CHAPTER 15 SEXUAL VARIATIONS NORMAL VS.

. DEVIANT SEXUAL BEHAVIOUR Statistical norm: Rare or unusual sexual behaviour abnormal Appears value free as its based on frequency of behaviour, not social responsibility Also consider if it deviates from a social norm What may be considered the norm in one culture may not be in another Terminology Deviant and abnormal are confusing, prefer atypical variations THE PARAPHILIAS Atypical patterns of sexual arousal or behaviour that become problematic in the eyes of the individual or society Sexual arousal in response to unusual stimuli (children, non-consenting persons, nonhuman/inanimate objects, pain or humiliation) Recurrent urges acted on or are distressing to individual Urges are insistent, demanding or compulsory Vary in severity: Function in absence of unusual stimuli Resort to behaviour in times of stress Preoccupied with thoughts and fantasies, unable to become aroused without stimulus Debate: Are they harmless or victimless Therapists should work towards eliminating but to learn how to express behaviour in a healthy manner problem is to not stereotype Prevalence (unknown) Fetishism Inanimate object elicits sexual arousal Clothing (panties, bra, lingerie, stockings, gloves, shoes, boots) Materials (rubber, leather, silk, fur) Some act on urges (masturbate while stroking item) some dont Partialism Excessively aroused by particular body part (feet, breasts, buttocks) Some touch women in public Most are harmless, private and involve masturbation or incorporation into coitus, but some may commit burglaries to acquire objects Breast Fetishism Sexual interest in female breasts Currently common in American and Japanese culture Fetish can vary (size of breast, nipples, lactation, mammary intercourse leading to a pearl necklace) Foot Fetish Sexually aroused by touching, licking, kissing, getting a footjob Shoes fetish Crush fetishism Desire to see others crush small creatures (insects, mammals, reptiles, fruit, etc.)

Other Fetishes Axillary intercourse (putting penis in others armpits) Agalmatophilia (sexual attraction to statues or dolls) Growing tails (watching women excrete in the standing position takes pleasure when stool hasnt separated from anus and resembles a tail) Maiesiophilia (pregnancy fetish) Medical fetishism (getting ears checked, enemas) Transvestism Cross dresses to achieve sexual arousal or gratification, may be troubled by persistent urges to cross dress Most are married and otherwise masculine May overlap with transsexualism but it isn't the same Transsexuals motivated by autogynephilia (sexually stimulated by fantasies that own bodies are female) Origins & Patterns Birth order (most likely eldest child or only child) Closer relationships with mother Petticoat punishment humiliated by being dressed in girls attire Behaviour Wearing a single garment dresses, makeup, wigs, mannerisms Private affair Kept a secret from wives, some wives permit behaviour, but end up tolerant but unsupportive and more concerned about children finding out Exhibitionism (flashing) Persistent powerful urges and sexual fantasies that involve exposing genitals to unsuspecting strangers for arousal and gratification Known data gathered from apprehended men or those treated by mental health professionals (biased) Begins before 18, urges as soon as early adolescence, declines by 40 Psychological consequences Feel violated, recurrent images/nightmares, fearful of going out alone (exacerbated for young children) Evidence Attempt to assert masculinity Shy, dependent, passive, lacking in sexual/social skills, inhibited Preferred victims Girls, young women who they can drive or walk up to and expose themselves almost always have erection, some ejaculate Forms Gwen Jacobs (Ontario Court of Appeal legal for women to go topless) Internet (Girls Gone Wild) Couples Obscene Telephone Calling (Telephone Scatologia) Making of obscene phone calls where they are aroused by shocking Patterns Some limit to obscenities, or sexual overtures, others breathe heavily Describe masturbatory behaviour Profess to have met the victim

Usually a socially inadequate heterosexual male who has difficulty forming intimate relations with women Safety/anonymity shield him from rejection Shock/fright instill feelings of power and control Difficult to track Block number Call from public phones

