Fat’s life: Another look inside the world of feederism

Online letter from Jill to ‘Dr. Feeder’: “I am a feedee from Boston in desperate need of a feeder. I have tried dieting and I know my mission is to be fat. I feel I can’t do it alone. I fantasize about meeting a dominant man who is a Feeder…How do I get fat on my own? What foods? Can you give me a sample daily diet?”

Response to Jill’s letter from ‘Dr. Feeder’: “See my article ‘How To Get Fat‘. The kinds of foods don’t matter so much. Eat what you enjoy the most, especially if it’s fattening. The more you enjoy overeating, the more you will overeat. A lot of variety is also important”.

In a previous blog on fat fetishism, I noted that the fetish also included ‘feederism’ and ‘gaining’ in which sexual arousal and gratification is stimulated through the person (referred to as the ‘feedee’) gaining body fat. Feederism is a practice carried out by many fat admirers within the context of their sexual relationships and is where the individuals concerned obtain sexual gratification from the encouraging and gaining of body fat through excessive food eating. Sexual gratification may also be facilitated and/or enhanced the eating behaviour itself, and/or from the feedee becoming fatter – known as ‘gaining’ – where either one or both individuals in the sexual relationship participate in activities that result in the gaining of excess body fat.

Since writing my previous article on the topic, I have briefly written about feederism in two of my academic papers on sexual paraphilias (one in the Archives of Sexual Behavior in relation to a case study I wrote on fart fetishism, and the other in the Journal of Behavioral Addictions on how the internet has facilitated scientific research into paraphilias – see ‘Further reading’ below). However, I was also interviewed for the Discovery Channel’s television programme Forbidden about American Gabi Jones from Colorado (aka ‘Gaining Gabi’) who appeared in the episode ‘Pleasure and Pain’.

At the time when the television programme was being recorded, Gabi weighed 490 pounds and her sole aim was to get even fatter and heavier (before she became a feedee she was 250 pounds). It is also her career and her thousands of online fans pay money who pay $20 a month to watch her eat as well as sending her food to eat (you can check out her online website here, but pleased be warned that it contains explicit sexual content). She also claims that she becomes sexually aroused when eating excessively.

“When I indulge, I never rush. I take my time and treat all meals as very sexual experiences. I love being fat and the idea of getting large excites me…For as long as I remember, I always loved the idea of getting softer and being this piece of art that I am creating…My body is a work of art”.

She claims she does it to show that women can be empowered and that fat can be sexy. She’s also a campaigner for ‘fat acceptance’. However, the (US) National Association for the Advancement of Fat Acceptance (NAAFA) is anti-feederism. The NAAFA exists “to help build a society in which people of every size are accepted with dignity and equality in all aspects of life” but has specifically noted in its manifesto that:

“NAAFA supports an individual’s right to control all choices concerning his or her own body. NAAFA opposes the practice of feeders, in which one partner in a sexual relationship expects and encourages another partner to gain weight…That all bodies, of all sizes, are joyous and that individuals of all sizes can and should expect and demand respect from sexual partners for their bodies just as they are. That people of all sizes become empowered to demand respect for their bodies in the context of sexual relationships, without attempting to lose or gain weight in order to win a partner’s approval or attract or retain that partner’s desire”.

At the time she was interviewed, Gabi had two ‘feeders’ – one male (Kenyon, from Kansas, US) and one female (nicknamed ‘Hearts’, from Colorado). As the show’s production notes reported:

“Kenyon lives in a small town in Kansas…Gabi says that Kenyon has actually been a fan of hers since he was 12 or 13 [years old], he discovered her online. Gabi says that she wouldn’t have anything to do with him because he was not of age, but after [Kenyon’s 18th birthday she] accepted him into her life as her food slave. Kenyon says that he had fantasized for years about feeding her live in person…He is now totally devoted to Gabi and she is happy to have him as part of her ‘chosen family’ and hopes to move him out from Kansas to Colorado to live with her fulltime someday soon…Hearts makes sure that Gabi has all the food she could want and need. Gabi also feeds her. It’s not a sexual thing or anything – ‘we’re not lesbians, we’re just really close friends’ – but when they feed each other it’s ‘sexy and fun’. They met in college at the start of this year and haven’t left each other’s side since…Hearts is also gaining. Gabi got her into it one day when they were lying on her bed and Hearts noticed how soft Gabi’s tummy was. This made her decide she wanted to get fat too. Hearts is currently 201 pounds and her goal weight is 400 pounds…Gabi says there are two types of gainers – ‘feedees’ who’ll eat anything and ‘foodees’ who’ll eat only quality food, not junk. Gabi says she identifies more with a foodie”.

Academically, there have been an increasing number of papers published over the last few years. For instance, Dr. Lesley Terry and her colleagues have also published papers on feederism in the Archives of Sexual Behavior. The first was a case study (which I outlined in my previous blog), and more recently an interesting experiment that assessed individuals’ arousal to feederism compared to ‘normal’ sexual activity and neutral activity. A total of 30 volunteers (15 men and 15 women) were assessed using penile plethysmography (for the males) and vaginal photoplethysmography (for the females) – none of who were feeders or feedees. The paper reported that:

“The volunteers were all shown sexual, neutral, and feeding still images while listening to audio recordings of sexual, neutral, and feeding stories. Participants did not genitally respond to feeding stimuli. However, both men and women subjectively rated feeding stimuli as more sexually arousing than neutral stimuli…the results of this study provide limited, but suggestive, evidence that feederism may be an exaggeration of a more normative pattern of subjective sexual arousal in response to feeding stimuli that exists in the general population.

Dr. Ariane Prohaska has published papers on feederism in such journals as the International Journal of Social Science Studies and Deviant Behavior. In one of her studies, she carried out a content analysis of feederism-related websites and examining feederism within heterosexual relationships. She concluded that feederism websites can take many forms “such as groups, advice sites, personal ads, and pornography. The content analysis also revealed that the internet is a place where fat women can find a community of similar others to support them”. She also noted that although feedersim has been classified as a transgressive sexual behaviour, it “usually mimics patriarchal sex in the process”. She also claimed that at its extreme “feederism is an abusive behavior dangerous to the partner (usually the woman) who desires to gain weight as quickly as possible”. As highlighted in the case of Gabi above, Dr. Prohaska concludes that feederism is a communal behavior, but she also notes:

“[W]hen it comes to feederism, men are still in control of the behavior and of how women are portrayed and treated as feedees. Although some of the websites discussed here may be advancing transgressive ideas about fat women as sexual beings, the objectification of women as sex objects is further perpetuated by these same websites. Bodies matter; normative ideas about fat women and heterosexual sex offline are perpetuated online. The internet is patriarchal as offline society. At its extreme, ideas about control over women involve manipulating their bodies using dangerous means, and the lines between consent and sexual assault are blurred. Consent is a difficult term to define in a culture where patriarchal values about sex have been internalized by members of society. Still, the internet has the potential to create loving, supportive communities for people of size rather than exploitative communities that mimic the offline world”.

Dr Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Charles, K., & Palkowski, M. (2015). Feederism: Eating, Weight Gain, and Sexual Pleasure. Palgrave Macmillan.

Griffiths, M.D. (2012). The use of online methodologies in studying paraphilia: A review. Journal of Behavioral Addictions, 1, 143-150.

Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.

Haslam, D.W. (2014). Obesity and Sexuality. In Controversies in Obesity (pp. 45-51). London: Springer.

Kyrölä, K. (2011). Adults growing sideways: Feederist pornography and fantasies of infantilism. Lambda Nordica: Tidskrift om homosexualitet, 16(2-3), 128-158.

Monaghan, L. (2005). Big handsome men, bears, and others: Virtual constructions of ‘fat male embodiment’. Body and Society, 11, 81-111.

Murray, S. (2004). Locating aesthetics: Sexing the fat woman. Social Semiotics, 14, 237-247.

Prohaska, A. (2013). Feederism: Transgressive behavior or same old patriarchal sex? International Journal of Social Science Studies, 1(2), 104-112.

Prohaska, A. (2014). Help me get fat! Feederism as communal deviance on the internet. Deviant Behavior, 35(4), 263-274.

Swami, V. & Furnham, A. (2009). Big and beautiful: Attractiveness and health ratings of the female body by male ‘‘fat admirers’’. Archives of Sexual Behavior, 38, 201-208.

Swami, V., & Tovee, M.J. (2006). The influence of body weight on the physical attractiveness preferences of feminist and non-feminist heterosexual women and lesbians. Psychology of Women Quarterly, 30, 252-257.

Swami, V. & Tovee, M.J. (2009). Big beautiful women: the body size preferences of male fat admirers. Journal of Sex Research, 46, 89-96.

Terry, L. L., Suschinsky, K. D., Lalumiere, M. L., & Vasey, P. L. (2012). Feederism: an exaggeration of a normative mate selection preference? Archives of Sexual Behavior, 41(1), 249-260

Terry, L.L. & Vasey, P.L. (2011). Feederism in a woman. Archives of Sexial Behavior, 40, 639-645.

Flaming desire: A beginner’s guide to pyrophilia

Pyrophilia (also known as pyrolagnia and sexual arson) is a sexual paraphilia in which a person derives sexual arousal from fire and/or fire-starting activity. It is sometimes confused with pyromania but pyromaniacs do not get any sexual pleasure when they start fires. Most of what is known academically comes from case studies published in the academic and clinical literature. Writings dating back to the 19th century have suggested that psychosexual factors may sometiems play a role in pyromaniac activities. Pyrophilia is thought to be very rare and there are no incidence or prevalence studies on the condition. Even in major texts on sexual paraphilias such as Richard Laws and William O’Donohue’s Sexual Deviance: Theory, Assessment and Treatment (2008) it is not even mentioned, and in Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices (2009) it is only given ten lines (and much of that is taken up with the speculation that the Roman Emperor Nero was a possible pyrophiliac).

