Paraphilia (Sexual Perversion) – General
Paraphilia is the medical term applied to many sexual behaviors commonly referred to as kinky, bizarre, or perverted. A paraphilia is a recurrent and intense sexual urge or sexually arousing fantasy that generally involves either (1) nonhuman objects as in fetishism or bestiality, (2) the suffering or humiliation of oneself or one’s partner as in sadism or masochism), or (3) children or other nonconsenting persons as in pedophilia, exhibitionism, voyeurism, or obscene phone calls. This topic discusses paraphilias in general. The following specific paraphilias are discussed separately:
Sexual Sadism and Masochism
( NOTE : Six other topics have not been reproduced , see : http://www.dss.mil/nf/adr/sexbeh/sexT3.htm for the full text and all references . )
Paraphiliacs are fixated on a narrow range of sexual objects or situations that are not normally sexually arousing to others. The more severe the paraphilia, the more likely it will interfere with the capacity for reciprocal, affectionate sexual activity. A severe paraphilia causes an individual to act compulsively, alone and in secret, and blocks development of an enduring sexual relationship based on mutual affection.
“… a full-fledged paraphilia has nothing optional or elective about it. It is a usurper that takes over completely. Its injunctions are compulsory and must be obeyed, no matter what else they might interfere with. They may interfere during any waking hour… They defy voluntary attempts at control.” Ref 87
Severe paraphilia is a concern as behavior is out of control, and the consequences of this for professional performance are unpredictable.
Another concern is that paraphilias are not stable. They tend to become worse over time, or during periods of stress when sound judgment is most important. Some paraphilias such as pedophilia, exhibitionism, making obscene phone calls, voyeurism and frotteurism involve criminal offenses and should also be evaluated under Criminal Conduct.
Clinical psychologists and psychiatrists find that when an individual has one paraphilia, there are often other paraphilias present as well. The childhood trauma suspected of causing the paraphilia may also have other residual effects on psychological adjustment. Ref 88 Personality disturbances frequently accompany paraphilia. Symptoms of depression may develop and be accompanied by an increase in the frequency and intensity of the paraphilic behavior. Ref 89
When paraphilic behavior is reported, the known behavior may be only the tip of a much larger iceberg, as many sex offenders either cannot or will not cooperate fully even during a clinical interview when immunity from prosecution is guaranteed. This was demonstrated when male sex offenders in an outpatient program were fitted with a device to measure changes in their penis while they were shown movies or tapes of various sexual behaviors. When confronted with recordings of penile arousal that contradicted what they had said during previous clinical interviews, 62% of the patients admitted to previously concealed sexual interests and behaviors. As a consequence, it was learned that these patients had committed more different kinds of sex offenses, and far more offenses, than had previously been thought. Ref 90
Paraphilias are classified as mental illnesses in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (fourth edition, revised).
However, paraphilic fantasies or behavior are not always indicative of illness. They often exist in less severe forms that are not dysfunctional in any way, do not impede the development of reciprocal affectionate relationships, do not harm the individual or others, and do not entail criminal offenses. They may be limited to fantasy during masturbation or copulation. If acted out, they may be done in private and either alone or in a playful manner with a willing partner. They may be practiced occasionally by choice, rather than constantly by compulsion. Ref 91 Although unusual, such mild paraphilias do not cause an individual to be less reliable or trustworthy, nor do they indicate emotional disturbance or make a person more vulnerable to blackmail than many other types of personal secrets. Many fetishes, in particular, fall into this category.
“Imagining unusual sexual situations or behaviors to enhance stimulation or arousal is not uncommon.” Ref 92 Fantasies are generally not a security problem as long as they are not acted out. The fantasies themselves are beyond conscious control; the failure to act on them indicates that behavior is under control. Fantasies may be a problem, however, if they are vivid and frequent and the individual feels threatened by them; in such cases, the individual’s reaction to the fantasy could be symptomatic of an emotional problem that requires medical evaluation.
In other words, paraphilias exist with various degrees of severity. The security adjudicator dealing with a case of paraphilia must determine whether the paraphilia is severe enough to affect reliability, trustworthiness or job performance. Assessment by a mental health professional may be vital in making this judgment.
