Sunday, July 23, 2017 16:50

Cure Of Paraphilia

Posted by on Sunday, October 11, 2009, 12:23
This news item was posted in Sexual Problems category and has 0 Comments so far.

We don’t have any treatments than can guarantee the cure of Paraphilia. Unfortunately, recidivism rates are high. Paraphilias tend to be chronic and recurrent behaviors that are difficult to control even in those who are remorseful afterward and eager to change. Moreover, evaluating the success of treatment requires a very long term perspective.

Some individuals with Paraphilias may for prolonged periods keep their urges confined to fantasy and masturbation but then laterĀ  revert to criminal action when a special opportunity arises (like an attractive child moving in next door). For this reason, the provision of psychiatric treatment should not be seen as a protection against future criminal activity.

The therapies that have been tried for the sever Paraphilias include behavioral conditioning, cognitive and emotional refraining, and castration. The behavioral therapy has two faces and aversive pairing of unpleasant stimuli with paraphilic fantasies combined with the pairing of the pleasurable experiences with desired healthy sexual alternatives. An additional behavioral technique is to teach the person to reduce the acting out of sexual impulses by substituting fantasy and masturbation.

Refraining techniques challenge rationalizations that the criminal behavior is harmless or that the victims were willing partners. There is also an attempt to promote empathy for the victim’s experience, especially drawing on the fact that many perpetrators were themselves childhood victims of paraphilic behavior.

The most controversial treatment is castration, which can be achieved either through surgery or chemicals means, which is, for better or worse, reversible. Aside from the civil liberties issue, the major concern about castration is that it may provide a false sense of security since recidivism, although reduced, can sometimes occur even after it has been performed.

The treatment is much more successful for milder Paraphilias in individuals who are strongly motivated to change. If there is a partner involved, couples treatment is usually preferable. The goal is to broaden the person’s repertoire of sexual arousalĀ  beyond the narrow paraphilic focus on a particular fantasy or fetish.

It may be useful to encourage the person to learn how to be satisfied with keeping things in fantasy or using pornographic material rather than going all the way, that is, indulging in actions that might lead to trouble.

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