Paraphilic Disorders


To be diagnosed with a psychiatric disorder a person has to be experience significant distress or impairment by their behavior.

According to American Psychiatric Publishing,

Most people with atypical sexual interests do not have a mental disorder. To be diagnosed with a paraphilic disorder, DSM-5 requires that people with these interests:

• feel personal distress about their interest, not merely distress resulting from society’s disapproval;


• have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent (Paraphilic Disorders, 2013).

Paraphilia usually develops during adolescents and continues to become conic. “Atypical sexual preferences have been called praphilias. Paraphilias are sometimes divided into those that involve the consent of others (e.g., some sadomasochistic practices) and those that involve nonconsenting others (e.g., voyeurism)” (Nolen-Hoeksema, 2014).

The causes of paraphilia have not been determined to be genetic or biological. According to Benuto, "researchers have yet to identify a specific biological or biochemical cause. Instead, psychological factors seem to be central. In most cases, one or more events occurred during childhood that led the individual to associate sexual pleasure with that event (or object) thus resulting in the development of a paraphilia" (Benuto, 2009).

Treatment options may include the following:

1. Medications which can help reduce the behavior.

2. Victim identification helps the client recognize the harm he is causing or has caused others.

3. Covert conditioning asks the client to feel shame associated with the behavior causing the client to have less pleasure and eliminate the behavior.

4. Orgasmic reconditioning asks the client to identify a fantasy which includes the paraphilia in question. They are then asked to masturbate while being aroused by the fantasy but complete the orgasm while looking at an appropriate object.

5. Masturbatory extinction asks the client to masturbate and orgasm to an appropriate fantasy. This will help reinforce appropriate fantasies for the client.

6. Masturbatory satiation the client is asked to masturbate using a deviant fantasy. After orgasm the client is to continue masturbating for one hour thus eliminating the reinforcement connection between fantasy and ejaculation.

7. Aversive therapies include a mild electrical shock or unpleasant smells with the deviant fantasy. The connection made between the unpleasant shock or smell with the fantasy may decrease the unwanted behaviors.

8. Group therapy focuses on the client taking responsibility for the behavior. The client receives support from the group. Group therapy also builds relationships and develops social skills (Benuto, 2009).


Benuto, L. P. (2009, August 10). Paraphilias Causes and Treatments. Retrieved from

Nolen-Hoeksema, S. (2014). Abnormal Psycohlogy, Sixt Edition. New York: McGraw Hill-Education.

Paraphilic Disorders. (2013). Retrieved from American Psychiatric Publishing:

Committed to the Ethical Principles of Psychologist and Code of Conduct

Questions to consider when choosing a therapist are:

Credentials - What licensing and education does the therapist have?

Experience - How long has the therapist been in practice?

Treatment - What kinds of treatments does the therapist use?

Recovery - What are the outcomes of the treatments the therapist has used?