To date, some authors have identified sexual deviation with a disease that must be treated. This approach is also found in medical circles, which entails attempts to "cure", often leading to irreparable changes in the body and are severe iatrogenic trauma. Already the very treatment of sexual deviation in categories of a disease that can be "diagnosed" can be an iatrogenic trauma, especially since such "diagnoses" usually carry in themselves some element of moral condemnation and public contempt. However, the disease can only be called pathological forms of sexual deviation non prescription viagra sale, that is, progressive or impulsive forms of sexual perversion.
The problem of the relationship between sexual deviation and disease was developed by Schorsch (1972), and therefore it is worthwhile to present here six theses proposed by him, which will allow us to present the essence of the phenomenon quite clearly.
1. The psychiatric systematics of sexual deviations causes a perception of abnormality and morbidity of deviations in sexual behavior. In its development, psychiatry has created many conceptions of the disease, to which were also attributed sexual deviation. Sexual "disease" in accordance with the medical model of the disease causes incorrect associations in terms of biosomatic etiology (treating it in the categories of random painful disorders), but at the same time does not take into account social factors. The lack of consideration of social mechanisms in the approach to sexual deviations and the influence of these factors on a person's personality makes the concept of sexual disease useless.
Considering the issue in the historical aspect, it should be noted that psychiatric sexopathology developed on the positions of conformism, which it could not leave for a long time. The conformist position on morals and norms established by it is expressed in the tendency to identify behavior that deviates from the norm (primarily because it is, according to those ideas, rarely met), with a mental illness. Forms of behavior that corresponded to the norm, that is,conformist and taking into account the requirements of mandatory morality, were considered normal and healthy. With this approach to deviations, they were presented as manifestations of biological degeneration, a consequence of the organic inferiority of the brain, sexual illnesses such as drug addiction first of all as something happening in the dark depths of human life. On the basis of the biological, nonconformist approach, the doctrine of sexual perversions was developed, which were considered from the nosological point of view. Under the term "perversion" (and at that time all deviations were designated as perversions, and other terms were not used for this) was understood clearly
A limited syndrome of disorders that had features of the disease. This model of thinking "units of disease" was placed in the basis of various systematics of sexual deviations, which were "lists of diseases", as well as classifications of pathological changes. However, traditional psychiatric systematics and classifications are completely unsuitable for applying to sexual deviations. Classification of sexual deviations is not at all a list of diseases, but it is a systematic different opportunities for sexual behavior. Like any attempt to classify human behavior, it is also simplistic and schematic, and in many cases it is not even sufficient to explain the various individual forms of sexual behavior.
2. Sexual deviation is certainly not an abnormal or painful behavior, but is primarily a rare behavior, contrary to the principles of public morality. However, the identification of behavior that corresponds to social norms, with the concept of health is erroneous. Sexual behavior is a form of social behavior that should be considered outside the categories of health and disease (similar to how other forms of social behavior are considered).
Traditional psychopathology of sexuality, which psychiatry was engaged in, was based on the fact that sexual deviations (identified with perversions) are diseases that are largely independent of social factors, like kidney stone disease or brain tumors. This theoretical background of the disease, which does not take into account the pathogenic influence of mandatory norms, is only a kind of moral condemnation. It excludes sexual deviations from the sphere of normal human behavior, and the "form" of exclusion has a protective character (illness) or an evaluation (negative moral assessment). The theory of the disease is based on the fact that behavior, assessed as normal, that is, subject to social norms, is defined as health. This kind of psychopathology of sexuality plays an important role of the social stabilizer. Identifying the forms of behavior prohibited by society with insufficient health, it becomes a discipline in which society controls its own violations, oversights and mistakes in a way that does not reach the average person's consciousness at all. Evaluation of a person with sexual deviation in psychopathological categories is also means by which society absolves itself of responsibility. However, the doctrine of deviations is not nosology at all, and deviation should not be regarded as a disease. Whether it is possible to speak about illness if nobody (in connection with the atypical sexuality) does not subjectively suffer, nor objectively has any injuries, but is only condemned by the public because of certain sexual inclinations. Sexual deviations are not diseases until they do not fall under the effect of the criteria of sexual perversion, and a person exhibiting unusual sexual behavior should not be considered as mentally ill.
