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Home , Coprophilia, Frotteurism, Gerontophilia, Klismaphilia, Narratophilia, Partialism

Module 14 - Psychopathology “Psychodiagnosis & The ” Part 1 Dr. J. Davis Mannino Professor of & Psychologist Department of Behavioral Sciences Santa Rosa Junior College Academic Year 2014 - 2015 Copyright, Dr. J. Davis Mannino, 2014 Module 14 - Psychopathology “Psychodiagnosis & The Paraphilias” Part 1 Dr. J. Davis Mannino Professor of Psychology & Psychologist Department of Behavioral Sciences Santa Rosa Junior College Academic Year 2014 - 2015 Copyright, Dr. J. Davis Mannino, 2014 Sexuality Module 12: Psychopathology - “The Sexual Paraphilias!” Parts 2

Dr. J. Davis Mannino Professor of Psychology & Psychologist Department of Behavioral Sciences Santa Rosa Junior College Academic Year 2015 - 2016 Dr. J. Davis Mannino, Copyrighted 2015 Module 12: Psychopathology “The Sexual Paraphilias!” Parts 2

Dr. J. Davis Mannino Professor of Psychology & Psychologist Department of Behavioral Sciences Santa Rosa Junior College Academic Year 2015 - 2016 Dr. J. Davis Mannino, Copyrighted 2015 Psychopathology and Psycho-diagnosis

Classification of Mental Disorders

v With special emphasis on the sexual paraphilias v (To the aside of love) Psychopathology

I see bizarre kinky in your future!

The DSM-V The Sexual Paraphilias Psychodiagnosis

Classification of Disorders

v Anxiety Disorders

v Somatoform Disorders

v Dissociate Disorders

v Mood Disorders

v Schizophrenic Disorders

v Paraphilias

Consider this: “Can the environment bring on mental health conditions?

Environmental issues.. SAD. Seasonal Affective Disorder

…worst form of a common environmental-based mental condition called “Seasonality” Anxiety Disorders v Generalized Anxiety - excessive anxiety and worry about numerous events or activities, often called “free-floating anxiety v Phobic Disorder - from Greek word for “fear” - persistent and unreasonable fear of a particular object, activity, or situation---such as the dentist! v Panic Disorder - escalating anxiety attacks that occur when confronted with dreaded events, objects, situations Anxiety Disorders v Agoraphobia Disorder - phobic disorder in public places, may include panic: dizziness, palpitations, diarrhea, or nausea. v Obsessive-Compulsive Disorder (OCD) - persistent obsessive thoughts, ideas, impulses, or images that seem to invade a person’s consciousness. Compulsions are repetitive and rigid behaviors or mental acts that a person feels compelled to perform to reduce anxiety or distress. Obsessive-Compulsive Disorder (OCD) Somatoform Disorders All in your Head!

v Somatization Disorder

Ø Vague Physical Complaints

v Conversion Disorder

Ø Specific Physical Complaint

v Hypochondriasis

Ø Preoccupation & Health Worry Ø The Case of the Hospital Shopper

Somatoform Disorders All in your Head!

v Somatization Disorder

Ø Vague Physical Complaints

v Conversion Disorder

Ø Specific Physical Complaint

v Hypochondriasis

Ø Preoccupation & Health Worry Ø The Case of the Hospital Shopper Dissociative Disorders v Dissociative Amnesia v Dissociative Fugue v Dissociative Identity Disorder (Multiple-Personality Disorder) (video)

How many of you are familiar with the book and or movie: “The Many Faces of Eve?” The Many Faces of Eve Mood Disorders v Depressive Disorder - low sad state in which life seems bleak and its challenges seem overwhelming. v Manic-Depressive Disorder or Bipolar Disorder - periods of mania that alternate with periods of depression. Bipolar Disorder Schizophrenic Disorders v Paranoid Type v Catatonic Type v Disorganized Type v Undifferentiated Type

