From Libidines nefandæ to sexual perversions.

A conceptual evolution is traceable from early modern classifications of libido nefanda (execrable lust) to early nineteenth-century allusions to 'perversion of the sexual instinct', via pluralizing notions of coitus nefandus/sodomiticus in Martin Schurig's work, and of sodomia impropria in seventeenth- through late eighteenth-century legal medicine. Johann Valentin Müller's early breakdown of various unnatural penchants seemingly inspired similar lists in works by Johann Christoph Fahner and Johann Josef Bernt, and ultimately Heinrich Kaan. This allows an ante-dating of the 'specification of the perverted' (Foucault) often located in the late nineteenth century, and appreciation of pygmalionism and necrophilia as instances of 'perverted sexual instinct'. In this light, Kaan's early psychopathia sexualis was less innovative and more ambivalent than previously thought.

Conceptualization, History, and Future of the Paraphilias.

There is no accepted definition of the term paraphilia despite its being listed as an essential feature of a class of mental disorders known as the paraphilic disorders. The origin of the term, history of its inclusion as a diagnosis, and logical flaws inherent in the various definitions are discussed in this review. We examine the basis for pathologizing individuals with paraphilias, consider what paraphilias can tell us about how humans develop their sexual interests, and question the usefulness of dividing sexual interests into paraphilias and normophilias. The construct of the paraphilias appears to be poorly conceived and has outlived its usefulness.

Kränkung and Erkrankung: Sexual Trauma before 1895.

A tropology of moral injury and corruption long framed the plight of the sex crime victim. Nineteenth-century psychiatric acknowledgment of adverse sexual experience reflected general trends in etiological thought, especially on 'epileptic' and hysteric seizures, but on the whole remained descriptive, guarded and limited. Various experiential threats to the modern sexual self beyond assault and rape were granted etiological significance, however: illegitimate motherhood, masturbatory guilt, sexual enlightenment, 'homosexual seduction' and chance encounters leading to fetishistic fixation. These minor early appeals to medical psychology help us appreciate the multiple nuances of 'sexual trauma' advanced in Breuer and Freud's Studies on Hysteria (1895) and Freud's subsequent work.

'We Won't Ban Castrating Pervs Despite What Europe Might Think!': Czech Medical Sexology and the Practice of Therapeutic Castration.

The Czech Republic holds one of the highest numbers of men labelled as sexual delinquents worldwide who have undergone the irreversible process of surgical castration - a policy that has elicited strong international criticism. Nevertheless, Czech sexology has not changed its attitude towards 'therapeutic castration', which remains widely accepted and practised. In this paper, we analyse the negotiation of expertise supporting castration and demonstrate how the changes in institutional matrices and networks of experts (Eyal 2013) have impacted the categorisation of patients and the methods of treatment. Our research shows the great importance of historical development that tied Czech sexology with the state. Indeed, Czech sexology has been profoundly institutionalised since the early 1970s. In accordance with the state politics of that era, officially named Normalisation, sexology focused on sexual deviants and began creating a treatment programme that included therapeutic castration. This practice, the aim of which is to protect society from sex offenders, has changed little since. We argue that it is the expert-state alliance that enables Czech sexologists to preserve the status quo in the treatment of sexual delinquents despite international pressure. Our research underscores the continuity in medical practice despite the regime change in 1989. With regard to previous scholarship on state-socialist Czechoslovakia, we argue that it was the medical mainstream that developed and sustained disciplining and punitive features.

[Richard Freiherr v. Krafft-Ebing and Sigmund Freud--discourse on the "normality" and "perversion" of human sexuality at the close of the 19th century and the beginning of the 20th century]. / Richard Freiherr v. Krafft-Ebing und Sigmund Freud--Diskurs über die "Normalität" und "Perversion" von Sexualität im ausgehenden 19. Jahrhundert und beginnenden 20. Jahrhundert.

Sexuality has been defined a central feature of personal identity since the epoch of enlightenment and has gradually become a decisive issue also in societal and political terms. A major transfer from religion and religious institutions to medicine and medical experts and later on to neuropsychiatrists has to be underlined in the primary position to assess "normal" and "deviant" manifestations of sexuality. Richard Freiherr von Krafft-Ebing and Sigmund Freund play an eminent role in this "discourse on sexuality" (M. Foucault) during the nineteenth and beginning twentieth century on the way to modern sexology. Within this overarching context Krafft-Ebing's and Freud's theoretical conceptualizations of sexuality and perversion will be sketched and basic clinical and societal implications there out will be discussed.

Atypical suicides or the first undiagnosed autoerotic deaths in Europe?

