The Use of Cognitive Behavioural Therapy on Two Case Reports of Paraphilic Infantilism, Substance Misuse and Childhood Abuse

Abstract

Abbreviations: APA, american psychiatric association; AB, adult baby; SB, sissy babies'; DL, diaper lovers; CBT, cognitive behavioral therapy; SSRIS, selective serotonin re-uptake inhibitors; PTSD, posttraumatic stress disorder Introduction: An overview of paraphilic infantilismParaphilia refers to the intense and persistent sexual interest and arousal towards objects, situations or individuals which are atypical, equal to and/or greater than normophilic sexual interests.1 Paraphilic disorders in the DSM-5 include exhibitionism, fetishism, peadophilia, sexual masochism, sexual sadism, transvestic fetishism and voyeurism possess a formal diagnostic criteria (APA, 2015). However, paraphilic infantilism is classified as a sexual disorder under, 'other specified paraphilic disorder'. 1 It was during the 1960's that reference to clients' exclusive wearing of diapers as a means of attaining sexual arousal became documented. Tuchman & Lachman 2 reported a child sex offender, who had been molesting his 4 and 6 year old daughters. He would wear rubber pants over his diaper and enjoyed urinating and masturbating in them. Malitz 3 describes a 20 year old male who had broken into a house with the sole intention of wearing diapers and defecating in them and subsequently reaching orgasm. Dinello 4 provided a diagnostic understanding of a 17 year old male who wore diapers, had eaten baby food, drank from a baby bottle and masturbated whilst wearing a diaper.During the 1980's, Money 5 termed the paraphilic condition of impersonating a baby, autonepiophilia, diaperism or paraphilic infantilism. Money 6 distinguished between infantilism, autonepiophilia and paraphilic diaper-wearing, stating that the latter is a paraphilic fetish involving an erotic attraction to an article of clothing whilst the former is a non-fetishistic paraphilia aimed at regressive age identity role play. Paraphilic infantilism was described as an individual acting as an infant including associated behaviours of drinking from a baby bottle, being fed baby food, being breast fed, wearing baby cloths, wearing diapers and sleeping in a crib. This may have involved the assistance of a 'nanny', 'daddy' or 'mommy' to accommodate the infantilists requirements. 6,7 When role play involves regressing back to an infant state the individual is referred to as an adult baby (AB). The AB's like to dress up as a baby, get baby fed, have diaper changes and so forth.7 'Sissy babies' (SB) are adults who also play the infant role however, the role played is the opposite gender and may involve cross dressing SBs. Those who only engage in wearing diapers, as a sexual fetish, without the regressive fantasies are referred to as diaper lovers (DL). 7Those who experience both the sexual aspect of wearing diapers and the enjoyment of engaging in infantile play are referred to as adult baby/diaper lovers (AB/DL). 7Money 6 also referred to paraphilic juvenilism or age play. Age Play predominately involves adults who role play at being babies, children or younger adults. Money 6 examin...

An Exploratory Study of Adult Baby-Diaper Lovers’ Characteristics in an Italian Online Sample

“…Cernowsky and Bureau [9] reported a case of a woman affected by depressive symptoms and ABDL interests who was asking for help only for the former symptoms, not for the latter. Banbury, Lusher, Lewis, and Turner [10] described a case of two adults who practiced ABDL and had a drug addiction, showing that in both cases, either the addiction and the ABDL practices could be considered an auto-medication practices carried out to face sexual abuses during childhood. In both cases, only the drug addiction was perceived as distressing or as a dangerous problem.…”

“…These behaviours are likely aimed to encourage identification with a baby and to simplify infant regression [12,16,18]. Considering that for AB individuals neither research of sexual arousal nor sexual pleasure is a priority, it is not possible to consider this practice as a paraphilic interest or behaviour [10].…”

“…Zamboni [16] and Zamboni and Madero [18] hypothesized that for these persons, AB behaviour was a way to create social, romantic and/or affective links, decreasing simultaneously interpersonal anxiety. For other individuals, AB behaviours could be a way to relax, to avoid negative mood state or daily responsibility, even to become a lifestyle [8,10,11]. For other persons, instead, AB practices could reveal the attempt to re-live and change their own childhood [22] and to accomplish love and acceptance not felt during childhood [12].…”

“…In the literature, different hypotheses have been proposed for the genesis of ABDL interests. According to some scholars [3,8,10], ABDL practices are related to traumatic developmental experiences. In this perspective, ABDL interests are considered as a way to elaborate psychological conflict consequent to traumatic experiences from childhood, such as sexual or physical abuse or experiences of victimization.…”

“…Based on the statements of some ABDL individuals, other scholars have hypothesized that ABDL behaviours can be considered the expression of more general dysfunctional coping strategies [10,11,22] carried out to avoid negative mood states, such as sadness and frustration, to decrease anxiety or to escape from daily responsibilities. This interpretation is also confirmed by the data observed by Hawkinson and Zamboni [12] that showed that, in males, the levels of anxiety or a negative mood state were positively associated with the frequency of AB role-play not with DL interest.…”