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This post is dedicated to the paraphilias in the homosexual field. As it is well known, the "Dagnostical and Statistical Manual of the Mental Disorders - Fifth Edition" (DSM-5) contains some useful definitions for circumscribing the field, first of all the distinction between paraphilia and paraphilic disorder, and then establishes the criteria for defining a diagnosis for some types of paraphilia. As it is obvious, DSM-5 is a fundamental indication of principle, aimed primarily at psychiatrists and takes into consideration many different situations that psychiatrists can encounter in the daily practice of the profession. The manual also has an indicative value for the knowledge of paraphilic phenomena that do not necessarily lead to paraphilic disorders but which are decidedly more common and are also found outside the areas of intervention typical of psychiatry. As there is a psychopathology of daily life so there is a widespread paraphilia of daily life that in some cases can move towards the borderline with true paraphilic disorders.
 
Obviously I will try to address the issue based on the experiences gained in Gay Project.
 
Some fundamental methodological observations must be kept in mind.
 
1) To get to talk about one's own paraphilias, it is necessary to have the greatest guarantees of confidentiality, not just because it's about matters related to sexuality but because certain behaviors can be criminally relevant, as it happens with pedophilia. It happened to me several times to talk with people who had pedophile fantasies, but not exclusive and, what is more important, never put into practice. Fantasies are an individual question, while behaviors are criminally relevant, so it is not surprising that only fantasies emerge.
 
2) Some paraphilias may involve forms of sexual contact with non-consenting persons (frotteurism) or forms of violence (sadism) or deception (voyeurism) and therefore are difficult to admit because they may involve moral discredit, if they remain at the level of fantasies, or even sanctions if they produce concrete behaviors.
 
3) Some paraphilias (coprophilia, pissing, spermatophagia) can be very difficult to admit because they can generate repulsion.
 
4) It should be emphasized that, precisely for the above, only non-episodic paraphilias emerge in the interviews and often characterized by concomitant serious anxious states more or less connected with the paraphilia itself, so they are true paraphilic disorders.
 
5) Often more paraphilias manifest themselves together and a very complex picture is outlined closely related to the individual's personal history.
 
6) From the talks emerge some constant correlations that seem to indicate causal links more than probable, as for example the fact that "all, without exception," the people I met who had pedophile fantasies reported having suffered sexual abuse in childhood.
 
So, I think it is essential to emphasize an aspect of the paraphilias: the person who has paraphilic disorders often experiences the difficulty of relating "sexually" with another person because the presence of the paraphlia and the tendency to put it into practice in a sometimes obsessive manner arouse perplexities in the partner who sooner or later inevitably goes away because he has the impression that sexuality is literally dominated by the paraphilia or even reduced to it. 

The feeling of rejection and abandonment almost always accompanies the life of the person who manifests paraphilias. The tendency to project his paraphilias to other subjects is often observed in the subject carrying paraphilias, assuming that others can react to those stimuli with a similar sexual excitement, but this is not realized at all and this is one of the reasons that make particularly difficult a sexual relationship with a person who has paraphilic disorders.

I would like to add to the paraphilias listed in the DSM-5 another paraphilia related to the unconscious involvement of another person in sexual intercourse: it is about having sex while talking about something else on the phone with another person with whom you had sexual relations. In this behavior the central element is the "betrayal" of the trust of the person with whom you talk about something else. It should be emphasized that when the transgressive behavior loses its transgression meaning because somehow it is accepted and justified by the partner and especially by the third person, it quickly loses its sexual meaning. 

I have often observed boys with paraphilias who tended not to blame themselves or to try to change things but to consider themselves elements socially excluded and almost condemned to live a life without affections, now definitively prey to a sexuality that cannot be shared with others. Often the reaction to the feeling of marginalization does not lead to depression but to forms of rationalization and critical examination of one's sexuality. In practice, the person acts on two distinct levels, a rational one, in which solitude is accepted as something to live with and a sexual one, characterized by the loss of rational control and total abandonment to emotionality and inevitably to the paraphilia. 

The real problem lies in building an affective relationship "compatible with sexuality", because the person with paraphilic disorder generally has no problems in building a friendly relationship, if that relationship is born and keeps completely devoid of sexual values, the problems arise instead in relationships in which sexuality is explicitly involved. I have been able to observe several times as in such cases, in order to preserve at least the friendship, the person with paraphilic disorders has deliberately and rationally tried to avoid any chance of sexual involvement. 