Onset: Ages 16 - 25 - Rare after age 40 Psychodiagnosis

Classification of Disorders

v Anxiety Disorders

v Somatoform Disorders

v Dissociate Disorders

v Mood Disorders

v Schizophrenic Disorders

v Paraphilias The Paraphilias - The Factor

Fetishism Nonliving Objects TransvesticNon Human Fetishism Objects Cross-Dressing Bestiality - Sex with

Exhibitionism Exposing Oneself to Strangers VoyeurismNonconsenting PersonsUnsuspecting Strangers Touching or Rubbing Prepubescent Children Telephone Scatalogia Obscene Phone Calls Viewing or Contact with Dead

Sadism Inflicting Pain and Suffering Masochism Receiving Pain and Suffering Marker Paraphilias & Atypical Sexuality

v Questions to Ponder v Normal vs. Abnormal v Paraphilias Ø Fetishism Ø Ø Lecture Outline Ø Telephone Scatologia Ø Ø Sexual Masochism Ø Frotteurism Ø Pedophilia Ø Other Paraphilias Atypical Sexuality:Questions to Ponder v Consider what’s normal & abnormal in terms of sexual behavior? v What is atypical sexual behavior? Is this abnormal? v What are paraphilias? v Is there such a thing as ? v What is the difference between cross-dressing & transvestitism? v Is there a difference between sadism & masochism & domination & submission? v What is Nymphomania and Satyriasis? v What is the & leather scene all about? v What is voyeurism & exhibitionism? v What is Telephone Scatalogia? v What are the dynamics of pedophilia? Important Gender Terms

v Sex - difference between men and women based on biological characteristics such as genitalia. v Gender - the psychological experience of being either a female or a male. v - one’s view of oneself as either a woman or a man. v - the extent to which one’s behavior is representative of a cultural definition of masculinity or femininity. v - the preference for sexual partners of the same or the other sex. Paraphilias v - A diagnostic category used by the American Psychiatric Association to describe atypical patterns of or behavior that become problematic in the eyes of the individual or , such as fetishism or exhibitionism. v The urges are recurrent and are either acted on or are distressing to the individual. (From Greek roots meaning “to the side of” [para] “loving” [philos])

Watch Those Labels Please! v The late U. S. Senator, Claude Pepper of Florida, was a dynamic tireless advocate for the elderly and was generously supported by the political lobbying arm of the American Association of Retired Persons (AARP). v During an election campaign in the early 1990s, he was accused of being a “shameless extrovert” whose sister was a New York “thespian.” It was said he himself even “practiced celibacy” prior to and was also involved in “nepotism” with his sister-in-law (Catchpole, 1992). Was Senator Pepper in fact a closeted pervert? v One would think so unless one knew something about the English language. An extrovert is someone who has an outgoing personality; celibacy refers to ; a thespian is an actor or actress; and nepotism refers to giving family members favorable treatment. Clearly Pepper’s opponent was hoping to paint the Senator as a man involved in atypical or even illegal paraphilic behaviors. One must always be cautious about labeling people and, better yet, know something about the English language. Atypical or Typical? It’s My Party v The term atypical sexual behavior, as a concept, refers to sexual behavior that falls on a continuum that tends to be defined by a society's values, morals, and laws. v In other words, it is sexual behavior that many would agree falls on the "uncommon" side of the sexual behavior continuum. This does not mean it is abnormal, just different, and perhaps uncommon, in some or even many eyes. Atypical or Typical? It’s My Party v On the other , paraphilias, a term coined by German psychoanalyst Wilhelm Stekel in 1923, are pathological erotic preferences. v Experts divide them into two categories. First are pathological erotic target preferences, which are thoughts and activities (fantasies and ) other than with a physically mature and consenting adult. v And, second, pathological erotic activity preferences, which are activities that are atypical for most individuals who erotically prefer a physically mature and consenting adult (fetishes and sadism and masochism) (Freund et al., 1997). Atypical or Typical? It’s My Party v So too, the American Psychiatric Association considers paraphilias as mental disorders and specifically defines them as: Ø 1. recurrent intense sexual urges and sexually arousing fantasies lasting at least six months, and

