The salivation army: A brief look at spit fetishes

In previous blogs I have examined many different bodily substances that have formed the basis of paraphilic and/or fetishistic behaviour including urine (urophilia), faeces (coprophilia), blood (menophilia and clinical vampirism), and breast milk (lactophilia). One bodily fluid that has not really been the subject of scientific research is saliva in relation to saliva fetishes and spit fetishes. In fact, the only purely academic reference I could find was from sociologist Eviatar Zerubavel who suggested in a 1991 book that many Americans seem to find sex “morally repugnant” and that it is because of the bodily fluids associated with sex (i.e., saliva and semen) are sticky, a liminal category between solid and liquid.

From my reading on this topic, there appears to be a difference between saliva fetishes and spit fetishes (which I will explain below). In researching this blog I came across two cases of saliva fetishes (one from New Zealand and one from Japan) that were both very similar.

• Case 1: Back in 2007 in Christchurch (New Zealand), a 28-year old male vineyard worker – Jared Simmonds – was jailed for 32 months because of his “deviant sexual arousal” towards saliva from young girls. He was arrested following an indecent sexual attack on an 11-year old girl. Simmonds had been previously convicted in 2005 for obtaining saliva from four pre-pubescent girls that he would use as a lubricant for masturbatory purposes. He had also been trying to do the same thing with the 11-year old girl. The court was told that Simmonds was incapable of relating to women of his own age and therefore targeted young girls to help maintain his sexual saliva fetish. The court was also told that Simmonds’ behaviour was premeditated as he approached the girls with plastic cups and chewing gum, and pretending to the girls that he was conducting a scientific survey and that their saliva would be analysed at Christchurch Polytechnic. He would give the girls gum to chew to stimulate salivation, and then get the girls to spit into the cup. As soon as the spittle was collected, he would rush back to his house to masturbate using the girls’ saliva as a lubricant.

• Case 2: More recently, at the end of 2011, there was a news report of a 55-year old Japanese man with an alleged saliva fetish. The man in question – Toshiko Mizuno – was arrested after approaching young women, and asking them to spit into a jar. While they spat into the jars, Mizuno filmed them and then kept their saliva to drink at a later point. To get them to spit in the jar, Mizuno used a cover story that he was doing research on saliva. After searching Mizuno’s house, they found over 200 video taped recordings of women spitting into jars, and dozens of empty jars that had once had women’s saliva in them. The police also found other videos of Mizuno masturbating and using the female saliva as a masturbatory lubricant. The man was charged with indecency as he had not actually caused any knowing harm to the women he had approached.

The online Urantia Book claims that (historically) saliva was a potent fetish. Apparently, “devils could be driven out by spitting on a person” and “for an elder or superior to spit on one was the highest compliment”. Furthermore, it could perhaps be argued that saliva plays a (direct or indirect) role in a lot sexual behaviour that raises the question of how “deviant” saliva fetishes actually are. However, in the case of Simmonds, the use of saliva from prepubescent girls suggests that the behaviour was a paedophilic precursor. There are also cultural variations that need to be taken into account. Few Westerners would disagree that kissing can be erotic and enjoyable. However, other cultures view kissing as simply the human exchange of saliva. For instance, the Amazonian Mehinaku tribe view kissing as disgusting and a sexual abnormality.

The saliva fetishists above don’t really appear to share much in common with spit fetishes that appear to be more a part of sadomasochistic sexual activity. For instance, at the ‘All Experts’ website, one of the female “experts” (“Hollie”) wrote speculatively about spit fetishes in response to one man’s question about what spit fetishes actually involved. Her perspective was clearly from those with an interest in sexual sadism and sexual masochism. She wrote:

“A spit fetish could manifest itself in a number of ways…either partner could have a fetish to be spat on, usually this is always closely linked to that individual seeking domination from the spitter, making the person being spat on submissive. it may also be part of sexual humiliation and other aspects of BDSM [Bondage, Discipline, Submission, Masochism]. Or, an individual could have the need to spit on someone, that would probably make them dominant and to want to control and/or humiliate their partner sexually. Or…both people could either enjoy to be spat on or to be the spitter…this could work both ways and simultaneously”.

In fact much of the online literature on spitting fetishes (as opposed to saliva fetishes) appears to be rooted in BDSM and is usually referred to as ‘spitting domination’. The dominant partner may spit into their submissive partner’s face and/or mouth. The submissive partner may also be forced to swallow the liquid spit if their mouth is spat into. Many of the online articles about spitting fetishes see parallels between the act of spitting and the act of ejaculation – particularly in relation to ‘facials’ (i.e., the act of men ejaculating onto someone’s face) and the practice of bukkake (i.e., the act of many men simultaneously ejaculating onto someone’s face and/or body).

In an online article on “Spit feeding [and] eating”, the [anonymous] writer examines spit fetishes, and asks whether spitting is an aggressive act of degradation, and if being spat on is always humiliating. The response was:

“Like any sex act, it all depends upon the attitudes of those involved. A slap can be aggressive or playful, hurtful or stimulating. Likewise, a wad of spit can be contemptuous or loving, depending on the intention. There’s nothing inherently demeaning about wanting to devour your lover’s liquid essences”.

In researching this blog I came across various people’s experiences of spit fetishism. The following quote was typical:

“I actually was in a relationship with a individual who had a spit fetish.  He longed for me, while we were having intercourse, to spit on him, his face all over him, he didn’t mind where but he especially liked it if I was dominant with him in doing so, maybe called him names at the same time, played a Dom to him. His fetish for spit also extended into dribbling, where he liked for me to dribble on myself, preferably across my chest, and for him to rub his face in it, in the spit. He loved the moistness physically, but it was more mental for him, the control aspect, the humiliation of it all, the dominance”.

Compared to all other paraphilic and fetishistic behaviours concerning sexual arousal to human bodily fluids, there is significantly less written about saliva and spitting fetishes. Whether academic and/or clinical research is needed is – at present – debatable.

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

Further reading

All Experts (2004). Fetishism/Spit fetish. January 14. Located at: http://en.allexperts.com/q/Fetishism-2835/spit-fetish.htm

Backdrop.net (2007). Spitting fetishism. Located at: http://www.backdrop.net/sm-201/index.php?title=Spitting_fetishism

Dahmer, J. (2011). The Guy with the Creepiest Fetish Ever! WDRG, December 14. Located at: http://wgrd.com/the-guy-with-the-creepiest-fetish-ever-yuk-bar-stool/

New Zealand Herald (2007). ‘Deviant saliva fetish’ led to attack, court told. July 30. Located at: http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10454692

Pervscan (2007). Deviant saliva fetish led to attack. August 19. Located at: http://pervscan.com/2007/08/19/deviant-saliva-fetish-led-to-attack/

UB The News (undated). Fetishes, charms and magic. The Urantia Book (Paper 88). Located at: http://www.ubthenews.com/UrantiaBook/papers/p088.htm

World of Sexual Fetishes (2012). Swapping spit. March 5. Located at: http://worldofsexualfetishes.com/wordpress/?p=158

Zerubavel, E. (1991). The Fine Line: Making Distinctions in Everyday Life. Chicago, IL: University of Chicago Press.

Waste not, want not: A brief overview of coprophagia

One of the most stomach churning behaviours among humans is coprophagia (i.e., the eating of faeces), and has the capacity to generate intense emotional reactions among those witnessing such behaviour. I don’t know about you, but my first visual exposure to human copraphagia was in the 1972 John Waters film Pink Flamingos when the leading “actress” Divine (a transvestite male) ate the freshly produced (and real) excrement from a dog that had just defecated on the pavement. As the narrator states immediately this as happened, Divine is “not only the filthiest person in the world, but is also the world’s filthiest actress”. The arts world is littered with coprophagic references and acts ranging from the detailed descriptions in the Marquis de Sade’s infamous novel The 120 Days of Sodom through to recent films such as The Human Centipede.

