SEXUAL+VARIATIONS+PSYCH+2075+2014+2015+PDF

Sexual Variations: Unusual Sexual Interests Professor William Fisher Department of Psychology Department of Obstetrics and Gynaecology University of Western Ontario London Ontario Center for Health Intervention and Prevention University of Connecticut Storrs Connecticut When is Sexual Behavior Abnormal? Some Relativist Definitions  Statistical definition: an abnormal sexual behavior is one that is statistically rare and not practiced by many people.  Waiting until marriage to have sexual intercourse.  Sociological approach: sexual behavior that violates the norms of a particular society  Waiting until marriage to have sexual intercourse.  Psychological approach: interference with meeting the personal and social demands of everyday life  Waiting until marriage to have sexual intercourse.  Recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving non-human objects (Fetishism, Transvestic Fetishism), the suffering or humiliation of oneself or one’s sexual partner (Sexual Sadism, Sexual Masochism), children (Pedophilia), or other non-consenting person (Voyeurism, Fortteurism, Exhibitionism).  Must occur over at least six months  Must cause significant distress or impairment in social and other important areas of functioning. A Normal-Abnormal Continuum  Normal and abnormal sexual behavior by any definitions are not two separate categories but rather gradations on a continuum  Normal range of sexual behavior - mild preference – strong preference, for something statistically, sociologically, or psychiatrically deemed abnormal  For example;  A man may have a preference for a fetish object such as high heels but when he cannot become aroused or engage in sexual activity without the object then he has drifted into the realm of paraphilia. Sexual “Addictions” or Compulsions  Compulsive sexual behavior: disorder in which the person experiences intense sexually arousing fantasies, urges, and associated sexual behaviours that are intrusive, compulsive, and interfere with adjustment to the demands of everyday life  Carne’s four-step cycle:  Preoccupation: Only thought is for the sexual act one is addicted to  Rituals: Certain acts become a prelude to the addictive act  Compulsive sexual behaviour: Person feels she or he has no control over impulse toward the act  Despair: Person does not feel good after act; may trigger paradoxical repetition of the act Fetishism A person’s sexual fixation on some object other than another human being and attachment of great erotic significance to that object Media fetishes and form fetishes Media fetish: a fetish whose object is anything made of a particular substance, such as leather, silk, hair. Form fetish: a fetish whose object is a particular shape, such as high-heeled shoes. Classical conditioning and acquisition of fetish Classical conditioning and aversion to fetish “Preparedness” to condition arousal to fetish object: black, red, shiny, leather Voyeurism and Exhibitionism  Voyeurism: a criminal sexual variation in which the person becomes sexually aroused from secretly viewing other’s sexual acts and genitals.  Exhibitionism: a criminal sexual variation involving exposing genitals to others in inappropriate situations  In one Ottawa study, 6% of offenders went on the commit a hands-on assault  Sexual Sadist: a person who derives sexual satisfaction from inflicting pain on another person.  Sexual Masochist: a person who derives sexual satisfaction from experiencing pain.  Bondage and Discipline: use of physical or psychological restraints to enforce servitude.  Dominance and Submission: the use of power, consensually given, to control the sexual stimulation and behavior of the other person, including BDSM Asphyxiophilia  The desire to induce in oneself a state of oxygen deficiency in order to create sexual arousal or to enhance excitement and orgasm  People engage in asphyxiophilia in the belief that arousal and orgasm are intensified by reduced oxygen  Danger of death by asphyxiation  Mainly males: three men for every one woman  118 recorded deaths in Alberta and Ontario (the only provinces that record these data) between Other Sexual Variations Coprophilia: deriving sexual satisfaction from contact with feces Urophilia - sexual satisfaction from contact with urine Necrophilia - sexual contact with a dead person Zoophilia - bestiality; sexual contact with an animal Frotteurism: rubbing one’s genitals against nonconsenting person Cybersex Use and Abuse  Compulsive behavior  Compulsive, intrusive, distressing, personally and/or socially maladaptive  Griffith’s six characteristics of cybersex “addiction”  Salience: Most important activity in life  Mood modification: Brings a buzz or high  Tolerance: requires more and more  Withdrawal symptoms: Crash when not engaging in cybersex  Conflict: With either people or with job or school responsibilities  Relapse: After quitting practice, may return and have same extreme pattern of use  Online sexual activity. (Or golf. Or eating.) Treatment of Sexual Variations  Cognitive-behavioural therapies  Behaviour therapy to reduce inappropriate sexual arousal and redirect it to appropriate targets.  Social skills training to form better and competing interpersonal relationships.  Modification of distorted thinking and acceptance of responsibility for one’s actions (i.e. a flasher might think “women find this amusing”. He needs to accept that this is a rationalization.)  Finding other, less problematic ways to meet needs/desires  Relapse prevention. Treatment of Sexual Variations  Medical treatments  Surgical castration  Chemical castration: medroxyprogesterone acetate  Psychopharmacological treatment: use of psychotropic medications, e.g.: anti-depressants such as selective serotonin reuptake inhibitors have had some positive research findings Criticisms of the Concept: Are Paraphilias Mental Disorders?  DSM IV definition of paraphilia:  The essential features of a paraphilia are recurrent, intense sexually arousing fantasies, urges, or behaviors that occur over a period of at least six months and are personally or socially disruptive or distressing.  Do adolescence and the sexual high of a new relationships thus qualify as paraphilia?  A behavior in and of itself is not evidence of psychopathology. Does a transvestite have a mental disease or a practical problem with society’s intolerance?  Specification of particular peculiar sexual behaviors and interests leads to discrimination against all practitioners of those behaviors even when their behavioral expressions are appropriate and non-distressing to them.  Dangerous? How about base jumping?. Moser and Kleinplatz, JPHS, 2006. Criticisms of the Concept: Are Paraphilias Mental Disorders?  DSM IV definition of paraphilia:  Social, political, and religious and historical factors affect the inclination to see certain behaviors or sexual interests as pathological.  The therapist’s own socialization or theoretical perspective is likely to affect judgements of health or pathology. Psychological Functioning and Injuries  Normative levels of psychopathology have been found in self-identified BDSM practitioners (Connolly, 2006).  Krueger (2010) concluded that BDSM practitioners by and large “Have shown evidence of good psychological and social function”  Despite an extensive review of the medical literature, no literature identifying injuries related to consensual BDSM exists. Moser and Kleinplatz, JPHS, 2006.  Cautious approach to paraphilias  When personal and social consequences of a pattern of sexual behavior are problematic, pattern of behavior merits attention  May involve seeking to eliminate the behavior, to have the behavior expressed in less problematic ways, or seeking to increase tolerance for the behavior. Moser and Kleinplatz, JPHS, 2006.