Voyeurism (Peeping Tom) Strong repetitive urges and related sexual fantasies of observing unsuspecting strangers who are naked, disrobing, or engaged in sexual relations Typically doesnt seek sexual relations, but may masturbate while peeping or afterwards Most are nonviolent, but some commit violent crimes (assault and sexual assault) Those who break into and enter home or tap on windows to gain attention of victims dangerous BDSM (Bondage Domination Sadism Masochism) Sexual Masochism Desire or need for pain or humiliation to enhance sexual arousal so that gratification may be attained Bound, flogged, humiliated, spanked, whipped, perform humiliating acts (walking on all fours, licking boots/shoes, vulgar insults, urinating and/or defecating on recipient) Some prefer particular type of pain others an assortment Dont enjoy other types of pain not connected with sexual practice Only paraphilia found with frequency among women Association of arousal with mildly painful stimuli is common Love bites, hair pulls, minor scratches Bondage Ritual restraint (shackles), blindfolded (sensory bondage) Hypoxyphilia Enhance sexual arousal, usually during masturbation, by becoming deprived of oxygen Plastic bags, nooses (thing used to hang yourself), pressure on chest (fantasize about strangulation) Sexual Sadism Sexually aroused by inflicting pain or humiliation on others Willing partners although some stalk and attack non-consenting victims (minority) Sadomasochism Mutually gratifying sexual interaction between consenting sex partners in which sexual arousal is associated with the infliction and receipt of pain or humiliation Occasional S&M is common, problematic becomes pathological Subculture S&M magazines (personal ads), clubs Elaborate rituals involving dominance and submission master and slave Types of pain: psychological & physical (erotic appeal from ritual) Most avoid serious injury and dangerous Assume either role but assuming both sadomasochists Cause Physiologically able to experience heightened sexual arousal from receiving pain or inflicting it Endorphins released which caused euphoria and well being

Frotteurism (Mashing) Recurrent, powerful sexual urges and related fantasies that involve rubbing against or touching a non-consenting person Exclusive among males who have difficulty forming relationships and have a fear of rejection Takes place in crowded places (buses, subways, elevators), many are unaware of what happened Incorporate images within masturbation Toucherism fondling on non-consenting strangers Other Paraphilias Zoophilia Persistent or repeated sexual urges and related fantasies that involve sexual contact with animals Bestiality (sexual contact with an animal) Prevalence is unknown Men had more contact (farm animals), more likely to masturbate or copulate Women (pets), more body contact (lick genitals, cases where pets were trained to engage in coitus) Urban rural difference: higher among boys raised on farms, and during adolescence (human outlets N/A) Criminal offense in Canada Necrophilia Desire for sexual activity with corpses 3 types: Regular Necrophilia sex with deceased person Necrophilic Homicide commits murder to obtain corpse for sexual purposes Necrophilic Fantasy fantasizes but doesnt carry out acts Obtain jobs with access to corpses (cemeteries, morgues, funeral home) Motivation: desire to possess a completely unresisting and non-rejecting partner Other Less Common Paraphilias Klismaphilia sexual arousal from the use of enemas Prefer the receiving role Derived from sexual pleasure in childhood from anal stimulation when given an enema Coprophilia sexual arousal in connected to feces Desire to be defecated on or to defecate on partner Childhood origins Urophilia sexual arousal is associated with urine Desire to be urinated on or to urinate on partner Childhood origins

Other Sexual Practices Dogging Public sex usually outdoors, that sometimes involves the voyeurs Pegging Woman uses a strap on to penetrate her male partner anally Bukkake A series of men take turns ejaculating on a woman Popular in Japan largely due to ban of showing penetration in pornography

Usually ends by the woman drinking the collected semen Different forms of bukkake Erotic asphyxiation Fisting Infantilism Glory Holes Toothing

THEORETICAL PERSPECTIVES Biological Perspectives Endocrine system (hormones) and nervous system Exhibitionist had significant elevated levels of the measure of testosterone linked to sex drive Shorter refractory periods after orgasm by masturbation and higher frequency of sexual fantasies and urges (hypersexual desire) Electroencephalograph (EEG) found an electrical response (P600) was an indicator of sexual arousal in men Normal sexual response was found on right side of brain Paraphilic stimuli was on the left, frontal part of brain Same neural circuits in brain are activated either by painful or pleasurable stimuli (reward circuitry) Psychoanalytic Perspectives Paraphilias are psychological defenses against unresolved castration anxiety Cognitive-Behavioural/Learning Perspectives Learned behaviours acquired through experience Develop an association, orgasm in presence of an object (masturbate and see stockings) then it becomes a masturbatory aid Sexual Masochism Punished when discovered masturbating Experience and erection if penis accidentally rubs against parents body while being spanked (pain and pleasure become linked) Exhibitionism/voyeurism Modeling/observational learning Books, magazine, films, TV, media plants the seed of excitement Sociological Perspectives Most indulge privately Relate to subculture: Shops, organizations, magazines, rituals, sexual contacts made, identities confirmed, paraphernalia acquired Rituals mirror social and gender roles Find reversing roles appealing (gender and social class) Integrated Perspective: The Lovemap May have biological psychological, and sociological origins Lovemap Representation in the brain of the idealized lover and of idealized erotic activity with the lover During childhood experiences determine what types of stimuli and activities become sexually arousing With paraphilias, lovemaps become distorted