Hundreds of years ago, medical doctors used to taste their patients’ faeces as a way to assess their patients health and condition. Such historical actions, while seemingly gross, at least had a functional goal. In contemporary society, coprophagia often occurs among individuals with severe developmental disabilities although for a very small minority, coprophagic acts may occur as part of the sexual paraphilia coprophilia (i.e., sexual arousal and pleasure from faeces).

Copraphagia is a complex behavioural disorder and is commonly regarded as a variant form of pica (i.e., the eating of non-nutritive items or substances), even though there are many health risks associated with it (e.g., intestinal parasites, diarrhea, blood-borne pathogens). Other problems include poor oral hygiene, chronic gingival infection, and salivary gland infections.

A number of medical disorders have been identified that are associated with coprophagia including seizure disorders, cerebral atrophy, and tumours. There are also many psychological and psychiatric disorders associated with coprophagia including mental retardation, alcoholism, severe depression, autism, obsessive-compulsive disorder, Klüver-Bucy syndrome, schizophrenia, fetishes, delirium, and dementia. The psychopathological roots and etiology of coprophagia still remain little known, and much of what has been published academically involves case studies. Furthermore, the prevalence of copraphagia is also unknown but thought to be very rare.

In a 1989 study of 14 elderly coprophagic patients (average age of 71 years) in psychiatric hospitals published in the British Journal of Psychiatry, Ghaziuddin and McDonald reported that nine had senile dementia, two were severely depressed, and one had cerebral atrophy. Three of the 14 were reported has having no cognitive deficits. Although comprising only 14 patients, this is actually one of the largest studies in the area as most published papers consist of case studies.

As mentioned above, copraphagia can on occasion be seen as part of a sexual fetish where the eating of faeces is associated with sexual arousal. In a 1995 issue of the Journal of Sex and Marital Therapy, Dr. T. Wise and Dr. R. Goldberg reported the case of a non-psychotic 47-year old man of normal intelligence who had a fetish for faecal smearing that escalated into coprophagia when combined with alcohol abuse and depression.

In researching this blog, I came across a form of culture bound syndrome called Arctic Hysteria (also known as Piblokto and Pibloktoq) where one of the common symptoms is coprophagia. Culture bound syndromes comprise a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies. Arctic Hysteria only manifests itself in winter among Inuhuit societies living (unsurprisingly) within the Arctic Circle. The condition is characterized by “an abrupt dissociative episode of intense hysteria, frequently followed by convulsive seizures and coma lasting up to 12 hours. Symptoms can include intense screaming, uncontrolled wild behaviour, depression, coprophagia, and insensitivity to extreme cold”. Some scholars have cast doubt on its existence as a bona fide medical entity, but the association with copraphagia occurs repeatedly.

There is a wide variety of treatments that have been used for coprophagia including behavioural therapy, dietary changes, pharmacotherapy (e.g., tricyclic antidepressants, haloperidol, perospirone), and electro-convulsive therapy. All of these have reported at least partial success.

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

Further reading

Beck D.A. & Frohberg, N.R. (2005). Coprophagia in an elderly man: a case report and review of the literature. International Journal of Psychiatry Medicine, 35, 417-427.

Donnellan, C.A. & Playfer, J.R. (1999). A case of coprophagia presenting with sialadenitis. Age and Ageing, 28, 233-234.

Foxx, R. M., & Martin, E. D. (1975). Treatment of scavenging behavior (coprophagy and pica) by overcorrection. Behavior Research and Therapy, 13, 153–162.

Friedin, B.D., & Johnson, H.K. (1979). Treatment of a retarded child’s feces smearing and coprophagic behavior. Journal of Mental Deficiency Research, 23, 55–61.

Ghaziuddin, N. & McDonald, C. (1989). A clinical study of adult coprophagics. British Journal of Psychiatry, 4, 53-54.

Harada, K.I., Yamamoto, K. & Saito, T. (2006). Effective treatment of coprophagia in a patient with schizophrenia with the novel atypical antipsychotic drug perospirone. Pharmacopsychiatry, 39, 113.

Ing, A.D., Roane, H.S. & Veenstra, R.A. (2011). Functional analysis and treatment of coprophagia. Journal of Applied Behavior Analysis. 44, 151–155

Pardini, M., Guida, S. & Gialloreti, L.E. (2010). Aripiprazole Treatment for Coprophagia in Autistic Disorder. Journal Neuropsychiatry and Clinical Neuroscience, 22(4), E33

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.

Messing around: A beginner’s guide to salirophilia and mysophilia

Salirophilia – sometimes called saliromania – is a paraphiic sexual fetish in which individuals experience sexual arousal from soiling or disheveling the object of their desire (typically an attractive person). Salirophilic behaviour may include a range of activities such as tearing or damaging the desired person’s clothing, covering them in mud or filth, or messing their hair or makeup. The fetish never involves harming or injuring the person in any way, only messing up how they look in some way, shape or form. The fetish was thought to be mainly heterosexual in origin although a 1982 book (Human Sexuality, by James McCary and Stephen McCary) said that it was known to occur within same sex relationships.

It is sometimes related to other fetishes and paraphilias including urophilia (deriving sexual pleasure from urine), coprophilia (deriving sexual pleasure faeces), mysophilia (deriving sexual pleasure from filth), sploshing (deriving sexual pleasure from wet substances – but not bodily fluids – being deliberately and generously applied to either naked or scantily clad individuals, and sometimes referred to as ‘wet and messy’ fetishism), bukkake (the act of many men ejaculating over a man or women simultaneously; there are also variations of this where men ejaculate over photographs and pictures and referred to as ‘face painting), and omorashi (deriving sexual pleasure from having a full bladder and/or feeling sexually attracted to someone else who has a full bladder). Salirophilia may also extends to other areas such a forcing a sexual partner to wear torn or poorly fitting clothing that make the person look more unattractive.

Other variations of the fetish may also include people become sexually aroused from acts of vandalism and defacement of statues, photos of attractive people (including celebrities). Videos of individuals ejaculating over celebrity photographs are known as “tributes” within the fetish community.

As far as I have been able to establish, there is not a single piece of empirical research directly on salirophilia. Not even a single case study. All the information, I have compiled in this blog comes from online sources and books on sexuality and sexual paraphilias (where salirophilia is only mentioned in passing, if mentioned at all). Dr. Ian Kerner, a New York City sex therapist, says that salirophilia often involves domination and submission fantasies. McCary and McCary noted that although salirophilia has been described as a category separate from sexual sadism, they claim that most cases of saliromania would meet the criteria for sexual sadism, as described in the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders. However, as Dr Joel Milner, Dr Cynthia Dopke, and Dr Julie Crouch note in a 2008 review of paraphilias not otherwise specified, it is unclear whether cases exist in which the salirophilic behavior (e.g., the act of damaging clothing) is distinct from a focus on the suffering and humiliation of the sexual partner. They also noted that the extent of overlap of salirophilia with fetishism, bukkake, mysophilia, urophilia, and coprophilia is unknown.

Like salirophilia, there is little empirical data on mysophilia. As mentioned above, mysiophiliacs derive sexual pleasure from filth and unclean items such as soiled knickers (but may also include related activities such as sexual arousal from seeing people wearing the same clothes for days or weeks on end). Magazines such as the Penthouse Forum: The International Journal of Human Relations has (for many years) contained classified advertisements for soiled women’s underwear for mysophiliacs to buy. According to Professor John Money, this focus may involve the “smelling, chewing or other-wise utilizing sweaty or soiled clothing or articles of menstrual hygiene”.  Back in the late 1940s, the American psychiatrist Dr. Benjamin Karpman put forward a number of psychodynamic speculations on the etiological factors associated with mysophilia in a couple of papers that focused on coprophilia. One of Karpman’s analytic interpretations concerning mysophilia was that it involves a symbolic association of sex with something that is dirty (i.e., bad). He said that the pairing of sex and filth was functional, because any guilt associated with sexual behavior could be washed away.