A 1989 paper by Dr. Vernon Quinsey and colleagues in the Journal of Behavior Therapy and Experimental Psychiatry examined arsonists and sexual arousal to fire setting. They wanted to further explore to what extent pyromania was sexually related. They measured and compared the penile responses of 26 arsonists and 15 non-arsonists to audio taped narratives. The narratives were categorized as (i) neutral, (ii) heterosexual activity, and (iii) fire setting motivated by (a) sexual excitement, (b) general (unspecified) excitement, (c) insurance, (d) revenge, (e) heroism, and (f) power. Penile responses to all categories were of small although both the heterosexual activity and the sexual excitement fire setting categories produced more erectile activity than the neutral category. However, Quinsey and colleagues reported there were no significant differences between the arsonists and non-arsonists to any of the story categories. They argued that their data demonstrated no support for the idea that sexual motivation is commonly involved in arson.

In 1979, the psychotherapist Dr D. Cox stated that, having set a fire, the fire fetishist “will claim that he has had his best ever orgasm as he watched the flames leap up” (although the claim was unsubstantiated by anything else in the book chapter). Dr. Stephen Lande arguably published the first case study of a pyrophiliac in a 1980 issue of the Journal of Behavior Therapy and Experimental Psychiatry. Lande reported the case of a 20-year-old male with a history of arson associated with masturbation as his sole means of obtaining sexual arousal and gratification. Physiological and subjective measures of sexual arousal were taken while he looked at various photographs. The man was most sexually aroused by those involving fire with lesser sexual arousal when looking at photographs of naked females. He was treated using orgasmic reconditioning to increase heterosexual arousal and covert sensitization to decrease arousal related to fire. At the end of treatment, sexual arousal was greater for heterosexual than for fire stimuli.

In 1987, Dr Dominique Bourget and Dr John Bradford reported two cases pyrophilia in the Canadian Journal of Psychiatry. Their two cases were both adult male arsonists whose intense interest in fire was sexually fetishistic. However, these cases concentrated more on their treatment than the psychological motivations behind such an activity.

In a 1999 issue of the Canadian Psychological Association Bulletin, Dr Larry Litman reported the case of a married 25-year old male pyrophiliac. He voluntarily referred himself for a psychological assessment (at the request of his wife) as a consequence of psychopathology and sexually motivated fire-setting activities. (However, he himself didn’t see his sexually motivated fire setting as a problem). He would set fire to anything at hand when the urge struck him (e.g., paper, clothing, etc.). He reported that for as long as he could remember he had been sexually aroused by fire and had a frequent irresistible compulsive urge to set fires. He recalled that his fascination with fire may have started when helping his mother to shovel lot coal and touching it to see how hot it was. He had also burned himself by accident on a number of occasions. He told Litman that he was “used to pain” as his father had regularly physically abused him when he was a child. Litman reported that:

“He used heat to give himself sexual excitement, and he reached a point where he could be sexually aroused by just talking about fires or having his wife talk about burning things (she reportedly resented having to do this)…The patient’s penile tumescence in response to audiotaped scenarios based on his self-reported sexually arousing fantasies of heat and fire (which I asked him to transcribe) was physiologically assessed via phallometry. Despite his self-reported attempts to not become sexually aroused by the scenarios (as a result of being anxious about the procedure), substantial psychophysiological sexual arousal in response to masochistic sexual scenarios of being forcibly and painfully set on fire by a heterosexual partner or by a mob of sadistic people and subsequent combined intense feelings of love, peace, warmth, pain, and sexual excitement was observed…[He] appeared to be suffering from a longstanding pyrophilic disorder with sexual masochistic features in a personality that revolved around hysteric, obsessive–compulsive, and masochistic dynamics”.

Litman reported that the man had actually engaging in behaviours designed to induce pain with fire for sexual stimulation (including sitting on a hot stove, and wrapping a pair of trousers around his arm and setting fire to them). His anti-depressant medicine helped reduce his thoughts about fire setting but stopped taking it due to other side-effects. His wife subsequently left him because of his sexual fascination with fire.

In a 2002 issue of the Canadian Journal of Psychiatry, Dr. Krishna Balachandra, and Dr. Swaminath described the what they believe is the only case in the literature of a female arsonist (a 29-year old heterosexual woman) with a fire fetishism. The case history revealed she had been sexually abused at the age of 8 years, and that during adolescence she had been cruel to animals, and began setting small fires. She used to scout for places to set fires and focused on setting fire to bins and recycling containers. No-one was ever hurt or burned as a result of the arson. She would hide, watch the fire, and then go home and masturbate (while thinking about the fire she had just started). She also kept a detailed diary of every fire she had started. The behaviour escalated and she had started over 175 fires by the time she received psychiatric help. The authors reported:

“The motives were described as an outlet for anger, sexual motivation and satisfaction, and an intense preoccupation with fire, together with tension and affective arousal that was relieved by setting fires. There was no correlation between the fires and her menstrual cycle or substance abuse”.

These cases studies (when taken together) suggest that pyrophilia doesn’t appear to include behaviours commonly associated with pyromania (such as watching neighbourhood fires, setting off false fire alarms, getting non-sexual satisfaction from being around those who work in the fire services, starting fires to be affiliated with the fire services, showing indifference to human life and property after setting fire to something. It also appears that sexual arousal may not always depend on an actual fire as it may also be facilitated by photographs and verbal stories about fire and/or arson. While seemingly rare, case studies show that pyrophilia is a real and bone fide clinical entity.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Balachandra, K. & Swaminath, S. (2002). Fire fetishism in a female Aasonist? Canadian Journal of Psychiatry, 47,

Bourget, D. & Bradford, J.M.W (1987). Fire fetishism, diagnostic and clinical implications: A review of two cases. Canadian Journal of Psychiatry 32, 459-462.

Cox, M. (1979). Dynamic psychotherapy with sex-offenders. In I. Rosen (Ed.), Sexual Deviation (pp. 306-350). Oxford, England: Oxford University Press.

Laws, D.R. & O’Donohue, W.T. (2008), Sexual Deviance: Theory, Assessment and Treatment (Second Edition). New York: Guildford Press.

Litman, L.C.  (1999). A case of pyrophilia. Canadian Psychological Association Bulletin, February, 18-20.

Quinsey, V.L., Chaplin, T.C. & Upfold, D. (1989). Arsonists and sexual arousal to fire setting: Correlation unsupported, Canadian Journal of Behavior Therapy and Experimental Psychiatry, 20, 203-209.

Baby love: A beginner’s guide to paraphilic infantilism

Paraphilic infantilism is a rare sexual paraphilia where individuals typically get sexually aroused from being a baby (and is commonly referred to as ‘adult baby syndrome’). Some websites claim that the condition also goes under the name of ‘autonepiophilia’ but the sexologist who coined this particular paraphilia (Professor John Money) described the condition as particularly relating to ‘diaper fetishism’ (i.e., people who get sexually aroused from wearing nappies). At present, infantilism does not appear in any diagnostic psychiatric texts in its own right (such as the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders [DSM-IV]). However, as Dr Joel Milner, Dr Cynthia Dopke, and Dr Julie Crouch note in a 2008 review of paraphilias not otherwise specified (NOS):

“Although infantilism is classified as sexual masochism in DSM-IV it is questionable whether the criteria for sexual masochism are always met. For example, if the infantile role playing does not involve feelings of humiliation and suffering, then the diagnosis of sexual masochism would not be appropriate and a diagnosis of infantilism as paraphilia NOS is warranted”.

Infantilists often wear nappies, may drink from a baby bottle and/or be wet-nursed (sometimes simulated), crawl about the floor, have baby baths, eat baby foods, play with baby toys, be spanked, and may roleplay and regress to an infant-like state. There may also be some crossover with other sexually paraphilic behaviour including masochism (as they may enjoy being spanked and/or humiliated), transvestism (as they may like to be dressed in baby clothes of the opposite sex, the so-called “sissy baby” syndrome), urophilia (as they may enjoy urinating in their nappies), coprophilia (as they may enjoy defecating in their nappies), and lactophilia (as they may enjoy being breast fed).

Up until 1980, there were only three published case studies on infantilism all in the American Journal of Psychiatry between 1964 and 1967. Malitz reported a case of a 20-year-old college student who had a compulsion to wear nappies underneath rubber pants and defecate in them (although did not see himself as an adult baby). While defecating he would typically reach orgasm even if he didn’t masturbate. Tuchman and Lachman reported the case of a father who was arrested for molesting his young daughters. Like the first case, he wore rubber pants over his nappy and enjoyed urinating and masturbating in it. Dinello reported the case of a 17-year-old male who in his mid-teens started wearing nappies under his clothing, drank from baby bottles, and ate baby food, and masturbated while wearing the nappy. He eventually, gave up wearing nappies and began dressing in women’s clothing. In a 1980 issue of the Medical Journal of Australia, Pettit and Barr published the case of 24-year-old man who began dressing in female clothes at the age of 10 years and by the age of 15 years began to dress as a baby and developed a fetish for nappies.

In a more recent issue of American Journal of Psychiatry, Dr Jennifer Pate and Dr Glenn Gabbard presented a case study showing many similarities with the earlier published case studies. Their case study was a 35-year-old single man who wanted to be a baby since the age of 12 years and he began wearing nappies at age 17 years. His nappy wearing had started to compromise his interpersonal relationships. Wearing nappies was “a kind of a sexual thing” and he masturbated while wearing the nappies. He only ever masturbated while wearing nappies, and also urinated and defecated while wearing them. He wore and used up to five nappies a day. Pate and Gabbard concluded that the object of sexual arousal was the nappies and that the behaviour was a paraphilia. More specifically, they said:

“Adult baby syndrome is still a new entity for psychiatrists, and there are undoubtedly variations within the syndrome. [One of the cases said] that he wanted someone to ‘make him be a baby’ evokes images of the sadomasochistic scenarios enacted by a dominatrix and her clients. Indeed, a significant number of middle-aged men seek out dominatrices to spank them, punish them, and tell them that they have been ‘a bad boy’. The wish to be treated as a baby is probably a spectrum condition that has many manifestations involving men, women, heterosexuals, bisexuals, and homosexuals”.

