One sexual sadist had a slow growing tumor in the left frontal-temporal lobe, likely present since childhood. In most cases, the judicious combination of biological and psychological treatment approaches will yield the most satisfactory results.
In a large sample of men who were child sex offenders, Freund et al. Discuss the prevalence of conflict and distress in marriages related to issues of sexual desire.
The focus of the paraphilia may be a variety of objects, situations, animals, or people such as children or nonconsenting adults. She teaches sex therapy courses through the Institute for Sexual Wholeness at Richmont Graduate University in Atlanta, Georgia, and has presented on various marriage and sexuality topics in graduate schools and conferences throughout the United States and internationally.
Some degree of variety in sexual activity is very common in healthy adult sexual relationships and fantasies. Treatment outcome studies suggest that these treatments are effective in reducing deviant sexual behavior provided that the treatment regimen is maintained, although more well-controlled treatment outcome studies are needed before the true effectiveness of these treatments can be determined.
This suggests that sexual arousal is not readily classically conditioned in women and may explain why, like other paraphilias, fetishism occurs almost exclusively in men. Of course there are serious consequences to performing such extreme and permanent techniques.