Paraphilic Disorders

The challenges amongst sexual functioning

What are Paraphilic Disorders?

Sexual interest and sexual desire is a normal aspect expected of human nature. When certain behaviors are outside of the normal range of sexual behavior, a Paraphilic Disorder may be present. In order to fully understand the definition behind Paraphilic Disorders, it is important to understand the terminology involved. The Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) explains that the term paraphilia refers to any "intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting humans partners" (Key, 2012). A paraphilia is not recognized as a potential disorder for diagnosis. When a paraphilia begins to cause distress or impairment to an individual due to sexual desire, urges, or fantasies, it may be the beginning of a Paraphilic Disorder. These conditions must be present for at least six months to be considered under a diagnosis. The sexual arousal from an individual will typically revolve around an object, children, non-consenting individuals, or the suffering or humiliation of onself or a partner (Key, 2012). The prevalence of Paraphilic Disorders generally includes more diagnosis in men as opposed to women. In addition, Paraphilic Disorders typically emerge during childhood or adolescence.

Disorders Recognized as Paraphilic

The following disorders are described by the American Psychiatric Association (2015):

Voyeuristic Disorder

  • Associated with patterns of spying or watching other's during private activities in order to receive sexual gratification.

Exhibitionistic Disorder

  • Associated with strong urges to expose one's genitals to other individuals. Individuals may arrange to be observed while having sexual intercourse.

Pedophilic Disorder

  • Associated with the attraction and sexual focus on children.

Fetishistic Disorder

  • Associated with recurrent, powerful sexual urges involving nonliving objects including: shoes, women's undergarments, or other items made from materials such as leather, latex, or silk.

Frotteuristic Disorder

  • Associated with the act of touching or rubbing against a non-consenting individual for sexual arousal.

Transvestic Disorder
  • Associated with powerful urges in which an individual is sexually aroused by cross-dressing. Cross dressing can be described as the act of wearing items of clothing that is generally associated with the opposite gender. Transvestic Disorder is commonly confused with gender dysphoria and homosexuality. Although they may sound similar, a transgender relates to an individual who feels as if they were born the wrong sex. Transvestic Disorder, on the other hand, relates to sexual arousal from dressing as the opposite sex (Nolen-Hoeksema, 2014). This does not necessarily mean that an individual wants to change their gender.

Sexual Masochism Disorder

  • Associated with becoming sexually aroused by being humiliated, bound, or made to suffer. Masochists will often times may ask someone to shock them, whip them, clothe them in diapers, urinate on them, and perform abusive acts. In addition, individuals typically inflict pain on themselves.

Sexual Sadism Disorder

  • Associated with becoming sexually aroused by inflicting physical or psychological pain to another individual. This physical or psychological pain generally includes humiliating, bounding, or making another individual suffer.

(Diseases and Disorders, 2008).

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Though the potential causation for paraphilic disorders is currently unknown, behavioral, theories, social learning theories, and cognitive theories are able to represent possible reasoning. According to the behavioral theory, an individual's sex drive may pair fantasies with sexual gratification (Nolen-Hoeksema, 2014). The social learning theory, on the other hand, expresses that an individual may have learned the behavior due childhood experiences (Nolen-Hoeksema, 2014). There has been evidence to show that a history of punishment and sexual abuse is shown in individuals with paraphilias. An individual may have the desire to seek authority and endorse childhood punishments that they were exposed to in order to seek sexual pleasure. Lastly, individual differences in specific genes or brain areas may set the stage for developing Paraphilic Disorders. Also, possible changes hormones may be a potential cause. Nolen-Hoeksema (2014) mentions that the occurrence of a head injury, lower intelligence levels, brain structure differences, and cognitive deficits are possible cognitive areas. Also, if the functioning in the frontal areas presented in the brain have been effected, it may be difficult for an individual to regulate impulsive or aggressive behaviors.

