Paraphilia: An abnormal sexual desire


Ever heard of crazy foot fetishes? Well, those are a type of paraphilia. This article will tell you everything you need to know what is a paraphilia, what the symptoms, causes, diagnosis, and treatments are and the different types of paraphilia.



What is paraphilia?

Paraphilia is the condition that is known for its abnormal sexual desires that usually involve extreme and/or dangerous conditions. Also known as sexual perversion and sexual deviation, it is also considered to be the intense sexual arousal to unusual objects, situations, individuals, or behaviors. It can revolve around an object (animals, underwear, children) or an act (exposing oneself, inflicting pain). It’s more common to find paraphilias in men than in women.


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For instance, many people want to be bitten or spanked due to their sexual desire or to watch people nude. These are normal. However, once these acts become a psychological dependence, meaning one can’t be aroused without these types of acts, it becomes a type of paraphilia.

The word paraphilia comes from a combination of the Greek words para (beside) and philia (friendship, love). The term paraphilia was coined by a German psychiatrist, Richard Von Krafft-Ebing, in his 1886 book Psychopathia Sexualis (Sexual Psychopathy).

Symptoms of paraphilia

All paraphilia involve recurrent sexually arousing fantasies, sexual urges, or behaviors that cause some sort of distress or impairment and remain present for at least six months. The unusual or forbidden nature of a paraphilia often causes symptoms of guilt and fear of punishment. It’s easier to understand a paraphilia when we think of the behavior in a less extreme or intense version. For example, “talking dirty” is a common sexual act. However, it is considered paraphilia when talking dirty is the only way that sexual satisfaction can occur.

Symptoms of paraphilia can include obsessiveness that may intrude on the person’s attempts to think about other things or engage in a more conventional sexual activity. Depression or anxiety are also common and are temporarily relieved by engaging in the paraphilic behavior, feeding the cycle.

Causes of paraphilia

As of now, the true cause for paraphilia is unclear. A high sex drive doesn’t correlate with a paraphiliac behavior. Nor does a high level of testosterone predispose a male to paraphilia. However, psychoanalysts have theorized that someone who suffers from a paraphilia picked it up from a habit that arose early in life. Some think that there is a predisposing factor, such as having difficulty in creating person-to-person relationships, that can be a cause of paraphilia.Non-sexual objects can become sexually arousing if they are continually associated with an enjoyable sexual activity. One study showed that we can develop sexual preferences for anything by successfully conditioning the participants to experience sexual arousal in response to an image of a jar of pennies. Sexual acts, like beastiality and peeping, can provide intense erotic pleasure that can result in someone preferring that behavior.

A 2008 study used the Wilson Sex Fantasy Questionnaire to analyze the sexual fantasies of 200 heterosexual men. The study discovered that males who were prone to a paraphilia fantasy had a greater number of older brothers and were left handed. The being left-handed suggests that our brain’s lateral hemispheres might play a role in kinky attractions.



Behaviorists have suggested that paraphilias begin by a conditioning process- meaning habits. Some behavioral learning models have suggested that a child that is a victim of or the observer of inappropriate sexual behaviors will learn to imitate these behaviors, which only reinforces the said behavior. Compensation models have suggested that people who have paraphilia are deprived of a normal social sexual contact and thus they seek satisfaction through less socially acceptable methods. Physiological models have focused on the relationship between hormones, our behavior, and the central nervous system (CNS), and how they might be the cause of the role of aggression and sexual male hormones.

Diagnosis of paraphilia

A paraphilia is considered a disorder when it begins to cause harm or distress to someone else. That said, there is no consensus as to the line between an unusual sexual interest and a paraphilic interest. However, there is a debate about which, if any, of the paraphilias, should be listed in the diagnostic manuals, such as the International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM).

The history within the different editions of the Diagnostic and Statistical Manual of Mental Disorders and paraphilia differs.

  • DSM-I (1952) claimed that sexual deviation is a personality disorder of a sociopathic subtype.
  • DSM-II (1968) continued to use the term “sexual deviation,” but it was categorized as more than just a personality disorder. Instead, it was coined under “personality disorders and certain other non-psychotic mental disorders.” For example, sexual orientation disturbance (homosexuality), pedophilia, exhibitionism, fetishism, transvestitism, sadism, voyeurism, masochism, and “other sexual deviation”.
  • DSM-III (1980) introduced the term paraphilia under a new category of “psychosexual disorders”.
  • DSM-III-R (1987) renamed and moved around a lot of the disorders under “sexual disorders” like adding frotteurism and moving zoophilia to a different category known as Paraphilia NOS (not otherwise specified).
  • DSM-IV-TR (2000) defined paraphilia as “recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving nonhuman objects, the suffering or humiliation of oneself or one’s partner, or children or other nonconsenting persons that occur over a period of six months.. which cause clinically significant distress or impairment in social, occupational, or other important areas of functioning”. This revised version of DSM-IV named eight detailed paraphilic disorders: exhibitionism, frotteurism, fetishism, sexual masochism, pedophilia, sexual sadism, voyeurism, and transvestic fetishism.
  • DSM-V (2013) distinguishes between paraphilia and paraphilic disorder by stating that a paraphilia doesn’t require or justify psychiatric treatment itself and that a paraphilic disorder is a “paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others.”