Who is involved in a relationship with a paraphilic guy, at the beginning, may not even realize it or can only perceive a polarization of his partner on the strictly sexual aspects of the relationship, then, with time, and with the development of the relationship, the paraphilic will come to talk about his problem with his partner for whom a period of doubts about the behavior to be held will start, with continuous oscillations between a minimization of the problem and a greater awareness. 

As I have already said, some paraphilias do not undermine affective relationships, but they heavily condition their possible sexual developments. The paraphilic needs love, is generally a pleasant person and tends to keep the paraphilia only at the level of fantasies or talking with a reliable partner and often gives a value of transgression to behaviors that have very little transgressive and tends to emphasize some of his transgressive behaviors as if they were habitual even if they occurred only once. Boys who have paraphilias need first of all respect and feel hurt by preconceived reactions and discriminatory behavior. Their need to integrate makes them generally pleasing to their friends and also to their sexual partners with whom they usually have a very honest interview and do not tolerate hypocritical behavior. I have often been able to notice how many paraphilias are connected to childhood experiences and tend reproduce situations of childhood experience, a childhood experience that remains very present in children's memories and which they consider to be the basis of paraphilias. 

The re-elaboration of childhood experience and its rationalization are indispensable conditions for getting out of the dependence on the paraphilias. Generally I am rather reluctant to the idea of an easy recourse to the intervention of a psychologist, but in front of the paraphilias the presence of a psychologist cannot be replaced by that of a friend or worse of the partner, because a friend or the partner can to be involved very deeply on an affective level and not only, and they are certainly not the most suitable people to help their friend in the recovery of rationality and above all in the elaboration of childhood experience. 

The difficulty of the paraphilic to create a shared emotional-sexual relationship is due to the obsessive mechanism of the paraphilia, not to the paraphilia itself. If the paraphilia does not present itself obsessively, it would be only a temporary variant of sexual behavior that probably would not generate problems within the couple, but the paraphilias always present with an obsessive mechanism, are a kind of fixed idea that the person must realize on the basis of a real addiction relationship, there can be periods of abstinence more or less long, relatively free from the paraphilia, which then however ends up reappearing and makes the rational mechanism of abstinence collapse. 

Often periods of abstinence are interrupted when the attempt to build a sexual relationship detached from the paraphilia meets unexpected difficulties, that is when the person experiences for the umpteenth time the mechanism of rejection. The return to the paraphilia through a sexual contact with a partner who accepts it, even if only episodically, provokes a feeling of security and control over that partner and is therefore at least relatively reassuring. But these are experiences that do not involve a real sharing of sexuality and that also leave a strong feeling of precariousness and non-genuine correspondence at the level of the couple. 

I have seen people subject to paraphilias who more than once, after a series of failures in the creation of emotional-sexual relationships, have ended up putting aside the idea of having a partner with whom to build a relationship and have operated a kind of splitting between affectivity and sexuality, reserving the affectivity to friends with whom they maintain a stable relationship without sexual implications and experiencing sexuality, with some occasional partners, usually always the same, with which however any implication of affection is excluded a priori. 

When I speak of occasional partners I do not intend to refer to unknown people found on the internet through dating sites or with particular applications, but almost always to ex-boyfriends, and this because while ex-boyfriends are more or less aware of the existence of the paraphilia and somehow accept it, strangers completely unaware would almost certainly be negatively affected and would not comply, thus accentuating the sensation of impossibility and rejection. 

Guys affected by paraphilias are not the only victims of paraphilia, because even the guys who try to build emotional-sexual relations with them live complex and contradictory experiences and they often go into crisis because seeing that things do not go, they try to understand who is responsible for it, and in this way or they blame the person affected by paraphilias who seems strange to them, complicated and in some way pathological, or they blame themselves, because they were not able to bear everything in the presumption that loving a person means accepting that person by sharing everything, and even the pathologies. 

The most wrong attitude towards a person with paraphilias consists in considering the paraphilias a kind of game made to experiment. This attitude manifests a radical misunderstanding of the seriousness of the problem and causes those who experience it to live a profound suffering, while they deserve the utmost respect. I add an obvious observation, but particularly important in these cases: people who come to talk about their own paraphilias have the right to maximum confidentiality and any violation of this confidentiality is a real wound to those who, seriously speaking about problems that are not at all easy to talk, are actually asking for help.