Paraphilic Disorders IN SOCIETY

Common Myths & Misperceptions

The term referred to as sexuality has become a central focus of society today. Sutton (2009) explains that sex amongst cultures has been reflected in the explicit coverage of sexual behaviors expressed throughout the media, newspapers, magazines, and movies all over the world. As sexuality continues to be expressed, there are blurred lines between what is considered socially appropriate expression and what may be considered as at risk behaviors or disease patterns. In society, Paraphilic Disorders are often viewed as distasteful, unusual, and abnormal. Amongst some cultures, some of these disorders are recognized as illegal acts resulting in jail time for an individual. Unfortunately, the stigmatization shown in the media creates an atmosphere that does not necessarily encourage prevention and treatment. In addition, movies such as Peeping Tom (1960), King of Hearts (1966), Looking for Mr. Goodbar (1977) and Fifty Shades of Grey (2015) have brought some negative attention to these possible paraphilias. When negative attention is directed towards an individual, it will often times lead to most individuals turning away from possible ways of seeking help in fear of embarrassment or judgement. If you or a loved one is suffering from uncontrollable desires or urges, it is important to recognize that you are not alone. What is presented in the media is not always true and it is imperative to understand that there will be no judgement or punishment during your process of seeking help. Professionals are there to help guide you through the challenges you may face and offer treatment options to relieve some of the symptoms you may be expressing.

When to seek help

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If symptoms lasting beyond a six month period interfere with daily functioning, it is imperative to seek professional help. Most people who receive treatment for paraphilic disorders see significant improvement and are able to enjoy a better quality of life. A variety of effective options for treatment are available, so you can be hopeful that you or a loved one can feel better soon. Treatment options generally include biological interventions, behavior modification therapies, and or cognitive treatments. Some of the possible behavioral techniques may include aversion imagery, desensitization, social skills training, and orgasmic reconditioning (Fundukian, 2011). Treatment will be based on the severity level of the paraphilia. In addition to these therapies, drugs may be prescribed to help normalize hormone levels. For instance, an antiandrogen called Cyproterone Acetate may be used to control testosterone levels (Fundukian, 2011).

In addition to treatment, support groups known as Love Addicts Anonymous, Sexual Addicts Anonymous, and Sexaholics Anonymous are widely available and accessible for all individuals (Sutton, 2009). These groups are able to provide a safe place for support free of charge. To view information related to each group, you may click the buttons below and it will take you directly to their webpage.

Finding Help

As an individual, we often times endure difficult periods in our lifetime. Although we may believe that we can get through it alone, there are some situations that should never be experienced by ourselves. Asking for help can be extremely difficult, especially when we are stressed or afraid of something. However, finding the strength and will power to seek help will provide you the necessary tools to get back to normal functioning. There are many sources that can direct an individual to the correct path. These sources may include friends, family members, doctors, helplines, and or mental health professionals. If you or a loved one is experiencing a possible Paraphilic Disorder, seeking professional help from a therapist may truly affect the outcome of the disorder. In order to gain the most benefit from therapy, it is important to first ensure that the therapist has the correct credentials and licensure. In addition, it is crucial that you feel comfort in talking to the individual. According to the American Psychological Association [APA], the therapist should represent doctoral-level training as well as a clinical internship (2015). Furthermore, the therapist should be licensed by the state or jurisdiction that their practice is in (APA, 2015).

Additional Resources

  • Visit ADAA at to find qualified mental health professionals.
Suffering from Paraphilic Disorder's can interfere with you life. ADAA provides sufficient resources that will help you and your loved ones better understand your personal condition, connect you with a community of people who are experiencing the same conditions, and help you locate potential mental health professionals in your area.


American Psychological Association [APA]. (2015). How to choose a psychologist. Retrieved from

Anxiety and Depression Association of America [ADAA]. (2015). Questions to ask: Choosing a Treatment Provider. Retrieved from

Sexual and gender identity disorders. (2008). Diseases and Disorders. Tarrytown, New York: Cavendish Square Publishing. Retrieved from|CX4096800262&docType=GALE

Key, K. (2012). The gale encyclopedia of mental health (3rd ed). Detroit: Gale Cengage Learning. p1121-1122. Retrieved from|CX4013200342&docType=GALE

Nolen-Hoeksema, S. (2014). Abnormal psychology (6th ed). New York: McGraw Hill

Sutton, A.L. (2009). Understanding compulsive sexual behaviors (4th ed). Mental Health Disorders Sourcebook. Detroit: Omnigraphics. Retrieved from|CX2288100044&docType=GALE