Paraphilias Sexual Disorder - Causes, Symptoms and Treatment of Paraphilias

What is Paraphilias ?

Paraphilias are referred to as sexual deviations or perversions. Paraphilias include fantasies, behaviors, or sexual urges focusing on unusual objects, activities, or situations. Paraphilias include:

• Sexual urges or sexual fantasies with non-human objects.
• Sexual behaviors with non-human objects.
• Sexual behaviors involving humiliation or suffering of oneself or another person.
• Adult sexual behavior that involves children or nonconsenting adults.

• Exhibitionism
• Fetishism
• Frotteurism
• Pedophilia
• Masochism
• Sadism
• Transvestitism
• Voyeurism

Causes of Paraphilias

It is not know for certain what causes paraphilia. Some experts believe it is caused by a childhood trauma, such as sexual abuse. Others suggest that objects or situations can become sexually arousing if they are frequently and repeatedly associated with a pleasurable sexual activity. In most cases, the individual with a paraphilia has difficulty developing personal and sexual relationships with others.

Many paraphilias begin during adolescence and continue into adulthood. The intensity and occurrence of the fantasies associated with paraphilia vary with the individual, but usually decrease as the person ages.

Symptoms of Paraphilias

Although many of the paraphilias seem foreign or extreme, they are easier to understand if one thinks of those behaviors that, in less extreme versions, are quite common. For instance, having a partner "talk dirty" may be a "turn-on" for some people, but when talking dirty is the only way that sexual arousal or satisfaction can occur, it would be considered a paraphilia. Others want to be bitten, or spanked, or become aroused by watching their partner. Viewing a nude person or watching sexually explicit videos can be arousing for most people. Paraphilias are magnified to the point of psychological dependence.

Treatment and Medication of Paraphilias

Treatment approaches have included traditional psychoanalysis, hypnosis, and behavior therapy techniques. Cognitive-behavioral therapy: This type of therapy involves applying behavioral therapy techniques to modify the patient's sexual deviations by altering distorted thinking patterns and making patients cognizant of the irrational justifications that lead to their sexual variations. Following medication are precsribed for paraphilias -

• Antiandrogen Drugs - In the USA, IM medroxyprogesterone acetate is the treatment of choice; cyproterone acetate is used in Europe. Typically, a male with a moderate to severe paraphilia is given medroxyprogesterone. Treatment is usually long-term, because deviant sexual arousal patterns usually reoccur shortly after testosterone levels return to normal.
• Antidepressants Drugs.
• Phenothiazine.
• Mood stabilizers.
• Long-acting gonadotropin-releasing hormones (GnRH, ie, medical castration).
• SSRIs ( selective serotonin reuptake inhibitors) - eg, fluoxetine or fluvoxamine may be useful.

The course of paraphilias is usually chronic in nature. The prognosis for complete recovery is generally considered to be guarded.