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Microsoft word - ppai occasional paper no 3[1].doc

PPAI Occasional Paper No 3
This paper was prepared initially at the request of a New South Wales lawyer. He was defending an apprehended offender from the Northern Territory. The paper proved useful at sentencing. The paper was revised for publication in 2005. Paraphilias (also known as sexual deviations and as sexual variations): are a problem of sexual preference or of the direction of one’s sexual desire. Prior to the last few decades, paraphilias were known as perversions. In professional circles, “paraphilia” is the term of choice as being devoid of any moral or value judgement. Exhibitionism, one of the most commonly referred to paraphilias, is described by de Silva, 1995 as “where the person derives sexual pleasure by exposing their genitals in inappropriate places, such as public highways or parks, and by Dorland 2003 as “recurrent intense sexual urges…exposing the genitals to an unsuspecting stranger. Exhibitionism occurs almost exclusively in
Paraphilias, and as one of them exhibitionism, have a place as disorders in the
American Psychiatric Associations’s Diagnostic and Statistical Manual of Mental A “paraphilia” as having “recurrent, intense sexually arousing fantasies, sexual
urges, or behaviours generally involving (1) non-human objects, (2) the suffering of humiliation of oneself or one’s partner, or (3) children or other non-consenting persons….” and
exhibitionism as involving “the exposure of one’s genitals to a stranger, sometimes
the individual masturbates while exposing himself…”
Exhibitionism (and other paraphilias) may lead people to experience adverse legal and/or
interpersonal consequences yet its practice may be found so rewarding and irresistible that the behaviour is continued (Seligman & Hardenburg, 2000). Seligman & Hardenburg also refer to treatment: Cognitive-behavioural techniques are widely used; medications that have been used include clomipramine; because of high rates of recidivism, long-term treatment, relapse prevention and monitoring may be needed. De Silva (1995) reports that, where incorporation of a paraphilia into a socially acceptable sexual behaviour is not an option, therapy should aim at elimination or control. Bradford (2000) directs attention to the strength of the sex drive. It is basic and biological and is analogous to hunger. Though not essential to survival (unlike hunger) the intensity of the sexual drive is similar to that of hunger, and the biomedical approach would involve reducing the force of the sexual drive and redirecting the drive toward normal sexual behaviour. He reports that recent studies show that “increased serotonin
levels reduce sexual drive.” (Clomipramine is a medication which has that effect as well as being effective as an anti-depressant.) Normal in this context may be taken to imply
Two essential components of a model of motivated behaviour are a drive and a learned mechanism for satisfying that drive. Practices for satisfying the sexual drive in humans, as against other animals, are learned mechanisms. Paraphilias are amongst these
mechanisms. Where the mechanism chosen is a paraphilia, there is the possibility that the “chooser” is influenced by a diathesis – an inherited predisposition (a physical and/or
a personality characteristic in this context) – which blocks the choice from being a mechanism in the normal range. Alternatively a non-afflicted “chooser” might
accidentally experience a deviant mechanism involving an other-sex person as the first
intensely satisfying sexual encounter. Should this be repeated and reinforced, it is likely that it would become fixed as a habit and be the “preferred learned mechanism.”
Exhibitionism, being a paraphilia and no matter how initially generated, becomes a
deeply ingrained habit. [Consider the neuroanatomy: from learning intake (hippocampus) via main pathway (fornix) to procreative pleasure centre (septum) and “with satisfaction feed back” to hippocampus.] This habit is one that from appearances has a process of fixation analogous to that of imprinting in young animals, birds, etc. Erasure from brain of such a paraphilic mechanism, if possible requires the concomitant occurrence of: generation and practice of a pleasure-creating alternative mechanism conditions facilitating “new mechanism” practice reduction to NIL of the stimulatory force of the occurrence of what has been perceived as an “opportunity circumstance” and the determined discontinuance and complete rejection of the paraphilia practised. Cognitive restructuring must be specifically directed towards extinction of any
thinking that would allow exhibiting to have any place amongst responses to the sexual drive. The generation of a prime alternative learned mechanism capable of
supplying no less intense satisfaction of the drive must occur as an element of the process of cognitive restructuring. Conditions allowing regular practice of the new
mechanism must be in place and remain in place during the whole of the time period needed for restructuring, dishabituation and extinction, and rehabilitation. Means must be found by counsellor and exhibitor conjointly to divest every known or
possible “opportunity circumstance” of its stimulatory power or association. (This,
in short, is the process of extinguishing a “conditioned” stimulus.) Discontinuance
of the exhibiting habit and of the inclination to “engage it” when desiring sexual
satisfaction must be fiercely and unbendingly self-enforced by the erstwhile exhibitor. Appropriate compulsion-reducing medication can be expected to be needed to assist this process. Medication and psychotherapy to correct or compensate for a physiological problem triggered by the habit or by genetic inheritance may also need
References
Bradford, J McD W (2000). The Treatment of Sexual Deviation Using a Pharmachological Approach. J. of Sex Research. Vol 37, Issue 3, p248 et seq. de Silva, P (1995). Paraphilias and sexual dysfunction. International Review of Psychiatry. Vol 7, Issue 2, p225 et seq. Dorland’s Illustrated Medical Dictionary. 30th Ed. (2003). West Philadelphia PA: Seligman, L & Hardenburg, S A (2000). Assessment and treatment of paraphilias. J. of Counseling & Developoment, Vol 78, Issue 1, p197 et seq. Carroll, B J & Barrett, J E (eds.) (1991). Psychopathology and the Brain. New York: Raven Press. (Chapter dealing with Chemical Imprinting). Crenshaw, T L & Goldberg, J P (1996). Sexual Pharmacology: Drugs that Affect Sexual Function. New York: W W Norton & Coy. (Contains a small section on

Source: http://www.psychologyprivate.org/docs/PPAI%20Occasional%20Paper%20No3.pdf

Microsoft word - pps 25 - 30 _final_11.doc

Problem 25: Cyclohexanes B forms in the reaction of A with a strong, non nucleophilic base. B reacts with bromine to form racemic C. The final products D (major) and E (minor) form by the reaction of C with a strong, non nucleophilic base. 25.1 Draw a 3-D structure of A in its most stable conformation. Circle the atoms that are possibly involved in the reaction to

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