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71 Cards in this Set
- Front
- Back
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Paraphilia
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To one side of love
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Coercive Paraphilias
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- Over a period of at least 6 months
- recurrent, intense, sexually arousing fantasies or sexual urges focused on sexual coercion |
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Fetishism
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Attraction to objects (non-living)
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Development of a fetish attachment
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- Usually begins in adolescence
- Can begin in early childhood with a special significance |
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Other crimes of the fetishist
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- 1/3 of those with bestiality
- 1/4 of obscene phone callers - 22% pedophiles - 20% Transvestites - 11% Voyeurs |
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Fetishistic Transvestism
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Sexually aroused by fabrics, materials or garments
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Transvestism with Autogynephilia
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Sexually aroused by the thought or image of self as female
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Sexual Masochism
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The act of being humiliated, bound, beaten or otherwise made to suffer
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Characteristics of an SM scene
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- relation of dominance & submission
- Infliction of pain that is experienced as pleasurable by both partners - Using fantasy or role playing by one or both - Deliberate humiliation - Fetishistic elements (clothes, devices) - One or more ritualistic activities |
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Exhibitionism
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- Exposure of one's genitals to a stranger
- Sometimes masturbates during exposure |
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Motivations for an Exhibitionist
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- want to elicit reactions of shock, interest or arousal.
- Only when angry at spouse. - Only when intoxicated. |
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Frotteurism
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- Touching or rubbing against a nonconsenting person
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Telephone Scatologia
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- Sexual arousal during prank/obscene phone call
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Voyeurism
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Involves the act of observing unsuspecting individuals, usually strangers, who are naked, in the process of disrobing or engaging in sexual activity
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Zoophilia
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The paraphilia characterized by an exclusive or predominant desire for sexual contact with animals
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Bestiality
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The act of being sexual with animals
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Species Dysphoria
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Wish they were the species of the animals they desire
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Paraphilia found in women
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Sexual Masochism
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Klismophilia
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Sexual pleasure associated with receiving enemas
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Coprophilia
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Sexual arousal associated with contact with feces
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Urophilia
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Sexual arousal associated with contact with urine
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Necrophilia
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Sexual gratification obtained by viewing or having intercourse with a corpse
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"Good Lives" Model
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Enhancing pts’ overall functioning will lead them to attain the goals of a “good life,” which, in turn, will reduce their need to continue the problematic behavior.
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Satiation Therapy
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Masturbates to preferred stimulus or fantasy images & continues past orgasm
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Covert Aversion Technique
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write down the exquisite details of the negative consequences & read them after having problematic urges/fantasies
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MPA
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medroxyprogesterone acetate
- lower rates of masturbation or sexual activity - diminishing frequency of erection, ejaculation & sexual desires - diminished erotic preoccupation - reduced obsession with paraphilic tendencies - increased ability to concentrate on nonsexual matters Can give as pill or injection |
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CPA
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Cyproterone acetate
- Anti-androgen, anti-gonadotropic and progestogenic effect. Blocks androgen receptors |
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Antidepressants
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- Prozac, Paxil, Anafranil, Luvox, Zoloft
- Reduces obsessiveness & compulsivity. - Reduces social anxiety. - Reduces depression |
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Factors for the success of treatment for Paraphilias
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Therapist features of empathy, warmth, directiveness & encouragement are responsible for a significant proportion of the success in treatment
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DSM-V Definition of Paraphilia disorder
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The term paraphilia refers to any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners
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Most common sexual dysfunction for males
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Premature ejaculation
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Most common sexual dysfunction for females
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Female Subjective Sexual Arousal
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Sensate Focus Exercises
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- 4 levles of touching and rubbing, plus feedback
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Treatment for Vaginismus
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- Dialation
- Desensitization - Mastering |
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Percentage of women who have difficulty achieving orgasm during intercourse
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- 2/3
- 67% |
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Reasons why people fake orgasms
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- Avoid disappointing or hurting partner
- To get sex over with - Poor communication - Limited knowledge of sexual techniques |
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Dyspareunia in Men
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- Phimosis - Tight foreskin
- Poor hygiene - Pelvic or genital infections - Peyronie's disease |
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Vaginismus
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- Spasm of the muscles right around the vaginal opening
- Different degrees - Can develop from or contribute to dyspareunia |
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Peyronie's Disease
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Fibrosis in Penis
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Priaprism
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An erection that will not go down
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Strategies for delaying ejaculation
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More frequent ejaculation
“Come Again” Change positions Communication Alternative activities - Start-Stop technique - Squeeze technique |
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Medical Treatment for delaying ejaculation
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- Parozetine (Paxil) & Sertraline (Zoloft).
