No fuss over pus? A bizarre case of oral partialism

According to Dr. Martin Kafka in a 2010 issue of the Archives of Sexual Behavior, partialism refers to “a sexual interest with an exclusive focus of a specific part of the body” and occurs in both heterosexual and homosexual individuals. Dr. Kafka also noted in the same paper that partialism is categorized as a sexual paraphilia ‘not otherwise specified’ in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, and then goes on to say that “individuals with partialism sometimes describe the anatomy of interest to them as having equal or greater erotic attraction for them as do the genitals”. Scientific research indicates that the most prevalent from of partialism is podophilia (i.e., sexual arousal from feet). Historically, partialism was viewed as synonymous with sexual fetishism. However, Dr. Kafka noted that there is a “diagnostic separation of partialism (intense, persistent, and ‘exclusive’ sexual arousal to a non-genital body part) from fetishism (intense and persistent sexual arousal to non-living objects, including some body products)”. Although I accept this very subtle difference, I essentially view partialism and fetishism as one and the same. In the 2008 book Sexual Deviance: Theory, Assessment and Treatment, Dr Judith Milner and colleagues noted that:

“In ‘partialism’, the paraphilic focus is on some part of the partner’s body, such as the hands, legs, feet, breasts, buttocks, or hair. Partialism appears to overlap with morphophilia, which is defined as a focus on one or more body characteristics of one’s sexual partner…it is unclear whether these two categories are unique paraphilias or different names for the same paraphilia. Historically, some authors (e.g., Berest, 1971; Wise, 1985) have included partialism as part of the general definition of fetishism, which once included both parts of bodies and nonliving objects (e.g., shoes, underwear, skirts, gloves). Again, however, the [DSM] criteria for fetishism indicate that the focus must involve the ‘use of nonliving objects’, which eliminates body parts from meeting this criterion”.

One of the most bizarre cases of partialism in the academic literature is a case study (of ‘oral partialism’) by Dr. Brian McGuire and colleagues published in a 1998 issue of the Journal of Sex and Marital Therapy. As far as I can see, the case has only been cited three times in the academic literature. One of these sources was Dr. Raj Persaud’s 2003 book From The Edge Of The Couch (and it is from this book that I have taken the case from).

The case in question involved a single and severely obese man in his late teens that lived at home with his father and sister (his parents had separated some years before), and of borderline intellectual disability. The father described his son as a recluse that spent the majority of the day alone in his room with little or no social interaction with anyone except his family (and even then the social interactions were minimal). The man had very poor personal hygiene (described as typically wearing torn and dirty clothes), rarely washed or bathed, and his weight was estimated at around 300 pounds. As a consequence of his very poor hygiene, the teenager “developed ulcerated sores under his arms, above the pubis, and in the groin area” (that he had for most of the teenage years). To treat the sores and skin ulcers he was prescribed a course of antibiotics. However, overall compliance by the man was low (taking just over half of the tablets initially prescribed) – even though he was extensively monitored by the medical staff taking care of him. The man then claimed that he had lost his antibiotics at home. It was then that the medics discovered what was really going on and why he didn’t want to take his medication. The unhealed sores and ulcers had taken on sexual significance for the man. As Dr. Persaud summarized:

“Upon questioning, the patient reported that he was easily sexually aroused and habitually masturbated at least twice a day, and more often four or five times a day. Ejaculation would always occur. He reported interest in the opposite sex and said that he often fantasized. However, the fantasy content and its accompanying behavior never involved sexual intercourse, nor indeed any conventional sexual act. The patient’s primary sexual fantasy stimulus was that of a women’s mouth, although the fantasy never involved kissing or oral stimulation…Rather, he imagined the woman licking her fingers or gently biting her own lips. Simultaneously, the patient would put his own fingers into the ulcers/sores in his groin and/or under his arms and then lick the pus from his fingers. It appears that he ingested the pus and found both the smell and taste exciting, although he was unable to pinpoint exactly the sexually stimulating aspect of this act. He reported that it was the mere sight of a women with her fingers to her mouth or lips was adequately arousing to initiate masturbation with the accompanying fantasy image and oral behaviour”.

As I’ve noted in many of my previous blogs, almost every (seemingly non-sexual) fluid that can come from a human body has a corresponding sexual paraphilia and/or fetish. This includes urine (urophilia), faeces (coprophilia), vomit (emetophilia), blood (menophilia, clinical vampirism, vorarephilia), saliva (spit fetish), breast milk (lactophilia), and pus (acnephilia). Obviously this bizarre case arguable shares some similarities with acnephilia (as both involve sexual arousal to pus) but they are different in terms of its sexualization.

At the outset, the man was given some psycheducation about the unhygienic nature of the sexual behaviour that initially resulted in a behavioural decrease of his strange sexual behavior – although the oral sexual fantasies still persisted. (Such psychoeducation has also been successfully used in the treatment of other sexual paraphilias. For instance, a case reported by Dr. R. Denson in a 1985 issue of the Canadian Journal of Psychiatry used psychoeducation as part of his treatment of a urophile). In his commentary on the case, Dr. Persaud said that it was open to debate as to whether the behaviour should be treated as problematic and/or psychopathological as (despite the arguably unsavoury nature) it had little impact on other people and wasn’t seen by the individual in question as problematic.

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

Further reading

Berest, J. J. (1971). Fetishism: Three case histories. Journal of Sex Research, 7, 237–239.

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

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

Kafka, M. P. (2010). The DSM diagnostic criteria for paraphilia not otherwise specified. Archives of Sexual Behavior, 39(2), 373-376.

McGuire, B.E., Choon, G.L., Nayer, P., & Sanders, J. (1998). An unusual paraphilia: Case report of oral partialism. Sexual and Marital Therapy, 13, 207-210.

