Paraphilias have been grouped into a number of major categories by researchers and clin­icians. We will review some of the more common types of paraphilias, including: fetishism; sadism and masochism; exhibitionism and voyeurism; transvestic fetishism; and pedophilia.


A fetish is an inanimate object or a body part not usually associated with the sex act that becomes an individual’s primary or exclusive focus of sexual arousal and orgasm. The fetishist (FEH-tish-ist) can develop a sexual response to an object, such as shoes, boots, panties, or bras; to a fabric, such as leather, silk, fur, or rubber; or to a body part, such as feet, buttocks, or hair (Wasserman, 2001). As with most paraphilias, the majority of fetishists are male. The strength of the preference for the object varies from thinking about or holding the object to a need to use it during all sexual acts. In the absence of the object, a male with a fetish may experience erectile dysfunction (American Psychiatric Association, 2000).

Many people enjoy using lingerie or even rubber or other fabrics as part of their lovemaking without becoming dependent on them for arousal. The fetishist, on the other hand, needs the presence or the fantasy of the object in order to achieve arousal and sometimes cannot achieve orgasm in its absence. Some fetishists integrate the ob­ject of their desire into their sexual life with a partner; for others it remains a secret fetish, with hidden collections of shoes, or panties, or photographs of a body part, over which they masturbate in secret, ever fearful of discovery.

Подпись:Many fetishists see their sexual habits as a major part of their life, a source of their sense of identity; yet because fetishism is often regarded by society as shameful, they may be embarrassed to admit to their sexual desires. It is therefore rare to find a person who is open about their fetish and even has a sense of humor about it, as Sargent does in his description of his rubber fetish in the accompanying Personal Voices, “The Story of a Rubber Fetishist.”

Different cultures hold up different body parts, objects, colors, or smells as symbols of attraction and sexuality for mating (see Chapter 7, page 194, for more information about Attraction in Different Cultures). Fetishism is symbol selection gone awry, in which the person becomes sexually attracted to the symbol itself, instead of what it rep­resents. Put another way, for the fetishist, the object—unlike the living, breathing person—can stand for pure eroticism without the complication of having to deal with another person’s feelings, wants, and needs. It can be a refuge from the complexity of in­terpersonal sexual relations. In that sense, all the paraphilias we discuss can be seen as a

type of fetishism; pain and humiliation, or women’s clothes, or looking at people having sex can each be a substitute for interpersonal sexuality.

Sadism and Masochism

Подпись:Sadism refers to the intentional infliction of physical or psychological pain on another person in order to achieve sexual excitement. The DSM-IV-TR describes sadism as a condition in which a person has sexual fantasies, urges, or behaviors that involve an

Подпись:Describing the ParaphiliasПодпись: Sadomasochists often use props, like leather clothes, studs, chains and nipple clips, to symbolize their dominance or submission. masochism Focus on receiving pain and humiliation as the preferred or exclusive method of sexual arousal and orgasm. Подпись:Подпись:infliction of pain, suffering, or humiliation to enhance or achieve sexual excitement. Sadistic fantasies or acts may include restraint, blindfolding, strangulation, spanking, whipping, pinching, beating, burning, electrical shocks, torture, and in some cases, killing (American Psychiatric Association, 2000).

The term is named after Donatien Alphonse Francois de Sade (1740-1814), known as the Marquis de Sade. De Sade was sent to prison for kidnapping and terror­izing a beggar girl and then later for tricking some prostitutes into eating “Spanish fly,” supposedly an aphrodisiac, but which caused such burning and blistering that one threw herself out a window (see Chapter 14 for more information about Spanish fly and other aphrodisiacs). While in prison, de Sade wrote novels describing such tor­tures as being bound hand and foot, suspended between trees, set upon by dogs, almost being eviscerated (cut open), and so on. De Sade believed that the highest form of sex­ual activity for women was pain, not pleasure, because pleasure could be too easily faked. Marquis De Sade spent much of his life in prison and died in a lunatic asylum (Bullough, 1976).

Masochism (MASS-oh-kiz-um), the achievement of sexual pleasure through one’s own physical pain or psychological humiliation, was named after another novelist, Leopold Baron Von Sacher-Masoch (1836-1895). Sacher-Masoch believed that women were created to subdue men’s “animal passions,” and he describes the whippings he him­self experienced at the hands of his mistresses (Bullough, 1976). Masochism involves the act of being humiliated, beaten, bound, or made to suffer (American Psychiatric Association, 2000).

Sadism and masochism both associate sexuality and pain, and most people who practice one are also involved with the other. Therefore, the phenomenon as a whole is often referred to as sadomasochism (say-doe-MASS-oh-kiz-um), or S&M. Because sado­masochism encompasses a wide variety of behaviors, the number of people who engage in it depends on how one defines it. In their survey, Janus & Janus (1993) found that 14% of men and 11% of women report some personal experience with S&M.

Freud and his followers made sadomasochism central to their theories about adult sexuality. Freud believed that to some degree we all feel ambivalent about the ones we love and even, at times, feel the desire to hurt them. But we also feel guilty about it, es­pecially in early childhood, and the guilt we feel is satisfied by turning that hurt on our­selves. Later psychoanalytic theorists believed that the goal of masochism was not pain or punishment itself, but rather relinquishing the self to someone else in order to avoid responsibility or anxiety for sexual desires. To these theorists, we all engage in some sadistic and some masochistic behaviors in our love relationships.