Other recent case studies have noted different etiological pathways into infantilism with childhood sexual abuse and transgender issues being apparent common factors among a number of published case studies. In a 2003 issue of the journal Sexual Abuse, Lehne and Money reviewed the case of a man with changing fetishes (transvestic fetishism, paedophilia) who in the final analysis described himself an adult baby (aged 45 years). In 2004, Croarkin and colleagues reported a case in the American Journal of Psychiatry. Here, a depressed 32-year-old male engaged in behaviours that included getting sexual arousal and gratification from wearing nappies and becoming a baby. The authors suggested that the infantilism may have been related to obsessive-compulsive disorder. Two years later in the Archives of Sexual Behavior, Evcimen and Gratz reported the case of a 25-year-old male who wished to be a 10-year-old girl although it is debatable whether this case would really be classed as infantilism.

The most recent case (2011) of ‘adult baby syndrome’ was reported by Kise and Nguyen in the Archives of Sexual Behavior. They outlined the detailed case a 38-year-old biological male who preferred to be identified as a female (and referred to him as ‘she’ throughout their paper). For the previous two years, she slept in a crib (rather than a bed), drank from baby bottles, sucked on dummies, and engaged in baby talk (and had wanted to be a baby since her early thirties). She suffered from Guillain-Barre Syndrome (a disorder affecting the peripheral nervous system) and had been a paraplegic since the age of 13 years following a complication from a tracheotomy. She was sexually abused as a child and had attempted suicide 28 times. Kise and Nguyen concluded:

“Perhaps desiring the identity of a baby is an entity all in itself, just like Major Depressive Disorder or Schizophrenia…This does not represent a new phenomenon…In some instances, [Adult Baby Syndrome] seems to represent a paraphilia. [In this case] she specifically denied sexual pleasure…her primary intent seems to be one of gaining attention and additional care, freeing her from adult responsibilities. Further investigation into the connection and potential co-morbidity between ABS and Gender Identity Disorder may lead to interesting findings”.

One of the few surveys (from an unpublished PhD thesis on the topic by Dr Thomas Speaker) reported that infantilists are typically male, employed, in their late thirties, well educated, and in stable sexual relationships. However, no-one knows how representative of infantilists the survey was. The two criminologists Stephen Holmes and Ronald Holmes have claimed that infantilism may involve an elements of stress reduction similar to some of the symptoms of transvestism.

Nothing is known about the incidence or prevalence of infantilism, and there is no consensus on the etiology of infantilism but has been linked to maladaptive learning in childhood, faulty childhood imprinting, and erotic targeting errors. For others, the sexual element may be downplayed. Such individuals may want to be gently nurtured, seek attention, be cared for and/or surrender their day-to-day adult life responsibilities.

One of the reasons so little is known about infantilism is that adult babies do not want to cease engaging in their behaviour. For most adult babies, their behaviour doesn’t constitute a medical condition that requires treatment or cause any functional impairment, personal distress or distress to others. Those who do end up seeking psychological or psychiatric help may do so because another individual (such as their sexual partner) encourages or forces them to seek help.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Croarkin, P., Nam, T., & Waldrep, D. (2004). Comment on adult baby syndrome. American Journal of Psychiatry, 161, 2141.

Dinello, F.A. (1967). Stages of treatment in the case of a diaper-wearing seventeen-year-old male. American Journal of Psychiatry, 124, 94-96.

Evcimen, H., & Gratz, S. (2006). Adult baby syndrome. Archives of Sexual Behavior, 35, 115–116.

Holmes, Ronald M.; Holmes, Stephen T. (2008). Sex Crimes: Patterns and Behavior. New York: Sage.

Kise, K. & Nguyen, M. (2011). Adult Baby Syndrome and Gender Identity Disorder. Archives of Sexual Behavior, 40, 857-859.

Lehne, G. K. & Money, J. (2003). Multiplex versus multiple taxonomy of paraphilia: Case example. Sexual Abuse: A Journal of Research and Treatment, 15, 61-72.

Malitz, S (1966). Another report on the wearing of diapers and rubber pants by an adult male. American Journal of Psychiatry, 122, 1435-1437.

Milner, J.S. Dopke, C.A. & Crouch, J.L. (2008). Paraphilia not otherwise specified: Psychopathology and Theory In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 384-418). New York: Guildford Press.

Money, J. (1984). Paraphilias: Phenomenology and classification”. American Journal of psychotherapy, 38, 164–179

Pate, J. & Gabbard, J.O. (2003). Adult baby syndrome. American Journal of Psychiatry, 160, 1932-1936.

Pettit, I., & Barr, R. (1980). Temporal lobe epilepsy with diaper fetishism and gender dysphoria. Medical Journal of Australia, 2, 208-209.

Speaker, TJ, Psychosexual Infantilism in Adults: The Eroticization of Regression, Sausalito, CA: Columbia Pacific University (Unpublished PhD thesis).

Tuchman, W.W. & Lachman, J.H. (1964). An unusual perversion: the wearing of diapers and rubber pants in a 29-year-old male. American Journal of Psychiatry, 120, 1198-1199.

Turn the eater on: Fat fetishes and feederism

Many years ago when I was just entering my teens (well, 1979 since you ask), I heard a song by Adam and the Ants called ‘Fat Fun’ which at the time completely passed me by that it was all about fat fetishes. I should have guessed given that so many songs written by Adam Ant at the time were about fetishes and paraphilias (something that I have written about in an essays at length elsewhere (you can check them out in various places here and there).

Over the last few years, fat fetishism and fat admiration have come into more into the public domain through national press and television documentaries (I was interviewed by The Times on the topic back in June 2010)

Fat fetishists – mostly heterosexual and sometimes colloquially referred to as ‘chubby chasers’ – have an overwhelming (and often exclusive) sexual attraction towards very obese individuals of the opposite sex. (As a number of researchers point out, there is no widely held consensus in defining a fat admirer (FA), but the term is typically used in relation to individuals who find attractive someone considered clinically overweight). However, a recent paper by Dr Lee Monaghan (University of Limerick, Ireland) also noted and described aspects of the small gay fat admiration community through the use of qualitative data he collected online.

Fat fetishism also includes both ‘feederism’ and ‘gaining’ in which sexual arousal and gratification is stimulated through the person (referred to as the ‘feedee’) gaining body fat. Feederism is a practice carried out by many fat admirers within the context of their sexual relationships and is where the individuals concerned obtain sexual gratification from the encouraging and gaining of body fat through excessive food eating. Sexual gratification may also be facilitated and/or enhanced the eating behaviour itself, and/or from the feedee becoming fatter – known as ‘gaining’ – where either one or both individuals in the sexual relationship participate in activities that result in the gaining of excess body fat. This may not only involve eating more food but also engaging in sedentary activities that leave the feedee immobile. Some fat admirers may also derive pleasure from very specific parts of the body becoming fatter. A recent paper by Dr Lesley Terry and Dr Paul Vasey (both at the University of Lethbridge, Canada) in the Archives of Sexual Behavior, also claim that feedees are individuals who become sexually aroused by eating, being fed, and the idea or act of gaining weight.

Even if a fat admirer does not have direct sexual access to someone grossly overweight, there are other activities that fat admirers can encourage their sexual partners to engage in such as ‘padding’ (where individuals wear padded or layered clothing in a way that the person appears to have a distended abdomen) and inflation (where individuals inflate their abdomen with air or liquid so their abdomen is distended).

There has been a lot of psychological research showing that attractiveness of women is related to both low body mass index (BMI) and low waist-to-hip ratio (WHR). However, there has been a great deal of debate the universality of the findings and there is a lot of research that body shape attractiveness is determined by other factors including cross-cultural differences and gender-role stereotyping. There has also been research on physical attractiveness among ‘subcultures’ such as those people with eating disorders or in relation to sexual orientation. For instance, a study by Dr Viren Swami (University of Westminster, UK) and Dr Martin Tovee (University of Newcastle, UK) found that lesbians appear to idealize a heavier body weight in a potential partner than do heterosexual women or men.

One of these relatively unexplored ‘subcultures’ is the FA community. A study by Dr Viren Swami (by this time at the University of Liverpool, UK) and Professor Adrian Furnham (University College London, UK) and published in the Archives of Sexual Behavior (2009), examined the body weight WHR preferences of 56 heterosexual ‘fat admirers’. They claimed that the “relative scarcity of studies on the preferences of FAs can probably be traced back to the misperception that it is inconceivable that an individual could be attracted to obese others or that such a preference is somehow ‘’deviant’”. Unsurprisingly, their study – which was the first published on notions of attractiveness within the FA community – reported that FAs preferred heavyweight individuals and rated those individuals with high WHRs as the most attractive. The results predictably suggest that heterosexual male FAs hold very different ideals relating to attractiveness when compared with heterosexual men from the general population. Although some of the participants were fat themselves, there was no difference between these individuals and those FAs who were not overweight. The authors conclude that:

“It seems plausible that male FA is paraphilic in the sense of it being a non-mainstream sexual practice without necessarily implying dysfunction or deviance. For instance, it may be that hunger or food was involved in the behavioral imprinting of a fat fetish in early childhood, a hypothesis favored by some psychoanalysts…A related theory also based on the principles of behavioral imprinting argues that when young men masturbate, the objects that are frequently nearby at the time of masturbation become objects of arousal in the future. The individual is thus associating the object with sexual orgasm, and this may include either eroticized images of overweight individuals, food, and so on” (p.206).

It is also worth noting that in the Journal of Sex Research, Dr Swami repeated the study comparing FAs with a control group of non-FAs and found the same results. Despite these studies, there is still little empirical research on fat admirers and feederism. The recent paper by Dr Terry and Dr Vasey reported the case study of a 30-year old female feedee (‘Lisa’).