In a previous blog on fetishism, I wrote at length about a study led by Dr G. Scorolli (University of Bologna, Italy) on the relative prevalence of different fetishes using online fetish forum data. 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). 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. They also reported that some of the sites featured references to mysophiliacs but that this particular fetish accounted for less than 1% of all fetishes

As with salirophilia, case studies of mysophilia appear hard to come by. In a paper by Dr John White published in a 2007 in the Journal of Forensic Sciences, he examinedevidence of primary, secondary, and collateral paraphilias left at serial murder and sex offender crime scenes. Two of the cases he reported involved mysophilia. In the first case, the offender was engaged in multiple paraphilias including mysophilia, picquerism (stabbing or cutting victims of sexual attacks), and attempted paraphilic rape intended to degrade the victim. In the second case, the offender manifested an even wider range of paraphilias including mysophilia, pogophilia (fascination with women’s buttocks), paedophilia, masochism, and urophilia. In both of these cases, the mysophilic tendencies did not seem to be central to the crimes committed, and mysophilia was clearly part of a much wider range of paraphilic behaviour.

There are also first person accounts of salirophilia and/or mysophilia on the internet. I came across this account (which I have edited down from a much longer posting on a psychology bulleting board:

“First of, let me say I’m not a dangerous or mean person. I really almost never hurt other people, and I really don’t want to. I’ve never really told anyone about this. When I was younger, I don’t know how young exactly, I had kind of unusual sexual fantasies. I think I was 6/7/8/9 [years old]. I don’t really remember. I used to think about them while lying in bed before I was going to sleep. Things I fantasized about, and this is a really hard part to type out for me, is people wearing diapers, people wearing clothes in weird ways, and people that got messy. Please don’t think I’m a sick person or something. If I could change it, I would, although it didn’t really harm anyone. When I got a little older, I think I was 9 or 10, maybe 11, I searched on the internet for people that got messy. I don’t know if that was because of fetish, or just because of normal interest in that. [After that] I mostly watched videos of game shows in which people got messy. Sometimes they were my age, sometimes they were younger, sometimes they were older. Only recently I started to realize that the fantasies I had when I was younger weren’t normal, and that I could have had a fetish. It kind of shocked me. Sometimes, I dream about it. I start watching those videos again. In others, I get messy myself, and in those dreams, I get aroused by that. Did I do anything wrong? Do I need to get help? Am I a bad person? Will this affect the rest of my life badly? I don’t want to hurt anyone. I just really had to tell this somewhere on some moment”.

Treatment for salirophilia and mysophilia is rarely sought unless the condition becomes problematic for the individual in some way. Although the individual may feel compelled to engage in the paraphilic behaviour, anecdotal evidence suggests that the great majority manage to integrate their fetishistic behaviour within their day-to-day life without harm to anyone (including themselves).

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

Further reading

Butcher, Nancy (2003). The Strange Case of the Walking Corpse: A Chronicle of Medical Mysteries, Curious Remedies, and Bizarre but True Healing Folklore. New York: Avery.

Holmes, R. M. (2009). Sex Crimes: Patterns and Behavior. Thousand Oaks: Sage Publications.

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.

McCary, J.L. & McCary, S.P. (1982). McCary’s Human Sexuality (4th ed.). Belmont, CA: Wadsworth.

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. (1986). Lovemaps: Clinical concepts of sexual/erotic health and pathology, paraphilia, and gender transposition in childhood, adolescence, and maturity. New York: Irvington.

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.

White, J.H. (2007). Evidence of primary, secondary, and collateral paraphilias left at serial murder and sex offender crime scenes. Journal of Forensic Sciences, 52, 1194-1201.

Blood lust: A brief overview of menophilia

I apologise in advance if this is “too much information” but back in 1985, I had a brief relationship with a woman who had just come out of a long-term relationship with someone in the Hell’s Angels. One of the things she told me was that her ex-boyfriend had earned his ‘red wings’ many times and that he couldn’t wait each month for her to be on her period. For those who are wondering what the hell I am talking about, ‘red wings’ are earned by Hell’s Angel’s members when the perform oral sex on a women while she is menstruating. As I later found out, other groups of males who spend a lot of time together – such as those in the armed services – also engage in such practices to earn their ‘red wings’.

Many reading this might find my first paragraph of today’s blog utterly disgusting. For many, blood is associated with injury, trauma and/or violence. The fact that some may associate blood with sexual arousal sets the stage for an uncomfortable psychological and physical dichotomy.

It wasn’t until I came across a 1966 book by one of my favourite US writers – Hunter S. Thompson – that I first saw this practice written about in print. In the book Hells Angels, A Strange and Terrible Saga of the Outlaw Motorcycle Gangs, Thompson wrote that red wings meant that the “the wearer has committed cunnilingus on a menstruating woman.” There were also other types of ‘wings’ that Hell’s Angels could earn including ‘black wings’ (engaging in oral sex on a black woman) and ‘brown wings’ (for anal sex with a woman).

Such practices were virtually unknown by anyone outside of Hell’s Angels circles until journalists like Thompson started chronicling their activities and interviewing Angels’ members. Although many of the badges, patches and tattoos were worn with pride, they were often earned as part of male initiation rituals (the key components of which are typically pain, sacrifice, disgust and/or a sense of accomplishment). Clearly my own personal anecdote highlights that for a minority (at least), performing oral sex on menstruating women was something to be treasured, celebrated, and enjoyed sexually. What may have started as a ‘rites of passage’ became a regular and – well at least monthly – highly arousing occurrence. The fact that for many women their sexual drives often increase during menstruation may be another reason why some men find this so sexually arousing.

In trying to research this blog, I didn’t come across too much information. In Tantric sex, the practice is mentioned but not encouraged. However, in Karezza (a Westernized form of Tantra), it is viewed as an opportunity for increased intimacy between consenting sexual partners. In voodoo folklore, it is claimed by some that having oral sex with a woman during their period ties the man with that woman for life.

In previous blogs I have examined sexual paraphilias in relation to other activities that have involved blood including sexual vampirism and vorarephilia (i.e., being sexually aroused by the idea of being eaten, eating another person, or observing this process for sexual gratification). Another blood-related paraphilia of direct interest here is menophilia. Menophilia is a sexual paraphilia in which an individual (almost always male) derives sexual arousal from menstruating females. Such individuals (which may have included the ex-boyfriend of the women I mentioned at the start of this article) are also aroused by the smell, image, taste and/or feel of the blood expelled during menstruation. As one female menophile reported online:

“Blood to me is exciting. Thrilling. A visual delight. It has been that way since I was a young girl. Nose bleeds and the sight of blood was exciting to me. I would sit in the mirror and watch the red rivulets run down my face. I began to menstruate and after a period of self loathing and fear of my cycle”

It has also been claimed that some menophiles also enjoy licking used sanitary towels and/or sucking on used tampons. For these individuals, there are some clear overlaps between mysophilia (sexual pleasure from filth and unclean items such as soiled knickers) and sexual vampirism. There was also a case of a man who was both a menophile and a coprophile (i.e., sexually aroused by faeces). He was allegedly caught tampering with public toilets as a way of collecting excreted waste products from female users to fuel his sexual desires. Anecdotal evidence suggests that most menophiles are male, some lesbians are also claimed to enjoy such practices.