Autoerotic accidental deaths (AAD) are increasingly reported deaths occurring during solitary sexual rituals used to enhance sexual excitement. The majority of these fatalities involve hanging or other form of self-inflicted asphyxia. The German medical literature, with the first recognized AAD published in the early 1900s, has antedated by decades the first significant AAD reports (1950-1953) in English. Early contributions in languages other than English and German are mostly overlooked in current AAD reviews, although AAD were recognised in some European countries as early as the 1940s and 1950s. For a variety of reasons, it is likely that, before the description of the first AAD in the medical literature, some asphyxia deaths have been classified as suicides with peculiar features, instead of as accidents resulting from life-threatening sexual practices. In the present study, we review and comment on three such atypical asphyxia deaths investigated in central Europe (Austria, Italy, Switzerland) during the period 1821 to 1927. The retrospective analysis of these cases revealed some circumstantial and individual features which nowadays could be linked to AAD, and disclosed the reluctance of medical examiners to analyse their motivational, and possibly sexual, background. The medico-legal approach to some autopsy findings of these cases also illustrates some controversial diagnostic issues regarding mechanical asphyxia, issues recurrently debated during the 19th century.

Impotence in the 18th and 19th century: concepts of etiology and approaches to therapy.

The old word impotence is derived from the Latin word impotencia, which literally translated means "lack of power." Impotence, in the course of the history, has been attributed to mental pathology, anxiety, or demons or witches. Historically, the pharmacological treatments for impotence started in Greek times, when a myriad of herbal medications were applied locally to the genitals to enhance "sexual strength." In the 18th century, theories about the main factors inducing impotence saw it as an abnormal state of the fibers, a defect in the solid or liquid substances or a bad structure (tumor, inflammation, abscess, ulcer or foreign body). According to these mechanisms, when impotence depended on the state of the muscular fibers, treatment included a tepid bath and a clyster. In very fat or very weak people, who get particularly tired, it was important to use the remedies able to give energy to the fibers, such as ferrous mineral waters, for a month. Moreover, other suggestions were to ride a horse, to sleep few hours, to breathe good country air, to take a purge every 2 weeks, to drink half a glass of wine from Borgogne or to distract the mind continuously. In the 19th century, therapies regarding impotence included slight electric stimulation through the application of stimulators on the scrotum in the testis or epididymis areas, until pain was induced. In the same period, another method for treating impotence was flagellation. This method consisted of little flagellations with leather strips.

The queer periphery: sexual deviancy and the cultural understanding of space.

The association of normative sexuality with the geographical center and sexual deviancy with the geographical periphery represents a pattern of thinking that has stayed with us in different guises throughout history. The article traces this pattern and some of its complex ramifications from the ancient Greeks to the present.

Nineteenth-century British psychiatric writing about homosexuality before Havelock Ellis: the missing story.

Recent accounts of the emergence of sexology have addressed the role played by homosexuals and sexual radicals in framing the questions posed by psychiatrists. This work has focused largely upon American and Continental psychiatry (with regard to homosexuality), with attention to British sexologists sometimes being tied to contemporary feminist concerns with the sexual double standard. In both cases, psychiatrists are shown to be following other social movements. In the existing work, British psychiatrists of the nineteenth century who wrote about homosexuality have been largely ignored because it appears to have been assumed that very little material existed prior to Havelock Ellis' Sexual Inversion (1897). In this article, I demonstrate that there were a number of British psychiatric discussions of sexual perversions, and that these discourses show an engagement on the part of British psychiatrists with the theoretical issues that occupied their (mostly) Teutonic colleagues, rather than evidence of any other external driving force behind the production of sexological discourses. These sexological texts are either original papers, or reviews of Continental sources, both of which illustrate the importation of sexological ideas into Britain before the writing of Havelock Ellis.

[Review of symptoms and therapy of paraphylias]. / A parafíliák tünettanák és terápiajának áttekintése.

The authors review the historical main milestones in the legislative aspects of sexual deviances, from ancient times through age of enlightenment to present times, including the factors affecting the Hungarian public attitudes towards it. The evolution of nomenclature of sexual orientation disorders is also evaluated thoroughly, detailing the DSM-IV-TR classification and the attempts and difficulties to further develop the present classification system. The authors also review the difficulties of epidemiological studies and sum up the pioneer work of Alfred Kinsey. The etiology of paraphylias is summed up based on biological, psychodynamic and learning theory approaches. Finally, the pharmacological and psychotherapeutic interventions are evaluated considering also comorbidity, outer control and forensic psychiatric aspects.

[Origin of psychiatric disorders ex sexualibus: explanatory approaches at the beginning of the 19th century]. / Die Entstehung psychischer Stöungen ex sexualibus: Erklärungsansätze zu Beginn des 19. Jahrhunderts.

In the first half of the 19th century there were the first publications, which dealt systematically with the relation between deviations of the sexual system or behaviour and mental disturbances. The knowledge and the theoretical ideas of medicine and of psychiatric diseases at that time and a discussion concerning the consequences of masturbation can be demonstrated in works like "De mentis aberrationibus ex partium sexualium conditione abnormi oriundis" by Hermann Joseph Löwenstein (1823) and "Ueber die Beziehungen des Sexualsystemes zur Psyche überhaupt und zum Cretinismus ins Besondere" by Joseph Häussler (1826). Both publications try to sytemize the issue and prove their hypotheses by numerous casuistics. The autors belong to the so called "Somatis School" in psychiatry at that time.

