Selective serotonin reuptake inhibitors (SSRIs) are used, especially with exhibitionists, non-offending pedophiles, and compulsive masturbators. They are proposed to work by reducing sexual arousal, compulsivity, and depressive symptoms. However, supporting evidence for SSRIs is limited.

Pharmacological treatments can help people control their sexual behaviors, but do not change the content of the paraphilia. They are typically combined with cognitive behavioral therapy for best effect.

Psychosexual disorders can vary greatly in severity and treatability. Medical professionals and licensed therapists are necessary in diagnosis and treatment plans. Treatment can vary from therapy to prescription medication. Sex therapy, behavioral therapy, and group therapy may be helpful to those suffering distress from sexual dysfunction. More serious sexual perversions may be treated with androgen blockers or selective serotonin reuptake inhibitors (SSRIs) to help restore hormonal and neurochemical balances.

Sadomasochism is the giving or receiving pleasure from acts involving the receipt or infliction of pain or humiliation. Practitioners of sadomasochism may seek sexual gratification from their acts. While the terms sadist and masochist refer respectively to one who enjoys giving or receiving pain, practitioners of sadomasochism may switch between activity and passivity.

The abbreviation S&M is often used for sadomasochism, although practitioners themselves normally remove the ampersand and use the acronym S-M or SM or S/M when written throughout the literature. Sadomasochism is not considered a clinical paraphilia unless such practices lead to clinically significant distress or impairment for a diagnosis. Similarly, sexual sadism within the context of mutual consent, generally known under the heading BDSM, is distinguished from non-consensual acts of sexual violence or aggression.

Sexual sadism disorder is the condition of experiencing sexual arousal in response to the extreme pain, suffering or humiliation of others. Several other terms have been used to describe the condition, and the condition may overlap with other conditions that involve inflicting pain. It is distinct from situations in which consenting individuals use mild or simulated pain or humiliation for sexual excitement. The words "sadism" and "" are derived from Marquis de Sade.

Psychosexual disorder is a term which may simply refer to a sexual problem that is psychological, rather than physiological in origin. "Psychosexual disorder" was a term used in . The term of psychosexual disorder (Turkish: "Psikoseksüel bozukluk") used by the TAF for homosexuality as a reason to ban the LGBT people from military service.

Some rubber and plastic fetishists have an affinity for diapers and rubber pants. In the case of disposable diapers, this attraction would be to their crinkly plastic backing. In the case of cloth diapers, it would be towards the latex or pvc of the pants worn over them.

Diaper fetishism, nappy fetishism or diaperism, is a type of garment fetish or paraphilic infantilism. A person with a diaper fetish derives pleasure from the diaper and/or use of it. Being forced to wear diapers as a form of humiliation is sometimes a behavior encountered in sexual masochism.

It is important to note that the diaper fetish community actively opposes and condemns child molesters. Both men and women can practice diaper fetishes, both inside and outside a relationship. As of September 2015, Huffington Post Arts & Culture published an interview on diaper fetishes that was widely regarded as informative within the community. While this clothing fetish is obscure, diaper fetishists engage in the behavior privately or with a partner who shares a mutual interest in the fetish.

Vorarephilia (often shortened to vore) is a paraphilia characterized by the erotic desire to be consumed by, or sometimes to personally consume, another person or creature, or an erotic attraction to the process of eating in general. Since vorarephilic fantasies cannot usually be acted out in reality, they are often expressed in stories or drawings shared on the Internet. The word "vorarephilia" is derived from the Latin "vorare" (to "swallow" or "devour"), and Ancient Greek φιλία ("philía", "love").

The fantasy usually involves the victim being swallowed whole, though occasionally the victims are chewed up, and digestion may or may not be included. Vore fantasies are separated from sexual cannibalism because the living victim is normally swallowed whole. Sometimes the consumers are human, but anthropormorphized animals, dragons, and enormous snakes also appear frequently in these fantasies. After consumption, the enlarged belly of the consumer is often described with great care. Vorarephiles sometimes prefer to differentiate between "soft vore" and "hard vore"; soft vore means the victim is swallowed whole and alive, and may possibly come back out in the case of a "non-fatal" scenario, while in hard vore the victim goes through a more gruesome, realistic digestion process, often getting chewed up beforehand.