Ø 2. either involving nonhuman objects, or

Ø 3. involving actual suffering or humiliation of oneself or one’s partner, or

Ø 4. involving children or other non-consenting persons, and

Ø 5. the person acting upon these urges is markedly distressed by them" (DSM-V). v The key difference between atypical and paraphilic behavior is whether the behavior intensifies one’s sexual arousal or is absolutely needed for sexual arousal and satisfaction. v Paraphilias, a term derived from the Greek root word for “to the side of love,” should also be viewed from another important angle; that is, whether or not the behavior is coercive or noncoercive. In other words, are unwilling victims involved? v Some therapists consider paraphilic behavior as compulsive or addictive as well, because of the constant need for such behavior in achieving sexual satisfaction (Money, 1988). v Also, location, time, and culture must be factored into any discussion of atypical and paraphilic behaviors, as does one’s personal belief system about what constitutes normal and abnormal. v For example, prior to 1973, a lesbian and gay sexual orientation was considered abnormal and deviant. v But over 15 years of research spearheaded by Dr. Evelyn Hooker and others clearly demonstrated that lesbians and gay males were not inclined to mental disorders as previously believed. Its removal from the DSM classification as a mental disorder was “voted out” by a simple democratic majority “show of ” at the 1973 APA Conference. In much the same way, alcoholism was also “voted in” as a disease and mental disorder. Democracy and the concept of normalcy make for strange fellows indeed! But any task of being fair, is always made easier when good solid research is conducted, reviewed, and used. Ultimately, it was such reputable research that brought about the aforementioned changes, not just the "democratic spirit!"

Chinese Sex Shops...

…how likely would you be to visit one?... What’s Normal? v Normality in sexuality is based on a statistical norm. From this perspective, rare and unusual sexual behaviors are considered abnormal or deviant. v Because of the confusing array of meanings for the terms deviant and abnormal, sexolo- gists prefer to speak about unusual patterns of sexual arousal or behaviors as atypical variations in sexual behavior rather than as sexual deviations. Sexual Behavior

Male Female ------

1. Watching a Partner Undress Second Sexual Choice

2. Third Sexual Choice

3. Watched their partner masturbate 38% 23%

4. Use Sex Toys 06% 14%

5. Sex Acts in Front of Mirrors 18% 11%

6. Watched Another in 04% 05%

7. Imagined being the other Gender 05% 10%

8. Imagined being a Prostitute 05% 10%

9. Cross Dressing 06% 03%

10. Domination and Submission (D&S) ()

A. Bondage and Discipline (B&D) 11% 11%

B. Humiliation (Debased or Degraded) 05% 07%

11. Body Play: Tattooing & Piercing 12- 20 Million Americans

12.

A. In lifetime 25% 25%

B. During Last Year 10% 10%

1 The Paraphilias - The Kink Factor

Fetishism Nonliving Objects TransvesticNon Human Fetishism Objects Cross-Dressing Zoophilia Bestiality - Sex with Animals

Exhibitionism Exposing Oneself to Strangers VoyeurismNonconsenting PersonsUnsuspecting Strangers Frotteurism Touching or Rubbing Pedophilia Prepubescent Children Telephone Scatalogia Obscene Phone Calls Necrophilia Viewing or Contact with Dead

Sadism Inflicting Pain and Suffering Masochism Receiving Pain and Suffering Paraphilias v Small number but lots of press v Pedophilia is most common v Largely male conditions, usually young men (peaks 15-25) v 50% have onset before age 18 v Usually multiple paraphilias occur in the same patient 3-5 concurrently or over lifespan

Happy Cows Come From California! Paraphilia-Etiologies

v Psychologically complex Ø Overly stimulated child - eroticized child

v Biological- Ø 74% had abnormal hormone levels Ø 27% with neurologic signs Ø 24% with chromosomal abnormalities Ø 9% with seizures (4% more with abnormal EEGs and no seizures) Ø 4% with major psychiatric disorders

