Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
PARAPHILIC DISORDERS, SEXUAL DYSFUNCTIONS, AND GENDER DYSPHORIA CHAPTER 11 Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. WHAT IS ABNORMAL SEXUAL BEHAVIOR? • When evaluating the “normality” of a given sexual behavior, the context is extremely important. • Attitudes and behaviors related to sexuality are continually evolving over time. • Contemporary human sexuality researchers: • Alfred Kinsey • William Masters • Virginia Johnson Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. PARAPHILIC DISORDERS • Behaviors in which an individual has recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving: • (1) nonhuman objects • (2) children or other non-consenting persons • (3) the suffering or humiliation of self or partner • Psychological dependence on the target of desire that results in inability to experience sexual arousal without target. Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. TABLE 11.1 PARAPHILIC DISORDERS Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. PEDOPHILIC DISORDER • A paraphilic disorder in which an adult is sexually aroused by children or adolescents. • • • • 2/3 of all sexual assault victims are children & adolescents Nearly 2/3 of victims are female Vast majority of perpetrators are male About 1/3 of offenders are relatives of the victimized children Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. EXHIBITIONISTIC DISORDER • A person has intense sexual urges and arousing fantasies involving the exposure of genitals to a stranger Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. VOYEURISTIC DISORDER • From French voir (“to see”) • The individual has a compulsion to derive sexual gratification from observing the nudity or sexual activity of others Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FETISHISTIC DISORDER • The individual is preoccupied with an object • Depends on the object rather than sexual intimacy with a partner for achieving sexual gratification • Behavior is not fetishistic when involving an object specifically designed for sexual excitation • Vibrator Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FETISHISTIC DISORDER • Partialism: The person is interested solely in sexual gratification from a specific body part: • Feet Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FROTTEURISTIC DISORDER • From French frotter (“to rub”) • The individual has intense sexual urges and sexually arousing fantasies of rubbing against or fondling an unsuspecting stranger Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL MASOCHISM • Attraction to achieving sexual gratification by having painful stimulation applied to one's own body Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL SADISM • Deriving sexual gratification from activities that harm, or from urges to harm, another person Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. ATYPICAL AND ABNORMAL SEXUAL BEHAVIOR (CONT.) • Sexual sadism: - practice of receiving sexual pleasure from inflicting pain on others • Sexual masochism: - obtaining sexual pleasure from receiving pain BDSM • • • • • • Bondage and Discipline Bondage: the practice of restraining for pleasure. Bondage is usually, but not always, a sexual practice. • Bondage means binding the partner by tying their appendages together; for example, by the use of handcuffs or by lashing their arms to an object. Discipline: describes the use of rules and punishment to control overt behavior in BDSM. • Punishment can be pain caused physically (such as caning), humiliation caused psychologically (such as a public flagellation) or loss of freedom caused physically (ex. chaining the Bottom to the foot of a bed). Sadism and Masochism Sadism: Deriving of sexual gratification, or the tendency to derive sexual gratification, from inflicting cruelty, pain or emotional abuse on others. • The word is derived from the Marquis de Sade, an 18th century French nobleman who got off on the sexual torment and humiliation of others. Masochism: Deriving of sexual gratification, or the tendency to derive sexual gratification, from being physically or emotionally abused, humiliated or mistreated. • It is named after Leopold von Sacher-Masoch, a 19th century Austrian novelist who delighted in being tortured and humiliated by his lovers. • Many people consider BDSM perverted, dehumanizing, or worse. But aficionados call it the most loving, nurturing, intimate form of human contact and play. CAUSES OF BDSM • Psychoanalytic theory: BDSM is the result of childhood trauma or significant childhood experiences that manifest itself in exhibitionistic behavior (Noyes, 1998). • BDSM is simply a sexual interest or subculture attractive to a minority, and for most participants not a pathological symptom of past abuse or difficulty with "normal" sex (Richters et al., 2008). • Psychobiological theory: BDSM is the result of hormonal influence on the central nervous system. • BDSM is associated with abnormally high levels of endorphins reinforcing an initial experimental or accidental experience with BDSM. • Learning theory: BDSM represents a form of conditioning; specifically, when a young boy becomes aroused while being spanked over his mother's lap. The pain is associated with arousal resulting in patterned masochism. • Behavioral theory: suggests the practice is acquired through early exposure to BDSM (through experience and/or observation) that is imitated and reinforced. • Safe, Sane and Consensual (Brennan, 2010) • SAFE: To start it must be said that nothing is 100% safe, including BDSM. Safety involves many things. It means knowing your limitations, Dom and Sub alike. It means taking precautions like having safety scissors (EMT shears are good for this, they will cut through almost anything) and having more then one key to anything