I have yet to come across any psychological theorizing about the roots and causes of menophilia in any academic paper or book. I did come across the following online speculation although there was seemingly no empirical evidence backing up such claims:

“Some theorize that men lust after menstruating women because they are envious of the woman’s body which is in constant preparation for fertilization.  Contrary to this however is the fact that it is almost impossible for a woman to become pregnant during her menstruation. Either way, a fascination of period blood is a fairly common fetish at [this website]. Luckily for menophiliacs, it is easy to find a female who is willing to have sex during menstruation.  Often, women are charmed by men who aren’t disgusted by what is a perfectly normal and healthy body process”

In a previous blog on fetishism, I wrote at length about a study led by Dr G. Scorolli (University of Bologna, Italy) on the relative prevalence of different fetishes using online fetish forum data. 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). They reported that some of the sites featured references to menophiles. However, this particular fetish was included in a ‘body fluids’ fetish category along with coprophilia, urophilia, lactophilia and mucophilia. Although this category made up a sizeable minority of all online fetishes (9%), it is unlikely that menophiles made up more than a handful of websites found compared to the fetishes of other bodily fluids.

As with many of the paraphilias I have examined in my blogs, there is almost a complete absence of any academic study on menophilia. Maybe this is one of those paraphilias that – amongst others – is seen as more trivial and/or devoid of academic merit.

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

Further reading

Flow Forum (A website about menstruation). Located at: http://www.dotcomjunkies.com/members/kayo/forum/

Red Wings (undated). The history and culture of red wings. Located at: http://www.red-wings.com/wings-culture.html

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.

Thompson, H.S. (1966). Hells Angels, A Strange and Terrible Saga of the Outlaw Motorcycle Gangs. London: Random House

Farting company: The strange world of eproctophilia

Olfactophilia (also known as osmolagnia, osphresiolagnia, and ozolagnia) is a paraphilia where an individual derives sexual pleasure from smells and odours. Given the large body of research on olfaction, it shouldn’t be surprising that in some cases there should be an association with sexual behaviour. The erotic focus is most likely to relate to body odours of a sexual partner, including genital odours.

One bizarre sub-type of olfactophilia is eproctophilia. This refers to a condition in which people are sexually attracted to flatulence. Therefore, eproctophiles are said to spend an abnormal amount of time thinking about flatulence, and have recurring intense sexual urges and fantasies involving flatulence. In trying to research this article, I did a complete literature search and couldn’t find a single academic or clinical paper that has ever been published on the topic – not even a case study. Therefore, all of the material here is based on non-academic sources. There are also examples of this practice on sites like YouTube where some people have uploaded their videos of farting on faces. Based on this anecdotal evidence, it would appear to be the domain of heterosexual men being farted upon by females.

Like most paraphilias, eproctophilia appears to be found mainly in men, although the anecdotal evidence suggests it is mainly found in heterosexual males particularly attracted to female flatulence. The accounts that I came across suggest that farts are typically targeted at the face, and sometimes more specifically at the mouth, the ear, or nose. Some claim it is a “softer form” of coprophilia (in which people are sexually aroused by faeces). Treatment for eproctophilia is generally not sought unless in some way it becomes problematic for the person. It appears that the majority of eproctophiles accept their fetish – particularly as there are no published treatment case studies in the sexology literature. However, it may be the case that people have this type of fetish but are simply unable to engage in it, even if they are in a stable relationship.

For instance, I came across was in the columns of Dan Savage who has a regular type of ‘agony aunt’ feature called “Savage Love” in ‘The Stranger’ newspaper based in Seattle (USA) but which focuses on more quirky and extreme aspects of human behaviour. This letter was sent into his column:

“My wife doesn’t understand or approve of my sexual needs. I would like her to pass gas in my face. It’s a common enough sexual interest that it has a name (eproctophilia). My wife does break wind from time to time, but she refuses to let me enjoy this natural functioning of her bowels no matter how often I discuss my needs with her”

The reply by Savage wasn’t very complimentary but the letter highlights the condition appears to exist. Another interesting snippet I found was this brief confession of someone asking for help on a fetish bulletin board:

“I’ve been a sufferer [of eproctophilia] for as long as I can remember. I can’t stop myself from getting turned on whenever someone leaves a long, loud fart in my presence. It’s starting to become a real problem for me as I am required to give a lot of enemas in my line of work, and as we all know, enemas provide gas before the ride”

One of the most detailed accounts of eproctophilia I came across was this online confession from an American eproctophile (most notable because Americans refer to flatulence as “gas”). The only demographic information given was that he was a male student at university, in his early twenties, and studying a biological subject:

“I first realised that I had eproctophilia when I was 15 years old. I was at my [female] friend’s house, to do a school project and she had terrible gas. We had known each other for about seven years so she felt more than comfortable to let her gas out in front of me. At that point I was really turned on by the fact that she was a hot girl farting around me but I didn’t know why. As we where sitting on her bedroom floor sticking pictures to a poster she got up and went to the other side of the room to get a piece of paper. When she came back she said ‘Hey John’, and forced my face onto her bum. She then sat on me and she let out a loud, warm, smelly fart on my face. Then she laughed and said ‘Doesn’t that smell delicious hehehehe!!’

I don’t know why but I found that very sexy. I was too embarrassed to tell her how I really felt about what she did, so I just pretended I found it disgusting and that I didn’t care. However, after a while I told her how much I loved when she did that to me and she found it hilarious and was totally OK with it. When we are alone, she always tells me when she is about to fart and if I want her to do it in my face again. I say ‘no’ because that would be too awkward, but I get closer and sniff them anyway. I feel really embarrassed that she knows how I felt about her farting and I feel like she thinks I am some kind of creepy fart freak. But she says its cute, and if she had a boyfriend who had this fetish she would find it fun farting on his face.

Out of all the girls I’ve dated in my whole life, I have never told any of them about this fetish, even when they felt comfortable farting around me. My [female] friend is probably the only hot girl in the world that would do that to their guy friend. I imagine it would be very hard to find a nice, and attractive, girlfriend I actually love that would be OK with my fart fetish. So tell me girls, what would you do if your boyfriend told you he found it hot when you fart? Would you break up with him? Let him smell your gas? Or break up with him and tell the whole world? I know this may be an odd subject but try to be open-minded. Some people might say I am sick and crazy but I’m a pretty normal person, I am mentally and physically fit, [and educated].

Why do I think I like this? I think I find this really sexy because girls don’t usually fart around guys and feel good about it, so when they do I feel like the girl is so comfortable around me that she would let out her nasty flatulence in my presence and not just in front of anyone, and that gets me really turned on. To me, this is the one of the sexiest things a woman can do. My perfect fantasy would probably be for my [female] friend and her other hot friend to be farting on my face in her room. You probably find this really disgusting but it’s not my fault. I have this fetish. I have heard about other fetishes I find to be even worse than mine, so I don’t feel so bad about it. Flatulence is made out of nitrogen, carbon dioxide, oxygen, methane, and hydrogen sulfide, which is completely harmless to the human body. So there is nothing dangerous about this fetish.”

This account seems to echo most of the scientific research on the development of fetishes and paraphilias that such behaviours originate from behavioural conditioning – in this case classical conditioning where being sexually aroused by an attractive women is paired with something that is not inherently sexual (in this case, flatulence) and then starts to become an erotic focus in and of itself. As this male eproctophile notes himself, there is nothing ‘dangerous’ about his activity and it certainly appears to be less stomach churning than compared to paraphilias that appear to be similar (such as copraphilia).

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

Further reading

Gilbert, Avery N. (2008). What the Nose Knows: The Science of Scent in Everyday Life. Crown.

Love, B. (1992). Encyclopedia of Unusual Sex Practices. Fort Lee, NJ: Barricade Books

Money, J. (1986). Lovemaps: Clinical concepts of sexual/erotic health and pathology, paraphilia, and gender transposition in childhood, adolescence, and maturity. New York: Irvington.

Van Toller, S. & Dodd, G.H. (1992). Fragrance: The Psychology and Biology of Perfume. London: Elesevier.