- Paxil (Most common) - Off label: Paxil, Zoloft, Clomid, Prozac |
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Treatment for Erectile Dysfunction
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Psychological: Reduce anxiety
Medical: Viagra and other treatments Mechanical: suction pump, Rejoyn Surgical treatment |
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Viagra
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- acts by blocking the enzyme phosphodiesterase-5 (PDE-5) whose normal job is to break cGMP down
- Nitric Oxide |
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Persistent Sexual Arousal Disorder
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- When women are constantly aroused
- Cannot ride in a car, too much vibration - Don't know the cause, don't know the treatment |
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Penile Impants
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- Semirigid Rod
- Inflatable |
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Self-Awareness
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- Physical: Self-exams, masturbation
- Emotional: emotional intelligence |
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Treatment for FSAD & HSDD
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- improving partner’s or her own skills of erotic stimulation
- relieve partner’s sexual dysfunction - increase the rewards & reducing punishment that the woman experiences within nonsexual domains of the relationship |
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Women learning to become orgasmic
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- Through self-stimulation, I.e., directed masturbation
- self exploration, genital self-exam, Kegel exercises. - Vibrator use - Allow time |
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Eros Device
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- Works by increasing vasocogenstion of the clitoris
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Masturbation in the presence of partner
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- Important effective way for an individual to indicate what kind of touching her or she finds arousing
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Dealing with Vaginismus
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- Relaxation & self-awareness: bath, genital pleasuring
- Insert fingers or dilators - Kegel exercises at each stage Partner repeats process. - Vaginal containment. - Pelvic movements |
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Treatment for women for were sexual abused as a child
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- encouragement that women can be in control of their sexual encounters
- women learning to be able to mentally & physically relax prior to & while receiving sexual stimulation - women’s recognition that they need only engage in encounters with which they are fully comfortable. - helping women to develop verbal & nonverbal communication with their partners to limit further sexual stimulation when they feel overwhelmed, “numb,” or fearful. - assisting women’s development of relationships where there is a healthy - balance of power to minimize feelings of victimization and maximize feelings of control. |
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Origins of Sexual Difficulties
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Physiological: Chronic Illness
- Cancer - Diabetes - Multiple sclerosis - Strokes |
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Origins of Sexual Difficulties
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Disabilities:
- Spinal Cord Injuries - Cerebral Palsy - Blindness - Deafness |
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Cultural Factors that contribute in sexual functioning
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Negative childhood learning
Sexual double standard Narrow definition of sexuality Performance anxiety |
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Negative Childhood Learning
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Observing parents’ interactions & how they feel about one another.
Religious orthodoxy |
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Sexual Double Standard
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Equality of gender roles is associated with men’s & women’s sexual satisfaction.
Women learn to be restrained to avoid label “slut.” Men have to act like men which means no tenderness or receptivity. Don’t ask for guidance. |
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Narrow Definition of Sexuality
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Sex=penile-vaginal intercourse. Means women might not get adequate stimulation & men feel burdened & anxious
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Performance Anxiety
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Men more than women.
Turns transitory problem into a sexual dysfunction |
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Hypoactive Sexual Desire Disorder
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Lack of interest in sexual activity
Usually temporary Often due to relationship problems, or internalized negative attitudes about sex |
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Female Subjective Arousal Disorder
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Physical signs of arousal are present, but feelings of sexual excitement and pleasure are absent or diminished
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Circular Sexual Response Model
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- Wish to experience physical pleasure
- To show affection - To please or pacify a partner - To feel strong or desirable - To dispel boredom - To distract from negative preoccupations - To continue a longstanding habit - To meet a felt obligation |
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Female Orgasmic Disorder
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absence, marked delay or diminished intensity of orgasm, despite high subjective arousal from any type of stimulation
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Premature Ejaculation
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persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it” with associated “marked distress or interpersonal difficulties
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Pyspareunia in Women
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Prevalence: 6.5-45% in older women, 14-34% in younger women
Decreased lubrication, not aroused Infections in vagina & bladder Vestibulodynia (PVD)* Endometriosis or STD Gynecologic surgery (scars), childbirth Developmental malformations, intersexed conditions, unruptured hymen Vaginal atrophy (aging) Allergic reactions Vaginismus (1-6% prevalence) |
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Vestibulodynia
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Most frequent type of superficial dyspareunia in premenopausal women
Localized strictly to the vestibule Knife-like or burning pain on first contact or during initial stages of penetration. Provoked by pressure or friction in the vestibule |
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Vestibulodynia (PVD)
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Increased trait anxiety
pain catastrophizing Reward dependency Harm avoidance Shyness Perfectionism Low self-esteem Erotophobia Problems with arousal/lubrication during partner sex but not with masturbation |
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Relationship Factors that contribute to sexual difficulties
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Unresolved problems
Ineffective communication Fears about pregnancy or STDs Sexual Orientation |
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Unresolved Problems
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lack of trust or respect, dislike of partner. Can use lack of interest to punish. Pressure & lack of power/control leads to less interest. Too much dependence
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Ineffective Communication
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Base encounters on assumptions, past experiences, wishful thinking.
Stereotyped gender roles a culprit |
