Masochism

Self-defeating Personality Disorder: Recognition and Treatment

July 27, 2012

Patients with masochistic tendencies present with self-defeating patterns and often reject help.

Breaking Up Is Hard to Do: Terminating Therapy Before Things Get Out of Hand

June 29, 2012

Cases that come to our attention as malpractice claims, ethics claims, or Board of Registration complaints raise the question: why did the treating clinician not terminate the treatment before things got so out of hand?

Borderline Personality Disorder and Resistance to Treatment

July 31, 2009

Historically, borderline patients were considered “help-rejecting complainers.” Clinicians should actively treat both mood/anxiety symptoms and BPD symptoms.

Sexual Impulsivity Disorders: Psychiatric "Orphans"

December 01, 2007

Paraphilias and paraphilia-related disorders (nonparaphilic sexual compulsivity or sexual addiction) are sexual disorders that predominantly afflict men.

Envy-The Forgotten Narcissistic Issue

September 01, 2007

Of the 7 "deadly" sins that are committed by humans, envy is primarily directed toward the destruction of an external object. Over the centuries, this unfortunate emotion has been the subject of inquiry by many disciplines (philosophy, religion, sociology, fiction, and so on).

Paraphilias: Clinical and Forensic Considerations

April 15, 2007

Paraphilias are defined by DSM-IV-TR as sexual disorders characterized by "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 6 months" (Criterion A), which "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning" (Criterion B). DSM-IV-TR describes 8 specific disorders of this type (exhibitionism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, voyeurism, and transvestic fetishism) along with a ninth residual category, paraphilia not otherwise specified (NOS).

Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders

August 25, 2006

Paraphilias as defined by DSM-IV, are sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors (of at least six months' duration) that are considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning. The common paraphilias described include exhibitionism (exposure of genitals to a stranger), pedophilia (sexual activity with a prepubescent child, generally 13 years of age or younger), voyeurism (observing others' sexual activities), fetishism (use of inert objects, such as female undergarments), transvestic fetishism (cross-dressing), sexual sadism (inflicting suffering or humiliation), sexual masochism (being humiliated, beaten, bound or made to suffer) and frotteurism (touching, rubbing against a nonconsenting person).

The Ethic of Humility and the Ethics of Psychiatry

June 01, 1998

A few decades ago, ethics was widely understood in the professions to be a synonym for etiquette; it described the consideration that members of a profession showed to each other. More recently, it has come to refer to the rules governing the relationship between a professional and a client or patient.

Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders

June 01, 1996

Paraphilias as defined by DSM-IV, are sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors (of at least six months' duration) that are considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning.

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