Paraphilias and Sex Addiction

In many cases, individuals with a sex addiction satisfy their cravings in what most people would consider “normal” sex, such as sexual intercourse or oral sex with a consenting partner. However, there are a significant number of sex addicts who are able to become sexually aroused and gratified only by engaging in behavior that is generally considered unusual (at best), distasteful, or perverted. These behaviors are clinically referred to as “paraphilias”.

According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), paraphilias are “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one’s partner, or 3) children or other nonconsenting persons that occur over a period of at least six months.” The preoccupation is often so intense that the person is unable to experience any sexual arousal or satisfaction without the object or activity.

Paraphilias, by their very nature, are devoid of genuine intimacy or mature love. Granted, some would argue this issue – usually those engaging in the behavior. For example, pedophiles often argue that they genuinely love their victims and that their sexual interaction with children is a way of expressing that love. There are many couples in which one or both partners has a fetish, which is incorporated into their sexual activity. Sexual partners who enjoy a sadomasochistic relationship may also argue that it is based in love. But when the underlying issues are considered, the problem with their arguments usually becomes quite evident.

For reasons yet to be determined, paraphilias are significantly more common in men than women. Some data suggests this ratio is approximately 20 to 1. It should be noted that while it’s not unusual for sex addiction to involve a specific paraphilia, not everyone who indulges in a particular paraphilia is a sex addict.

Following are several common types of paraphilias. All of them are listed in the DSM except necrophilia, which would be classified as a “paraphilia not otherwise specified”.


Pedophilia is one of the most common types of sex addiction. It involves sexual activity with children (of any age, prior to starting puberty). Sometimes the sexual preference is for a specific age range (e.g. 8 to 10 years of age), or for one gender only. Some pedophiles will victimize any available children, while others limit their activity to their own children, their stepchildren, or other children related to them (e.g. grandchildren or nieces and nephews).

Pedophiles can be very clever. Over time they develop various methods and strategies for getting children to trust them. It is very common for pedophiles to “groom” their victims. They may do this by playing with them, giving them gifts, and / or being there for the child when he or she is upset, sad, or needs someone to listen. They also often groom the families of the child by being the helpful new neighbor or befriending the parents. By doing so, they garner the trust of the unsuspecting parents and gain access to the child.


Individuals who have a fetish require a specific object for their arousal and sexual satisfaction. Common fetishes include shoes and underwear. Although the DSM-IV limits the criteria to nonliving objects, others often include body parts (e.g. feet are a very common fetish) and certain mediums (e.g. leather). Unlike other types of sex addiction, a fetish addiction doesn’t require any human interaction (unless the fetish involves a body part). Sadly, however, this type of sex addiction often creates significant problems in relationships.


This is one of the less common types of sex addiction, but it does occur. Frotteurism involves rubbing up against, touching, or fondling someone without his or her consent. Often, this activity takes place in a crowded venue (e.g. a crowded bus or a busy sidewalk), which makes it easier for the perpetrator to avoid getting caught.

Typically, frotteurs (as they are called) either fondle their victim’s breasts or genitals with their hands, or rub their genitals against the person’s buttocks or thighs. They usually try to make it look as if it happened by accident. During the actual physical act, the majority of frotteurs imagine that they’re in a caring, exclusive relationship with the other person.

~Sexual Sadism

Sexual sadists are sexually aroused by causing pain or humiliation to another person. Usually this starts as a pleasurable fantasy which eventually progresses to actually acting those fantasies out with another person. The other person may or may not be a consenting participant. The sadistic behavior often includes burning, cutting or scratching, whipping, choking, or biting.

When this is a sex addiction, sadists need to increase the amount of pain they cause in order to feel sexually satisfied. This may lead to violent acts including torture, rape, and murder. The victims may be adults, as well as children, adolescents, and even animals.

~Sexual Masochism

Sexual masochists are essentially the opposite of sexual sadists. In fact, they often partner up with sexual sadists. They are sexually aroused and obtain gratification from being humiliated or feeling physical pain. This is why they often pair up with a sexual sadist (referred to as sadomasochism). Sometimes the pain is self-inflicted. Being dominated by the other person is also part of the sexual excitement for a masochist.

The activity may be something that doesn’t result in injury, such as being restrained, shocked, whipped or spanked. Acts of humiliation may include having their partner urinate or defecate on them. However, the activity may also involve cutting, biting, burning, beating, and even choking to the point of passing out. Hypoxophilia, which means near-asphyxiation, involves using a noose or other means to decrease the oxygen supply to the brain. It is very dangerous and has resulted in millions of accidental deaths.


Individuals who engage in voyeuristic sex obtain sexual excitement by spying on unsuspecting individuals rather than actually having sexual contact with them. Their victims are typically engaged in a private or intimate act such as bathing, undressing themselves, or some type of sexual activity. Voyeurs are often referred to as “peeping Toms”.

Voyeurism can take various forms. These include watching the person from a distance, for example with binoculars, a telescope, a hidden video camera, or a small hole in the wall. Voyeurism may also include the use of pornographic material online, in books or magazines, in videos, or at peep shows.

Many voyeurs watch the same person over and over. They often masturbate excessively as they watch. They rarely make contact with their victims although they may fantasize about having sex with them.


Exhibitionism is a form of sex addiction that often lands the perpetrator in jail. Sex addicts who engage in this type of deviant behavior gain sexual gratification by exposing or “flashing” their genitals to strangers – usually in a public place. They are aroused and excited both by the attention and the startled response of their unwitting victims. In some cases, the exhibitionist not only exposes himself; he also masturbates in front of the observer.

Some exhibitionists find more “legitimate” ways to stimulate themselves and gratify their sexual cravings. Rather than shocking strangers in public venues, they may act in pornographic movies, expose themselves via adult webcam sites, or pose for pornographic photographs. They may also perform at strip clubs or in peep shows, obtaining gratification from knowing they are being observed.


One of the rarer types of sex addiction, necrophilia involves obtaining sexual gratification from dead bodies. As with many other paraphilias, the arousal may come from fantasies alone or from sexual contact with the corpse. Some necrophiliacs have sexual intercourse with the body. Necrophiliacs may gain access to corpses by digging up fresh graves, working in morgues or funeral homes, or, in the most severe cases, commit murder.

Necrophiliacs are often isolated individuals with low self-esteem. While some necrophiliacs are sexually attracted to dead bodies, their morbid behavior may also be motivated by other things. These include the desire to have a sexual partner who can’t resist or reject them, to reunite with a deceased lover, to boost their self-esteem by exerting power over a murder victim, or to soothe their painful sense of isolation.

Consequences of Paraphilias

Whether part of a sex addiction or not, most paraphilias can lead to serious consequences for the individuals who have them. Consequences may include damage to interpersonal relationships, legal consequences including incarceration and / or loss of child custody and visitation rights, or serious injury or health issues (e.g. contracting HIV or other STDs). This is one of the reasons why paraphilias are often associated with a sex addiction, since a key aspect of addictive behavior is continually engaging in it despite the consequences to oneself or others.


As with all addictions, treatment is available for individuals with a sex addiction. Unfortunately, few paraphiliacs seek treatment on their own. This is often because they don’t perceive their behavior as problematic, are in complete denial, or are unwilling to admit that they have a problem. Some won’t seek treatment due to shame and / or the fear of serious consequence. Of those who do receive treatment, the majority have been court mandated to do so after being charged with a crime. Sex addiction treatment typically includes individual and / or group psychotherapy, and may also include medication if indicated.