15 - paraphilias - part 6

• The Marquis de Sade's life was not an ordinary one. From early on, he was rejected by his parents and moved from one place to another. The Marquis would never gain his father's approval, no matter how hard he worked. His life lacked structure, appropriate discipline, balance, and unconditional love/approval. The young Marquis was exposed to complete self-indulgent behavior lacking any form of discipline while raised by his grandmother, aunts, and uncle. Then he was exposed to extreme corporal punishment while attending prep school with the Jesuits. He was also exposed to deviant sexual behavior in both of these very different settings.
• In theory, one might postulate that exposure to these extreme polarities of behavior, especially during the very crucial formative years, might cause the underdeveloped psyche to integrate the 2. Therefore associating pleasure with pain, hence the deviant masochistic behavior.
• Transvestic fetishism

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• Over a period of 6 months, heterosexual male patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Typically, patients derive sexual gratification from wearing clothes usually worn by the opposite sex, and patients typically are heterosexual married males (not a DSM-IV-TR criterion).
• Voyeurism

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• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Patients derive sexual gratification from seeing sex organs and sexual acts; scopophilia is a synonym for voyeurism (not a DSM-IV-TR criterion).
• Paraphilia not otherwise specified: This category is included so physicians can code paraphilias that do not meet the criteria for any of the other specific categories.

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• Scatologia involves making obscene phone calls.
• Necrophilia involves an erotic attraction or sexual interest in corpses. This paraphilia is rare and seldom reported to the police. Patients typically work in mortuaries and funeral parlors. This also involves dangerous situations where the individual could actually acquire infections from the corpse.
• Partialism is sexual interest exclusively focused on a particular body part.
• Zoophilia involves sexual activity with animals (ie, both actual sexual contact and sexual fantasies, higher in psychiatric patients).
• Coprophilia is sexual activity involving feces.
• Klismaphilia is sexual activity involving enemas.
• Urophilia is sexual activity involving urine.
• Masturbation is sexual self-gratification.