Complex: hormonal factors, brain abnormalities, or a combination of these and other factors play a role

TREATMENT Issues Do not want to seek treatment Ethical problems professionals are not supposed to impose societal goals on individuals Less success with resistant or recalcitrant clients Perceived responsibility (accountability) Psychotherapy Resolving unconscious conflicts believed to originate in childhood Bring unconscious conflicts into conscious awareness Cognitive-Behaviour Therapy Principles of learning to help people modify problem behaviour, To fully benefit from CBT, you have to want to and willing to change behaviour Systematic Desensitization Break the link between the sexual stimulus (fetishistic stimulus) and the inappropriate response (sexual arousal) Muscle relaxation paired with arousing paraphilic images/fantasies, eventually relaxation replaces sexual arousal Aversion Therapy Undesirable sexual behaviour (masturbation to fetishistic fantasies) is paired with an aversive stimulus (electric shock/nausea inducing chemical) Covert Sensitization Paraphilic fantasies are paired with an aversive stimulus in imagination Fellating a child then discovering a festering sore on penis Exhibitionist exposing to a woman but then discovered by wife/police Social Skills Training Improve ability to relate to other gender (model desired behaviour, role-play then provide feedback) Orgasmic Reconditioning Increase sexual arousal to socially appropriate sexual stimuli by pairing culturally appropriate imagery with orgasmic pleasure Medical Approaches Prozac Antidepressant that has made progress in treating exhibitionism, voyeurism, and fetishism, because it assists those with OCD Anti-androgen drugs Researchers believe there is a link between OCD and paraphilias Reduces sex drive ( frequency of erections and ejaculations) by lowering level of testosterone in the bloodstream (weekly injections) Used to treat sex offenders (reduce testosterone to prepubertal levels) High refusal and dropout rate Surgical castration Surgical removal of testes Selective Serotonin Reuptake Inhibitor (SSRI) Used with pedophiles and reduced all deviant sexual behaviours but did not decrease normal sexual arousal with consenting adults

6 Level Schema Based on Severity of Deviation (Bradford, 2000) Use of cognitive behavioural treatment Treating mild paraphilias with SSRIs such as Prozac If SSRI is ineffective use small does of androgen drugs Ant-androgen drugs or hormonal treatment Anti-androgen drugs or hormonal treatment administered by injection Completely reduce androgens and sex drive with high dosages of ant-androgens or luteinizing hormone releasing hormone (LHRH) Primary goal: suppress deviant fantasies, urges, and behaviours

SEXUAL ADDICTION, COMPULSIVE SEXUAL BEVAIOUR, AND HYPERSEXUALITY 3 terms inability to control excessively frequent sexual behaviour Sexual Addiction Similar to other addictions as behaviour is to relieve anxiety, but typically level of gratification as they feel bad about behaviour Treatments 12 step programs, group therapies Compulsive Sexual Behaviour Some argue that sex should not be viewed as an addiction but more so as an obsessivecompulsive disorder Treatments psychotherapy, medications anti depressants Hypersexuality (See diagnostic criteria p. 431) Being considered for inclusion in DSM IV as a distinct clinical disorder in the 5 th Edition REJECTED Controversial Pathologize consensual sexual thoughts and behaviours by linking them with psychiatric problems, like addiction, anxiety, depression, and compulsions, so it may affect labeling of those with mood disorders and they may not receive appropriate treatment FEATURE BOXES Female Paraphilics (p. 412) Responding to Exhibitionists and Obscene Phone Callers (p. 417) Normal Voyeurism p. 418 It Seems Like Voyeurs Are Everywhere p. 418 Womens Submissive Desires p. 422 READINGS Sexual Addiction and Compulsivity p. 430