List and discuss the various treatments for the paraphilias. How successful are these treatments?
Paraphilias are various kinds of sexual deviations, disorders and perversions. People who suffer from paraphilia have fantasias, dreams, desires, behaviors focusing on unusual objects or activities.
Exhibitionism, fetishism, pedophilia, sadism are all among common types of paraphilias. Paraphilias are quite rare and mainly affect males. Signs of paraphilias may begin at late childhood or adolescent and decrease as a person gets older, however, most of the cases are chronic.
There are psychoanalytic, cognitive and behavioral therapies to treat people with paraphilias. Some prescriptive medicines have been used as a part of treatment. Antidepressants, long-acting gonadotropin-releasing hormones (GnRH, ie, medical castration), antiandrogens, phenothiazine, and mood stabilizers have been a part of treatment. The treatment always have to be long-term in order to bring any results.
Psychotherapy applies behavioral therapy techniques in order to change person’s thinking patterns. It also helps a patient to control undesirable behavior by avoiding situations that may cause the initial desires.
During the treatment “covert sensitization” approach is also used, which proved to be effective for people who have pedophilia or sadism. It is similar to the way alcoholism is treated – patients’ negative sexual behavior is bonded with an unpleasant stimulus.
Orgasmic recondition is another way to treat a person with paraphilias, it is similar to reprogramic sexual cognition. At this technique, a patient masturbates to his/her typical stimulus. Just before the orgasm, a patient has to concentrate on a more socially acceptable stimulus. It is done until a patients begins to masturbate to a more acceptable object. This method has reported to bring some positive results.
Among other treatments is social skills training. It is considered that most people develop paraphilia because they are not able to develop a relationship. If this is the case, doctors help patients to develop intimacy, teach to carry on conversations with others, and give basic sexual education. This can be definitely very helpful on the early stages.
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