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What is a paraphilia? What are the different types of paraphilias?
The word Paraphilia derives from Greek; para means around or beside, and Philia means love. The definition of Paraphilia is any emotional disorder characterized by sexually arousing fantasies, urges, or behaviors that are recurrent, intense, occur over a period of at least six months, and cause significant distress or interfere with the sufferer’s work, social function, or other important areas of functioning. This is as opposed to sexual variants, which are sexual behaviors that are not typical but are not a part of any illness.
The number of people who suffer from a paraphilia is difficult to gauge for a number of reasons. Many people with one of these disorders suffer in secret or silence out of shame, and some engage in sexually offensive behaviors and so are invested in not reporting their paraphilia. Therefore, many of the estimates on the prevalence of paraphilic disorders come from the number of people involved with the criminal-justice system due to pedophilia. Most individuals with this sexual deviation are men (3%-5% of the male population), with just 1%-6% of those individuals being women.However, women tend to be under-diagnosed with paraphilias, wrongfully given the benefit of the doubt by those assessing their sexual behaviors.
Except for masochism, which is 20 times more common in women than men, paraphilias are almost exclusively diagnosed in men. Many people who suffer from one paraphilia have more than one. For example, about one-third of pedophiles also have another paraphilia. More than half engage in three or four such kinds of behaviors rather than just one. Most people who develop a paraphilia begin having fantasies about it before they are 13 years old.
According to the most current standard reference for mental disorders, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), preceded by the DSM-IV and DSM-IV-TR, there are a number of different types of paraphilias, each of which has a different focus of the sufferer’s sexual arousal: Voyeurism: watching an unsuspecting/non-consenting individual who is either nude, disrobing, or engaging in sexual activity Exhibitionism: exposing one’s own genitals to an unsuspecting person Frotteurism: touching or rubbing against a non-consenting person Sexual masochism: being humiliated, beaten, bound, or otherwise suffering Sexual sadism: the physical or emotional suffering of another person Pedophilia: sexual activity with a child that is prepubescent (usually 13 years old or younger) Fetishism: sexual fascination with nonliving objects or highly specific body parts (partialism). Examples of nspecific fetishisms include somnophilia (sexual arousal by a person who is unconscious) and urophilia (derivingn sexual pleasure from seeing or thinking about urine or urinating) Transvestism: cross-dressing that is sexually arousing and interferes with functioning Autogynephilia is a subtype of transvestism that refers specifically to men who become aroused by thinking or visualizing himself as a woman.
Causes and risk factors for Paraphilia:-
Biological issues thought to be risk factors for paraphilias include some differences in brain activity during sexual arousal, as well as general brain structure. Mental health professionals have found that male pedophiles have lower IQ scores on psychological testing compared to men who are not pedophiles. Research has also determined that they tend to have a history of earning lower grades in school than their non-pedophilic counterparts, regardless of intellectual abilities and learning styles.
There are a number of psychological theories about how paraphilias develop. Some view these disorders as a manifestation of arrested psychosexual development, with the paraphilic behaviors defending the person’s psyche against anxiety (defense mechanisms). Others believe paraphilias are the result of the sufferer associating something with sexual arousal and interests, or by having unusual early life sexual experiences reinforced by having an orgasm. Some view these disorders as another form of obsessive-compulsive disorder.
Psychologically, pedophiles who act on their urges by sexually offending tend to engage in grossly distorted thinking, in that they use their position of power and view offending as an appropriate way to meet their needs, think about children as equal sexual beings to adults, and consider their sexual needs as uncontrollable.
Another theory about paraphilia
risk factors is that they are linked to stages of childhood psychological
development like temperament, early relationship formation, trauma repetition,
and disrupted development of sexuality, as follows: Temperament: a tendency to
be overly inhibited or uncontrolled with emotions and behaviors Early
relationship formation: a lack of stable self-awareness, trouble managing
emotions, and in seeking help and comfort from others Trauma repetition: People
who are the victim of sexual or other forms of abuse, especially if it occurs
during childhood, may identify with the abuser such that they act out what was
inflicted on them by victimizing others
in some way. They may also act out the trauma by somehow harming themselves.
Disrupted development of sexuality: The patterns of what brings one sexual
pleasure tend to form by adolescence. People raised in a household that is
either excessively sexually permissive or inhibited are at higher risk for
developing a paraphilia.
Family risk factors for paraphilia development include high conflict between parents or low supervision by parents, a lack of affection from the mother, and generally not feeling treated well by their parents. People with paraphilia tend to have trouble making and keeping friends and other relationships.
Paraphilia symptoms and signs
While the desired sexual stimulant for the paraphilia sufferer depends on the specific paraphilia, the characteristics of the illness are often very similar. Specifically, people with a paraphilia tend to experience arousal by the stimulant to the exclusion or near exclusion of more common sources of sexual interest, like an attractive person of similar age. The intensity of the sexual attraction can be overwhelming enough to cause distress. The unusual or forbidden nature of a paraphilia often causes symptoms of guilt and fear of punishment. Symptoms of paraphilia can include preoccupation to the point of obsessiveness that may intrude on the person’s attempts to think about other things or engage in more conventional sexual activity with an age-appropriate partner. Paraphilia sufferers may experience depression or anxiety that is temporarily relieved by engaging in paraphilic behavior, thus leading to an addictive cycle.
How do health professionals diagnose paraphilias?
Usually providers of mental
health care help make the diagnosis of paraphilias, including licensed mental
health therapists, psychiatrists, psychologists, psychiatric nurses, physician
assistants, and social workers. One of these professionals will likely conducts
or refers the person with paraphilia for an extensive medical interview and
physical examination as part of establishing the diagnosis. To ensure that the
paraphilic individual does not suffer from a medical condition that could
complicate the assessment or treatment of their mental health
condition, medical professionals often perform routine laboratory tests during
the initial evaluation.
As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help assess the presence of paraphilic symptoms. A mental health professional will conduct a thorough exploration for any history or presence of all mental health symptoms such that paraphilia can be distinguished from other types of mental disorders. People with pedophilia may also suffer from a personality disorder or mood disorder, and about 60% have an additional paraphilia, like exhibitionism, voyeurism, or sadism. In order to qualify for the diagnosis of a paraphilic disorder, the individual has to experience recurrent, significant sexual arousal by the object of their attraction; act on that attraction in urges, fantasies, or actions; and experience the symptoms for at least six months to the point that the individual suffers significant levels of distress or interference with his or her work, social function, or other important aspects of life.
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