Waste not, want not: A brief overview of coprophagia

One of the most stomach churning behaviours among humans is coprophagia (i.e., the eating of faeces), and has the capacity to generate intense emotional reactions among those witnessing such behaviour. I don’t know about you, but my first visual exposure to human copraphagia was in the 1972 John Waters film Pink Flamingos when the leading “actress” Divine (a transvestite male) ate the freshly produced (and real) excrement from a dog that had just defecated on the pavement. As the narrator states immediately this as happened, Divine is “not only the filthiest person in the world, but is also the world’s filthiest actress”. The arts world is littered with coprophagic references and acts ranging from the detailed descriptions in the Marquis de Sade’s infamous novel The 120 Days of Sodom through to recent films such as The Human Centipede.

Hundreds of years ago, medical doctors used to taste their patients’ faeces as a way to assess their patients health and condition. Such historical actions, while seemingly gross, at least had a functional goal. In contemporary society, coprophagia often occurs among individuals with severe developmental disabilities although for a very small minority, coprophagic acts may occur as part of the sexual paraphilia coprophilia (i.e., sexual arousal and pleasure from faeces).

Copraphagia is a complex behavioural disorder and is commonly regarded as a variant form of pica (i.e., the eating of non-nutritive items or substances), even though there are many health risks associated with it (e.g., intestinal parasites, diarrhea, blood-borne pathogens). Other problems include poor oral hygiene, chronic gingival infection, and salivary gland infections.

A number of medical disorders have been identified that are associated with coprophagia including seizure disorders, cerebral atrophy, and tumours. There are also many psychological and psychiatric disorders associated with coprophagia including mental retardation, alcoholism, severe depression, autism, obsessive-compulsive disorder, Klüver-Bucy syndrome, schizophrenia, fetishes, delirium, and dementia. The psychopathological roots and etiology of coprophagia still remain little known, and much of what has been published academically involves case studies. Furthermore, the prevalence of copraphagia is also unknown but thought to be very rare.

In a 1989 study of 14 elderly coprophagic patients (average age of 71 years) in psychiatric hospitals published in the British Journal of Psychiatry, Ghaziuddin and McDonald reported that nine had senile dementia, two were severely depressed, and one had cerebral atrophy. Three of the 14 were reported has having no cognitive deficits. Although comprising only 14 patients, this is actually one of the largest studies in the area as most published papers consist of case studies.

As mentioned above, copraphagia can on occasion be seen as part of a sexual fetish where the eating of faeces is associated with sexual arousal. In a 1995 issue of the Journal of Sex and Marital Therapy, Dr. T. Wise and Dr. R. Goldberg reported the case of a non-psychotic 47-year old man of normal intelligence who had a fetish for faecal smearing that escalated into coprophagia when combined with alcohol abuse and depression.

In researching this blog, I came across a form of culture bound syndrome called Arctic Hysteria (also known as Piblokto and Pibloktoq) where one of the common symptoms is coprophagia. Culture bound syndromes comprise a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies. Arctic Hysteria only manifests itself in winter among Inuhuit societies living (unsurprisingly) within the Arctic Circle. The condition is characterized by “an abrupt dissociative episode of intense hysteria, frequently followed by convulsive seizures and coma lasting up to 12 hours”. Symptoms can include intense screaming, uncontrolled wild behaviour, depression, coprophagia, and insensitivity to extreme cold”. Some scholars have cast doubt on its existence as a bona fide medical entity, but the association with copraphagia occurs repeatedly.

There is a wide variety of treatments that have been used for coprophagia including behavioural therapy, dietary changes, pharmacotherapy (e.g., tricyclic antidepressants, haloperidol, perospirone), and electro-convulsive therapy. All of these have reported at least partial success but as with research on coprophagia more generally, most treatment papers are based on case studies.

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

Further reading

Beck D.A. & Frohberg, N.R. (2005). Coprophagia in an elderly man: a case report and review of the literature. International Journal of Psychiatry Medicine, 35, 417-427.

Donnellan, C.A. & Playfer, J.R. (1999). A case of coprophagia presenting with sialadenitis. Age and Ageing, 28, 233-234.

Foxx, R. M., & Martin, E. D. (1975). Treatment of scavenging behavior (coprophagy and pica) by overcorrection. Behavior Research and Therapy, 13, 153–162.

Friedin, B.D., & Johnson, H.K. (1979). Treatment of a retarded child’s feces smearing and coprophagic behavior. Journal of Mental Deficiency Research, 23, 55–61.

Ghaziuddin, N. & McDonald, C. (1989). A clinical study of adult coprophagics. British Journal of Psychiatry, 4, 53-54.

Harada, K.I., Yamamoto, K. & Saito, T. (2006). Effective treatment of coprophagia in a patient with schizophrenia with the novel atypical antipsychotic drug perospirone. Pharmacopsychiatry, 39, 113.

Ing, A.D., Roane, H.S. & Veenstra, R.A. (2011). Functional analysis and treatment of coprophagia. Journal of Applied Behavior Analysis. 44, 151–155

Pardini, M., Guida, S. & Gialloreti, L.E. (2010). Aripiprazole Treatment for Coprophagia in Autistic Disorder. Journal Neuropsychiatry and Clinical Neuroscience, 22(4), E33

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.

Milking the situation: A beginner’s guide to lactophila

Lactophilia (i.e., breast milk fetishism) is a sexual paraphilia where individuals (typically male) derive sexual pleasure from watching women lactate, sucking on women’s milk-filled breasts and/or having sex with lactating women. Sometimes, the sexual arousal is enhanced by the woman also being pregnant, although many men prefer lactating women post-pregnancy. The paraphilic aspect may also be part of other sexual paraphilias such as infantilism (where sexual arousal is derived from being an adult baby). For many infantilists, the practice is often referred to as adult adult nursing, suckling, and adult breastfeeding. In fact, some lactophiles describe themselves as being in an adult nursing relationship. Those who suckle and are suckled within the confines of a monogamous sexual relationship are often referred to as a “nursing couple”.

There are a number of different methods by which erotic lactation can take place. “Lactation games” typically refers to any kind of sexual activity that includes female breast milk. The activity is thought to be widespread but can be unintentional post-pregnancy as many women who have just had babies release milk as a reflex action when sexually aroused.

Over the last decade there appears to have been an increased demand for lactation pornography with magazines such as ‘Pregnant Pink and Milking’. It is evidently a specialty market although the internet has increased the opportunity to see such pornography – even if the person is not a lactophile. Such niche pornography may also be considered taboo – even by those who have no objections to pornography – particularly because of its association with children and incest.

Adult nursing relationships involve a person (typically male) breastfeeding from a woman’s lactating breast. It is only considered to be an ANR when the practice is regular rather than a one-off or happens almost accidentally during post-pregnancy sex. Anecdotal evidence suggests that successful ANRs are reliant on trusting and stable long-term relationships. If the practice is not regular, the women’s milk production ceases. It is thought that in some cases, the suckling can be a replacement for sex and that the mutual and intimate tenderness involved between consenting couples has a stabilizing influence on such relationships. It has also been noted that some women are capable of achieving orgasm during the suckling process. There may also be a number of inherently non-sexual reasons as to why such behaviour is found within loving couples. For instance, couples who may want to adopt a child may use the context of an ANR to stimulate the production of breast milk pre-adoption.

It has also been notes that an apparently small minority of womenexperience sensual and/or sexual pleasure from pumping breast milk (either manually or from a breast pump. The feelings produced may depend on the context (for instance, some women may only get sexual pleasure if their partner is present during the pumping process. Dr. Fiona Giles (of the University of Sydney, Australia) in her 2003 book ‘Fresh Milk – The Secret Life of Breasts’noted that some women feel more “feminine” when breast feeding, and may therefore may want to continue with lactation, even after their child have been weaned for emotional and/or sensual motivations.

In a previous blog on fetishism, I wrote at length about a study led by Dr G. Scorolli (University of Bologna, Italy) on the relative prevalence of different fetishes using online fetish forum data. 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). They reported that some of the sites featured references to lactophiles. However, this particular fetish was included in a ‘body fluids’ fetish category along with coprophilia, urophilia, menophilia and mucophilia. Although this category made up a sizeable minority of all online fetishes (9%), it is unknown what proportion of these online fetish sites were lactophilic in comparison to the fetishes of other bodily fluids.