Milner, J.S., & Dopke, C.A., & Crouch, J.L. (2008). Paraphilia not otherwise specified: Psychopathology and theory. In D. R. Laws & W. O’Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment (2nd ed., pp. 384-428). New York: Guilford.

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.

Persaud. R. (2003). From The Edge Of The Couch. London: Bantam Press.

Wise, T.N. (1985). Fetishism – etiology and treatment: A review from multiple perspectives. Comprehensive Psychiatry, 26, 249–257.

Shape and sighs: A beginner’s guide to morphophilia

Are you the type of person who finds people who are very physically different from you physically and sexually attractive? If you do, you may have be engaged in a sexually paraphilic behaviour known as morphophilia. According to a very simple definition provide by Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, morphophilia refers to the gaining of sexual pleasure and “arousal from a person with a different physique” whereas a definition provided by the less academic Quipper website says it is simply the “love of odd body shapes”.  Dr. Raymond Corsini in his Dictionary of Psychology says that morphophiles are attracted to a partner with bodily characteristics that are different and/or prominent from one’s own.

This therefore suggests that there are various sub-types of morphophilia as it is the marked discrepancy that is the sexually arousing focus. For instance, anasteemaphilia refers to individuals that derive sexual arousal from individuals who are much taller or shorter than themselves (i.e., it is the large difference in height that is the primary source of sexual arousal). I would also argue that sthenolagnia (in which individuals are sexually aroused by very muscular people) may also be a sub-type of morphophilia). This is lightly expanded upon in the online encyclopedia Encyclo that states:

“[Morphophilia]…in psychiatry, a type of sexual perversion in which sexual arousal and orgasm depend upon some discrepancy between the partner’s bodily characteristics and the subject’s; that is, the partner must be markedly thinner or taller than the subject”

The online Gay Slang Dictionary is a little more blunt and describes the condition as a fetish in which the source of sexual arousal is “peculiar body shapes and sizes, such as obese persons, short persons, dwarfism, etc.” As Dr Joel Milner, Dr Cynthia Dopke, and Dr Julie Crouch note in a 2008 review of paraphilias not otherwise specified noted in the 2008 book Sexual Deviance: Theory, Assessment and Treatment:

“Morphophilia” (from the Greek, morphe, “form”; philia, “love” –Money, 1986) involves an erotic focus on one or more of the body characteristics of one’s sexual partner. Morphophilia appears to include partialism, which is defined as a focus on a single body part…It is unclear from the literature whether these two categories are unique paraphilias or different names for the same paraphilia. Both morphophilia and partialism are differentiated from fetishism, which involves a focus on ‘the use of nonliving objects’ (American Psychiatric Association, 2000).”

Finally, Dr. George Pranzarone’s Dictionary of Sexology has an arguably  more scientific definition and also takes the line that morphophilia is an umbrella term in that it is:

“One of a group of paraphilias of the stigmatic/eligibilic type in which sexuoerotic arousal and facilitation or attainment of orgasm are responsive to and contingent on a partner whose body characteristics are selectively particularized, prominent, or different from one’s own. [Alternative: the bodily characteristics of the partner are selectively particularized, prominent, or essential as a prerequisite to sexuoerotic arousal and the facilitation or attainment of orgasm]”.

As far as I am aware, the only time that morphophilia has been mentioned in the academic literature (outside of general definition) is in relation to feederism where individuals gain sexual arousal, gratification and stimulation through a person’s sexual partner being over-fed  (and which I covered in a previous blog). In my previous blog I mentioned a paper by Dr Lesley Terry and Dr Paul Vasey (both at the University of Lethbridge, Canada) who published an interesting case study of feederism in the Archives of Sexual Behavior. The paper claimed that feeders and feedees are individuals who become sexually aroused by eating, being fed, and the by the idea or act of gaining weight. Terry and Vasey noted in their case study of ‘Lisa’ that:

“Like many paraphilic sexual activities, Lisa’s pattern of sexual arousal was characterized by recurrent and intense sexual urges, fantasies, and behaviors that involved unusual activities. Given that much of Lisa‘s sexuality was focused on eroticizing body fat, the question arose as to whether it represented a form of morphophilia…Morphophilia is the peak erotic focus on a particular body characteristic. As such, it is similar to, but distinct from, partialism, which is the peak erotic focus on a particular body part(s) (i.e., legs, feet, breast or buttocks). Morphophilia is an appropriate descriptor of Feederism given that Feederism focuses on the physical characteristic of fat, which does not necessarily have to be associated with a particular body part. This is clearly demonstrated by Lisa’s description of her life-long sexual arousal to fat bodies, in general, as opposed to fat body parts. At the same time, however, Feederism appears to involve the integration of an erotic focus on usual activities (i.e., eating and/or being fed and/or gaining weight), in addition to, an erotic focus on particular body characteristics (i.e., fat). This raises the possibility that it might be a paraphilic form of sexuality that is taxonomically distinct from morphophilia…More research could also be done to ascertain if, and how, Feederism is taxonomically distinct from various forms of morphophilia”.

Personally, (and this is based on my watching of various television documentaries on fat fetishes and feederism), I have observed that most (male) feeders are substantially thinner than (female) feedees, and on this basis it could be argued that the males may also be morphophiles as they appear to be sexually attracted as much to the fat as they are to the feeding. Obviously research is needed to support such claims, as my own views are speculative to say the least.

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

Further reading

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

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

Corsini, R.J. (1999). The Dictionary of Psychology. London: Psychology Press.

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.), (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.

Pranzarone, G.F. (2000). The Dictionary of Sexology. Located at: http://ebookee.org/Dictionary-of-Sexology-EN_997360.html

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