Personality and Paraphilic Disorders Essay
Paraphilic disorders are defined as intense, recurrent, sexually arousing fantasies and behaviors that distress and involve inanimate objects, children, and nonconsenting adults. These can also include suffering the humiliation of oneself or a partner with the potential to cause harm (Zakhari, 2021). This paper will discuss paraphilic disorders, the controversies surrounding the disorder, professional beliefs about the disorder, and strategies for maintaining therapeutic relationships with patients with the disorder. These behaviors also include sex with excrements, animals, and corpses.
Controversies Surrounding the Disorder
The main controversy about paraphilic disorders is that individuals can seriously impair reciprocal and affectionate sexual activity capacity (Zakhari, 2021). The partners of individuals with the disorders may feel like objects since they are unimportant in the sexual relationship (MDedge, 2020). The disorder is controversial because it mainly involves fantasies of abusing a helpless individual (Buchanan, 2020). For instance, paraphiliacs have fantasies about abusing a person who is drunk, asleep or unconscious, or urinating or defecating on their partners. Some individuals get aroused by spying on others and having sex, violating privacy.
Professional Beliefs about the Disorder
Studies indicate that paraphilic behavior may be learned. Paraphilia is more common in men than women and often begins between 8-and 12 years. The individuals often have underlying mental disorders. Paraphilia is an emotional disorder defined by sexually arousing urges and behaviors that have been recurrent and intense for more than six months. These often lead to significant distress and interfere with important areas of functioning. While the condition is not innately pathological, the disorder can evolve if paraphilia invokes harm, distress, or functional impairment in the lives of the affected individuals (MDedge, 2020). The DSM-IV lists paraphilia as including conditions such as pedophilia, voyeurism, exhibitionism, sexual masochism, fetishism, frotteurism, sexual sadism, and transvestic fetishism. Paraphilic disorders are thought to be caused by cognitive, neurobiological, and interpersonal processes.
Strategies For Maintain the Therapeutic Relationship with Patients
To maintain a therapeutic relationship with the patients, developing a safe care environment is important. This will ensure the patient is comfortable opening up about their issues (Buchanan, 2020). They will also be able to trust that the clinical will uphold their privacy and provide them with the best solutions for their situation. Since there is a lot of shyness and controversy around the issues, likely, the patient may not be comfortable speaking about the issue (Zakhari, 2021). Therefore, it is essential to listen to the patient without judging. It is also essential to develop professional boundaries in therapy (MDedge, 2020). It will ensure that the patients can discuss their issues to get help, medication, and coping strategies. Clinicians should consistently demonstrate empathy for therapeutic relationships. Empathy ensures the healthcare provider can recognize and understand the patient’s situation.
Ethical and Legal Considerations
Informed consent is a critical ethical consideration. It ensures that the patient understands the treatment course and is willing to adhere to all the recommended treatment processes. Clinicians also have an ethical and legal obligation to protect the privacy and confidentiality of patients (Buchanan, 2020). Patients need to know that their information will not be shared with third parties without their consent. The ethical principle of beneficence should also be upheld. The healthcare provider needs to act in the patient’s best interest at all times.
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References
Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disorders [Video]. YouTube. https://www.youtube.com/watch?v=ykkMo9t0bxs
MDedge. (2020, January 22). Personality disorders with Dr. Frank Yeomans [Video]. YouTube. https://www.youtube.com/watch?v=ESQIDslCX_s
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
The Assignment
In 2–3 pages:
Explain the controversy that surrounds your selected disorder.
Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
Between 10% and 20% of the population experience personality disorders. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others. Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.
In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.
To Prepare
Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
Select a specific personality or paraphilic disorder from the DSM-5 to use for this Assignment.
Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
Learning Resources
Required Readings (click to expand/reduce)
National Institute for Health and Care Excellence: NICE Guidelines. (2010). Antisocial personality disorder: Prevention and management.
https://www.nice.org.uk/guidance/cg77
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)
Chapter 22, “Personality Disordersâ€
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 67, “Disorders of Personalityâ€
Chapter 68, “Developmental Risk for Psychopathyâ€
Chapter 69, “Gender Dysphoria and Paraphilic Sexual Disorders†(pp. 988–993 only)
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 14, “Personality Disordersâ€
Required Media (click to expand/reduce)
Buchanan, N. T. (2020, April 13). Lecture 14 part 3: Paraphilic disorders [Video]. YouTube. https://www.youtube.com/watch?v=ykkMo9t0bxs
MDedge. (2020, January 22). Personality disorders with Dr. Frank Yeomans [Video]. YouTube. https://www.youtube.com/watch?v=ESQIDslCX_s