Vore is most often enjoyed through pictures, stories, videos, and video games, and it can appear in mainstream media. In some cases, vorarephilia may be described as a variation of macrophilia and may combine with other paraphilias. Apart from macrophilia, vore fantasies often have themes of BDSM, microphilia, pregnancy fetishism, furry fetishism, "unbirthing" (a desire to be swallowed whole into the vagina and returned to the uterus), and sexual cannibalism.

One case study analysis connected the fantasy with sexual masochism, and suggested that it could be motivated by a desire to merge with a powerful other or permanently escape loneliness. With "no known treatment" for vorarephiles who feel ill at ease with their sexuality, psychologists at Toronto's Centre for Addiction and Mental Health have recommended trying to "adjust to, rather than change or suppress" the sexual interest. Medication for sex drive reduction could be used if deemed necessary.

BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics. Given the wide range of practices, some of which may be engaged in by people who do not consider themselves as practicing BDSM, inclusion in the BDSM community or subculture is usually dependent upon self-identification and shared experience.

The term "BDSM" is first recorded in a Usenet posting from 1991, and is interpreted as a combination of the abbreviations B/D (Bondage and Discipline), D/s (Dominance and submission), and S/M (Sadism and Masochism). BDSM is now used as a catch-all phrase covering a wide range of activities, forms of interpersonal relationships, and distinct subcultures. BDSM communities generally welcome anyone with a non-normative streak who identifies with the community; this may include cross-dressers, body modification enthusiasts, animal roleplayers, rubber fetishists, and others.

Activities and relationships within a BDSM context are often characterized by the participants taking on complementary, but unequal roles; thus, the idea of informed consent of both the partners is essential. The terms "submissive" and "dominant" are often used to distinguish these roles: the dominant partner ("dom") takes psychological control over the submissive ("sub"). The terms "top" and "bottom" are also used: the top is the instigator of an action while the bottom is the receiver of the action. The two sets of terms are subtly different: for example, someone may choose to act as bottom to another person, for example, by being whipped, purely recreationally, without any implication of being psychologically dominated by them, or a submissive may be ordered to massage their dominant partner. Despite the bottom performing the action and the top receiving they have not necessarily switched roles.

The abbreviations "sub" and "dom" are frequently used instead of "submissive" and "dominant". Sometimes the female-specific terms "mistress", "domme" or "dominatrix" are used to describe a dominant woman, instead of the gender-neutral term "dom". Individuals who can change between top/dominant and bottom/submissive roles—whether from relationship to relationship or within a given relationship—are known as "switches". The precise definition of roles and self-identification is a common subject of debate within the community.

Nichols (2006) compiled some common clinical issues: countertransference, non-disclosure, coming-out, partner/families, and bleed-through.

Countertransference is a common problem in clinical settings. Despite having no evidence, therapists may find themselves believing that their client’s pathology is "self-evident". Therapists may feel intense disgust and aversive reactions. Feelings of countertransference can interfere with therapy. Another common problem is when clients conceal their sexual preferences from their therapists. This can compromise any therapy. To avoid non-disclosure, therapists are encouraged to communicate their openness in indirect ways with literatures and artworks in the waiting room. Therapists can also deliberately bring up BDSM topics during the course of therapy. With less informed therapists, sometimes they over-focus on clients’ sexuality which detracts from original issues such as family relationships, depression, etc. A special subgroup that needs counselling is the "newbie". Individuals just coming out might have internalized shame, fear, and self-hatred about their sexual preferences. Therapists need to provide acceptance, care, and model positive attitude; providing reassurance, psychoeducation, and bibliotherapy for these clients is crucial. The average age when BDSM individuals realize their sexual preference is around 26 years. Many people hide their sexuality until they can no longer contain their desires. However, they may have married or had children by this point. Therefore, therapists need to facilitate couple's counselling and disclosure. It is important for therapists to consider fairness to partner and family of clients. In situations when boundaries between roles in the bedroom and roles in the rest of the relationship blurs, a "bleed-through" problem has occurred. Therapists need to help clients resolve distress and deal with any underlying problems that led to the initial bleed-through.

