Paraphilias: How They Develop And Possible Treatments


As a complex human experience, sexuality manifests in patterns unique to each person, deriving from the way fantasy imagery merges with his or her sexual and emotional development. — Katherine Ramsland Ph.D.

There is a great deal of controversy associated with deviant sexual behaviors and preferences. The definition of what is normal over aberrant or disordered is partly dependent on the cultural view of acceptability. Paraphilia is defined as a strong sexual attraction to an object or people other than genital stimulation. Having an unusual taste regarding sexual behavior doesn’t automatically result in having a paraphilic disorder; it needs to cause distress and threatens the psyche of the self, others, and the community.

A paraphilia is gaining arousal or gratification on the fixation on particular subjects such as children or animals, parts of the body, dressing items like underwears and intimate apparel, and even on dead people. Some would exhibit eccentric and unacceptable social behaviors that connote sexualism such as showing their genitals in public or peeping on other’s houses while people are doing some personal activities. The incidence of paraphilia is frequent in men than women excluding masochism.

Paraphilics often depend on stimuli which elicit fear or disgust. The psychophysiology is rather straightforward: when something alters our heart rate and respiration, the mind interprets this contextually. — Jeffrey Lockwood Ph.D.

Theories of Causation

Diagnosis of paraphilia and other sexual disorder is challenging to identify and differentiate. In fact, one expert explained that deviant sexual behavior could be “illegal, immoral and undesirable or cause of distress but not an expression of underlying mental disorder,” (Quinsey, 2012).  Similar to other mental disorders, the cause of paraphilia is also unknown, but psychoanalysts suggest that individual with paraphilia might be due to exposure to repeated sexual practice that began early in life.

The behaviorists believe that the disorder begins with the conditioning process. Innate sexual objects are turned into a vehicle for sexual arousal when the object was repeatedly used. A fixture in a previous pleasurable encounter or sexual acts that can provide strong erotic pleasure which then leads a person to choose the behavior over the “norm.”

Telephone scatophilia (sometimes referred to as telephone scatologia and telephonicophilia) is a paraphilia that comprises overt or covert repetitive telephone calls with sexual and/or obscene content to an unsuspecting victim. The behavior is also known to have a high association with other paraphilic disorders such as voyeurism and exhibitionism. — Mark D. Griffiths Ph.D.


Moreover, based on the behavioral learning model, a child or an individual who is a victim or a witness of unfortunate sexual behaviors can learn through imitation and reinforced the response later on. In the compensation model, it suggests that these individuals might be deprived of regular social, sexual contacts, therefore, seek gratification through other non-conventional means. On the physiological model, theorists view that it is due to the combination of bodily hormones and chemicals and the interaction of the brain mechanisms emphasizing the aggression and male sex hormones.   In addition, there are predisposing factors linked to the development of paraphiliae such as a history of sexual abuse and the inability to form relationships.




The treatment protocol for paraphilia is an interdisciplinary approach which may include psychoanalysis, behavioral therapy, hypnosis and pharmacologic. It was discovered recently that the usage of antiandrogen which lowers the level of testosterone temporarily giving the person time to focus on counseling and disruption from the paraphiliac urges by curbing the sex drives. Evidence shows that a combination of pharmacology with psychoanalysis therapy is effective. With regards to medication for paraphilias, it is best to take note that the intensity of sex drive is not relative to behaviors or tendencies as mentioned earlier. Moreover, the level of testosterone in the system is not a risk factor for the development of males with paraphilias. At times, antidepressants are administered to decrease sex drive but do not effectively target sexual fantasies.




Quinsey VL: Pragmatic and Darwinian views of the paraphilias.Arch Sex Behav 2012, 41:217-20.