SEXUAL PERVERSION (PARASILIA) DISORDERS

Although the etiology of paraphilia is not fully known, early theorists stated that paraphilias were a part of brain degeneration, and it was suggested that this degeneration continued for generations. Because many people do not want to talk about their paraphilias, researchers have few opportunities to understand the causes of this disorder.

In DSM-5, paraphilia disorders are defined as repetitive sexual activities against unusual objects lasting at least 6 months. According to the American Psychiatric Association (APA), people often use paraphilic fantasies for sexual excitement and arousal (cited in Malin & Saleh, 2007). It is not illegal for a person to have paraphilia, but in some cases it may be enough to go to the judicial authorities. DSM-5 attempted to distinguish this issue by adding the phrase "disorder" next to paraphilia. In short, having a paraphilia is not enough for that person to be diagnosed with paraphilia disorder.

Paraphilia disorders included in DSM are fetishism disorder, pedophilia disorder and incest, voyeurism disorder, demonstrative disorder, friction disorder, sexual sadism and sexual masochism disorder.

Fetishism disorder is the use of an object or a non-genital part of the body as the basis for sexual arousal. Those with fetishism disorder are usually men. Types of sexual fetishism can be very diverse. These; These are sexual fetishisms such as foot fetishism, shoe fetishism, sock fetishism, hand fetishism, breast fetishism, race fetishism, underwear fetishism, belly fetishism, necrophilia, and more.

Although fetish has special importance even in childhood, the disease usually begins in adolescence. Those with fetishism disorder often have other paraphilias, such as pedophilia disorder, sadism and masochism (Mason, 1997).

Pedophilia disorder and incest is an intense and distressing desire that causes a person to be sexually attracted to prepubescent children and to have a sexual orientation towards children. According to DSM-5, the offender must be at least 18 years old and at least 5 years older than the child. Many men who admitted to having pedophilia disorder stated that they used child pornography (Riegel, 2004).

People with pedophilia disorder are often neighbors or friends of the family, and these people abuse children they know, and sexual abuse may continue unless the child speaks up or this is noticed by other adults.

Incest is listed as a subtype of pedophilia disorder. Incest is sexual relations between close relatives for whom marriage is prohibited. The most common is between brother and sister. The second incest, which is seen as more pathological and is the most common, is between father and daughter. It has also been proven that incest rarely occurs in patriarchal families, especially in families where women's subordination to men is respected (Alexander and Lupfer, 1987).

Voyeuristic disorder is the state of being sexually gratified by watching the naked or during sexual intercourse. Observers orgasm either during the viewing or by masturbating afterwards. Its prevalence is a matter of debate, as such incidents are often not reported to the police.

It usually starts during adolescence. Those who meet the diagnostic criteria for voyeuristic disorder usually have other paraphilias, but their tendency to other mental disorders is not high.

Demonstration disorder is an intense desire to achieve sexual satisfaction by repeatedly exposing one's genitals to an unwilling stranger, sometimes to a child. It usually starts during adolescence.

The urge to display is very intense and dominant. Exhibitionism appears to be triggered by feelings of anxiety and restlessness, as well as by almost uncontrollable sexual arousal. Due to the compulsive nature of the urges, exposure may be repeated frequently, at the same time of day or even in the same place. The social and legal consequences do not occur to the exhibitionist at the time of the behavior (Stevenson and Jones, 1972).

Frictional disorder involves sexually directed touching of a person. A person may rub his penis on a woman's hips or butt, or caress her breast or genitals. These behaviors often occur in crowded places or on sidewalks that make escape easy. It is usually seen together with other paraphilias (Longstrom, 2010).

Sexual sadism is defined as an intense and recurring desire for sexual gratification that is caused by pain or psychological suffering. Sexual self-abnegation (masochism) is defined as the state of being subjected to pain or humiliation in order to achieve sexual satisfaction. Some sadists orgasm by inflicting pain, while some masochists achieve orgasm by being exposed to pain.

Indicators of masochism vary. Physical slavery; blindfolding, beating, whipping, cutting, etc. It also involves the person being forced to follow rules and orders by taking on the role of slave.

In big cities, clubs meet the needs of people looking for sadomasochistic partners. Many people who exhibit sadomasochistic behaviors are relatively comfortable with their sexual practices (Spengler, 1977).

Sadism and masochism occur in early adulthood and both occur in gay and heterosexual relationships. In surveys, it was found that 20-30% of the members of sadomasochistic clubs were women (Moser and Levitt, 1987). There is evidence that many sadists and masochists live traditional lives and their income and education levels are above average (Moser and Levitt, 1987). Alcohol abuse is common among sadists (Allnutt, Bradford, Greenberg et al., 1996).

Research findings on treatments for paraphilia disorders are limited. Treatment approaches should begin with a focus on motivating and engaging the client. Early cognitive behavioral approaches focus on aversion therapy and cognitive techniques that challenge distorted thoughts about the consequences of sexual behavior. The most common drug treatment is antidepressants, or drugs that reduce male hormone levels, but research on antidepressants is weak and drugs that affect hormones have serious side effects.

REFERENCES

Duman, N. (2018). Parafililer ve DSM’lerdeki seyri. OPUS–Uluslararası Toplum Araştırmaları Dergisi, 9(16), 1285-1306. DOI: 10.26466/opus.481118

Kring A., Johnson S., Davison G., Neale J., (2019), Anormal Psikoloji (Abnormal Psychology) (12. Basım), Nobel Akademik Yayıncılık, Ankara.