At the time of the study, Lisa was 30 years of age, married and Caucasian. She was recruited by the researchers from a feederism website (FantasyFeeder.com). By age 13 years (at 5 feet 11 inches tall) she was mildly preoccupied with her weight. She weighed 120-130 lbs and had BMI of 16-18 (i.e., underweight). However. Like many girls, she viewed herself as fat and became self-conscious about her hips, thighs, and belly. She claimed to experience sexual thoughts about weight gain and fat from a very young age. Because of her sexual fantasies about fat women during adolescence, she experienced some confusion about her sexual orientation (but deemed herself heterosexual).

As an adult, Lisa said she was still sexually aroused in response to fat women but that it was limited to visual images found on the internet. Her ideal website would be where there were several pictures of the same woman getting fatter over time (and which she would masturbate over). Lisa also fantasized about being forced to gain weight by a dominant male who would became sexually aroused by making her gain weight. She also reported that all of her orgasms involve fantasizing about some form of feederism and that sometimes all she needs to reach orgasm is to fantasize about being a little bit heavier. Although she has actively engaged in weight gain for a four-month period in 2008, she has never been in a feedee/feeder relationship (as she doesn’t want the negative health consequences of becoming extremely overweight). She also reported her sexual arousal had significantly declined after the weight gain period.

In their discussion of Lisa’s case, Terry and Vasey made the point that as with many paraphilias, her pattern of sexual arousal was characterized by intense and repetitive sexual urges, fantasies, and behaviours involving unusual activities (i.e., the intense focus on eroticizing body fat). Terry and Vasey also questioned whether Lisa’s behaviour represented a form of morphophilia (i.e., peak erotic focus on a particular body characteristic – in this case body fat). They also speculated that some of the behaviour was sexually masochistic and that this supported their view that feederism had paraphilic elements (although Lisa reported that masochistic behaviours generally repulsed her). As with any case study, it may not be representative of the entire feederism community. Terry and Vasey also assert that more research needs to consider if, and how, feederism is taxonomically distinct from the various forms of morphophilia.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Griffiths, M.D (1999). Adam Ant: sex and perversion for teenyboppers. Headpress: The Journal of Sex, Death and Religion, 19, 116-119.

Monaghan, L. (2005). Big handsome men, bears, and others: Virtual constructions of ‘fat male embodiment’. Body and Society, 11, 81-111.

Murray, S. (2004). Locating aesthetics: Sexing the fat woman. Social Semiotics, 14, 237-247.

Swami, V. & Furnham, A. (2009). Big and beautiful: Attractiveness and health ratings of the female body by male ‘‘fat admirers’’. Archives of Sexual Behavior, 38, 201-208.

Swami, V., & Tovee, M.J. (2006). The influence of body weight on the physical attractiveness preferences of feminist and non-feminist heterosexual women and lesbians. Psychology of Women Quarterly, 30, 252-257.

Swami, V. & Tovee, M.J. (2009). Big beautiful women: the body size preferences of male fat admirers. Journal of Sex Research, 46, 89-96.

Terry, L.L. & Vasey, P.L. (2011). Feederism in a woman. Archives of Sexial Behavior, 40, 639-645.

Perverse curse or worse? Survival of the fetish

Any regular readers of this blog will no doubt be aware that fetishes refer to the obtaining sexual excitement primarily or exclusively from a non-living (inanimate) object or a particular part of the body that is not conventionally viewed as being particularly sexual in nature (e.g., a sexual attraction by males to feet is more likely to be viewed as a sexual fetish than a sexual attraction towards breasts). Attraction to a very particular body part is typically classed as ‘partialism’. The word ‘fetish’ was first coined by the French psychologist Alfred Binet (1857-1911), who is arguably best known for inventing the earliest IQ tests. Fetishes rarely develop into an offence that harms anyone although offences may include things like theft (of underwear) or cutting hair from an unwilling victim.

Sexual fetishes may also involve some kind of enhancement of a sexual act such as a person being asked to wear a particular piece of clothing by the fetishist during sex (e.g., leather outfit or fishnet stockings). Fetishists (usually male) are often unable to orgasm without the fetish present, and can be established as young as 4 years old. Fetishes in and of themselves are not considered to be disorders of sexual preference unless the fetishistic behaviour causes significant negative detriment and/or psychosocial distress for the individual. If the fetish does cause significant distress it would be diagnosed as a paraphilia in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Furthermore, it is sometimes difficult to draw the line between normal and paraphilic behaviours. Dr Martin Kafka (McLean Hospital, Belmont, USA) pointed out in a recent review about the DSM criteria that fetishes can be “non-clinical manifestations of a normal spectrum of eroticization or clinical disorders causing significant interpersonal difficulties”. The etiology of fetishes is also complicated by the fact that empirical research such as that by Dr Chris Gosselin and Dr Glenn Wilson (Institute if Psychiatry, London, UK) that some fetishists report their behaviour is relaxing rather than arousing (such as some from of fetishistic transvestism).

Psychological research has shown that many fetishes appear to be the result of early imprinting and conditioning experiences in childhood or adolescence (for instance, where sexual excitement and/or orgasm is paired with non-sexual objects or body parts) or as a consequence of strong traumatic, emotional and/or physical experience. Fetishes may in part be influenced by rejection of the opposite sex and/or by youthful arousal being channelled elsewhere (deliberately or accidentally). Some children have been said to associate sexual arousal with objects that belong to an emotionally significant person like a mother or older sister and is known as symbolic transformation. However, there is also evidence that some fetishes have more biological origins such as those people whose fetish results from conditions such as temporal lobe epilepsy.

Empirical research by Gosselin and Wilson has also indicated that the most prevalent body fetishes are for feet, hands, and hair, and that the most prevalent fetish objects are shoes, gloves, and (soiled) underwear. However, there may be differences in relation to sexual orientation. Most fetishism research concerns heterosexual men who have fetishistic desires for feminine items such as high-heeled shoes, lingerie, and hosiery. Among homosexual men, the fetishistic objects tend to be highly masculine.

As with many other sexual disorders, there is very little reliable epidemiological data for fetishism. In a study from the 1950s, only 0.1% of 4,000 patients in private practice were recorded as having fetishism as a primary problem (Curren, 1954). Another study carried out among 561 non-incarcerated sex offenders (and all paraphiliacs) by Dr Gene Abel and colleagues (1998) reported that only 3.4% were diagnosed with fetishism. Another study (1992) led by Dr Gene Abel investigated the comorbidity rates of various paraphilic behaviors in a group of 859 male paraphiliacs. Of the 859 subjects, only 12 were diagnosed with fetishism as either a primary or a secondary diagnosis. In a recent review of fetishism by Dr. Shauna Darcangelo (Forensic Psychiatric Services Commission, Victoria Regional Program, Victoria, British Columbia, Canada), noted that fetishism, transvestic fetishism, and homosexuality have often been linked. Darcangelo’s review also noted that fetishism has also been linked with other psychiatric behaviours including kleptomania, borderline personality disorder, obsessive-compulsive personality, and attention-deficit /hyperactivity disorders.

My favourite study in this area was one that was led by Dr G. Scorolli (University of Bologna, Italy) in 2007 on the relative prevalence of different fetishes (probably because it used an online methodology to collect the large amounts of data). Most studies on fetishistic behaviour are either case studies or small-scale surveys where sample sizes are rarely above 100 participants. Additionally, data from the studies examining rare fetishes are typically from psychiatric patients, sex offenders, and/or those who have sought (or have been referred to) a therapist.

Scorolli and colleagues examined the content found in fetish discussion groups. Via a search of Yahoo! groups online, the research team located 2,938 groups whose name or description text contained the word ‘fetish’. They then applied a number of inclusion and exclusion criteria.

• First, the identified groups that dealt with sexual topics and discarded groups that used ‘fetish’ in a non-sexual context (e.g., fetish for a rock band).
• Secondly, they excluded groups that used ‘fetish’ to deny that the group was about sex (e.g., a support group for pregnant women stated explicitly that the group did not discuss ‘pregnancy fetish’).
• Thirdly, some groups were excluded because the sexual nature of the topic could not be established with confidence (e.g., there was no description text of what the fetish was).
• Fourthly, groups were excluded if the group discussed ‘sex’ or ‘fetishism’ generically and therefore couldn’t be categorized.
• Fifthly, groups that had no identified members were excluded

Following the application of the inclusion and exclusion criteria, 381 fetish discussion groups were left for analysis. The average number of posts per month within the groups was over 4,000 that included over 150,000 members. The authors argued that figure was inflated, because many fetishists would be subscribed to more than one group. It was estimated (very conservatively in the authors’ opinion), that their sample size comprised at least 5000 fetishists (but was likely to be a lot more). The authors devised a classification scheme whereby fetish preference was assigned to one or more categories. Three main categories were: body, objects and behaviours, and then further sub-divided to describe a:

• Part or feature of the body (e.g., feet, fat people) and body modifications (e.g., tattoos).
• Object associated with some part of the body (e.g., shoes).
• Object not associated with some part of the body (e.g., candles).
• Person’s own behaviour (e.g., biting fingernails).
• Behaviour of other persons (e.g., smoking).
• Behaviour requiring interaction with others (e.g., humiliation role-play).

Approximately 70% were assigned to just one of these categories. The relative frequency of each fetish was estimated by taking into account (a) the number of groups devoted to the particular fetish, (b) the number of individuals participating in the fetish groups and (c) the number of messages exchanged within the group forum. Their results showed that body part fetishes were most common (33%), followed by objects associated with the body (30%), preferences for other people’s behavior (18%), own behavior (7%), social behavior (7%), and objects unrelated to the body (5%). Feet (and objects associated with feet) were by far the most common fetishes.

From this brief overview it’s evident that research is biased towards small-scale studies with biased samples. Therefore, as Dr Shauna Darcangelo concludes in her recent literature review, in order to increase the understanding surrounding fetishistic behaviour, future empirical research needs to focus on large, population-based, representative samples.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Abel, G.G., Becker, J.V., Mittelman, M., Cunningham-Rathner, J., Rouleau, J.L. & Murphy, W.D. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153-168.