"La manie d'ecrire": psychology, auto-observation, and case history.

This essay examines the modern psychiatric case study as a scientific method and as a genre of writing about the self. As psychological discourse became a privileged language of selfhood at the fin de siècle, the penultimate signifier of the self came to be found in the realm of sexuality, in the particular contours of an individual's sexual desire. The investigative tool used to uncover these secrets of identity was the case history. This article concerns an influential project of sexual research based on "auto-observations"-autobiographical patient narratives-conducted by Dr. Georges Saint-Paul, who published under the inverted pseudonym "Laupts." The article focuses on the central autobiography of his collection, the "roman d'un inverti," and related sexological literature to suggest how this emphasis on patient stories in psychiatric writing engendered new narrative possibilities for doctors and patients alike. Putting patient stories at the center of psychiatric investigation created a new relationship between patient and doctor, observation and diagnosis, subject and discourse. The tools of psychological observation simultaneously placed a subject's confession more firmly at the center of the investigation and made it more open to interpretation by nonspecialists. Rather than simply confirming the authority of the trained observer, the story of Laupts's enquête suggests that the method actually authorized inquiry by others.

A brief history of behavioral and cognitive behavioral approaches to sexual offenders: Part 1. Early developments.

This is the first of two papers which briefly outline the development of behavioral and cognitive behavioral treatment of sexual offenders from the mid-1800s to 1969. We first consider the historic role of Sigmund Freud and note that a broad scientific interest in deviant sexual behaviour was well established by 1900. In the early to mid-20th century, two psychologies were prominent in the development of behaviorial approaches, those of John B. Watson and Alfred Kinsey. Behavior therapy for a variety of problems emerged in the 1950s and soon found application to deviant sexuality. The development of penile plethysmography helped to focus interest on deviant sexual preference and behavior. While nonbehavioral approaches to sexual offenders paralleled these developments, a combination of behavioral and cognitive behavioral treatments began to emerge in the late 1960s which ultimately developed into the approaches more commonly seen today.

A brief history of behavioral and cognitive behavioral approaches to sexual offender treatment: Part 2. The modern era.

This paper is the second in our attempt to highlight the major influences, trends, and emerging issues in cognitive behavioral approaches to treating sexual offenders. In this paper the developments from 1970 until the present are covered.

Social basis of deviant sexual behaviour: a historical perspective.

Sexual perversions are often a product of civilized life. Most societies permit some degree of deviant sexual behaviour as a relief from stress of routine life. Criteria for labelling such behaviour have changed over a period of time. There have been instances of normalizing deviant sexual behaviour by formation of pressure groups by the deviants e.g. homosexual clubs, particularly in Western countries. Attitude of church on masturbation & homosexuality has fluctuated from forbidding these activities to accepting these as harmless acts. Extra marital sex, premarital sex, homosexuality, fellatio, masturbation have been reported from almost all societies. Swinging and mate-swapping is more prevalent in the West. Social factors associated with deviant sexual behaviour are discussed. Incest lobbies have come up in U. S. Prostitution has also been there in all societies since antiquity. Earlier, prostitutes enjoyed a relatively higher social status. Their degradation started with the dawn of Christianity. In 1960s there was sexual revolution in U. S. with emphasis on free sex. There is evidence of slowing down of sexual revolution with the advent of AIDS. Safe-sex and fidelity are now being emphasized.

[Not Available]. / Psychopathia sexualis - die ärztliche Konstruktion der sexuallen Perversionen zwischen 1869 und 1914.

The article investigates the culture- and socialhistorical background of the origin and early development of sexual pathology in Germany. In its first part it shows how sexual pathology, first known as Psychopathia sexualis, came into being as a special field of psychiatry. Its most important founder, Richard von Krafft-Ebing, constructed a system of sexual perverts. After 1869, together with colleagues he developed wholly new concepts of deviant sexuality and how to deal with it. In the second part it is shown which points of Krafft-Ebing's concept of perversity were taken over by his medical successors and which points were modified or even rejected as a result of sharp criticism. Finally the long-term effects of the pathologization of deviant sexual behaviour are depicted, the medicalization of social deviance, the change in understanding of sexuality and other developments.

Deviance as history: the future of perversion.

An approach to the social construction of concepts of sexual deviance and sexual perversions is considered. Deviance is conceptualized as a problem of control, perversion a problem of desire. These are seen as related to the larger sexual and nonsexual discursive practices of society and given to change as these contextualizing practices change. Changing conceptions regarding masturbation, homosexuality, pedophilia, and sadomasochism are examined.