Have you ever looked around and thought about just how far our society has advanced? By no means is it finished, but it truly is astonishing to see how far we have come in the technological and health sectors. However, we have remained relatively similar for the past 3,000 years; this is ever present with the existence of “urges”—that is, sexual desires. There isn’t anything inherently wrong with these urges though; they are our evolutionary baggage—things our ancestors used to ensure the continued growth of the human population. Nevertheless, for some in modernity, these “urges” present themselves in unhealthy ways, leading to a classification as a paraphilic disorder.
Paraphilic disorders are described as “intense sexual urges, behaviors, or fantasies which cause distress or impairment to the individual or whose satisfaction has entailed personal harm or risk of harm to others” (Paraphilic Disorders | Johns Hopkins Psychiatry Guide, 2017). This definition is quite the mouthful and for good reason—as described in the DSM-5 (a manual used for the assessment and diagnosis of mental disorders), there is a fundamental difference between atypical sexual preferences and paraphilic disorders. Essentially, there needed to be an emphasis and distinctive boundaries to not involuntarily label someone whose sexual preferences deviate from societal norms as mentally ill.
The inherent nature of sexual urges means that virtually anything can be considered a paraphilic disorder, depending on how it is present within someone’s life. The American Psychiatric Association chose to highlight 8 of them to further explain what their definition of a paraphilic disorder is. The 4 most common are pedophilia (sexual attraction to children), exhibitionism (exposure of genitals to strangers), voyeurism (observing private activites of unaware victims) and frottuerism (touching or rubbing against a nonconsenting person) (Paraphilias, 2021). Notice how although these four paraphilic disorders are all unique, they follow a similar trend of being outside of what the legal system permits due to the potential harm they can cause towards others.
Like many mental disorders, there are very few existent solutions for paraphilic disorders, but there are a few treatment options. One option is heavily reliant on the use of certain classes of medication, which include antidepressants and long-acting gonadotropin-releasing hormones (i.e. medical castration) (Reardon, 2020). This option primarily works to chemically alter the intensity of the sexual urge, with the hope that this would lower the chances of the person committing a potentially harmful behavior. Another potential remedy is cognitive behavioral therapy (CBT), which is a developing psychosocial intervention that can improve mental health. CBT works to help a person control and manage their urges and its success is heavily dependent on what that person wants to get out of the therapy (Baez-Sierra et al., 2016).
Much of how our minds work is still a mystery, and many disorders of the mind continue to leave professionals baffled because of their intricate complexity. However, one thing that we know for sure is that no one chooses to have a mental health disorder. We cannot preach about the importance of mental health while picking and choosing which disorders are subject for criticism. Instead, we must approach the entire topic of mental health with an open mind in order to create a more welcoming environment for those who may be too afraid to seek help.
Paraphilic Disorders | Johns Hopkins Psychiatry Guide. (2017). Hopkinsguides.com. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787119/all/Paraphilic_Disorders
Paraphilias. (2021). Psychology Today. https://www.psychologytoday.com/us/conditions/paraphilias
Reardon, C. L. (2020, June 30). Paraphilic Disorders Treatment & Management: Approach Considerations, Psychotherapeutic Interventions, Pharmacologic Therapy. Medscape.com; Medscape. https://emedicine.medscape.com/article/291419-treatment
Baez-Sierra, D., Balgobin, C., & Wise, T. N. (2016). Treatment of Paraphilic Disorders. Practical Guide to Paraphilia and Paraphilic Disorders, 43–62. https://doi.org/10.1007/978-3-319-42650-1_4