Abel, G. G., & Osborn, C. A. (1992). The paraphilias: The extent and nature of sexually deviant and criminal behavior. Psychiatric Clinics of North America, 15, 675-687.

Chalkley, A.J. & Powell, G.E. (1983). The clinical description of forty-eight cases of sexual fetishism. British Journal of Psychiatry, 142, 292–295.

Curren, D. (1954). Sexual perversion. Practitioner, 172, 440-445.

Darcangelo, S. (2008). Fetishism: Psychopathology and Theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (Second Edition) (pp.108-118). New York: Guildford Press.

Gosselin, C. & Wilson, G. (1980). Sexual variations. London: Faber & Faber.

Kafka, M. (2010). The DSM diagnostic criteria for fetishism. Archives of Sexual Behavior, 39, 357–362

Milner, J. S., & Dopke, C. A. (1997). Paraphilia not otherwise specified: Psychopathology and theory. In D. R. Laws & W. O’Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment (pp. 393-423). New York: Guilford Press.

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

Wiederman, M.W. (2003). Paraphilia and fetishism. The Family Journal, 11, 315-321.

Wilson, G. & Gosselin, C. (1980). Personality characteristics of fetishists, transvestites and sadomasochists. Personality and Individual Differences, 1, 289–295.

Eaten to death: A beginner’s guide to vorarephilia

Vorarephilia – usually shortened to vore – is a sexual paraphilia in which people are sexually aroused by the idea of being eaten, eating another person, or observing this process for sexual gratification. Since the behaviour is unlikely to actually be carried out by the vorarephiliac, the behaviour is more likely to be fantasy-based via different media (e.g., fictional stories, fantasy art, fantasy videos, and bespoke video games). The behaviour doesn’t necessarily involve digestion and/or pain. Probably because it is both rare and fantasy-based, it doesn’t appear in any psychiatric manuals such as the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

Vorarephilia can sometimes co-exist with other fetishistic behaviour such as masochism (sexual arousal from receiving pain), hypoxyphilia (sexual arousal from suffocation and oxygen restriction), and ‘snuff’ fetishes (sexual arousal from seeing someone die). In some cases vorarephilia has been argued to be a variant of macrophilia (i.e., sexual fascination and/or fantasy relating to giants). Most of the fantasies of vorarephiliacs involve the person being the ones being eaten (i.e., the ‘prey’, although a few like to be the ‘pred’ taken from the word ‘predator’). Some vorarephiliacs are known to derive pleasure – sometimes sexual – from watching some animals (e.g., snakes) eating other animals whole.

There have been many different types of vorarephilia documented including ‘hard vore’ and ‘soft vore’. Being primarily fantasy-based, almost any orifice or body part can be capable of vore (e.g., ‘vaginal vore’, ‘anal vore’ and ‘cock vore’). Very briefly:

• Hard vore (sometimes simply called ‘gore’) is where the person is often subjected to horrific injuries and involves lots of blood because of the ripping, cutting, biting, tearing and/or chewing of flesh. It is not typically thought of as either sensually or sexually motivated.
• Soft vore is where the person (that may not necessarily be a willing victim) is consumed alive and whole and is typically unharmed before reaching the stomach but then may be asphyxiated and/or digested. Compared to ‘hard vore’, soft vore is usually seen as more sensual and sexually oriented because of its relatively non-violent nature.
• Female genital vore (vaginal vore) is where the person is consumed by the vagina and taken into the womb (and often referred to as ‘unbirthing’ or a ‘reverse birth’).
• Male genital vore (cock vore) is where the person is consumed by the urethral opening of the penis and taken into the scrotum, prostate, or bladder.
• Anal vore is where the person is consumed by the anus and taken into the rectum, colon, or stomach.
• Breast vore is where the person is consumed by the nipples and taken into the breast.

Here’s a confessional piece I found on a psychology forum discussion group:

“I’m almost 17 now. But since I was really young, I’ve been a phagophile (with a specific interest in being swallowed whole). I’ve had a few girlfriends now, but my present one is by far the most engaging and interesting person I have ever met. She’s the only one I’ve engaged in any real sexual contact with. After meeting her, my interests expanded somewhat; she’s the only person I’ve ever been interested in eating. Fortunately this was impossible, for obvious reasons: I was still thinking in terms of “soft vore”, in which no damage is done to either party. This is where things get difficult. We’ve been together a while now and within the past few weeks, I’ve begun to shift towards “hard vore”. This includes cannibalism: I’ve been attracted especially to biting at her neck, hands, and nose. I feel that I’ve done a good job at communicating this to her, so I haven’t crossed any lines because I’ve controlled myself.”

The motivational driving force underlying vorarephilia is some ways appears to resemble that of sadomasochism from a dominance and submission perspective. Devouring someone could be viewed as the ultimate act of dominance by a predator, and the ultimate act of submission by the prey. Paradoxically, most vorarephiliacs have no real interest in cannibalism, although a few do. Possible vorarephiliacs include the Japanese man (Issei Sagawa) who in 1981 killed and then ate a Dutch woman (Renée Hartevelt), and the serial killer Jeffrey Dahmer who killed 17 men and boys and engaged in both cannibalistic and necrophilic acts with his many victims between 1978 and 1991.

However, the most infamous vorarephiliac is arguably the German Armin Meiwes. His case was referred to at length in a 2008 essay in the Archives of Sexual Behavior, by Dr Friedemann Pfafflin (a forensic psychotherapist at Ulm University, Germany). Meiwes, a computer technician, gained worldwide media attention as the ‘Rotenburg Cannibal’ for killing and eating a fellow German male victim (also a computer technician). Meiwes had allegedly been fantasizing about cannibalism since his childhood and frequented cannibal fetish websites and posted around 60 advertisements asking if anyone would like to be eaten by him. Meiwes claimed around 200 men responded to his request but only one finally met face-to-face.

In March 2002, Bernd Jürgen Brandes responded to Meiwes’ advertisement on the Internet. At their one and only meeting at Meiwes’ house, their first cannabilistic act was for Meiwes to bite off Brandes’ penis and then jointly cook and eat it. Brandes then drank lots of alcohol, cough syrup, and took sleeping pills, and was stabbed to death by Meiwes in his bath (and videotaped). The body was then stored and over time, Meiwes ate large amounts of it (about 20 kg). The one aspect that shocked most people was not the fact that Meiwes ate a lot of Brande’s body but that Brandes appeared to consent to being eaten. Email exchanges between Meiwes and Brandes were later shared in the court case:

Brandes: “Thanks for your mail. You really turn me on…Winter with the temperature at around 5 to 15 degrees below freezing is good weather for slaughter. Great to be naked and tied in weather like that and to be driven to the slaughter. Where you then stun me and I collapse. You then hang me up, jerking, and cut my carotid artery. Warm blood flows. Everything goes routinely. I don’t have any chance to escape my slaughter at the last moment. It’s a real turn-on, the feeling of being at your mercy being in your possession. Having to give up my flesh”

Meiwes: “It’ll be awesome, anyway. Your tasty body on show like that. Spicing it…Tying you up will be no problem, I’ve got rope and some cuffs for your hands and feet. I’ll really enjoy the bit with the needles. I’ll see if I can get hold of some really long ones. I can’t wait for you to be here”

It wasn’t until about 18 months after Brande had been killed that the German police started to investigate Meiwes. An Austrian student had seen Meiwes boasting that he had successfully killed and eaten another man. The police then arrested Meiwes and found human body parts in the freezer and the videotape of the killing. In court, Brandes’ consent to being killed was accepted by the jury and Meiwes was given an eight and a half year prison sentence for manslaughter. Neither Meiwes or Brandes were deemed mentally ill by the court appointed psychiatrists. Dr Klaus Beier (Institute of Sexology and Sexual Medicine, Free and Humboldt-University of Berlin, Germany) was the expert witness who twice provided forensic expertise on Miewes. He said that:

“Armin suffered neither from a psychosis nor any other mental illness or any personality disorder. Quite the contrary, he had a normal IQ and his social competence was high. To everybody who had private or professional contact with him, Armin seemed to be an open-minded and friendly contemporary man who, in the forming of contacts, appeared pleasant-natured, flexible, and socially competent, even agile. Even extremely experienced police officers, who could not believe what he had done, had to put on record that, if they had not known about the offence, Armin M. never offered anything conspicuous during the entire period of investigation.”

A later paper by Dr Beier in response to Dr Pfafflin noted that:

“Before the age of 11 years [Armin] was preoccupied by the idea of incorporating another male by eating his flesh. This paraphilia caused him to seek unsolicited partners who pretended to mirror his desire insofar that they should have the wish of being incorporated. It took him years to find such a counterpart using the frighteningly developed subculture on the internet for that purpose, where people with this special inclination can encourage each other.”

Dr Pfafflin outlined some other cases of German cannibalism including cases he was personally involved in. he said that:

“From my intensive knowledge of both these case histories just referred to, I have no doubt that every form of cannibalism, excepting at most those which happen in times of extreme hunger and whose only purpose is to secure survival, has a pathological, perverse background.”

Little is known about how prevalent this type of behaviour is although Meiwes claimed that based on his internet activity on cannibal fetish websites that there were at least 800 Germans that shared his passion for wanting to eat another person. The number of people that have a desire to be eaten and actually go through with it is likely to be incredibly small – but the internet helped Meiwes locate a willing victim.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Adams, C. (2004). Eat or be eaten: Is cannibalism a pathology as listed in the DSM-IV? The Straight Dope, July 2. Located at: http://www.straightdope.com/columns/read/2515/eat-or-be-eaten

Beier, K. (2008). Comment on Pfafflin’s (2008) “Good enough to eat”. Archives of Sexual Behavior, 38, 164-165

Brundage, S. (2002).  Fetish confessions. The Wave Magazine 2(15). Located at: http://web.archive.org/web/20070927061721/http://www.thewavemag.com/pagegen.php?articleid=22026&pagename=article

Pfafflin, F. (2008). Good enough to eat. Archives of Sexual Behavior, 37, 286-293.

