Therapies for Sexual Deviants
Sexual deviants almost never voluntarily seek therapeutic treatment for the simple reason that they do not identify their condition as atypical sexual behavior. They meet a doctor only when an unwilling partner or a victim decides to take legal action or when concerned family members who have detected a paraphilic behavior refer and compel them to benefit from a mental health system. Also, given the immense pleasure sexually deviant people derive from their paraphilic behaviors they are reluctant to change their compulsive behavior and hinder therapeutic treatments –especially psychotherapy and behavior therapies.
It is a non-invasive treatment where a client and the therapist (usually a psychiatrist or a trained social worker) converse for a period of time each week to help the person overcome powerful urges that dictate paraphilic behaviors. This method has not proved very effective, even in the case of cognitive therapy where the therapist tries to change the mindset of the sexually deviant person. Cognitive therapists try to change a person’s maladaptive abnormal sexual behaviors by changing what he thinks about these acts. The reason why these therapies meet with very little success is that, other than the obsessive nature of deriving pleasure from such acts, the clients believe that the problems associated with these sexual acts stem from society’s intolerance of their variant sexual behaviors.
Behavior therapy works on the assumption that maladaptive sexual behaviors have been learned and hence can be unlearned. Aversive conditioning, Systematic desensitization, Organic reconditioning and Satiation therapy are some of the therapeutic methods employed in Behavior therapy.
Aversive conditioning: Recent studies have shown some degree of success in the use of aversive conditioning to treat exhibitionism. An undesired sexual behavior such as masturbating to a paraphilic fantasy is given an aversive (negative) stimulus like mildly painful electric shocks or a nausea-inducing drug. These are also administered to a person while he is viewing photographs or slides depicting paraphilic behavior.
Systematic desensitization: This Behavior therapy works on the premise that people are sexually deviant because of a sense of inadequacy and lack of interpersonal skills that trigger anxiety and cause deviant behavior. The technique aims to help such people to overcome their anxieties and condition them to relax in socio-sexual situations so they can replace deviant behavior with satisfying sexual relationships. The basic technique links gradual exposure to anxiety-inducing situations with relaxation training.
Orgasmic reconditioning: In this behavior therapy masturbation plays a central role. The client is instructed to masturbate to his usually desired deviant fantasy and when orgasm is imminent he is to switch to more socially healthy fantasies particularly at the moment of masturbatory orgasm so that he may get conditioned to sexual arousal from socially acceptable behaviors.
Satiation therapy: In this technique too masturbation plays a central role. The client is encouraged to masturbate to orgasm while fantasizing on appropriate sexual situations. Immediately after orgasm he/she is instructed to continue masturbating while switching to his/her desired deviant fantasy. The idea behind this technique is to experience reduced sexual arousal to inappropriate stimuli.
Anti-androgen drugs thatcan drastically lower testosterone levels are widely used to block deviant sexual arousal patterns in coercive paraphilic behavior. Sex offenders who are referred to therapists by legal authorities are commonly treated with Medroxyprogesterone acetate (MPA) and cyproterone acetate (CPA). Drug treatments are most effective in sexual deviants when combined with psychotherapy or behavior therapy.
Social skills training
This treatment is based on the premise that sexual deviants have difficulty forming healthy relationships that give access to healthy forms of sexual expression. The training is designed to teach clients the necessary social skills like conversation, courtship, companionship, to cope with rejection etc, to enable the person to enter into and maintain satisfying intimate, healthy relationships with a sexual partner.