Edward Hyde, appointed by Ann, was Governor of New York and New Jersey (1702-1708) posed for his official portrait in --- how shall we say-- “!” üApotemnophilia - amputation. üAutogynephilia - Imaging having female attributes. üCoprophilia - Contact with . üExhibitionism - Exposing one’s genitals to non-consenting strangers. üFetishism - Inanimate object. üFrotteurism/Toucherism - Pressing, rubbing, or touching in a crowded place. üGerontophilia – A young person having sex with a much older person. üHypoxyphilia/Auteoerotic Asphyxia - reducing oxygen to the brain. üKleptomania - The act of stealing; objects often have sexual significance. üKlismaphilia - Receiving . üMysophilia - Proximity to filth, smelly underwear, or soiled menstrual pads. üNarratophilia - Listening to erotic narrative or stories. üNecrophilia - Pseudonecrophilia - having sex with a corpse. üPansexuals - Open to any and all range of sexual activities and encounters. üPartialism - A particular body part; related to fetishism. üPedophilia - Prepubescent children. üPictophilia - Dependence on sexy or erotic pictures. üPyromania - Setting fires. üSadomasochistic Behavior – Inflicting-receiving pain bondage & . üSaliromania - Soiling a woman, her clothes, or damaging some image üScoptophilia - Secretly watching sexual acts, a precise form of voyeurism. üSomnophilia - Actual intrusion on and fondling of an asleep stranger. üStigmatophilia - Form of masochism whereby one inflicts pain on oneself. üTelephone Scatologia -Obscene phone calls - shock /horror with a stranger üTransvestism - Wearing of the other gender, but not cross-dressing. üTroilism - Viewing/sharing a partner or family member with a third person. üUrophilia - Contact with urine. (Golden Showers) üVoyeurism - Observing nude individuals without . üZoophilia or Bestiality - Sexual contact with an . Fetishism v Fetishism - A paraphilia in which an inanimate object, such as an article of clothing or items make of rubber, leather, or silk, elicits sexual arousal. From the French fe´tiche, which is derived from Portuguese feitico, meaning “magic charm.” So what is the “charm” in a fetish? v - A paraphilia related to fetishism, in which sexual arousal is exaggerated by associated with a particular body part, such as feet, , or . Paraphilias

“He was into feet, but, unfortunately, not duck feet!” Transvestism v Transvestism - A paraphilia in which a person repeatedly cross- dresses to achieve sexual arousal or gratification, or is troubled by persistent, recurring urges to cross- dress. From the Latin roots trans, meaning “cross,” and vestis, meaning “garment.” Also know as . v What is the difference between transvestism and transsexualism? Exhibitionism v Exhibitionism - A paraphilia characterized Bubba Bubba Fat with Blubber by persistent, powerful urges and sexual Loved to Flash fantasies involving exposing one’s genitals His Teenie Weenie! to unsuspec-ting strangers to achieve sexual arousal or gratification v 1 in 3 sex arrests are for exhibitionism. 50% have and 80-90% masturbate during the incident or Bubba shortly thereafter. The Flasher v One-third of 846 women at nine randomly chosen colleges said they had run-ins with “flashers.” Telephone Scatologia

v Obscene Telephone Calling - Like exhibitionists, obscene phone callers seek to become sexually aroused by shocking their victims. Whereas an exhibitionist exposes his genitals to produce the desired response, Phone the obscene phone caller exposes himself verbally by uttering and sexual provocations to a non-consenting person. A sub-type of exhibitionism.

v Telephone Scatologia - “lewdness.” A paraphilia characterized by the making of Sex ob-scene telephone calls. From the Greek skatos, meaning “excrement” v In the 11th century Leofric, Lord of Coventry, agreed to lower taxes if his wife, Lady Godiva, would ride naked on a white stallion horse through town. She, being a supporter of the poor, agreed. The town out of respect, gratitude, and appreciation shuttered their windows and hid their eyes. v All except for Tom the tailor, who stole a “peek” and then went blind, thus becoming our legendary “Peeping Tom,” the first voyeur. Though part of "Old English" folklore, the tale would seem to demonstrate that many of the paraphilias have been around for a long time. v Also, as one may see from reviewing personal ads, voyeurism should not always be viewed as pathological. v In fact, the Sex in America study found that couples watching each other undress was considered quite a turn on (Michael et al, 1994). Voyeurism

v Voyeurism - Also called peeping toms or peeping. A paraphilia characterized by strong, repetitive urges and related sexual fantasies of observing unsuspecting strangers who are naked, disrobing, or engaged in sexual relations. From the French voir, meaning “to see.”