Pfafflin, F. (2009). Reply to Beier (2009). Archives of Sexual Behavior, 38, 166-167.

Faecal attraction: A beginner’s guide to coprophilia

Coprophilia (also known as coprolagnia) is a paraphilia where people get sexual pleasure from faeces. Sexual excitement typically comes from either (i) watching somebody defecate on somebody else or (ii) they themselves defecating on somebody else. In rare instances, some people may become sexually aroused when they are defecated upon by somebody else. As Dr Judith Milner and colleagues wrote in the 2008 book ’Sexual Deviance: Theory, Assessment and Treatment’:

“Although some authors have defined the focus of coprophilia as the act of elimination (McCary, 1967), others have defined it as the act of consumption of excrement (Allen, 1969). To complicate the definition further, it appears that some individuals may have an interest in eliminating on one’s partner or in playing with the fecal matter. According to Smith (1976), a common analytic interpretation is that the excrement symbolically represents the penis and that the presence of the fecal matter serves as a defense against castration anxiety”

In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), it is classified under ‘Paraphilia Not Otherwise Specified’ (PNOS) along with other paraphilias such as necrophilia, zoophilia, klismaphilia, and telephone scatophilia. As with all paraphilias in the PNOS category, diagnosis is only made “if the behavior, sexual urges, or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning…Fantasies, behaviors, or objects are paraphilic only when they lead to clinically significant distress or impairment (e.g., are obligatory, result in sexual dysfunction, require participation of non-consenting individuals, lead to legal complications, interfere with social relationships)”. The psychologist Dr Tamara Penix (Eastern Michigan University, USA) says there are no data indicating successful treatment of coprophilia.

Surprisingly little scientific research has been carried out on coprophilia, probably because it is so rare. There are certainly pornographic films that include sexual defecation acts (notably some Japanese pornography). Some of these films include coprophiliacs engage in coprophagia (i.e., the eating of faeces and typically referred to more commonly as ‘scat’) which can provides a significant health risk in the form of hepatitis (perhaps another reason as to why the act is so rare). The psychiatrist, Dr Charles Lake (University of Kansa Medical Center, USA) notes that both coprophilia and coprophagia are traditionally considered characteristics of schizophrenia. However, there are case reports in the literature of non-psychotic coprophiliacs with normal intelligence such as one published in the Journal of Sex and Marital Therapy in 1995.

The most infamous copraphiliac was allegedly Adolf Hitler. This was alluded to in a recent 2011 biography of Hitler’s lover Eva Braun by Heike B. Gortemaker. However, other books on Hitler have been more explicit. For instance, Greg Hallet in his chapter ‘Hitler’s Sexuality’ (from his 2008 book ‘Hitler was a British Agent’) wrote:

“Hitler’s close boyhood friend from Linz, August Kubizek, wrote Adolf Hitler, Mein Jugendfreund (My Youth Friend), ‘Adolf did not engage in love affairs or flirtations. He always rejected the coquettish advances of girls or women. Women and girls took an interest in him but he always evaded their endeavours’…During deconstruction, it is customary that the person is sexually abused in the manner which is most embarrassing to that person. In Hitler’s case, he was sodomised, creating a submissive distant respect for homosexuals like his bodyguards and some of his highest-placed leaders. His natural bent was developed into coprophilia (being shat on)…With each deconstruction an embarrassing addiction is developed and filmed. With Hitler it was sadomasochism, coprophilia and homosexuality. That is, he liked to be verbally abused and slapped around, to have his head urinated on, his chest shat on, and to have sex with men”

The few studies that have been carried out have tended to be done on sadomasochist individuals (although even for sadomasochists this appears to be a rare activity for them to engage in). A study led by psychologist Dr Kenneth Sandnabba (Åbo Akademi University, Turku, Finland) and published in the Journal of Sex Research surveyed 164 Finnish male sadomasochists and reported that that 18% of them had engaged in at least one coprophilic act (6% as a masochist, 3% as a sadist, and 9% as both). There was no difference in sexual orientation with 18% of heterosexual sadomasochists and 17% of homosexual sadomasochists having engaged in at least one coprophilic act. The results also showed that the sadomasochists were socially well-adjusted and that their SM behavior was mainly a facilitative aspect of their sexual lives.

In a follow-up study published in the journal Deviant Behavior, Sandnabba and colleagues analysed data from a subset of twelve men from their study of sadomasochists who had also engaged in zoophilic activities. This group was then compared with a control group of sadomasochists from the same data set but who had not engaged in zoophilic activities. Results showed seven out of twelve zoophilic sadomasochists had engaged in coprophilic acts whereas only one in twelve non-zoophilic sadomasochists had engaged in coprophilic acts. In fact, the zoophilic sadomasochists were more likely to engage in a wide range of sexual behaviours including spanking, gagging, biting, urophilia (urinating on or being urinated on for sexual pleasure), fisting, coprophilia, skin branding, and transvestism (i.e., cross-dressing). The authors concluded that zoophilic sadomasochists were more sexually experimental than the non-zoophilic sadomasochistic controls.

An earlier study on a much bigger sample of paraphiliacs also reported that zoophiles appear to engage in many paraphilic behaviours including coprophilia. In their survey of 561 non-incarcerated paraphiliacs seeking treatment, Dr Gene Abel and colleagues found that all of the 14 zoophiles in their sample reported more than one paraphilia and seven of them reported at least five other paraphilas including coprophilia, urophilia, pedophilia, exhibitionism, voyeurism, frotteurism, telephone scatophilia, transvestic fetishism, fetishism, sexual sadism, and/or sexual masochism.

There doesn’t appear to be any consensus as to the origins of these highly unusual paraphilias although (as with most paraphilic behaviour) operant and classical conditioning would appear to play a major role. The following example is a self-report that I found in an online discussion group:

“It all started when I was young. I hated white underwear for some reason and when I wore them I’d be turned on. Eventually it felt odd and good that I urinated in them. I wet my bed for days when I was a young boy and stopped when my parents found out about it. When I was young, I hated bowel movements. It felt gross and stuff. After discovering masturbation, I eased my bowel movements by masturbating. It felt good, and my bowel movements weren’t so gross. I don’t know how it happened but the two finally caught up to each other and I became accustomed to the smell when I masturbated. Everything escalated as time went on, I’ve been in this fetish for a while now – since I was 12 years old. I am 18 now”

The origins of the coprophilic behaviour certainly appear (in this case) to be as a result of both classical and operant conditioning. However, other people suggest different etiological factors may contribute in the development of coprophilia. For instance, in Canada, Dave Hingsburger published a case study of an institutionalized and mentally handicapped man who engaged in coprophilic acts approximately three times a week. It was argued that the cause of the coprophilia was the patient’s maladaptive response to a severely limited institutional environment rather than any behavioural conditioning.

Whatever the origins, it is evident that compared to many other paraphilic behaviours, there is a dearth of empirical and clinical data relating to the acquisition, development, and maintenance of coprophilia.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M. S., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153–168.

Allen, C. (1969). A textbook of psychosexual disorders (2nd ed.). London: Oxford University Press.

Denson, R. (1982). Undinism: The fetishizaton of urine. Canadian Journal of Psychiatry, 27, 336–338.

Hallett, G. (2008). Hitler was a British agent. London: Progressive Books.

Hingsburger, D. (1989). Motives for coprophilia: Working with individuals who had been institutionalized with developmental handicaps. Journal of Sex Research, 26,139-140.

Karpman, B. (1948). Coprophilia: A collective review. Psychoanalytic Review, 35, 253–272.

Karpman, B. (1949). A modern Gulliver: A study in coprophilia. Psychoanalytic Review, 36, 260-282.

Lake, C.R. (2008). Hypothesis: Grandiosity and guilt cause paranoia; Paranoid schizophrenia is a psychotic mood disorder; a review. Schizophrenia Bulletin, 34, 1151-1162.

McCary, J. L. (1967). Human sexuality. New York: Van Nostrand Reinhold.

Milner, J.S., Dopke, C.A. & Crouch, J.L.  (2008). Paraphilia not Otherwise Specified: Psychopathology and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp.384-418). New York: Guildford Press.

Penix, T.M. (2008). Paraphilia not Otherwise Specified: Assessment and treatment. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp.419-438). New York: Guildford Press.

Sandnabba, N.K., Santtila, P. & Nordling, N. (1999). Sexual behavior and social adaptation among sadomasochistically-oriented males. Journal of Sex Research, 36, 273-282.

Sandnabba, N.K. Santtila, P., Nordling, N. Beetz, A.M., Alison, L. (2002). Characteristics of a sample of sadomasochistically-oriented males with recent experience of sexual contact with animals. Deviant Behavior, 23, 511-529.

Smith, R. S. (1976). Voyeurism: A review of the literature. Archives of Sexual Behavior, 5, 585–608.

Wise, T.N. & Goldberg, R.L. (1995). Escalation of a fetish: Coprophagia in a nonpsychotic adult of normal intelligence. Journal of Sex and Marital Therapy, 21, 272-275.

Enema of the state of mind: A beginner’s guide to klismaphilia

Klismaphilia – a term coined by Dr Joanne Denko in the reporting of two case studies early 1970s (‘klisma’ is the Greek word for ‘enema’) – is a very unusual variant in sexual expression in which an individual obtains sexual pleasure from receiving enemas (i.e., the cleansing of the colonic canal via anal douching). Less commonly, some people also get sexual pleasure from the giving of enemas to other people. Typically, it is warm water that is used to clean the lower rectum although other substances have been reported including coffee, yogurt, air, whisky, wine, beer, cocaine, epoxy resin and even cement (see case study below). For instance, Dr Anil Hernandas and colleagues from Medway Maritime Hospital (in Gillingham, UK) reported a unique case of a unemployed 27-year old patient self-administering epoxy resin (a liquid used as a masonry adhesive) for anal sexual gratification. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders classifies it under the diagnosis of “Paraphilias, Not Otherwise Specified”.