The rise in interest surrounding lactophilic activity has led to lactation prostitution where grown adults – including women – pay for the opportunity to be breastfed. This can either be part of other activities such as infantilism (where other activities such as having a diaper [i.e., nappy] changed may play a more primary role) or may be an activity done is isolation to any other service or activity. A 2004 paper in the journal Australian Feminist Studies (again) by Dr. Fiona Giles made reference to a New Zealand brothel that offered lactation services to its clients. In a paper in Women’s Studies the following year, Giles also wrote that:

“Induced lactation allows for a splitting away of breastfeeding from maternity, opening up possibilities for elaborating on the cultural meanings and uses of breastmilk as a substance, breastfeeding as a practice, and lactation as a process. Finally, by introducing lactation into sexual play, it offers the opportunity for a mutual confluence of bodily flows which may help to disassemble the binaries of sexual difference”.

Breastfeeding can also feature in other types of sexual activity such as sadism and masochism (as part of wider set of dominance and submission sexual practices). For instance, submissive women may be commanded by their (male or female) dominant partner to be milked or to produce milk. Alternatively, breastfeeding can be used as a surrogate pleasure reward (or surrogate pleasure) for (male or female) submissive partners who have done exactly as they have been told by the dominant partner.

Lactophilia may also be associated with other specialist types of paraphilia. One such sexual fetish is Maieusiophilia (i.e., pregnancy fetishism). This is where individuals (typically male, but some bisexual or lesbian females also) derive attraction and/or sexual gratification from someone being (or appearing pregnant). There is also a very small minority of people who develop a sexual fascination with the idea of themselves being pregnant (i.e., gravidophilia). This would appear to be psychologically similar to those people who get sexually excited by the thought of being an amputee (i.e., apotemnophilia).

There has been very little empirical research on lactophilia (or associated behaviours). A recent 2011 study was published in the Journal of Sexual Medicine led by Dr. Magnus Enquist (Stockholm University, 2011). They reported the results of a questionnaire study designed to investigate whether two specific sexual preferences (for pregnant women and for lactating women) were associated with exposure to pregnant or lactating women early in an individual’s life. Their data were collected via an online questionnaire advertised in newsgroups (e.g., alt.sex.fetish and alt.sex.fetish.breastmilk) and Yahoo! discussion groups (e.g., Lactaters and Pregnant Ladies). Individuals in these online communities typically describe themselves as fetishists for pregnant and/or lactating women. The research team collected usable data from 2,082 participants. Some of the main findings were that:

• Average age of the respondents was 37 years
• Average age at which respondents became aware of their preference for pregnant and/or lactating women was 19 years
• Most respondents reported both a pregnancy and a lactation preference (71%; 1,474 people);
• A small minority of the respondents reported having a preference for pregnancy fetish only (14%; 296 people)
• An even smaller minority of the respondents reported having a preference for lactation fetish only (11%; 224 people)
• A total 4% (87 people) had neither preference and were excluded from further analysis
• A great majority of the sample had younger brothers or sisters suggesting that they were exposed to pregnant women and/or experienced seeing their siblings being breastfed when in childhood.

Because of this final finding, the authors suggested their results were consistent with the hypothesis that specific sexual preferences may be acquired through exposure to particular stimuli during a specific period early in life (similar to “sexual imprinting” in birds and mammals). In fact, there have been a number of studies offering empirical support for the idea that human partner choice is (at least in part) determined by parental characteristics. The authors concluded that their study offered new insights to growing issue of the correlation between pregnancy, lactation, and sexuality.

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

Further reading (Lactophilia)

Enquist, M., Aronsson, H., Ghirlanda, S., Jansson, L. & Jannini, E.A. (2011). Exposure to mother’s pregnancy and lactation in infancy is associated with sexual attraction to pregnancy and lactation in adulthood. Journal of Sexual Medicine, 8, 140–147.

Giles, F. (2003). Fresh Milk – The Secret Life of Breasts. New York: Simon and Schuster.

Giles, F. (2004). Relational, and strange: A preliminary foray into a project to queer breastfeeding. Australian Feminist Studies. 19, 301-314.

Giles, F. (2005). The well-tempered breast: Fostering fluidity in breastly meaning and function. Women’s Studies: An inter-disciplinary journal. 34, 301-326.

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.

Further reading (Sexual imprinting)

Bereczkei, T., Gyuris, P. & Weisfeld, G.E. (2004). Sexual imprinting in human mate choice. Proceedings of Biological Science, 271, 1129-1134.

Perrett, D.I., Penton-Voak, I.S., Little, A.C., Tiddeman, B.P., Burt, D.M., Schmidt, N., Oxley, R., Kinloch, N., & Barrett, L. (2002). Facial attractiveness judgements reflect learning of parental age characteristics. Proceedings of Biological Science, 269, 873–80.

Jedlicka, D. (1980). A test of psychoanalytic theory of mate selection. Journal of Social Psychology, 112, 295-299.

Wilson, G.D. & Barrett, P.T. (1987). Parental characteristics and partner choice: Some evidence for oedipal imprinting. Journal of Biosocial Science, 19, 157-161.

Zei, G., Bereczkei, T., Gyuris, P., Koves, P., Bernath, L. (2002). Homogamy, genetic similarity, and imprinting: Parental influence on mate choice preferences. Personality and Individual Differences, 33, 677-90.

Urine demand: A beginner’s guide to urophilia

In an earlier blog, I examined coprophilia (i.e., a paraphilia in which people are sexually aroused by faeces). Another related paraphilia is urophilia in which people are sexually aroused by urine (i.e., the sight or thought of either the act of urination or the urine itself). The condition is known by many different names. In scientific circles it can also be called urophagia, urolagnia, renifleurism, undinism, and ondinisme. In non-scientific circles it is more popularly called ‘water sports’, ‘golden showers’ and (most crudely) ‘piss play’. This has also led to dedicated websites where ‘pee lovers’ can meet up.

Press reports have reported a few celebrities engaging in the activity. For instance, in an interview with the music magazine Blender, the Puerto Rican popstar Ricky Martin stated that he enjoyed ‘golden showers’. The actor Andy Milonakis and host of MTV’s ‘The Andy Milonakis Show’ said in an interview with People Magazine that liked the feeling of “warm urine” on his chest during sexual intercourse. Interestingly, it was recently discovered that Havelock Ellis – one the ‘founding fathers’ of sexology – was aroused by the sight of a woman urinating.

“In childhood, as his autobiography reveals, Ellis had exclusive attention from his mother during long absences of his sea captain father. Ellis was the eldest child and only son, whose intimacy with his mother included sponging her back and being present when he was twelve and older as she urinated. (His sister, when she heard of one incident, thought that their mother was being flirtatious, since normally she was rather a reserved person.) The consequences of this malimprinting Ellis dignified with the term urolagnia, which he denied had become a real perversion or a dominant interest in his sexual life. His candour had limits, and the evidence is otherwise… In Ellis’s instance the trauma of witnessing his mother urinate was converted into the hostile pleasure of humiliating other women, women in no way connected with his mother, by persuading them to do something for reasons mainly unintelligible to them. When he had the gratification of inducing Franroise [his partner] to urinate in crowded Oxford Circus, she may not have felt especially humiliated. With such an initiate his satisfaction was mainly symbolic…The perversion was enough on his mind for him to write it into his seventh volume of Studies in the Psychology of Sex. There he dignifies the pathological sounding “urolagnia” with the new and enticing term “undinism”. Grosskurth thinks that this volume came into existence principally to defend the perversion which is not discussed elsewhere” (Andrew Brink’s book review of Phyllis Grosskurth’s biography of Havelock Ellis, 1980).

In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (and like coprophilia), urophilia is listed as a ‘paraphilia not otherwise specified’ (PNOS). 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)”.

