] [[pl:Parafilia]] [[pt:Parafilia]] [[ru:Сексуальные девиации]] [[simple:Paraphilia]] [[sk:Porucha voľby sexuálneho objektu]] [[sr:Парафилије]] [[sh:Parafilija]] [[fi:Parafilia]] [[sv:Parafili]] [[tr:Parafili]] [[zh:性欲倒错]]