Carved statue of “Peeping Tom” in the city of Coventry, England site of Godiva’s nude ride to lower taxes

Site of Godiva’s Ride Sexual Masochism

v Sexual Masochism - A paraphilia characterized by the desire or need for pain or humiliation to enhance sexual arousal so that gratification may be attained. Named after author Leopold von Sacher-Masoch

v Bondage - Ritual restraint, as by shackles, as practiced by many sexual masochists.

v Sexual Sadists - People who become sexually aroused by inflicting pain or humiliation on others.

v Hypoxyphilia - Also called Autoerotic asphyxia. A practice in which a person seeks to enhance sexual arousal, usually during masturbation, by becoming deprived of oxygen. From the Greek root meaning “under,” as in hypo.

v Shibari - Cross-cultural considerations in Japan Frotteurism v Frotteurism - A paraphilia characterized by recurrent, powerful sexual urges and related fantasies involving rubbing against or touching a nonconsenting person. From the French frotter, meaning “to rub.” v Toucherism - A practice related to frotteurism and characterized by the persistent urge to fondle non-consenting strangers. Sexual Addiction v Don Juanism v Nymphomania v Issue is not how much but how much the person goes through to engage in the sex act (Compulsive behavior) and whether it is dangerous or maladaptive. v Not related to intimacy

Is having online “” infidelity in a relationship? Other Paraphilias v Zoophilia - A paraphilia involving persistent or repeated sexual urges and related fantasies involving sexual contact with animals. v Necrophilia - A paraphilia characterized by a desire for sexual activity with corpses. From the Greek nekros, meaning dead body. v - A paraphilia in which sexual arousal is derived from use of enemas. v - A paraphilia in which sexual arousal is attained in connection with feces. From the Greek copros, meaning “dung.” v Urophilia - A paraphilia in which sexual arousal is associated with urine--called water sports. Date Drugs

1. 10:45 - Class starts 2. 10:45 – 11:00 Small Group Discussion (TPQ) 3. 11:00 – 12:25 - Lecture: 4. 12:25 – 12:45 - Break (20 mins) 5. 12:45 – 01:15 – Film: (30 mins)

Module #15 “Psychopathology ”

This Week's Thought-Provoking Question #11:

First discuss types of you may have engaged in. Second, which of the various types of therapy you reviewed in your readings or in life were you most impressed by. Sexual Orientation v Ø to members of one’s own sex ü Gays or Lesbians v Ø Sexual attraction to members of the other sex. v Ø Sexual attraction to members of both sexes. Origins of Sexual Orientation

v Sexual orientation develops through an interaction of biological & sociocultural factors (, 1987, 1988).

v Biological Evidence: Ø Differences have been found in an area of the hypothalamus related to sexual behavior in the brains of gay and heterosexual men (LaVay, 1991).

Ø MZ twins adopted out at birth are more likely to both be gay or lesbian than siblings raised in their family of origin (Eckert et al., 1986). Psychodiagnosis & The Paraphilias Psych 1A - Module 14 – Part One

The Paraphilias To the “Side of Love.” Now consider what “turns you on!” The End

May 06, 2015 - Exam #3 ------. Summer Break Coming – Yea! .

Psychodiagnosis & The Paraphilias Psych 03 - Module 12 – Parts 2

The Paraphilias: To the “Side of Love.” Consider how off the sexual edge you could get or might be!

Next Week – No Class - Thanksgiving Exam #3 - December 3, 2014 Holiday Break Coming Soon – Yea!