A Review on Paraphilias


Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran


Sexual deviations are disorders in which the individual has fantasies, sexual desires or behaviors that are repetitive and sexually provocative and often include inhumane issues for at least 6 months. Since these people usually make various legal problems for both themselves and others, this disorder is of special interest. Different models have discussed on the etiology of sexual deviations among of which the special psychoanalysis of Freud have investigated this disorder more comprehensively. In Freudian’s psychoanalysis, sexual deviation has a neurosis structure and shows that sexual deviated has in fact accepted the deprivation of the mother, but is still trying to return to the bosom of the mother and the denying father. Also, in self-psychology the sexual deviant who has had wrong repeating scenarios in regards to his/hers relationship with parents or as a sadistic seeks to create a temporary and false glorious sense of confidence, to create a grandiose "self" who is self- sufficient and does not need anyone. In many cases body organ justifications are also considered for sexual deviations. Among the examined patients in psychiatric clinics, 74% had hormone level disorders, 27% had neurologic symptoms, 24%, had chromosomal disorders, 9% had epilepsy, 4% had abnormal EEG, 4% had major psychiatric disorders , and 4% had mental retardation .Some sources propose 9 identifications for sexual deviation which include: Fetishism, Pedophilia, Exhibitionism, Voyeurism, Sexual Masochism, Sexual Sadism, Transvestic fetishism, Frotteurism and Paraphilias. The treatment of sexual deviations has great complexity due to its coincidence with psychiatric disorders such as personality disorders, as well as other factors such as the patients’ shame and modesty and not stating their problems. The treatment of sexual deviation is considered to have four general purposes including a) reducing sexual desires b) giving insight and understanding to the patient c) controlling external stimuli d) treating concurrent disorders. The treatment of sexual deviation involves extensive ranges of biological therapies to mental therapies. One of the major approaches to psychotherapy in the treatment of sexual deviations is the insight oriented approach that causes a person to improve his interpersonal skills and to find an acceptable method for sexual gratification. Treatment in groups through specific procedures and guidelines and practices can also help the patients. When a person has other psychiatric disorders, pharmacotherapy can treat concurrent biological problems of the individual as well as reducing sexual and obsessive desires. In rare cases where the problem is very serious or causes legal conflicts, surgical treatment is recommended.