No hard data are available on the prevalence of paraphilias in the general population.
People with these disorders tend not to regard themselves as ill, and usually come to the attention of mental health professionals only when their behavior has brought them into conflict with sexual partners or the law. Judging from the large commercial market in paraphilic pornography and paraphernalia, the prevalence in the community is believed to be far higher than that indicated by statistics from clinical facilities. Males are far more prone to paraphilias than females. For cases in which sexual masochism has developed to the point of paraphilia, for example, the sex ratio is estimated to be 20 males for each female. Many other paraphilias are practically never diagnosed in females. Ref 93 There appears to be no difference in the prevalence of paraphilias among homosexuals and heterosexuals. Ref 94
The study of sex offenders noted above showed that most offenders had developed deviant sexual interests and fantasies by age 12 or 13. The age of onset is relevant, as it is generally believed that the earlier deviant behavior begins, the more difficult it is to treat effectively. For half or more of the offenders, the age at which the offenses began was before age 15 for voyeurism, before age 16 for homosexual sex with children, before age 17 for frotteurism, and before age 18 for exhibitionism. A different study of sex offenders has shown that about 90% have a history of more than one paraphilia at some point in their lives. Pedophiles might also engage in exhibitionism, sadism, or fetishism, for example. Engaging in one deviant behavior may break down the barriers to others. Ref 95
There is no cure for paraphilia in the sense of complete eradication or reversal of its cause. It can be treated to ameliorate its consequences, but relapse is not unusual. In serious cases, it may be controlled effectively with a drug trade-named Depo-Provera. This medication reduces the sex drive by drastically reducing the level of male hormone in the bloodstream and by acting directly on the portion of the brain which governs mating behavior. Ref 96
In fetishism, sexual arousal occurs in response to some inanimate object or to a body part that is not primarily sexual in nature. The person with the fetish generally masturbates while holding, rubbing or smelling the fetish object, or asks the sexual partner to wear the object. Common fetish objects are women’s clothing such as panties, brassieres, slips, stockings, shoes, or gloves. Other fetishists depend upon objects made of specific fetish materials, such as leather, rubber, silk or fur, or they are aroused by body parts such as hair, feet, legs, or buttocks.
Fetishism usually begins by adolescence, although it may have its origin in some sexual experience in early childhood. Fetishists often collect the objects that turn them on and may go to great lengths to add just the right item to their collection. An example is cited of a man who had a fetish for women’s high-heeled shoes. He gradually accumulated more than a thousand pairs which he catalogued and concealed from his wife in his attic. Ref 97
In severe cases, the fetishist can be sexually aroused and reach orgasm only when the fetish is being used. In moderate cases, the fetish adds to the excitement but is not required. The man who is turned on by a woman in black, lacy lingerie is not a fetishist unless this is the primary focus of his sexual arousal.
As a general rule, the person with a fetish poses no danger to others and pursues the fetish in private. Fetishism may be a security concern in severe cases when the fetish prompts behavior that is illegal, compulsive or lacking in discretion. When fetishism is reported, the possible coexistence of other sexual or emotional problems should be evaluated.
Sexual Sadism and Masochism
Sadism involves intense sexual urges or fantasies that involve inflicting pain or humiliation on others. In masochism, the pain or humiliation is directed at oneself.
Humiliation may involve being required to crawl and bark like a dog, being kept in a cage, verbal abuse, or being urinated or defecated upon. Pain might be inflicted by tying a person down with rope or chains, or by whipping, pinching, biting, spanking, burning, electrical shocks, rape, strangulation, torture, mutilation, or lust-murder. All of these behaviors emphasize the transfer of power from a submissive to a dominant partner. The varied roles may be master/slave, guardian/child, employer/servant, owner/owned, etc. Practitioners of sadomasochism “often report it is this consensual exchange of power that is erotic to them and the pain is just a method of achieving this power exchange.” Ref 98
Sadomasochism encompasses a wide range of activities from the benign to the bizarre and occasionally fatal. Arousal may come only from fantasy, without any need to act out the behavior. It may be limited to gentle and playful biting and spanking, or it may be a carefully controlled symbolic ritual with a trusted partner. At the other extreme, it may involve self-strangulation (which causes one or two accidental deaths per million persons per year) as a means of gaining sexual arousal through oxygen deprivation. Ref 99 Some engage in sadomasochistic behavior in all their sexual interactions, while others do it only occasionally. Masochism may be self-inflicted or inflicted by a cooperative partner. Sadism may be acted out with a willing partner or imposed by violence on an unwilling subject.
