Is he mentally ill?


Preferred victims are girls or young women



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Preferred victims are girls or young women

  • Indirect means of expressing hostility toward women, but they aren’t in touch with this

  • About 50% report erections during, usually masturbate later



  • Few are women—women who do this are typically motivated by rage/revenge

    • Few are women—women who do this are typically motivated by rage/revenge

    • Males—motivated by desire for sexual excitement

    • Most aren’t dangerous, don’t make repeated calls to the same person

    • Many patterns—obscenities, breathe heavily, sexual overtures, sex surveys, etc.

    • Life exhibitionist-socially inadequate heterosexual male who can’t form intimate rel.



    Sexual sadism—sexual arousal from inflicting pain on another person

    • Sexual sadism—sexual arousal from inflicting pain on another person

    • Sexual masochism—experiencing pain

    • Masochism is the only paraphilia found with any frequency in women—about 5% of masochists are women

    • Sadomasochism is highly ritualized—not all pain is gratifying

    • In a mild form—not uncommon

    • Pain may be symbolic—like rubber paddle

    • Serious injury is usually avoided

    • Survey from S&M magazine—3/4 male, most married, men interested since childhood, women introduced to it

    • Causes

      • May have bio links to pleasure—pain causes release of endorphins, but this doesn’t explain symbolic pain or sadism
      • Learning theorists—being spanked for masturbation
      • Sociologists—losing control, letting go


    Problems—

    • Problems—

      • 1) Don’t want/seek tx
      • 2) No motivation to change even if in tx (thus cog tx doesn’t work)
      • 3) Should therapist impose own goals?
      • 4) Perceived responsibility—client must know he can change
    • Behavior tx

      • Systematic desensitization—pair relaxation with arousing images
      • Aversion tx—shock, nausea inducing drugs
      • Social skills training
      • Orgasmic reconditioning—begin with old images, then switch to appropriate ones
    • Drugs

      • Prozac—some effectiveness for exhibitionism, voyeurism, fetishism (OCD-type beh)
      • Anti-androgen drugs—depo provera—decreases sexual desire in those at risk for sexual offenses. Decreases desire—not urges or behavior in a particular direction. High refusal and drop out rates for this treatment.


    Money (1978)—8 variables of gender

    • Money (1978)—8 variables of gender

      • Chromosomal (xx vs. xy)
      • Gonadal (testes vs. ovaries)
      • Prenatal hormonal gender
      • Prenatal and neonatal brain hormonalization
      • Internal accessory organs
      • External genital appearance
      • Pubertal hormonal gender
      • Assigned gender identity


    1) Persistent cross-gender identification

    • 1) Persistent cross-gender identification

    • 2) Profound discomfort or disgust with biological sex

    • In kids

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