Paraphilia
A paraphilia is an uncommon, intense, and persistent sexual arousal or attraction to anything not sexual by nature. It has also been defined as a sexual interest in anything other than a legally consenting human partner. Paraphilias are contrasted with normophilic sexual interests, although the definition of what makes a sexual interest normal or atypical remains controversial.
The exact number and taxonomy of paraphilia is under debate; Anil Aggrawal has listed as many as 549 types of paraphilias. Several sub-classifications of paraphilia have been proposed; some argue that a fully dimensional, spectrum, or complaint-oriented approach would better reflect the evident diversity of human sexuality. Although paraphilias were believed in the 20th century to be rare among the general population, subsequent research has indicated that some level of paraphilic interests are relatively common.
Etymology
Coinage of the term paraphilia has been credited to Friedrich Salomon Krauss in 1903, and it was used with some regularity by Wilhelm Stekel in the 1920s. The term comes from the Greek παρά, meaning 'other' or 'outside of', and φιλία, meaning 'loving'. The word was popularized by John Money in the 1980s as a non-pejorative designation for unusual sexual interests. It was first included in the DSM in its 1980 edition.Definition
There is no broad scientific consensus for definitive boundaries between what are considered "unconventional sexual interests", kinks, fetishes, and paraphilias. As such, these terms are often used loosely and interchangeably, especially in common parlance.History of paraphilic terminology
Many terms have been used to describe atypical sexual interests, and there remains debate regarding technical accuracy and perceptions of stigma. John Money described paraphilia as "a sexuoerotic embellishment of, or alternative to the official, ideological norm". Psychiatrist Glen Gabbard writes that despite efforts by Wilhelm Stekel and John Money, "the term paraphilia remains pejorative in most circumstances."In the late 19th century, psychologists and psychiatrists began to categorize various paraphilias so as to have a more descriptive system than the legal and religious constructs of sodomy, as well as perversion. In 1914, Albert Eulenburg observed a commonality across paraphilias, using the terminology of his time writing, "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."
Before the introduction of the term paraphilia in the DSM-III, the term sexual deviation was used to refer to paraphilias in the first two editions of the manual. In 1981, an article published in American Journal of Psychiatry described paraphilia as "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving":
- Non-human objects
- The suffering or humiliation of oneself or one's partner
- Prepubescent children
- Non-consenting persons
Criticism of common definitions
Many paraphilic communities are unaware of the traumatic impact they reproduce and consider the strangeness of sexual practices to be purely subjective and dependent on the societal context. In BDSM, sadists and masochists reactivate their dissociative circuits by triggering a hormonal release similar to that experienced during the initial trauma: cortisol, adrenaline, and oxytocin disrupt their pleasure and reward systems by associating them with violence and humiliation. Each time they act out, their brains replay the traumatic programme, reinforcing the neural circuits of traumatic functioning.
Inclusion and subsequent exclusion of homosexuality
, a widely accepted variant of human sexuality, was once categorized as a sexual deviation. Sigmund Freud and subsequent psychoanalytic thinkers considered homosexuality and paraphilias to result from psychosexual non-normative relations to the Oedipal complex, although not in the antecedent version of the 'Three Essays on Sexual Theory' where paraphilias are considered as stemming from an original polymorphous perversity. As such, the term sexual perversion or the epithet pervert have historically referred to gay men, as well as other non-heterosexuals.By the mid-20th century, mental health practitioners began formalizing "deviant sexuality" classifications into categories. Originally coded as 000-x63, homosexuality was the top of the classification list until the American Psychiatric Association removed homosexuality from the DSM in 1973. Martin Kafka writes, "Sexual disorders once considered paraphilias are now regarded as variants of normal sexuality."
A 2012 literature study by clinical psychologist James Cantor, when comparing homosexuality with paraphilias, found that both share "the features of onset and course, but they appear to differ on sex ratio, fraternal birth order, handedness, IQ and cognitive profile, and neuroanatomy." The research then concluded that the data seemed to suggest paraphilias and homosexuality as two distinct categories but regarded the conclusion as "quite tentative" given the current limited understanding of paraphilias.
Characteristics
Paraphilias typically arise in late adolescence or early adulthood. Persons with paraphilias are generally egosyntonic and view their paraphilias as something inherent in their being, although they recognize that their sexual fantasies lie outside the norm and may attempt to conceal them. Paraphilic interests are rarely exclusive and some people have more than one paraphilia. Some people with paraphilias may seek occupations and avocations that increase their access to objects of their sexual fantasies.Research has found that some paraphilias, such as voyeurism and sadomasochism, are associated with more lifetime sexual partners, contradicting theories that paraphilias are associated with courtship disorders and arrested social development. Scientific literature includes some single-case studies of very 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.
Ego alien sexual interests in an individual can cause individuals to become suicidal due to the embarrassment or shame that it causes.
Causes and correlations
The causes of paraphilias in people are unclear, but it is believed to be a mixture of neurological, cultural, and psychodynamic factors. No two or more people with a paraphilia will develop it for the same reasons or be interested in the same qualities of the specific sexual interest. The specific causes of the development of paraphilic sexuality are numerous and vary from person to person, but psychological research has established that childhood trauma is strongly correlated with the development of paraphilic sexuality, particularly emotional abuse, neglect, and sexual abuse.A 2008 study analyzing the sexual fantasies of 200 heterosexual men by using the Wilson Sex Fantasy Questionnaire exam determined that males with a pronounced degree of fetish interest had a greater number of older brothers, a high 2D:4D digit ratio, and an elevated probability of being left-handed, suggesting that "disturbed" hemispheric brain lateralization may play a role in paraphilic attractions. Behavioral explanations propose that paraphilias are conditioned early in life, during an experience that pairs the paraphilics stimulus with intense sexual arousal. Susan Nolen-Hoeksema suggests that, once established, masturbatory fantasies about the stimulus reinforce and broaden the paraphilic arousal.
Genetic causes, particularly genes that encode the behavior of neurotransmitter receptors and androgen release have been implicated in studies, though others have shown no correlation between genetics and paraphilic behavior.
It is possible for an individual to acquire a paraphilia from various types of brain lesions and epilepsy.