Dr Alfred Kinsey’s surveys of sexual behaviour of males and females in the late 1940s and early 1950s research specifically mentioned women using enemas as a masturbatory aid but no such practice was reported by males. Although Kinsey’s research provided evidence that klismaphilia was engaged in by women, as with most paraphilias, it is typically males who are more likely to be klismaphiliacs. Published research on klismaphiliacs is rare and it is thought that most klismaphiliacs keep their engagement in this activity very secret.

The little research into klismaphilia suggests that the act of receiving enemas can cause intense stimulation and produce pleasurable sensations (e.g., gaining pleasure from a large, water distended belly or the feeling of internal pressure). Enemas cause mechanical distension of rectum that then cause stimulation of nerve endings supplying the pelvic organs (i.e., stimulating the rectal stretch receptors). It has also been reported that drugs that are administered rectally (including aqueous and alcoholic solutions) are absorbed very rapidly and has a “mainlining effect” similar to that of intravenous drug injection.

Typically, klismaphiliacs retrospectively report discovering these very particular sexual desires after being given enemas sometime in their childhood. Published case studies suggest that klismaphilia ost likely arises in those children who received them as children by a loving and affectionate mother. This association of loving attention with anal stimulation may eroticize the experience for some people so that as adults they may manifest a need to receive an enema as a substitute for or necessary prerequisite to genital intercourse.

Following the publication of her two case studies, Dr Joanne Danko published a study in the mid-1970s on 15 klismaphiliacs. Based on these limited data, she concluded that klismaphiliacs comprised one of three groups she labeled Type A, Type B and Type C.

• Type A: These individuals were unhappy, believed their klismaphilic behaviour as abnormal, and kept the behaviour compartmentalized. The behaviour originated in childhood and the enemas were usually self-administered. Some of the cases in this group also engaged in other paraphilic behaviour (e.g., fetishism, masochism, coprophilia).
• Type B: These individuals were similar to Type A individuals, but accepted the condition and were more likely to engage in klismaphilia with their sexual partner.
• Type C: These individuals engaged in multiple paraphilic behaviours with other similar like-mined individuals, and their klismaphilia was integrated with a range of other praphilic behaviours (e.g., transvestism, masochism).

Back in 1991, the American sexologist Dr William Arndt placed advertisements in sex magazines to recruit klismaphiliacs. He managed to survey 22 individuals (all males except for one female) and aged 25 to 54 years. Most were homosexual (80%; the other 20% were bisexual) although nearly two-thirds were married (or had been married). They typically engaged in enema use twice a week and half of the klismaphiliacs reported the enemas were self-administered. The remainder gave and/or received enemas from their sexual partner. Just over one-third of the sample (40%) had other paraphilic interests that typically revolved around sexual masochism (e.g., being spanked).

In a 1982 American Journal of Psychotherapy paper, Jeremy Agnew (1982) provided a physiological perspective on klismaphilia concentrating on the ritualization of insertion, filling, and expulsion components. He compared the physiological similarities between rectal stimulation and vaginal intercourse and said that the behaviour was reinforcing. This observation – taken together with the work of Dr Danko – suggests that much of the klismaphiliac’s behaviour is maintained by both classical and operant conditioning. In a later 2000 paper, Agnew also noted that some individuals receive such extreme pleasure from the practice that they reach orgasm. He also links klismaphilia with sadomasochistic activities.

Accidental rectal trauma and the lodging of foreign bodies in the gastrointestinal tract have been widely reported in the medical literature. Arguably the most notorious case of klismaphilia is that reported by Dr Peter Stephens and Dr Mark Taff in the American Journal of American Pathology. They wrote about a young man who turned up at the hospital complaining of rectal pain. After an examination by the doctor, it became apparent that there was a stony hard mass lodged in the man’s rectum. Upon further questioning, the patient revealed that four hours earlier, he and his boyfriend had been “fooling around” and that after stirring a batch of concrete mix, the patient had laid on his back with his feet against the wall at a 45 degree angle while his boyfriend poured the mixture through a funnel into his rectum. The concrete had set and was eventually removed. On removal, a ping-pong ball was also found. The reason a ping-pong ball was also found in the rectum was because klismaphiliacs use the ball as a plug to promote retention and increase stimulation. The use of such a device suggests the person was an experienced klismaphiliac.  As Dr Anil Hernandas and colleagues conclude “as the exploration of anal eroticism increases in popularity, more and more cases of complications as a direct result of their abuse are likely to be encountered”.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Agnew, J. (1982). Klismaphilia: A physiological perspective. American Journal of Psychotherapy, 36, 554–566.

Agnew, J. (2000). Klismaphilia. Venereology, 13(2), 75-79

Arndt, W.B. (1991). Gender disorders and the paraphilias. Madison, CT: International Universities Press.

Boglioli, L.R., Taff, M.L., Stephens, P.J. & Money, J. (1991). A case of autoerotic asphyxia associated with multiplex paraphilia. American Journal of Forensic Medicine and Pathology, 12, 64– 73.

Denko, J.D. (1973). Klismaphilia: Enema as a sexual preference. American Journal of Psychotherapy, 27, 232–250.

Denko, J.D. (1976). Klismaphilia: Amplification of the erotic enema deviance. American Journal of Psychotherapy, 30, 236–255.

Hemandas, A.H., Muller, G.W. & Ahmed, I. (2005). Rectal Impaction With Epoxy Resin: A Case Report. Journal of Gastrointestinal Surgery, 9, 747–749.

Kinsey, A. C., Pomeroy, W. B., Martin, C.E., Gebhard, P.H. (1953). Sexual Behavior in the Human Female. Philadelphia, PA: W.B. Saunders Company.

Kinsey, A. C., Pomeroy, W. B., Martin, C.E., (1948). Sexual Behavior in the Human Male. Philadelphia, PA: W.B. Saunders Company.

Stephens, P. & Taff, M. (1987). Rectal impaction following enema with a concrete mix. American Journal of Forensic Medicine and Pathology, 8, 179–182

Animal passions: The strange world of zoophilia

Of all the sexual paraphilias, arguably the two most repelling are necrophilia (covered in a previous blog) and zoophilia. Zoophilia (also more commonly know as bestiality) is typically defined as relating to recurrent intense sexual fantasies, urges and sexual activities with non-human animals.

The Kinsey Reports (of 1948 and 1953) arguably shocked its readers when it reported that 8% of males and 4% females had at least one sexual experience with an animal. As with necrophiliacs who are often employed in jobs that provide regular contact with dead people, the Kinsey Reports provided much higher prevalence for zoophilic acts among those who worked on farms (for instance, 17% males had experienced an orgasmic episode involving animals). The most frequent sexual acts engaged in with animals comprised calves, sheep, donkeys, large fowl (ducks, geese), dogs and cats. Males were most likely to engage in penile-vaginal intercourse or to have their genitals orally stimulated by the animals. Female zoophilia was most likely to involve household pets licking genitals. Less commonly, women have trained dogs to mount them and engage in intercourse. The sexologist Professor John Money asserted that zoophilic behaviours were usually transitory occurring when there is no other sexual outlet available.

The most recent studies of zoophilia since 2000 have typically collected their data online from non-clinical samples. This has included studies by Dr Andrea Beetz (University of Erlangen, Germany; 32 zoophiles), Dr Colin Williams and Dr Martin Weinberg (of Indiana University, USA; 114 zoophiles), and Dr Hani Miletski (Institute for Advanced Study of Human Sexuality, San Francisco, USA; 93 zoophiles). For instance, Hani Miletski used the internet to find zoophiles, and recruited them via advertisements in a zoophile magazine (i.e., Wild Animal Review). These studies all reported that both male and female self-identified zoophiles were attracted to animals out of either a desire for affection, a sexual attraction toward, and/or a love for animals. Many of the zoophiles in these three studies had a preference for sex with non-human animals.

Miletski’s study comprised 82 male and 11 female zoophiles. The most reported sexual fantasies of the sample were having sex with animals (76 % males and 45% females) and watching other humans have sex with animals (35% males and 40% females). The reasons that men said they engaged in sex with animals was sexual attraction to the animal (91%), love and affection for the animal (74%), the animals being accepting and easy to please (67%). Only 12% said it was because no human partners were available, and only 7% said it was because they were too shy to have sex with humans. For the females, the main reasons for having sex with animals was because they were sexually attracted to the animal (100%), love and affection for the animal (67%) and because they said the animal wanted it (67%). Most of the sample preferred sex with dogs (87% males; 100% females) and/or horses (81% males; 73% females). Only 8% of males wanted to stop having sex with animals and none of the females.

Hani Miletski went as far as to claim that zoophilia could perhaps be considered as an alternative sexual orientation. Interestingly, Miletski’s study – which I should add has never been published in a peer reviewed academic journal – noted that her participants differentiated themselves from the bestialists who used animals as sex objects without emotional attachment.

Andrea Beetz’ study comprised 32 male zoophiles. Sex had occurred with dogs (78%), horses (53%), cats (13%) and farm animals (19%). Over half (56%) had never been in therapy. Many of the zoophiles had a very close emotional attachment to their animals and reported that they love their animal partner as others love their human partner (and are devastated when their animal partner dies). They also claimed they cared about the sexual pleasure of their animal partner as well as their own. Beetz also examined how the interest in zoophilia began. She reported:

“Some have always been interested in their preferred animal and only later developed sexual fantasies about them, some read in books/magazines about zoophilia (e.g. the Sex Atlas), some found it very exciting to watch animal matings on TV (especially on the Discovery Channel in the US) and fantasized about that. Others started to touch the genitals of their pet-dog out of curiosity, in some cases the dog came up and licked the person`s genitals. Others did not remember when their fantasies started, but the behavior often started with nonsexual cuddling with the animal and then became sexual. So we see that there are a lot of ways that can lead up to the first sexual experience with an animal”

In all three studies, the most commonly preferred animals were either dogs or horses. However, it must be noted that these three studies, while extensive compared to the case reports published since Alfred Kinsey’s pioneering studies, collected data from non-clinical samples. Therefore, and unlike case study reports, the participants did not appear to be suffering any significant clinical significant distress or impairment as a consequence of their behaviour.