Urophiliacs typically derive sexual pleasure from urinating on (and/or being urinated upon by) another person. Some urophiliacs may also bathe in urine, enjoy smelling people in urine-soaked clothes, and/or engage in urophagia (i.e., drinking the urine). For urophiliacs, the drinking of the urine typically takes place while someone else urinates directly into their mouth. Urophagia (in and of itself) is not necessarily a sexually arousing activity as there are many urine drinkers who don’t do it for sexual pleasure but for other reasons (e.g., ritualistic and ceremonial purposes or they think there are health or cosmetic benefits as witnessed by those who engage in ‘urine therapy’).

However, for urophiliacs, the act of urophagia may be sexually stimulating for them. They may also engage in the activity as part of other paraphilic activity such as sadism, masochism, voyeurism, and infantalism (i.e., being sexually excited from dressing as an adult baby). Some urophiliacs may also experience sexual arousal from having a full bladder and/or feel sexually attracted to someone else who has a full bladder (‘bladder desperation’) or wets themselves (i.e. ‘panty wetting’ or wetting the bed). In Japan, this latter parahilic behaviour occurs as part of a fetish subculture known as ‘omorashi’ and is seen as different from urophilia.

In 2009, Dr Garth Mundiger-Klow (Beverly Hills Institute of Sexual Health Research, USA) published a whole book comprising 15 urophiliac case studies (The Golden Fetish) but despite the academic credentials of the author, and the lengthy accounts, the book was little more than a collection of erotic stories based around urophiliacs with little analysis provided by the author.

To date, there has been very little scientific research and almost all of what is known is based on either case studies or as a co-occurring behaviour with other paraphilias. For instance, in a survey of 561 non-incarcerated individuals seeking treatment for paraphilias, Dr Gene Abel, and colleagues found that many paraphiliacs engaged in more than one paraphilic behaviour. For instance, all the zoophiles in the sample reported more than one paraphilia and for a small number this included urophilia. However, it appears that urophilia is mostly likely associated with sadomasocism. For instance, in a study of 245 male sadomasochists, Dr Andreas Spengler (University of Hamburg, Germany) reported that 10% of those surveyed had an interest in urophilia. This finding is similar to that of Dr Neil Buhrich (St. Vincent’s Hospital, New South Wales, Australia) who found that 8% of his sample of sadomasichists reported an interest in urophilia.

A paper in a 1982 edition of the Canadian Journal of Psychiatry by Dr R. Denson found that the urine fulfilled many different functions for urophiles. The functions of urine included it (i) serving as a fetishistic object, (ii) being used to humiliate or be humiliated (i.e., through urinating on another person or being urinated upon), and/or (iii) capturing the spirit of a sexual partner. Based on the case studies examined, Dr Denson also argued that urination may serve masochistic and/or sadistic purposes and that therefore it should be labeled ‘uromasochism’ or ‘urosadism’.

While most explanations for paraphilic urophilia focus on early behavioural conditioning in childhood and adolescence, I also came across an interesting snippet in Professor John Money’s 1980 book Love and Love Sickness: The Science of Sex, Gender Difference and Pair-bonding:

“Some years ago, when I visited the Yerkes primate laboratory in Atlanta…How, I asked, did a wild chimpanzee mother keep its baby clean from soiling? The answer was that, as in many other species, she licks it clean…Among the people of Bali, in Indonesia, small dogs lick the babies clean…The dog’s assigned duty is to provide diaper service by licking clean the baby, and the mother, whenever the baby soils. Subsequently I have learned that Eskimo mothers once had a custom of licking their babies clean. Even though human primates have graduated from using the mother’s snout end to keep the baby’s tail end clean, it is safe to assume that, as a species, we still possess in the brain the same phyletic circuitry for infant hygiene as do the subhuman primates. Just as males and females have nipples, so also do both sexes have these brain pathways that relate to drinking urine and eating feces. These are the pathways that, when they become associated with neighboring erotic/sexual pathways, produce urophilia and coprophilia as paraphilias”.

Additionally, an internet essay examining ‘forced retention of bodily waste’ among children, Laurie Couture makes the following observations in relation to the origin of urine-related paraphilias:

“Some sufferers of forced waste retention develop sexual fetishes involving waste and waste retention…adult respondents reported using masturbation as a way to dissociate from the pain of a full bladder. Websites that cater to the sadomasochistic desires of urolagnia (“water sports”) enthusiasts are prevalent on the Internet…Adults who engage in urolagnia are often reenacting scenes from childhood, some of which involved denial of toilet use by school teachers or caretakers for purposes of punishment or containment…Due to the close proximity of the urethra and bladder to the sex organs, some adults who chronically suffered this form of bodily control as children developed a conditioned response in which wetting themselves or bladder tension was association with sexual arousal”

Clearly, there is still much to learn in this area but there are certainly some interesting speculations as to the origins and initiation of urophilic behaviour.

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., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153-168.

Buhrich, N. (1983). The association of erotic piercing with homosexuality, sadomasochism, bondage, fetishism, and tattoos. Archives of Sexual Behavior, 12, 167-171.

Collacott, R.A. & Cooper, S.A. (1995). Urine fetish in a man with learning disabilities. Journal of Intellectual Disability Research, 39, 145-147.

Couture, L.A. (2000). Forced retention of bodily waste: The most overlooked form of child maltreatment. Located at: http://www.nospank.net/couture2.htm

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

Grosskurth, P. (1980). Havelock Ellis: A Biography. Toronto: McClelland and Stewart.

Massion-verniory, L. & Dumont, E. (1958). Four cases of undinism. Acta Neurol Psychiatr Belg. 58, 446-59.

Money, J. (1980). Love and Love Sickness: The Science of Sex, Gender Difference and Pair-bonding, John Hopkins University Press.

Mundinger-Klow, G. (2009). The Golden Fetish: Case Histories in the Wild World of Watersports. Paris: Olympia Press.

Skinner, L. J., & Becker, J. V. (1985). Sexual dysfunctions and deviations. In M. Hersen & S. M. Turner (Eds.), Diagnostic interviewing (pp. 211–239). New York: Plenum Press.

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456.

Hit me baby, one more time: A brief overview of sexual masochism

In a previous blog, I briefly examined the psychological literature on sexual sadism. Today’s blog looks at its counterpart – sexual masochism – often viewed as two sides of the same coin. Sexual masochists comprise those individuals who derive sexual gratification from receiving physical and/or psychological pain. The sexologist Richard von Krafft-Ebing coined the term ‘masochism’ in his 1886 sexology book Psychopathia Sexualis deriving the name from the 19th-century novelist Leopold von Sacher-Masoch, whose book Venus in Furs (well known to us that are big Velvet Underground fans) depicts a man’s humiliation and suffering by a female dominatrix. There are other names for the same phenomenon – such as ‘algolagnia’ – that refer to those people who have a craving for pain. Algolagnia was coined by the German physician in the late 1880s but never caught on in the same way as the term ‘masochism’.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) acknowledges the overlap between masochism and sadism but they are classed as two distinct entities. The DSM-IV defines masochism as when the individual experiences “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer” over a six-month period. To distinguish it as a disorder rather than a non-problematic sexual preference, the masochistic sexual urges, fantasies and/or behaviours have to cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning”. Interestingly, other paraphilic behaviours such as hypoxyphilia (examined in a previous blog) come under the rubric of sexual masochism.

Early empirical studies such as those published in the Kinsey Reports in the late 1940s and early 1950s reported that a quarter of both males and females had experienced sexual arousal from being bitten by their partner during sex although later studies have reported much lower figures of around 3% to 5%. In a late 1980s, a study published in the Journal of Sex and Marital Therapy, by Dr Ethel Person (Columbia University, New York, USA) and colleagues surveyed college students about their sexual behaviours and fantasies. Results showed that around 4% had been tied up or sexually degraded during sex, and that 1% had spanked, whipped, or hit a consenting partner during sex (although ‘consenting partner’ does not necessarily mean they enjoyed being smacked, whipped or beaten). Dr Charles Moser (Institute for Advanced Study of Human Sexuality, California, USA) claims about 10% of the adult population engages in sadomasochistic activity.