With paraphilic coercive disorder, the individual employs enough force to subdue a victim, but with sexual sadism disorder, the individual often continues to inflict harm regardless of the compliance of the victim, which sometimes escalates not only to the death of the victim, but also to the mutilation of the body. What is experienced by the sadist as sexual does not always appear obviously sexual to non-sadists: Sadistic rapes do not necessarily include penile penetration of the victim. In a survey of offenses, 77% of cases included sexual bondage, 73% included anal rape, 60% included blunt force trauma, 57% included vaginal rape, and 40% included penetration of the victim by a foreign object. Moreover, in 40% of cases, the offender kept a personal item of the victim as a souvenir.

On personality testing, sadistic rapists apprehended by law enforcement have shown elevated traits of impulsivity, hypersexuality, callousness, and psychopathy.

Although there appears to be a continuum of severity from mild ("hyperdominance" or "BDSM") to moderate ("paraphilic coercive disorder") to severe ('sexual sadism disorder), it is not clear if they are genuinely related or only appear related superficially.

Very little is known about how sexual sadism disorder develops. Most of the people diagnosed with sexual sadism disorder come to the attention of authorities by committing sexually motivated crimes. Surveys have also been conducted including people who are interested in only mild and consensual forms of sexual pain/humiliation (BDSM).

Most of the people with full-blown sexual sadism disorder are male, whereas the sex ratio of people interested in BDSM is closer to 2:1 male-to-female.

People with sexual sadism disorder" are at an elevated likelihood of having other paraphilic sexual interests.

Gynophobia or gynephobia is an abnormal fear of women, a type of specific social phobia. In the past, the Latin term horror feminae was used.

Gynophobia should not be confused with misogyny, the hatred, contempt for and inveterate prejudice against women, although some may use the terms interchangeably, in reference to the social, rather than pathological aspect of negative attitudes towards women.

An antonym is philogyny, the love, respect for and admiration of women.

The term "sadomasochism" is used in a variety of different ways. It can refer to cruel individuals or those who brought misfortunes onto themselves and psychiatrists define it as pathological. However, recent research suggests that sadomasochism is mostly simply a sexual interest, and not a pathological symptom of past abuse, or a sexual problem, and that people with sadomasochistic sexual interest are in general neither damaged nor dangerous.

The two words incorporated into this compound, "sadism" and "masochism", were originally derived from the names of two authors. The term "Sadism" has its origin in the name of the Marquis de Sade (1740–1814), who not only practiced sexual sadism, but also wrote novels about these practices, of which the best known is "Justine". "Masochism" is named after Leopold von Sacher-Masoch, who wrote novels expressing his masochistic fantasies. These terms were first selected for identifying human behavioural phenomena and for the classification of psychological illnesses or deviant behaviour. The German psychiatrist Richard von Krafft-Ebing introduced the terms "Sadism" and "Masochism"' into medical terminology in his work "Neue Forschungen auf dem Gebiet der Psychopathia sexualis" ("New research in the area of Psychopathology of Sex") in 1890.

In 1905, Sigmund Freud described sadism and masochism in his "Drei Abhandlungen zur Sexualtheorie" ("Three papers on Sexual Theory") as stemming from aberrant psychological development from early childhood. He also laid the groundwork for the widely accepted medical perspective on the subject in the following decades. This led to the first compound usage of the terminology in "Sado-Masochism" (Loureiroian "Sado-Masochismus") by the Viennese Psychoanalyst Isidor Isaak Sadger in his work "Über den sado-masochistischen Komplex" ("Regarding the sadomasochistic complex") in 1913.