Sexual responses to pain exist, to some degree, in many sexual relationships. Kinsey and his colleagues (1953), for example, found that about half the men and women in his sample experienced erotic response to sexual biting, and 24% of men and 12% of women had some erotic response to sadomasochistic stories. Another study found that 25% of men and women reported occasionally engaging in sadomasochistic behavior (Rubin,

1990) . For example, some couples use bondage as a variation on their lovemaking with­out any other strong sadomasochistic elements (Comfort, 1987).

The paraphiliac sadomasochist takes these natural sadomasochistic tendencies to an extreme. S&M involves the use of physical pain, psychological humiliation, or both as part of sexuality. In most S&M encounters, one partner plays the dominant role (“mas­ter”) and the other the submissive (“slave”). Overall, bondage and restraint are the most common expressions of S&M, although spanking and exposure to urine and feces may also be involved (Seligman & Hardenburg, 2000).

A variety of techniques are commonly used to physically dominate the submissive partner. Tying the submissive partner up or using restraints to render him or her helpless is often referred to as “bondage and discipline” (B&D). B&D is often accompanied by flagellation, caning, birching, or other painful or shocking stimuli on the skin such as the use of hot wax, ice, or biting. Psychological techniques can include sensory deprivation (through the use of face masks, blindfolds, earplugs), humiliation (being subject to verbal abuse or being made to engage in embarrassing behaviors such as boot-licking, scatophagic (scat-oh-FAJ-ick) behavior, urolagnia (yur-oh-LOG-nee-uh), or acting like a dog), forced cross-dressing, or infantilism (American Psychiatric Association, 2000;

Gosselin, 1987; Moser, 1988). This is accompanied by verbal descriptions of what is to come and why the person deserves it, increasing in intensity over time to eventual sexual climax. Note that the pain is used as part of a technique to enhance sexuality—the pain itself is not exciting. If the submissive partner were beat up on his or her way home from a sexual encounter, he or she would not find the resultant pain in any way exciting.

S&M does not generally result in any lasting physical damage, as the encounter is usually a carefully scripted sexual ritual, with both sides knowing how far they can go and what roles to play. Partners often have an agreed on “exit phrase” that serves as a signal to end the role playing. Still, sometimes S&M can go too far and result in acci­dental injury or even death. Though a small number of people are nonconsensual, crim­inal sadists who derive joy in hurting or killing others, they bear little relation to the sub­culture of sadomasochists who use S&M as a mutual sexual activity.

People can participate in S&M to different degrees. For some couples, S&M is an oc­casional diversion in their lovemaking. Others pursue it outside of a committed relation­ship; for example, most big cities have newspapers with advertisements for sado­masochistic services, in which a dominatrix will offer her services to submissive males. Many report that executives and politicians and other men with power are among their biggest clients. For these men, the opportunity to absolve themselves of decision making and put their sexual lives completely in the hands of a dominant woman is very exciting.

A sadomasochistic subculture exists for those who have adopted S&M as a lifestyle (see the accompanying Personal Voices, “Vanilla’s Okay, But I Prefer Rocky Road”). Partners meet in S&M clubs, read S&M newsletters and magazines, and join organiza­tions (such as the Eulenspiegel Society, the Society of Janus, or the lesbian S&M group SAMOIS). Specialty shops cater to S&M advocates, selling restraints, whips, and leather clothing. The sadomasochistic encounter, which is really a kind of drama or per­formance, is enhanced by both sides knowing their roles and dressing the part.

Much of S&M is about playing roles, usually with appropriate attitude, costuming, and scripted talk (Hoff, 2003). The S&M encounter is carefully planned, and the dominant partner is usually very careful not to actually hurt the submissive partner while “torturing” him or her. A “safe word” is usually agreed on so that the submissive partner can signal if he or she is in real distress. The Master’s and Mistress’ Handbook, a guide to S&M encoun­ters, offers a set of rules on how to torture one’s partner without really causing harm:

Remember that a slave may suddenly start to cough or feel faint. If masked and gagged, choking or lack of oxygen may result in serious consequences within seconds. . . . Never leave a bound and gagged slave alone in a room. . . . It is essential that gags, nostril tubes, enema pipes, rods and other insertions should be scrupulously clean and dipped into mild antiseptic before use. . . . Never use cheap or coarse rope. This has no “give” and can quickly cause skin-sores. (Quoted in Gosselin, 1987, pp. 238-239)

Sadomasochistic subcultures exist among gays, lesbians, and heterosexuals. In het­erosexual S&M, power relations between the sexes are often overturned, with the female being the dominant partner and the male submissive. The sadomasochistic drama is used to explore the nature of social relations by using sex as a means to explore power (Truscott, 1991). Both heterosexual and homosexual S&M practitioners derive sexual excitement from playing with power relations, from either being able to dominate an­other completely or to give in completely to another’s will.

Подпись:Подпись:Подпись:Подпись:The S&M subculture takes symbols of authority and dominance from the general culture, such as whips, uniforms, and handcuffs, and uses them in a safe erotic drama in which scripted roles take the place of “real self.” It even mocks these symbols of author­ity by using them for erotic pleasure. R. F. Baumeister (1988) suggests that sado­masochism is a reaction to modern society itself. Noting that sexual masochism prolif­erated when Western culture became highly individualistic, Baumeister suggests that it relieves the submissive partner of a sense of responsibility for the self by placing one’s be­havior completely under someone else’s control (which may be why many businessmen pay a dominatrix to humiliate them). For the sadistic partner, it relieves the sense of in­teraction and sensitivity usual to some degree in sexual intercourse; the personhood of the submissive partner is ignored, and he or she can become a vehicle for the pleasure of the dominant partner.

Personal Voices