Love Hurts. An Old Cliché Reborn a Propos of a Clinical Case.

Abstract

Abstract Introduction: The spectrum of sexually motivated behaviors is extremely wide, including behaviors that are not biologically reproductive and hold exclusively ludic functions. We refer to the persistent and recurrent patterns of sexual arousal resulting from the exposure to non-normative sexual stimuli as paraphilias, and they are paradigmatic of the broad heterogeneity of human sexuality. Among these, paraphilic infantilism was first reported in the scientific literature by Tuchman and Lachman in 1964. It is characterized by the presence of sexual arousal or pleasure when playing childhood roles or using objects proper of childhood. Objective: We intend to describe a clinical case, with a focus on the atypical profile of sexual interests and behaviors comprising paraphilic infantilism and sadomasochism phenomena. We also seek to discuss the understanding of these phenomena in the context of the global clinical picture, their nosological framework, and their implication in the psychotherapeutic process. Methodology: In this study, we present the clinical case of a patient observed in the outpatient clinic of the first author. A targeted literature review was carried out through a bibliographic search in the PubMed database and a selection of reference works in the Sexology field. These data provided a basis from which we develop our clinical discussion of the case. Results: This article illustrates the case of a patient referred for psychotherapeutic intervention due to an anxious-depressive syndrome. During follow-up, a cluster of sexual behaviors was observed that involved preferential sexual interest for role-playing as a baby, and practices that involved physical suffering, dominance and submission. Conclusions: Paraphilia is a controversial clinical category. As a broad category, it mirrors the diversity of human sexual behavior and is spread over a spectrum that ranges from nearly normal sexual behavior to being hurtful or destructive to oneself or others. Clinical work with these phenomena requires a special focus on the individualized clinical formulation, with a particular emphasis on the detailed assessment of subjective suffering and the personal and social deficits that underpin it, while taking the cultural context in which it occurs as reference.

Keywords

• Paraphilia
• Paraphilia in women
• Paraphilic infantilism
• Autonepiophilia
• Sadomasochism
• BDSM