Hot flat mate: The unusual case of co-existent pyrophilia and crush fetishism
Over the Christmas period, I was at a family wedding in the Cotswolds when by chance I came across Dr. Raj Persaud’s 2003 book From The Edge of the Couch (subtitled ‘Bizarre psychiatric cases and what they teach us about ourselves’) for sale in a charity shop in nearby Moreton-in-Marsh. As it was selling really cheaply I decided to buy it (even though this was the book where a number of the cases Dr. Persaud recounted were plagiarized from other people’s work).
One of the more interesting case studies in the book concerned a 1998 case study published by Dr. R.S. Shiwach and Dr. J. Prosser in the Journal of Sex and Marital Therapy. The paper concerned the treatment of an “unusual case of masochism” (where the individual gained sexual arousal and pleasure from being burnt (i.e., pyrophilia) and crushed (i.e., ‘crush fetishism’) that often meant he was in dangerous and potentially life threatening situations. As the authors summarized:
“Masochistic sexual activity is potentially dangerous, rarely reported voluntarily, and hard to treat. [Our paper] describes a masochist patient who received sexual gratification from being burnt or crushed. Anti-androgen medication [leuprolide acetate], serotonin uptake inhibitor [fluoxetine], and psychodynamic psychotherapy along with sexual education and social-skills training and aversive behavior therapy [covert sensitization and olfactory aversion] were all tried over a period of 9 months. The response was measured by effects of treatments on the frequency of erotic fantasies and masturbation”.
The male masochist was a single 38-year-old man that turned up at a hospital burns unit for treatment to extensive burns on his lower body (around 20% of his total body area) before being referred to the psychiatric unit. His pyrophilic urges and interest in being crushed were long-standing and dated back to mid-adolescence. The incident that led to the hospital admission had involved one of the man’s regular ways of gaining sexual arousal which was to set fire to refuse collecting trucks (i.e., ‘dumpsters’) while he was inside of them and simultaneously masturbating. Dr. Persaud’s reported that:
‘[The man] would then masturbate before getting out [of the dumpster]. His burns had occurred when a plastic dumpster melted and turned over. His first sexual experience at age 15 [years] had occurred when he curled himself up in an oven and ejaculated – an adventure that had been prompted by having been threatened as a child with being roasted ‘like a pig’ as a punishment. A social isolate, he enjoyed watching videos and reading about people being burned at the stake or crushed. He had also attempted autoerotic asphyxia, but relinquished this as ‘too dangerous’”.
The recollection of ejaculating while inside an oven appears to be a critical event in the acquisition and development of the man’s unusual sexual preferences. As Dr. Persaud noted:
“[The man remembered] entering a big unlit oven out of curiosity and liking the warmth and sense of suffocation but did not realize he had ejaculated until the third such instance. He remained a socially isolated virgin and gave a history of sexual disinterest in males or females and of ignorance of sexuality in general…Twice he came close to self-immolation after pouring gasoline on himself…he denied getting any pleasure out of seeing other people suffer…he worked in places where he could have easy access to large waste disposers, ovens, and box compactors”.
Consequently, Dr. Persaud thought (as I do) that learning theory best explained this man’s etiology and that psychoanalytic factors like guilt and punishment may have also been important. This particular case was also reported in a 2006 paper by Dr. D.J. Williams (i.e., ‘Different [painful) strokes for different folks) in the journal Sexual Addiction and Compulsivity. Williams noted that the man had been arrested on a number of different occasions for climbing into refuse collecting dumpsters and had also broken his pelvis as a consequence of being crushed by a box compactor. Williams noted that: “clearly, most experts would agree that acting out fantasies in these dangerous situations posed a significant risk of severe physical harm and death, not to mention being illegal”. Dr. Persaud’s account also more specifically reported that:
‘[The man] would climb into refuse collecting trucks and ejaculate at the sensation of being crushed, only escaping at the last possible minute. He admitted masturbating almost daily to deviant sexual fantasies or to pictures of fire, people being burned or crushed, and even just the sight of chimneys. Recently he had been climbing into a large dumpster, pouring alcohol on the refuse and setting it on fire. He managed to masturbate and get out of the refuse bin with minor burns twice, but the plastic dumpster eventually melted and overturned, causing the injuries he now had”.
Despite the many different pharmacological and psychological interventions, none appeared to have any long-lasting effect. The first intervention was pharmacological and involved being injected weekly with an anti-androgen. This treatment resulted in a decrease of his fetishistic sexual fantasies and an overall decrease in his sex drive. However, the man didn’t like the fact that his sex drive has been significantly inhibited and asked to be taken off the medication. He also took anti-depressants over an 18-week period and then had aversive behaviour therapy (olfaction aversion) and psychodynamic therapy, social skills training, and sexual education. He was discharged after 34 weeks of treatment but on follow-up had resumed his fetishistic behaviour. Drs. Shewach and Prosser concluded that: “Anti-androgens and aversive behavior therapies may be the most effective treatments for such cases, at least in the short-term, although the underlying social deficits and the need to reshape the sexual behavior ought to be addressed in the long-term”.
One of the observations that Dr. Persaud made about this case was that the masochism in this case did not involve psychological humiliation or any interaction with other people in the man’s life. I would also add that most of the focus and commentary in this particular case has been on the pyrophilic aspects rather than the crush fetishism aspects. This may be because there has been far less in the medical and clinical literature on crush fetishism than pyrophilia. However, this is not the only case where crush fetishism has been associated with another sexual paraphilia. At the end of last year, my case study of eproctophilia (i.e., sexual arousal from flatulence) in the Archives of Sexual Behavior involved an eproctophile that was also a crush fetishist.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Balachandra, K. & Swaminath, S. (2002). Fire fetishism in a female Aasonist? Canadian Journal of Psychiatry, 47, 487-488.
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.
Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.
Litman, L.C. (1999). A case of pyrophilia. Canadian Psychological Association Bulletin, February, 18-20.
Persaud. R. (2003). From The Edge Of The Couch. London: Bantam Press.
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.
Shiwach, R. S., & Prosser, J. (1998). Treatment of an unusual case of masochism. Journal of Sex and Marital Therapy, 24, 303-307.
Williams, D. J. (2006). Different (painful) strokes for different folks: A general overview of sexual sadomasochism (SM) and its diversity. Sexual Addiction and Compulsivity, 13, 333-346.
Posted on March 4, 2014, in Case Studies, Compulsion, Mania, Obsession, Paraphilia, Psychiatry, Psychology, Sex, Sex addiction and tagged Autoerotic asphyxiation, Crush fetishism, Eproctophilia, Hypoxyphilia, Pyrophilia, Sexual fetishism, Sexual masochism, Sexual paraphilia. Bookmark the permalink. Leave a comment.