Treatment Options for Paraphilias

As popular as the movie, “Fifty Shades of Grey” was, the overall theme centered around paraphilias, particularly those involving sadism and masochism. While this may make for good entertainment on the big screen, people who live with paraphilic disorders often experience considerable confusion and shame on a daily basis.

Considering paraphilias are a severe form of sexual addiction, the importance of getting treatment early on cannot be overstated. Knowing what types of treatment options to look for can help in taking the necessary steps to get well.

For information on paraphilias treatment options, call our toll-free helpline at 888-647-0051 (Who Answers?) .



According to the journal of F1000 Faculty Reviews, paraphilia-based conditions center on sexual arousal and gratification and the means by which a person achieves these ends. The activities, objects and behaviors that characterize paraphilias account for the “disorder” aspect of this condition as cultural norms deem these activities to be abnormal and distasteful.

In effect, someone affected by this condition has developed a perverse obsession that grows progressively worse with time.



The guilt that often accompanies a paraphilic disorder can cause suicidal thoughts and actions.

Paraphilias can take on any number of activities and forms, some of which are illegal. The most common forms of this condition include:

  • Fetishism (involves inanimate objects)
  • Pedophilia (involves children)
  • Voyeurism
  • Frotteurim (involves touching or rubbing up against another person without his or her consent)
  • Exhibitionism (exposing one’s genitals to strangers)
  • Sadism
  • Masochism

Treatment Considerations

People affected by paraphilias typically know their behavior is looked down upon by society in general. Like any compulsive, addiction-based behavior, those affected have little to no control over their urges and behaviors.

These conditions can become a source of considerable stress, guilt and shame for someone struggling with paraphilias. According to Medscape, the type of treatment that works best for any one person can vary depending on the severity of the addiction and the degree of emotional distress experienced.

In cases of severe paraphilia, it’s not uncommon for a person to become suicidal when confronted or exposed. Under these conditions, inpatient treatment may well be necessary to ensure his or her safety during the early stages of treatment.

Treatment Approaches

Cognitive-Behavioral Therapy

The cognitive-behavioral therapy approach addresses the warped thinking patterns that fuel the addiction. By replacing the core beliefs and logic that underlie sexual compulsions with a healthy outlook on sex, a person can eliminate paraphilias from his or her lifestyle.

Cognitive-behavioral therapy employs a range of interventions to accomplish these ends, including:

  • Aversive conditioning
  • Interpersonal skill training
  • Developing relapse prevention strategies
  • Group therapy settings

Victim Identification

People struggling with paraphilias that ultimately victimize another person may benefit from the victim identification approach. The overall goal of victim identification works to instill a sense of empathy in the addict towards the people he or she “preys” upon.

Techniques, such as role reversal help a person develop an understanding of his or her partner experiences. As feelings of empathy become stronger, paraphilic obsessions lose their hold over a person’s life.

Medication Treatments

In the most extreme of cases, paraphilias, such as sadism and pedophilia may well require medication treatment. Medication treatments work to suppress or reduce sexual urges and behaviors.

Medications commonly used in this capacity include:

  • Mood stabilizers
  • Phenothiazines
  • Antiandrogens
  • Antidepressants

If you or someone you know struggles with paraphilias and don’t know where to turn, call our helpline at 888-647-0051 (Who Answers?) to speak with one of our addiction counselors.


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