that locks (as well as having locks that use a common key). It means keeping things clean and using condoms or other barrier protection when needed. It means having some simple first aid items handy. • SANE: It means understanding what's possible and what should remain fantasy. Knowing the difference between what must remain a fantasy and what you can actually do is an important step to being a responsible member of our scene community, even if you only play privately. It also means taking the time to learn about that newest thing you want to try, by reading, observing, talking to others, and practicing if needed. Finally, it also means not incorporating drugs/alcohol and/or anger. • CONSENSUAL: This may be the most important concept of all. It's what separates us from the abusers. Everything we do is based on consent. Consenting to play and then negotiating what will happen. Consenting to enter into a Dom/sub relationship. The ability to do that can be modified by negotiated agreements, but, if, and when consent is withdrawn, that withdrawal must be honored. TRANSVESTIC DISORDER • Transvestic fetishism• A man has an uncontrollable craving to dress in women's clothing in order to derive sexual gratification. • Transvestic disorder• Diagnosis applied to individuals who engage in transvestic behavior and have the symptoms of a paraphilic disorder Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. THEORIES AND TREATMENT OF PARAPHILIC DISORDERS • Biological perspectives • Castration • Psychotherapeutic medications • Psychological perspectives • • • • Lovemaps Group therapy The cognitive behavioral perspective Relapse prevention Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL DYSFUNCTIONS Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL DYSFUNCTIONS • Abnormality in an individual’s sexual responsiveness and reactions • Feelings of significant distress or impairment • Lifelong or acquired • Generalized or situational Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL AROUSAL DISORDERS • Male hypoactive sexual desire disorder• Low level of interest in sexual activity. • Female sexual interest/ arousal disorder• Persistent or recurrent inability to attain or maintain normal physiological and psychological arousal responses during sexual activity. Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL AROUSAL DISORDERS • Erectile disorder • Male cannot attain or maintain an erection during sexual activity that is sufficient to allow them to initiate or maintain sexual activity Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. DISORDERS INVOLVING ORGASM • Female orgasmic disorder • Male orgasmic disorder Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. DISORDERS INVOLVING ORGASM • Delayed ejaculation • A sexual dysfunction in which a man experiences problems having an orgasm during sexual activity. • also known as inhibited male orgasm. • Premature ejaculation • A sexual dysfunction in which a man reaches orgasm well before he wishes to, perhaps even prior to penetration. Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. DISORDERS INVOLVING PAIN • Genito-pelvic pain/penetration disorder • The individual experiences recurrent or persistent genital pain before, during, or after sexual intercourse. • Can affect both males and females. Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL DYSFUNCTIONS: THEORIES AND TREATMENT • Biological perspective • Erectile dysfunction - Medications to treat include the prescription drugs Viagra, Levitra, and Cialis • Hormonal replacement therapy • Application of corticosteroids and physical therapy Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SEXUAL DYSFUNCTIONS: THEORIES AND TREATMENT • Psychological perspectives • Macho myth • Sensate focus Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. GENDER DYSPHORIA Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. GENDER DYSPHORIA • Gender Dysphoria • Distress that may accompany the incongruence between a person’s experienced or expressed gender and that person’s assigned gender. • Gender identity: • A person’s inner sense of maleness or femaleness • Biological sex • The sex determined by a person’s chromosomes. Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. • Transsexualism, • The phenomenon in which a person has an inner feeling of belonging to the other sex. • Some people with gender dysphoria disorders wish to live as members of the other sex, and they act and dress accordingly. • Unlike individuals with transvestic disorder, these people do not derive sexual gratification from cross-dressing. Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. GENDER DYSPHORIA: THEORIES AND TREATMENT • New approaches are used that emphasize a more fluid view of gender than the binary male-female dichotomy. • New DSM 5 terminology reflects a theoretical perspective that does not focus specifically on what is “wrong” with people whose selfidentification differs from their biological characteristics or social roles. • Clients will still likely struggle with Transphobia • New therapeutic approaches encourage clients to create their own gender identities, which can result in an improved sense of well-being. Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. THE BIOPSYCHOSOCIAL PERSPECTIVE • Clinicians are increasingly developing models that incorporate integrated treatment • DSM-5’s sweeping changes reflects: • Expansion of the empirical approaches to sexual disorders • Adoption of a broader, more inclusive, and socioculturally sensitive approach to their understanding and treatment Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. • For more information on material covered in this chapter, visit our Web site: • http://www.mhhe.com/whitbourne7eupdate Copyright (c) 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.