3. A part of sexual deviations is nothing else but varieties of sexual behavior within the framework of a normal, unbroken personality.
4. Because sexual deviation is not necessarily a psychopathological syndrome, its presence is not an indication for treatment. The doctor's task is the treatment of diseases or mental disorders, and not compliance with legal norms that regulate behavior on the basis of mandatory morality. Sexual deviation, especially sexual deviation, is not a psychiatric disorder requiring treatment, including the use of rigid methods of aversion therapy, contrary to humanity. If, without any criticism, the "treatment" of sexual deviation was carried out, then this would be only a form of adaptation of a person to public order, that is, it would be a kind of repression applied to people who violate moral norms.
Criteria for the need to treat sexual abnormalities would, however, go too far if they were generally denied medical assistance to a person only on the grounds that, due to their deviant behavior, they fall into very different conflict situations. Such cases are not at all rare. But since there is still a lot of uncertainty in this area, it becomes necessary to develop as soon as possible the criteria by which a person can be distinguished from a sexual deviation in need of treatment from one that does not need treatment. According to CoCkott, Dittmar (1972), sexual deviations alone do not require treatment. It would really be unclear why it is necessary to change the deviant behavior that delights the person and his partner with pleasure and, moreover, does not cause any damage to other people. Deviant behavior only then acquires the features of soreness, when a person suffers because of this; Only in this case it is necessary to think about the possibility of treatment.
5. If sexual deviation is subjectively experienced as a "disease", then the sufferings of a deviant person are basically a reaction to the intolerance of society or an expression of intrapsychic conflict caused by the deep (up to the loss of freedom of choice) internalization of mandatory morality. Many deviant people seek help from a doctor. They are subject to this subjectively experienced suffering, from which they want to get rid of. Deviant people fall into a double conflict. One type of conflict is caused by fears of violating legal or moral norms. The second kind of conflict has an internal character and is caused by a contradiction between sexual behavior and internalized (acquired) social norms that deprive deviant persons of the right to satisfy sexual needs according to their inclinations. Manifestations of sexual activity that do not correspond to the norms recognized by them cause a strong internal protest of an attempt to resist their attraction, a spiritual break with the experience of suffering. Such people often come to the doctor with the inner certainty of their abnormality or illness. However, the doctor can not accept it, because the suffering associated with sexuality can not be considered in isolation from the attitudes towards it. A teenager, brought up in the rules of shame, modesty, virtue and practicing masturbation only occasionally, can experience pronounced suffering, while another teenager practicing masturbation is permanent, considers it quite normal. Thus, suffering related to sexuality is a consequence of external or internal prohibitions. In accordance with the nature of the occurrence of suffering, they should be distinguished (which may have some significance for the choice of appropriate treatment): some of them are due to intolerance of the social environment and interpersonal conflicts; The cause of others is rather the inability of the individual to cope with their own problems and reconcile themselves to the contradictions between sexual inclinations and the learned moral norms; The third may be due primarily to the neurotic development of the individual, within whose framework deviation is one of many manifestations. The decisive criterion for the initiation of treatment is "the increase in suffering".
A person with a sexual deviation in a tolerant environment subjectively does not suffer in connection with this (rather sexual deviation gives him pleasure in its implementation) and does not experience any objective injuries caused by external causes. If a person with a sexual deviation appeals to a doctor for the purpose of "treatment", then this does not happen in connection with painful manifestations of deviation, but in connection with the impact of society. A person with a sexual deviation who is rejected by society experiences the "pressure" of traditional views even in cases when his propensities are unknown to others, because he himself considers himself sick, perverted, for fear of hiding his inclination, alienates people, so that to discover them before them, is locked in itself, experiences a feeling of inferiority; Sometimes the growing frustration of his needs can lead to aggressive behavior, especially since he may have a hatred for people, whom fate has saved from such suffering.
Such a person, seeing the inadequacy of his behavior or even his inclination, and also in relation to the norms established by the majority of members of the society in which he lives, mourns his fate; Fearing compromise, he hides his predilections even from the next of kin. It is among these people, rushing between the desire to satisfy their sexual needs and get full satisfaction and the need to submit to the pressure of the society in which they live, are those who suffer more than others and seek help. However, their suffering does not arise from the presence of sexual deviations, but because society rejects the appropriate forms behavior (and thus, indirectly, and themselves).