There may, of course, be other more idiosyncratic explanations for zoophilic behaviour. There are several medical conditions accounting for zoophilic behaviour (e.g., cerebral tumors located in the frontal lobe or in the lymbic system or hypothalamus). A very recent case reported in the journal Romanian Neurosurgery described the late onset of zoophilia in a 42-year old man who suddenly started engaging in zoophilic behaviour following an aneurysm in the posterior cerebral artery. More specifically, he developed a sexual interest towards the hens in his garden, and his wife found him several times having sex with the hens. Unfortunately, the man died a few weeks later following a rupture of the aneurysm. Another report published in the Annals of Pharmacotherapy highlighted the case of a 74-year old man who developed zoophilic tendencies five days after the start of his dopaminergic therapy for his Parkinson’s Disease.

Finally, it’s worth noting that there have also been papers and editorials published in the Veterinary Journal (VJ) about the violent sexual abuse of female calves. Vets – who often have to deal with the animals that have been sexually abused by humans – do not like the term ‘zoophilia’ as it tends to focus on the human perpetrator, with no attention being paid to the harm that might result for the animal. A 2006 editorial in the VJ claimed that the sexual abuse of animals is almost a last taboo – even to the veterinary profession. As Piers Beirne (University of Sothern Maine, USA) argues, the sexual abuse of an animal should be understood as sexual assault because: (i) human–animal sexual relations almost always involve coercion; (ii) such practices often cause pain and even death to the animal; and (iii) animals are unable either to communicate consent to us in a form that we can readily understand, or to speak out about their cause.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Beetz, A.M. (2000, June). Human sexual contact with animals: New insights from current research. Paper presented at the 5th Congress of the European Federation of Sexology, Berlin.

Beirne, P., 1997. Rethinking bestiality: towards a concept of interspecies sexual assault. Theoretical Criminology, 1, 317–340.

Ene, S., A. Sasaran, A. (2011). Zoophilic behavior in a patient with posterior cerebral arterial aneurysm. Romanian Neurosurgery, 18, 349-355.

Hvozdık, A., Bugarsky, A., Kottferova, J., Vargova, M., Ondrasovicova, O., Ondrasovic, M., & Sasakova , N. (2006). Ethological, psychological and legal aspects of animal sexual abuse. The Veterinary Journal, 172, 374-376.

Jimenez-Jimenez F.J., Sayed Y., Garcia-Soldevilla M.A. & Barcenilla B. (2002). Possible zoophilia associated with dopaminergic therapy in Parkinson disease. Annals of Pharmacotherapy, 36, 1178-1179.

Kafka, M.P. (2010). The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified. Archives of Sexual Behavior, 39, 373-376.

Kinsey, A. C., Pomeroy, W. B., Martin, C.E., Gebhard, P.H. (1953). Sexual Behavior in the Human Female. Philadelphia, PA: W.B. Saunders Company.

Kinsey, A. C., Pomeroy, W. B., Martin, C.E., (1948). Sexual Behavior in the Human Male. Philadelphia, PA: W.B. Saunders Company.

Miletski, H. (2000). Bestiality and zoophilia: An exploratory study. Scandinavian Journal of Sexology, 3, 149–150.

Miletski, H. (2001). Zoophilia – implications for therapy. Journal of Sex Education and Therapy, 26, 85–89.

Miletski, H. (2002). Understanding bestiality and zoophilia. Germantown, MD: Ima Tek Inc.

Munro, H.M.C. (2006). Animal sexual abuse: A veterinary taboo? The Veterinary Journal, 172, 195-197.

Williams, C. J., & Weinberg, M. S. (2003). Zoophilia in men: A study of sexual interest in animals. Archives of Sexual Behavior, 32, 523–535.

Sexual perversions and paraphilias: Compulsion, obsession or addiction?

Back in 1986, during the second year of my undergraduate psychology degree, we had a psychiatrist called Dr Alex Oswald come in give a guest lecture on sexual paraphilias. It was the best (and most interesting) lecture I have ever seen. I had always taken an interest in human sexual behaviour but this was unlike any lecture I had ever had before. It was also the stimulus for my (now) lifelong academic interest in extreme sexual behaviours.

The German psychiatrist Richard Von Krafft-Ebing is usually credited with first identifying paraphilias in his 1886 book Psychopathia Sexualis (Sexual Psychopathy). Paraphilias (from the Greek “beyond usual or typical love”) are uncommon types of sexual expression and often more commonly described as sexual deviations, sexual perversions or disorders of sexual preference. To many people, the may appear bizarre and/or socially unacceptable, and represent the extreme end of the sexual continuum. They are typically accompanied by intense sexual arousal to unconventional and/or non-sexual stimuli. In some cases, the behaviour may only occur sporadically whereas for others it may be compulsive and/or addictive. Many sexologists (such as the late Professor John Money of the John Hopkins University) have described some paraphilic behaviours as “fixated” and for those affected the desire is insistent and demanding.

It is thought that paraphilias are rare and affect only a very small percentage of adults. It has been difficult for researchers in the field to estimate the proportion of the population that experience paraphilic behaviours because much of the scientific literature is based on case studies (which suffer from problems around reliability because of their self-report nature). As paraphilias typically offer pleasure, many individuals affected do not seek psychiatric treatment. Furthermore, reliable statistics are further compounded by the fact that many paraphilic acts are illegal. Because of the illegality, paraphiliacs often experience high levels of shame and guilt and (like those who experience pleasure from the behaviour) may not seek medical or psychiatric help. For those that do seek professional help the disorders are often difficult to treat. Therapeutic success is more likely to be related to curbing or suppressing the behaviour rather than eliminating it altogether.

Although the statistics are biased by differential reporting and prosecution, there is general agreement among the psychiatric community that all paraphilias are male dominated (with at 90% of all those affected being men and with some estimates suggesting the ratio is as high as 30 to 1). Research also indicates that some paraphilias appear to be more common than others. For instance, the most common paraphilias reported in the scientific literature appear to be masochism, sadism and fetishism. Within clinics that treat sex offenders, the most common paraphilias are (perhaps unsurprisingly) paedophilia, voyeurism and exhibitionism.

It is also known that atypical sexual behaviours often cluster and/or overlap (either simultaneously or sequentially). For instance, some research has reported that paraphiliacs commonly experience two to three concurrent paraphilas with around 5% experiencing up to 10 concurrently. The onset of paraphilic behaviour is typically initiated during early adolescence through a complex biopsychosocial network of causes. The behaviour usually reaches its full development by the age of 20 years. Some of the causes of paraphilic behaviour are known to include various genetic and hormonal abnormalities, pre-natal neuro-developmental factors, neuro-cognitive and brain dysfunctional, maladaptive learning, and dysfunctional family life during childhood.

Paraphilas are rarely described as addictions as most of the debate surrounds whether they are impulse control disorders or whether they fall within the spectrum of obsessive-compulsive disorders. Arguably, the best criteria for diagnosis of a paraphilia is found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). In the DSM-IV-TR, a paraphilic disorder has to meet two essential criteria. The first criterion is that the essential features of a paraphilia are recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving (i) non-human objects, (ii) the suffering or humiliation of oneself or one’s partner, or (iii) children or other non-consenting persons that occur over a period of at least six months. The second criterion is that a diagnosis is made if the behaviour, sexual urges, and/or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The element of coercion is another key distinguishing characteristic of paraphilias. Some paraphilias (e.g., sadism, masochism, fetishism, hypoxyphiilia, urophilia, coprophilia, klismaphilia) – which I will be discussing in future blogs – are engaged in alone, or include consensual adults who participate in, observe, or tolerate the particular paraphiliac behaviour. These atypical non-coercive behaviours are considered by many in the psychiatric community to be relatively benign or harmless because there is no violation of anyone’s rights. Atypical coercive paraphilic behaviours are considered much more serious and almost always require therapeutic intervention (e.g., exhibitionism, voyeurism, frotteurism, necrophilia, zoophilia).

Finally, it is also worth noting that some practitioners working in the field have made distinctions between what are referred to as optional, preferred and exclusive paraphilias. An optional paraphilia is a behaviour that provides an alternative route to becoming sexually aroused. For instance, a male with fairly normal sexual interests might occasionally enhance their sexual arousal by wearing women’s high-heeled shoes and fishnet stockings while having sex. In preferred paraphilias, a person prefers the paraphilia to conventional sexual activities, but is still able to engage in conventional sex. For instance, a male might prefer – whenever possible – to wear women’s high-heeled shoes and fishnet stockings during sex. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia. In this case, a male would be unlikely to get sexually aroused during sex unless he was wearing high-heeled shoes and fishnet stockings.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Abel, G. G., & Osborn, C. (1992). The paraphilias: The extent and nature of sexually deviant and criminal behavior. Psychiatric Clinics of North America, 15, 675–689.

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M., & Rouleau, J.-L. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153–168.

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revised). Washington, DC: Author.

Krueger, R. B., Kaplan, M. (2001). The paraphilic and hypersexual disorders: An overview. Journal of Psychiatric Practice, 7, 391-403.

Money, J. (1994). Principles of Developmental Sexology. New York: Continuum.

Raymond, N.C., & Grant, J.E. (2008). Sexual disorders: Dysfunction, gender identity, and paraphilias. The Medical Basis of Psychiatry, 1, 267-283.

Wiederman, M.W. (2003). Paraphilia and fetishism. The Family Journal: Counseling and Therapy for Couples and Families, 11, 315-321.