In the later 20th century, BDSM activists have protested against these ideas, because, they argue, they are based on the philosophies of the two psychiatrists, Freud and Krafft-Ebing, whose theories were built on the assumption of psychopathology and their observations of psychiatric patients. The DSM nomenclature referring to sexual psychopathology has been criticized as lacking scientific veracity, and advocates of sadomasochism have sought to separate themselves from psychiatric theory by the adoption of the term "BDSM" instead of the common psychological abbreviation, "S&M". However, the term BDSM also includes, B&D (bondage and discipline), D/s (dominance and submission), and S&M ( and masochism). The terms "bondage" and "discipline" usually refer to the use of either physical or psychological restraint or punishment, and sometimes involves sexual role playing, including the use of costumes.

In contrast to frameworks seeking to explain sadomasochism through psychological, psychoanalytic, medical or forensic approaches, which seek to categorize behavior and desires, and find a root cause, Romana Byrne suggests that such practices can be seen as examples of "aesthetic sexuality", in which a founding physiological or psychological impulse is irrelevant. Rather, according to Byrne, sadism and masochism may be practiced through choice and deliberation, driven by certain aesthetic goals tied to style, pleasure, and identity, which in certain circumstances, she claims can be compared with the creation of art.

There are many different forms (modalities) of treatment used for personality disorders:

- Individual psychotherapy has been a mainstay of treatment. There are long-term and short-term (brief) forms.

- Family therapy, including couples therapy.

- Group therapy for personality dysfunction is probably the second most used.

- Psychological-education may be used as an addition.

- Self-help groups may provide resources for personality disorders.

- Psychiatric medications for treating symptoms of personality dysfunction or co-occurring conditions.

- Milieu therapy, a kind of group-based residential approach, has a history of use in treating personality disorders, including therapeutic communities.

- The practice of mindfulness that includes developing the ability to be nonjudgmentally aware of unpleasant emotions appears to be a promising clinical tool for managing different types of personality disorders.

There are different specific theories or schools of therapy within many of these modalities. They may, for example, emphasize psychodynamic techniques, or cognitive or behavioral techniques. In clinical practice, many therapists use an 'eclectic' approach, taking elements of different schools as and when they seem to fit to an individual client. There is also often a focus on common themes that seem to be beneficial regardless of techniques, including attributes of the therapist (e.g. trustworthiness, competence, caring), processes afforded to the client (e.g. ability to express and confide difficulties and emotions), and the match between the two (e.g. aiming for mutual respect, trust and boundaries).

Theodore Millon has proposed four subtypes of masochist. Any individual masochist may fit into none, one or more of the following subtypes:

Until the 1990s, it tended to be described mostly as acrotomophilia, at the expense of other disabilities, or of the wish by some to pretend or acquire disability. Bruno (1997) systematised the attraction as factitious disability disorder. A decade on, others argue that erotic target location error is at play, classifying the attraction as an identity disorder. In the standard psychiatric reference "Diagnostic and Statistical Manual of Mental Disorders", text revision (DSM-IV-tr), the fetish falls under the general category of "Sexual and Gender Identity Disorders" and the more specific category of paraphilia, or sexual fetishes; this classification is preserved in DSM-5.

Historically, masochism has been associated with feminine submissiveness. This disorder became politically controversial when associated with domestic violence which was considered to be mostly caused by males. However a number of studies suggest that the disorder is common. In spite of its exclusion from DSM-IV in 1994, it continues to enjoy widespread currency amongst clinicians as a construct that explains a great many facets of human behaviour.

Sexual masochism that "causes clinically significant distress or impairment in social, occupational, or other important areas of functioning" is still in DSM-IV.

Attraction to disability or devotism is a sexualised interest in the appearance, sensation and experience of disability. It may extend from normal human sexuality into a type of sexual fetishism. Sexologically, the pathological end of the attraction tends to be classified as a paraphilia. (Note, however, that the very concept "paraphilia" continues to elude satisfactory definition and remains a subject of ongoing debate in both professional and lay communities) Other researchers have approached it as a form of identity disorder. The most common interests are towards amputations, prosthesis, and crutches.

