Chapter 12 - Hyperactive sexual desire and the paraphilias

Abstract

Hyperactive sexual desire and the paraphilias represent aspects of human sexual behavior that are morally questionable in contemporary society. This chapter reviews the current understanding of high sexual desire and paraphilias including the proposed diagnostic criteria, epidemiology, and treatment. Hyperactive sexual desire is an ambiguous concept. Its meaning is most variable and always arbitrarily determined. Dominant social prejudice appears to be the main determinant. Hyperactive sexual desire, sexual addiction, or compulsive sexual behavior all refer to some state of heightened sexual activity. The causes for unusually intense sexual activity are essentially unknown. If treatment is required, there are plenty of efficient pharmacological alternatives available. Paraphilia is the display of sexual arousal and/or behaviors in response to stimuli not judged appropriate as sexual incentives or not judged appropriate in the specific situation. The paraphilias, with such conditions as pedophilia, exhibitionism, and fetishism among others, have been the objects of much attention in most Western societies for many years. Some psychotherapeutic approaches may selectively reduce fetishistic behaviors. Pharmacological treatments affect all sexual behaviors in the same way. There is a psychotherapeutic procedure potentially useful for treating pedophilic behaviors without affecting other sexual behaviors.