Types of paraphilia

There are eight types of paraphilia disorders that are officially recognized by the DSM-V, although there are more that exist:

  • Pedophilia is a sexual focus on children.
  • Exhibitionism is exposing one’s genitals to strangers.
  • Voyeurism is being a Peeping Tom and observing others without their knowledge.
  • Frotteurism is groping, touching, and rubbing against a non-consenting person- usually in public places.
  • Fetishism is the use of inanimate objects sexually
  • Sexual masochism is wanting to suffer or be humiliated
  • Sadism is inflicting suffering or humiliation
  • Transvestism disorder is being sexually aroused just by cross-dressing


However, there are over 40 more paraphilia that can develop into a paraphilia under certain circumstances which include, but are not limited to:

  • Telephone scatologia is an obscene phone call with a twist. It involves calling strangers and saying foul/dirty things.
  • Necrophilia is being sexually aroused by dead bodies and corpses. While it seems like something quite disgusting to a non-necrophiliac person, there are several U.S. States, like Louisiana, North Carolina, Oklahoma, Kansas, Nebraska, New Mexico, Vermont, and Wisconsin, among others, and a couple European countries that find it okay.
  • Partialism is when someone can only get sexual pleasure by focusing on one part of the body, such as a foot.
  • Zoophilia, also known as beastiality, is deriving sexual pleasure from sex with non-humans. One study found that the percentage of people who have had a sexual encounter with an animal in their lives is 8% for men and 3.6% for women- the majority living on or near farms.
  • While a rather rare paraphilia, coprophilia is being sexually aroused by feces.
  • Klismaphilia is being aroused by the introduction of liquids into the rectum.
  • Autogynephilia is a man being aroused by thinking of himself as a woman. It’s theorized that nearly 3% of men around the world experience some sort of autogynephilia.
  • Asphyxiophilia and hypoxyphilia are both types of erotic asphyxiation (sexual choking). This means the intentional restriction of oxygen for sexual arousal purposes.
  • Video voyeurism is being a Peeping Tom, but with a video camera. Essentially, videoing someone without their knowledge while they are getting undressed or engaged in sexual activities.


Treatment of paraphilia

Treatments in the past have included psychoanalysis, hypnosis, and behavior therapy techniques. However, there has been a recently developed drug that can now be added to the treatment process: antiandrogens. Antiandrogens, like medroxyprogesterone acetate (Depo-Provera) and cyproterone, temporarily lower testosterone levels with the hopes of lowering the male sex drive and thus, reducing the amount of mental imagery/sexually arousing scenes. Antidepressants, like fluoxetine (Prozac), also decrease one’s sex drive, but they don’t target sexual fantasies as much as an anti androgen. There is increasing evidence that combining cognitive behavioral therapy and drug therapy is an effective treatment method. Some cognitive-behavioral models include:

  • Aversive conditioning which involves using negative stimuli to eliminate or reduce a certain behavior.
  • Covert sensitization involves relaxing and visualizing scenes of kinky behavior followed by a negative event, like getting one’s penis stuck in their pants zipper.
  • Assisted aversive conditioning is similar to covert sensitization, but the negative event is made real. Mostly it’s a bad smell pumped into the air by a therapist with the goal that the patient associates the kinky behavior with the bad smell and take measure to avoid the smell by avoiding the kinky behavior.

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  • Vicarious sensitization involves showing videotapes of kinky behavior and their consequences. For example, watching surgical castrations.
  • Reconditioning techniques entails giving the patient constant and immediate feedback to that the behavior will be changed right away.
  • Masturbation training focuses on separating the pleasure of masturbation and the kinky behavior.
  • Empathy training entails on helping the offender take on the perspective of the victim in order to help them identify with and understand the harm that they did. For example, a paraphiliac rapist could go through empathy training to help them grasp the situation from a different perspective.


Most interesting cases of paraphilia

  • Formicophilia is a derivation of zoophilia and means becoming sexually aroused by having insects, like ants or bees, crawl all over and bite/sting one’s body and genitals
  • Troilism/cuckoldism is becoming sexually aroused by watching one’s partner have sex with another person or know that they are having an affair.
  • Paraphilic infantilism is the ability to be sexually aroused by dressing up or being treated as a baby. This can overlap with diaper fetishism which means someone finds pleasure in wearing or using diapers.
  • Unlike urophilia in which someone experiences sexual pleasure from being urinated on, omorashi involves getting pleasure from having a full bladder or watching someone else wet themselves.
  • Symphorophilia is deriving sexual pleasure from watching a disaster occur, like a fire or a car accident.
  • Vorarephilia is deriving sexual arousal by (thinking of) being eaten by someone else. While most people simply fantasize about it, some people actually do it.

Let us know what you think in the comments below!

Anna is a freelance writer who is passionate about translation, psychology, and how the world works.