Psychological Aspects

of Human Sexuality

University of British Columbia

Department of Psychology

Dr. Kaitlyn Goldsmith

Why do women fake orgasm?
 Fakin’ it

28% of men, 67% of women

Most commonly during PVI

Reasons:
• Orgasm was unlikely
• Wanted sex to end
• Wanted to avoid negative consequences
• Wanted to obtain positive consequences
Variations in Sexual
Behaviour
 Common Sexual Fantasies

• 97% of Americans reported having sexual

fantasies

• Group sex
• Sadomasochism
• Novelty, adventure, and variety

• Less than 1/3 have acted out their biggest fantasy

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Internet searches: among 20 most popular sexual searches, 7
“atypical”:

• youth, incest, domination, submission, bestiality,

transsexual, and “grannies”
When is sexual behaviour abnormal?

• Statistical definition: Frequency of occurrence

• Sociological approach: Deviance

• Legal approach: Breaks laws

• Psychological approach: Causes distress or impairment

• Medical approach: Paraphilias

Interest/preference ≠ behaviour
 Atypical Sexual Interests
Joyal & Carpentier, 2016

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 Atypical Sexual Interests

DSM-5-TR Paraphilic Disorders

“A paraphilic disorder is a paraphilia that is
currently causing distress or impairment
to the individual or a paraphilia whose
satisfaction has entailed personal harm, or
risk of harm to others.”

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 Atypical Sexual Interests

DSM-5-TR Paraphilic Disorders

• “any intense and persistent sexual interest other than
sexual interest in genital stimulation or preparatory
fondling with phenotypically normal, physically
mature, consenting human partners”
• urges, fantasies, behaviours
• distress, impairment, or harm required for diagnosis
» distress can’t be result of society’s disapproval

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 Atypical Sexual Interests

DSM-5-TR Paraphilic
Disorders Anomalous Target Preference
Anomalous Activities Pedophilic Disorder
Voyeuristic Disorder Fetishistic Disorder
Exhibitionistic Disorder Transvestic Disorder
Frotteuristic Disorder
*Other Specified Paraphilic Disorder
Algolagnic Disorders *Unspecified Paraphilic Disorder
Sexual Masochism Disorder
Sexual Sadism Disorder

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 Atypical Sexual Interests

Exhibitionistic Disorder
• exposing one’s genitals to an unsuspecting
person

Voyeuristic Disorder
• observing an unsuspecting person who is
naked, in the process of disrobing, or
engaging in sexual activity
• risk → charge

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 Atypical Sexual Interests

Frotteuristic Disorder
• touching or rubbing against a non-consenting person

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 Atypical Sexual Interests

Sexual Sadism Disorder

• psychological or physical
suffering of the victim is
sexually exciting to the person

Sexual Masochism Disorder

•being humiliated, beaten, bound or
otherwise made to suffer is sexually
exciting to the person

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 Atypical Sexual Interests

BDSM
1. bondage and discipline
• physical and psychological restraint

2. dominance and submission

• behaviours, customs, and rituals relating to the giving and
accepting of dominance

3. sadomasochism
• pain, degradation, and humiliation
• hypermasculinity, administering and receiving pain, physical
restriction, and humiliation
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 Atypical Sexual Interests
BDSM
• top and bottom (or master and slave, dominant and submissive)
• consensual
• Safe, Sane, and Consensual
• Risk-Aware Consensual Kink (RACK)
• Personal Responsibility Informed Consensual Kink (PRICK)
• pre-play negotiations
• bottom sets limits
• safe word(s)
• knowledge of physical limits/potential injury

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 Atypical Sexual Interests
BDSM
“A good scene is an incredible stress-reliever
for both myself and my dominant. It gives us
the opportunity to escape the real world, so to
speak, for at least a short time and focus
entirely on one another…On the
psychological side, it’s strengthened our bond
to one another, deepened our understanding
of ourselves, and opened up a much wider
path of communication not only between one
another, but to other people in general.”
--Jenn

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 Atypical Sexual Interests

BDSM Myths
• submissives want/like to be victims (i.e., abuse)
• submissives have no control
• scenarios have to increase in severity
• can lead to serious injury and psychological trauma
• BDSM always involves sex (or intercourse)

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 Atypical Sexual Interests

BDSM Myths
participants:
• have psychological problems
• can’t have normal intimate relationships
• like pain in general
• are all sex abuse survivors
• are all weirdos

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 Atypical Sexual Interests

BDSM Theories
• learning theory
• endorphins
• escape from the self
• giving oneself over for another’s pleasure

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 Atypical Sexual Interests

Pedophilic Disorder
DSM-5
A. Over a period of 6 months, recurrent, intense sexually
arousing fantasies, sexual urges, or behaviors involving
sexual activity with a prepubescent child or children
(generally age 13 or younger).
B. The individual has acted on these urges, or the sexual
urges or fantasies cause marked distress or interpersonal
difficulty.
C. The individual is at least age 16 years and at least 5 years
older than the child or children in Criterion A.

