It is okay to talk about your paraphilia…

but choose a trained therapist

Paraphilias are intense sexual arousals to certain situations, objects, individuals or behaviors. Years ago, it was popular to consider paraphilia as perversions, but, with more research, we have learned they can be part of an average person’s sexual repertoire. They become problematic when individuals act on their urges without the other person’s consent or when the activity is illegal. These behaviors can have serious social and legal consequences. That’s when the individual probably should seek therapy – from a trained therapist – someone who has sexual health training or a certification in sexology – someone who can help you in a non-judgmental way.

Let’s take a closer look into behaviors considered paraphilias. Here are a few of the more than 200:


Exhibitionism is an act or acts of exposing oneself to attract attention to oneself. This can be a welcome activity among consenting adults and can add to the anticipation of being with another person. Also known as flashing, exhibitionism can involve someone exposing his or her genitals to an unsuspecting stranger. In most cases, the “flasher” means no harm, however, indecent exposure is illegal. 


Fetishism occurs when people are intensely sexually aroused by inanimate objects or non- genital body parts. For example, a person can become sexually aroused by touching or wearing an article of clothing. When these items are necessary for sexual arousal, they are considered a fetish. Partialism – similar to fetishism – is when someone becomes sexually interested in a body part. A common form of partialism is podophila or a “foot fetish.”


The focus of the person’s sexual urges is on touching or rubbing his or her genitals against the body of a non-consenting, unfamiliar person, often in a crowded location. This is illegal.

These individuals have fantasies, urges or behaviors that involve sexual activity with a child, usually one under the age of 13. Acting on pedophilic urges is illegal.

Sexual masochism
Individuals will use the act of being humiliated, beaten or made to suffer in order to achieve sexual excitement and climax. In many cases, the humiliation and power exchange are acted out as a fantasy between two consenting adults. 


“Dirty talking” over the telephone is another type of paraphilia.

Voyeurism (“Peeping Tom”)
Voyeurs gain sexual pleasure from watching unsuspecting non-consenting people who are naked or engaged in sexual activity. This too can be included in the sexual repertoire of consenting adults. 

Most paraphilias are not harmful

Although many may consider paraphilias distasteful and abnormal, in most cases, they are not harmful if they present in less extreme forms. For example, having a partner “talk dirty” can be sexual arousing, but when this is the only way a partner can experience sexual arousal, it can be considered a paraphilia. If the activity is interfering with a healthy relationship, if the partner has not consented, if it is illegal, and if it is becoming magnified – causing significant distress – it may be time to seek help.

Men are about 20 times more likely to have a paraphilia, a statistic not understood at this time. How do paraphilias develop? Some experts believe it is caused by a childhood trauma, such as sexual abuse. Others suggest that objects or situations can become sexually arousing if they are frequently and repeatedly associated with a pleasurable sexual activity. In some cases, those with paraphilias may have difficulty forming person-to-person relationships. Many paraphilias begin during adolescence and continue into adulthood. 

Seek professional help from an expert

If a paraphilia interferes with healthy relational functioning, one can seek treatment with counseling and therapy, with the goal of helping these individuals understand their feelings and desires. Treatment can determine if and how modification of the paraphilia is needed for healthy functioning and improved quality of life.

Unfortunately, many therapists are not trained to deal with complex sexual issues such as paraphilia. When looking for professional help, find a therapist trained or certified in human sexology, sexual and behavioral addictions or sexual orientation.

When I work with clients exhibiting signs of a paraphilic disorder, I start by asking a few basic questions:

  • What is your goal for coming to therapy?
  • What do you want help with?
  • How do you enjoy your sexuality without engaging in your paraphilia?
  • Do you want to continue this behavior?
  • Are you asking your partner(s) for consent?

Often, I find somatic psychotherapy is successful when working with clients who want to understand their unwanted thoughts and behaviors.  

Somatic psychotherapy is a holistic, therapeutic approach that involves talk therapy while connecting the mind, body and emotions. I help clients get in touch with how their body is feeling and reacting during any activity (including paraphilias). The idea is to raise awareness of the connections between their mind, body, spirit and emotions. 

For example, a client may be talking with me about a traumatic event; I may ask them to gently bring awareness to their breath, asking them to just notice how their body is reacting to what they are talking about. In a non-judgmental way, I observe their body movements, and work with them to notice their body and how it is reacting.

Somatic psychotherapy also is a great tool to help clients who suffer from stress, anxiety, depression or grief when traditional therapy doesn’t seem to work. I will use deep breathing, relaxation exercises and meditation. My goal is to help clients engage in a full, healthy, happy life. 

If you are concerned that you have a paraphilia, The Center for Relationship and Sexual Health has a team of qualified, trained experts who can help you. Simply call the center at 248.399.7447 to arrange an appointment or visit the website at to review a list of therapists and their qualifications.

Charon Normand-Widmer, LMSW, specializes in working with individuals seeking support navigating erotic, gender and sexual identity challenges; alternative relationships; and trauma, utilizing a strengths-based, psychodynamic, mindfulness-based approach. To schedule an appointment with Charon, call The Center for Relationship and Sexual Health at 248.399.7447.