The management and treatment of personality disorders can be a challenging and controversial area, for by definition the difficulties have been enduring and affect multiple areas of functioning. This often involves interpersonal issues, and there can be difficulties in seeking and obtaining help from organizations in the first place, as well as with establishing and maintaining a specific therapeutic relationship. On the one hand, an individual may not consider themselves to have a mental health problem, while on the other, community mental health services may view individuals with personality disorders as too complex or difficult, and may directly or indirectly exclude individuals with such diagnoses or associated behaviors. The disruptiveness that people with personality disorders can create in an organisation makes these, arguably, the most challenging conditions to manage.

Apart from all these issues, an individual may not consider their personality to be disordered or the cause of problems. This perspective may be caused by the patient's ignorance or lack of insight into their own condition, an ego-syntonic perception of the problems with their personality that prevents them from experiencing it as being in conflict with their goals and self-image, or by the simple fact that there is no distinct or objective boundary between 'normal' and 'abnormal' personalities. Unfortunately, there is substantial social stigma and discrimination related to the diagnosis.

The term 'personality disorder' encompasses a wide range of issues, each with a different level of severity or disability; thus, personality disorders can require fundamentally different approaches and understandings. To illustrate the scope of the matter, consider that while some disorders or individuals are characterized by continual social withdrawal and the shunning of relationships, others may cause "fluctuations" in forwardness. The extremes are worse still: at one extreme lie self-harm and self-neglect, while at another extreme some individuals may commit violence and crime. There can be other factors such as problematic substance use or dependency or behavioral addictions. A person may meet the criteria for multiple personality disorder diagnoses and/or other mental disorders, either at particular times or continually, thus making coordinated input from multiple services a potential requirement.

Therapists in this area can become disheartened by lack of initial progress, or by apparent progress that then leads to setbacks. Clients may be perceived as negative, rejecting, demanding, aggressive or manipulative. This has been looked at in terms of both therapist and client; in terms of social skills, coping efforts, defense mechanisms, or deliberate strategies; and in terms of moral judgments or the need to consider underlying motivations for specific behaviors or conflicts. The vulnerabilities of a client, and indeed a therapist, may become lost behind actual or apparent strength and resilience. It is commonly stated that there is always a need to maintain appropriate professional personal boundaries, while allowing for emotional expression and therapeutic relationships. However, there can be difficulty acknowledging the different worlds and views that both the client and therapist may live with. A therapist may assume that the kinds of relationships and ways of interacting that make them feel safe and comfortable have the same effect on clients. As an example of one extreme, people who may have been exposed to hostility, deceptiveness, rejection, aggression or abuse in their lives, may in some cases be made confused, intimidated or suspicious by presentations of warmth, intimacy or positivity. On the other hand, reassurance, openness and clear communication are usually helpful and needed. It can take several months of sessions, and perhaps several stops and starts, to begin to develop a trusting relationship that can meaningfully address a client's issues.

The term "gynophobia" comes from the Greek γυνή - "gunē", meaning "woman" and φόβος - "phobos", "fear".

Hyponyms of the term "gynophobia" include "feminophobia",

A cuckold is the husband of an adulterous wife. In evolutionary biology, the term is also applied to males who are unwittingly investing parental effort in offspring that are not genetically their own.

Psychology regards cuckold fetishism as a variant of masochism, the cuckold deriving pleasure from being humiliated. In Freudian analysis, cuckold fetishism is the eroticization of the fears of infidelity and of failure in the man's competition for procreation and the affection of females. In his book "Masochism and the Self," psychologist Roy Baumeister advanced a "Self Theory" analysis that cuckolding (other forms of sexual masochism) among otherwise mentally healthy people was a form of escapism. According to this theory, cuckold fetishists are relieving themselves of the stress of the burden of their social role and escaping into a simpler, less-expansive position.

If a couple can keep the fantasy in the bedroom, or come to an agreement where being cuckolded in reality does not damage the relationship, they may try it out in reality. However, the primary proponent of the fantasy is almost always the one being humiliated, or the "cuckold": the cuckold convinces his lover to participate in the fantasy for them, though other "cuckolds" may prefer their lover to initiate the situation instead. The fetish fantasy does not work at all if the cuckold is being humiliated against their will.