Masochistic fantasies are not uncommon. For instance, in a 1980s study published in the Archives of Sexual Behavior, Dr Claude Crépault and Marcel Couture (University of Quebec, Canada) reported that 46% of men had sexual fantasies of being kidnapped and raped by a woman, 12% had fantasies relating to being humiliated, and 36% fantasized about being bound and sexually stimulated by a woman.

Although there is a lot of evidence showing that sexually masochistic desires, fantasies and behaviours are relatively common among men, there has been some dispute about women’s interest in sexual masochism. Research certainly indicates that consensual sexually masochistic behaviour by females can occur and some authors argue that there is a biologically based tendency towards submissiveness in females. However, some claim that it is very rare in women. Back in 1977, Dr Andreas Spengler (University of Hamburg, Germany) has claimed that almost all women who participate in sadomasochist activities are prostitutes that have no personal preference for such activity. However, a number of more recent studies among sadomasochists (1985-2002) have all indicated that a small but significant minority of women engage in both sexually masochistic and sadistic activities (13% to 30%) – very few of which were prostitutes. However, when compared to male sadomasochists, female counterparts were less likely to need sadomasochist activity to fulfil their sexual satisfaction.

Research has also indicated that men are more likely than women to experience masochistic desires during adolescence although a significant minority of male masochists do not express an interest in such behaviour until they have reached adulthood. Studies of sadomasochists show little difference in sexual orientation. For instance, Spengler’s study of 245 male sadomasochists reported that 30% were heterosexual, 31% were bisexual and 38% homosexual. Other studies have found much higher levels of heterosexuality although amongst female sadomasochists there tends to be higher levels of bisexuality than in the study by Spengler.

In a 1985 study carried out by academics at California State University and led by Dr Norman Breslow, 182 sadomasochists (of which 52 were women) were surveyed. One-third of the men (33%) were dominant, 41% were submissive, and 26% were both. Similar results were found among the females. Spanking and ‘master-slave relationships’ were the most preferred sexual activities for both male and female sadomasochists although there were some minor differences. More females preferred bondage and restraint whereas more men preferred pain and whipping. Klismaphilia may also have been a co-morbid paraphilia as 33% men and 22% of females made sexual use of enemas.

A more recent Finnish study led by Dr Laurence Alison reported in the Archives of Sexual Behavior reported that flagellation and bondage were among the most popular activities among sadomasochists. However, there was a wide range of lesser activities that carried greater risk of physical harm including piercings, hypoxyphilia, fisting, knifeplay, and electric shocks. There were also major differences depending upon sexual orientation (for instance, gay men were more likely to engage in activities such as “cock binding”). Most interestingly, the research team identified four sadomasochistic sub-groups based on the type of pain given and received. These were:

• Typical pain administration: This involved practices such as spanking, caning, whipping, skin branding, electric shocks, etc.
• Humiliation: This involved verbal humiliation, gagging, face slapping, flagellation, etc. Heterosexuals were more likely than gay men to engage in these types of activity.
• Physical restriction: This included bondage, use of handcuffs, use of chains, wrestling, use of ice, wearing straight jackets, hypoxyphilia, and mummifying.
• Hyper-masculine pain administration: This involved rimming, dildo use, cock binding, being urinated upon, being given an enema, fisting, being defecated upon, and catheter insertion. Gay men were more likely than heterosexuals to engage in these types of activity.

There are many theories on why people engage in such behaviours from traditional learning theories (based on both operant and classical conditioning) through to psychoanalytic interpretations. Most of these theories place the origins of the behaviour within a developmental framework and argue that the root of the paraphilic behaviour begins in childhood. Somewhere in childhood and adolescence, the individual starts to associate pleasure with pain, and then become sexualized in adulthood.

In a 1995 paper published by the sexologist Kurt Freund and colleagues, they noted there was a distinct difference between commonplace consensual and play-oriented sadomasochistic activities and more dangerous and potentially fatal practices of a small minority of hardcore sadomasochists. As with many paraphilias, sexual masochism would only classified as a mental disorder if it causes significant psychological and physical impairment (that in very extreme circumstances may be life threatening). This has been echoed by Dr Richard Krueger (New York State Psychiatric Clinic, USA) who noted in a 2010 review on the diagnostic criteria for sexual masochism that the main criticisms and concerns surrounding this behaviour (and paraphilias more generally) is that they “should not be included in the DSM because they are not mental disorders, they are unscientific, they are unnecessary, and to do so pathologizes groups who engage in alternative sexual practices” (p.348).

However, in 2006, Dr Charles Moser and Peggy Kleinplatz (Carleton University, Canada) argued in the Journal of Psychology and Human Sexuality that there is no evidence that sadomasochists more often need emergency services “than practitioners of other sexual behaviours” (p. 106), although this has been disputed by others in the field. The review by Dr Krueger concludes that:

“While masochistic and/or sadomasochistic behavior occur with some frequency in the population and is associated with generally good psychological or social functioning, there are a very small number of cases where masochistic fantasy and behavior result in severe harm or even death. These cases clearly indicate a sexual interest pattern that has become pathological. Since so little is know about this behavior, further research is indicated, and inclusion in the DSM would facilitate this” (p.353).

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

Further reading

Alison, L., Santtila, P., Sandnabba, N. K., & Nordling, N. (2001). Sadomasochistically oriented behavior: Diversity in practice and meaning. Archives of Sexual Behavior, 30, 1–12.

Baumeister, R. F. (1988). Masochism as escape from self. Journal of Sex Research, 25, 28–59.

Breslow, N., Evans, L., & Langley, J. (1985). On the prevalence of roles of females in the sadomasochistic subculture: Report of an empirical study. Archives of Sexual Behavior, 14, 303–317.

Crépault, C., & Couture, M. (1980). Men’s erotic fantasies. Archives of Sexual Behavior, 9, 565–576.

Donnelly, D., & Fraser, J. (1998). Gender differences in sado-masochistic arousal among college students. Sex Roles, 39, 391-407.

Freund, K., Seto, M. C., & Kuban, M. (1995). Masochism: A multiple case study. Sexuologie, 4, 313-324.

Hucker, S. J. (2008). Sexual masochism: Psychopathology and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 250-263). New York: Guildford Press.

Kinsey, A. C., Pomeroy, W. B., Martin, C. E., & Gebhard, P. H. (1953). Sexual behavior in the human female. Philadelphia: Saunders.

Krueger, R.B. (2010). The DSM diagnostic criteria for sexual masochism. Archives of Sexual Behavior, 39, 346–356.

Moser, C., & Kleinplatz, P. J. (2006). DSM-IV-TR and the paraphilias: An argument for removal. Journal of Psychology and Human Sexuality, 17, 91-109.

Ormerod, D. (1994). Sado-masochism. Journal of Forensic Psychiatry, 5, 123–136.

Paclebar, A. M., Furtado, C., & McDonald-Witt, M. (2006). Sadomasochism: Practices, behaviors, and culture in American society. In E. W. Hickey (Ed.), Sex crimes and paraphilia (pp. 215–227). Upper Saddle River, NJ: Pearson Education.

Person, E.S., Terestman, N., Myers, Goldberg, E.L. & Salvadori,  C. (1989). Gender differences in sexual behaviors and fantasies in a college population. Journal of Sex and Marital Therapy, 15, 187-198.

Sandnabba, N. K., Santtila, P., Alison, L., & Nordling, N. (2002). Demographics, sexual behaviour, family background and abuse experiences of practitioners of sadomasochistic sex: A review of recent research. Sexual and Relationship Therapy, 17, 39–55.

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

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456.

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.