Although some sadomasochists engage in violence on unwilling partners, most do not. The psychology of the rapist is generally quite different from the sadist, as most rapists are not sexually aroused by their victim’s suffering. Ref 100 Most sadomasochists seek willing partners, and for many the partner search is facilitated by joining a club for sadomasochists or frequenting a bar which caters to such persons. The clubs stress and teach safety, so serious injury is rare. Ref 101
Sadomasochism has been reported in many different cultures and in many time periods. It is pictured in an ancient Indian marriage manual from 450 AD, for example. Ref 102 It is also found in other mammals. There are at least 24 different mammalian species that sometimes bite during intercourse, so some association between sex and pain probably must be considered biologically normal. Ref 103
Masters et al. report that “sadomasochistic fantasies are very common, but most people who find such fantasies arousing have no desire to have the real-life experience.” When these fantasies are acted out, it is generally mild or even symbolic behavior, with no real physical pain or violence involved. Ref 104
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) defines sadism and masochism as mental disorders only if “the person has acted on these urges, or is markedly distressed by them.” Ref 105 Persons beginning to explore sadomasochistic desires often worry that their desire will escalate and lead them to cause serious injury or commit sex crimes. Actually, serious injury or crime caused by sadomasochism is rare, although the urge does escalate in some cases. Masters et al. report their impression that only rarely is sadomasochism a full-fledged paraphilia in the sense that it is the predominant or exclusive means of attaining sexual excitement. They also find that sadism and masochism occur as paraphilias mainly in men. Ref 106 Sadomasochists are found among homosexuals and bisexuals as well as heterosexuals. Ref 107
No statistics are available on the more hard core forms of sadomasochism, but its prevalence is indicated by an entire industry which has evolved to support the practice through equipment supply catalogues (whips, chains, etc.), specialized magazines with picture spreads and how-to articles, bars, and “private” clubs. A few empirical surveys are available on the sadomasochistic practices of those who subscribe to these publications or belong to the clubs. Ref 108
The causes and psychological significance of sadomasochism are unclear. Noting that many masochists are men who occupy positions of high status and authority (such as executives, politicians, judges, and bankers), some experts theorize that private acts of submissiveness and degradation provide the masochists with an escape valve from their rigidly controlled public lives. Seeking sexual pain or humiliation may also be a way of atoning for sexual pleasure for a person who was raised to believe that sex is sinful and evil. Conversely, sadists either may be seeking a means to bolster their self-esteem (by “proving” how powerful and dominant they are) or may be venting an internal hostility that they cannot discharge in other ways. Ref 109
From a security viewpoint, sadism and masochism raise several concerns.
One is vulnerability to blackmail. This depends upon risk of exposure and the consequences if the specific behavior were exposed. Clearly, the senior officer who frequents a sadomasochism club to pick up partners who will chain and whip him, make him crawl and bark like a dog, or swaddle him in diapers presents an attractive blackmail target. On the other hand, the individual who engages in some symbolic sadomasochistic ritual with a willing spouse in private is not a security concern.
Emotional stability is another concern. Several limited attempts to use psychological testing to see if a sample of sadomasochists differs from a control group have shown no significant differences, but empirical research on this is still sketchy. Ref 110
On the other hand, many sadomasochists are unable to sustain a long-term sexual relationship. Clearly, the regular practitioner of sadomasochism has at least one unusual personality quirk. Any individual who has one mental/emotional problem is at greater risk than the general population for having other mental/emotional problems as well. When sadomasochistic tendencies are present, it is necessary to determine whether the individual has other emotional problems that might impact on security or job performance. Of particular concern is the judgment that sadism and masochism, like all compulsive behaviors, tend to get worse under stress when high performance is most important. Ref 111
87. Money, J. (1988). Gay, straight, and in-between: The sexology of erotic orientation. New York: Oxford University Press, p. 143.
