Introduction to the Realm of Paraphilias
Paraphilias and what we now call paraphilic disorders have been puzzling, curiosity-arousing, attention attracting, famous and infamous (take masochism and sadism), maligned, and misunderstood for centuries. Our full understanding of paraphilic behaviors
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raphilias and what we now call paraphilic disorders have been puzzling, curiosity-arousing, attention attracting, famous and infamous (take masochism and sadism), maligned, and misunderstood for centuries. Our full understanding of paraphilic behaviors is still lacking. The lack of understanding probably starts with the lack of consensus about the definition, its use, and, at times, its, unfortunately, pejorative use. The term paraphilia is about 100 years old (the introduction of the term is credited to Friedrich Salomon Krauss in 1903, but it was more generally suggested/introduced by Wilhelm Stekel in German in 1908 and later in 1930). Its meaning and definition vary. The word paraphilia is a construction of two Greek words. The first is para, the meaning of which could vary from “beside, side by side” to “beyond,
R. Balon, M.D. (*) Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Tolan Park Building, 3rd Floor, 3901 Chrysler Service Dr., Detroit, MI 48201, USA Department of Anesthesiology, Wayne State University, Tolan Park Building, 3rd Floor, 3901 Chrysler Service Dr., Detroit, MI 48201, USA e-mail: [email protected] © Springer International Publishing Switzerland 2016 R. Balon (ed.), Practical Guide to Paraphilia and Paraphilic Disorders, DOI 10.1007/978-3-319-42650-1_1
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past, by” to “abnormal or defective” (e.g., in paranoia) to “irregular, altered.” The other term -philia means love, friendship, brotherly love, affection. In “modern” language it could mean a whole spectrum from a friendly feeling toward something or someone, to an abnormal feeling, depending on the context. Thus, paraphilia in a general sense means love beyond the usual (less derogative term) to abnormal love or sexuality (whatever the term normal sexuality means). Some may also define paraphilia as “love for other/marginal object.” The term paraphilia was, in a way, meant to replace terms such as sexual deviation, sodomy, or perversion. It seems that this well-meant semantic change has not been really successful. The definition of paraphilic or sexually “deviant” behavior is also problematic from a fuzzy border between the so-called “normal” or acceptable sexual behavior and abnormal sexual behavior. Take the example of occasional mild spanking of one’s sexual partner during sexual activity enjoyed and asked for by the partner vs. binding, whipping, and even kicking the sexual partner during sexual activity. Where is the border between acceptable (or normal) behavior and abnormal behavior here?
Diagnosis of Paraphilia/Paraphilic Disorder As we do not understand the etiology of paraphilias/paraphilic behaviors (like most mental disorders), our definition/ diagnosis of paraphilias/paraphilic behaviors is purely descriptive. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) ([1], p 685) states that, “The term paraphilia denotes any intense and persistent sexual interest other than [Italics mine] sexual interest in genital stimulation or preparatory fondling with ph
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