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.

Blog-nitive psychology: 500 articles and counting

It’s hard for me to believe that this is the 500th article that I have published on my personal blog. It’s also the shortest. I apologise that it is not about any particular topic but a brief look back at what my readers access when they come across my site. (Regular readers might recall I did the same thing back in October 2012 in an article I wrote called ‘Google surf: What does the search for sex online say about someone?’). As of August 26 (2014), my blog had 1,788,932 visitors and is something I am very proud of (as I am now averaging around 3,500 visitors a day). As I write this blog, my most looked at page is my blog’s home page (256,262 visitors) but as that changes every few days this doesn’t really tell me anything about people like to access on my site.

Below is a list of all the blogs that I have written that have had over 10,000 visitors (and just happens to be 25 articles exactly).

• Coprophilia (40,001)
• Urophilia (38,933)
• Somnophilia (22,291)
• Trampling fetishes (20,651)
• Urethral manipulation (20,234)
• Scrotal infusion (20,041)
• Genital bisection (18,715)
• Felching (18,193)
• Vorarephilia (16,566)
• Insect sting fetishes (16,236)
• Transformation fetishes (15,731)
• Amputee fetishes (15,467)
• Macrophilia (15,322)
• Sexual masochism (13,937)
• Formicophilia (13,655)
• Eproctophilia (13,295)
• Lactophilia (12,656)
• Equinophilia (12,434)
• Spit fetishes (12,259)
• Menophilia (11,855)
• Paraphilic infantilism (11,590)
• Zoophilia (11,235)
• Transvestic fetishism (10,661)
• Forniphilia (10,046)
• Necrophilia (10,020)

The first thing that struck me about my most read about articles is that they all concern sexual fetishes and paraphilias (in fact the top 30 all concern sexual fetishes and paraphilias – the 31st most read article is one on coprophagia [7,250 views] with my article on excessive nose picking being the 33rd most read [6,745 views]). This obviously reflects either (a) what people want to read about, and/or (b) reflect issues that people have in their own lives.

I’ve had at least five emails from readers who have written me saying (words to the effect of) “Why can’t you write what you are supposed to write about (i.e., gambling)?” to which I reply that although I am a Professor of Gambling Studies, I widely research in other areas of addictive behaviour. I simply write about the extremes of human behaviour and things that I find of interest. (In fact, only one article on gambling that I have written is in the top 100 most read articles and that was on gambling personality [3,050 views]). If other people find them of interest, that’s even better. However, I am sometimes guided by my readers, and a small but significant minority of the blogs I have written have actually been suggested by emails I have received (my blogs on extreme couponing, IVF addiction, loom bands, ornithophilia, condom snorting, and haircut fetishes come to mind).

Given this is my 500th article in my personal blog, it won’t come as any surprise to know that I take my blogging seriously (in fact I have written academic articles on the benefits of blogging and using blogs to collect research data [see ‘Further reading’ below] and also written an article on ‘addictive blogging’!). Additionally (if you didn’t already know), I also have a regular blog column on the Psychology Today website (‘In Excess’), as well as regular blogging for The Independent newspaper, The Conversation, GamaSutra, and Rehabs.com. If there was a 12-step ‘Blogaholics Anonymous’ I might even be the first member.

“My name is Mark and I am a compulsive blogger”

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

Further reading

Griffiths, M.D. (2012). Blog eat blog: Can blogging be addictive? April 23. Located at: https://drmarkgriffiths.wordpress.com/2012/04/20/blog-eat-blog-can-blogging-be-addictive/

Griffiths, M.D. (2012). Stats entertainment: A review of my 2012 blogs. December 31. Located at: https://drmarkgriffiths.wordpress.com/2012/12/31/stats-entertainment-a-review-of-my-2012-blogs/

Griffiths, M.D. (2013). How writing blogs can help your academic career. Psy-PAG Quarterly, 87, 39-40.

Griffiths, M.D. (2013). Stats entertainment (Part 2): A 2013 review of my personal blog. December 31. Located at: https://drmarkgriffiths.wordpress.com/2013/12/31/stats-entertainment-part-2-a-2013-review-of-my-personal-blog/

Griffiths, M.D. (2014). Top tips on…Writing blogs. Psy-PAG Quarterly, 90, 13-14.

Griffiths, M.D. (2014). Blogging the limelight: A personal account of the benefit of excessive blogging. May 8. Located at: https://drmarkgriffiths.wordpress.com/2014/05/08/blogging-the-limelight-a-personal-account-of-the-benefits-of-excessive-blogging/

Griffiths, M.D., Lewis, A., Ortiz de Gortari, A.B. & Kuss, D.J. (2014). Online forums and blogs: A new and innovative methodology for data collection. Studia Psychologica, in press.