88. Oral communication to R. J. Heuer, PERSEREC, from Richard Rees, CIA Office of Medical Services, May 1991.
89. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised. Washington, DC: Author, p. 524.
90. Rosenfeld, A. H. (1985, April). Discovering and dealing with deviant sex. Psychology Today.
91. Money, J. (1988). Gay, straight, and in-between: The sexology of erotic orientation. New York: Oxford University Press, pp. 138-140.
92. Reinisch, J. M. (1990). The Kinsey Institute new report on sex. New York: St. Martin’s Press.
93. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised. Washington, DC: Author, p. 524.
94. Money, J. (1988). Gay, straight, and in-between: The sexology of erotic orientation. New York: Oxford University Press, Chapter 6.
95. Reinisch, J. M. (1990). The Kinsey Institute new report on sex. New York: St. Martin’s Press.
96. Money, J. (1988). Gay, straight, and in-between: The sexology of erotic orientation. New York: Oxford University Press, p. 178.
97. Masters, W., Johnson, V., & Kolodny, R. (1985). Human sexuality (2nd ed.). Boston: Little, Brown & Co., p. 440
98. Moser, C. (1988). Sadomasochism. Journal of Social Work and Human Sexuality, 7 (Special issue entitled The sexually unusual: Guide to understanding and helping), 43-56.
99. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised. Washington, DC: Author, p. 529.
100. Groth, A. N. (1979). Men who rape. New York: Plenum Press reports that only 5% o rapists are sadists.
101. Moser, C. (1988). Sadomasochism. Journal of Social Work and Human Sexuality, 7 (Special issue entitled The sexually unusual: Guide to understanding and helping), pp. 49, 53-54.
102. Vatsysayana (1964). Kama sutra. New York: Lancer Books. (Originally written in 450 AD.)
103. Kinsey, A.C., et al (1953). Sexual behavior in the human female. Philadelphia: Saunders.
104. Masters, W., Johnson, V., & Kolodny, R. (1985). Human sexuality (2nd ed.). Boston: Little, Brown & Co., p. 448.
105. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised. Washington, DC: Author, pp. 529-530.
106. Masters, W., Johnson, V., & Kolodny, R. (1985). Human sexuality (2nd ed.). Boston: Little, Brown & Co., p. 446.
107. Moser, C. (1988). Sadomasochism. Journal of Social Work and Human Sexuality, 7 (Special issue entitled The sexually unusual: Guide to understanding and helping), p. 46.
108. Breslow, N., Evans, L., & Langley, J. (1986). Comparisons among heterosexual, bisexual, and homosexual male sado-masochists. Journal of Homosexuality, 1, 83-107.
109. Masters, W., Johnson, V., & Kolodny, R. (1985). Human sexuality (2nd ed.). Boston: Little, Brown & Co., p. 447.
110. Moser, C. (1988). Sadomasochism. Journal of Social Work and Human Sexuality, 7 (Special issue entitled The sexually unusual: Guide to understanding and helping), p. 47. Moser cites the following studies. Gosselin, C. & Wilson, G. (1980). Sexual variations. New York: Simon and Schuster; Miale, J. P. (1986). An initial study of nonclinical practitioners of sexual sadomasochism. Unpublished doctoral dissertation, the Professional School of Psychological Studies, San Diego; Moser, C. (1979). An exploratory-descriptive study of a self-defined S/M (sadomasochistic) sample. Unpublished doctoral dissertation, Institute for Advanced Study of Human Sexuality, San Francisco.
111. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised. Washington, DC: Author, p. 529-530.
” That position assumes that spanking eroticism is, at least to some degree, a bad thing. However, neither sexual masochism nor sexual sadism are classified as psychiatric disorders by the American Psychiatric Association unless they “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.” Furthermore, while traditional morality condemns non-marital intercourse, “Thou shalt not spank for fun or profit” is nowhere to be found in any scripture of which I am aware. ”
…………………. Corporal Punishment: Hitting Two Goals With One Swat?