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 Atypical Sexual Interests

Pedophilic Disorder

1. increased attention in popular culture and media

2. stigmatization
3. interaction between CJS and mental health
4. challenge: empathy
5. emergence of online support groups
 Atypical Sexual Interests

Pedophilic Disorder

Diagnostic Issues
• urges and fantasies versus behaviour
• child molesters are not always pedophiles and vice versa
• pedophilic sexual interest versus PD
Atypical Sexual Interests

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 Atypical Sexual Interests

Autogynephilia
Blanchard
• a male’s paraphilic tendency to be sexually aroused by the
thought/image of himself as a female

subtypes
transvestic – wearing women’s clothing
behavioural – typically feminine behaviours (e.g., knitting)
physiologic – pregnancy, menstruation, breast feeding
anatomic – having a women’s body

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 Atypical Sexual Interests

Fetishistic Disorder

• nonliving objects or non-genital body parts

• stands alone as sexually stimulating

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 Atypical Sexual Interests

Autonepiophilia (Paraphilic Infantilism)

• impersonating or being treated as an infant
• infantilism

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 Atypical Sexual Interests

Sthenolagnia

• muscles and displays of strength

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 Atypical Sexual Interests

Feederism

• feeding partner, often to obesity, or incapacitation

• power, care-taker role

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 Atypical Sexual Interests

Balloon Fetish

• popping, blowing up, sitting on

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 Atypical Sexual Interests
Paraphilia Erotic Focus
zoophilia animals
klismaphilia enemas
mysophilia filth
urophilia urine
psychrophilia contact with extremely cold objects or watching others freeze
coprophilia feces
agalmatophilia statues, mannequins and immobility
hierophilia religious or sacred objects (e.g. masturbation with a cross)
vampirism blood
vomerophilia vomit
necrophilia corpses
symphorophilia stage-managed disaster
abasiophilia lamed or crippled partner
apotemnophilia own amputation

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 Atypical Sexual Interests

Theories
Courtship Theory – distortions (exaggerations) in courtship
behaviour during adolescence become ingrained

1. looking for a potential partner – initial phase of courtship

2. pretactile interaction – talking or flirting with a potential
partner
3. tactile interaction – usually consists of touching, hugging,
hand holding, etc. (this could also be considered foreplay)
4. affecting genital union – more commonly known as sexual
intercourse

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 Atypical Sexual Interests

Theories
Learning Theory – classical conditioning
• pairing of non-sexual stimuli with sexual arousal

Biological Theory – brain organization

Lovemap Theory
• during childhood, develop template for sexual relationships

• disruptions → paraphilias

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 Atypical Sexual Interests

Treatment
• why treat paraphilias?
• are they treatable?
• motivation?

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 Atypical Sexual Interests
Treatment
Therapy
1. Psychoeducation, Acceptance, and Integration
2. Couples Therapy (if partnered)
3. Cognitive Behavioural Therapy
• anxiety reduction, reduced rumination, reduced
intrusive thoughts
• challenge cognitive distortions, e.g., catastrophizing,
black and white thinking
• behaviour management (if risk)

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 Atypical Sexual Interests
Treatment
Behavioural Treatments

1. aversion therapy – pairing of unpleasant stimuli with

problematic stimuli
2. social skills training – learn to better interact with
appropriate target
3. orgasmic reconditioning – pairing of sexual arousal with
appropriate target

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 Atypical Sexual Interests

Treatment
Pharmaceuticals
selective serotonin reuptake inhibitors (SSRIs)
» e.g., fluoxotine, sertraline
» reduce anxiety, intrusive thoughts, compulsions, increase
positive affect
» dampen sex drive

anti-androgens (i.e., chemical castration)

» reduces sex drive
» cyproterone acetate (CPA)
» medroxyprogesterone acetate (MPA)

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Sex Addiction?

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 Sexual Compulsions
(Coleman et al., 2001)

Intense, sexually arousing fantasies, urges and

associated behavior that are intrusive and
driven and repetitive

• Lack impulse control

• Often incur social and legal sanctions
• Cause interference in interpersonal and occupational
functioning
• Create health risks
 Sexual Compulsions

Carne’s 4-step cycle: triggered by negative affect

-preoccupation
-rituals
-compulsive sexual behaviour
-despair