Other behavioral methods³⁶

Masturbatory satiation

• The goal is to reduce deviant sexual attraction by associating it with boredom.
• The patient is instructed to masturbate while verbalizing his deviant fantasy, for up to an hour, continuing even after orgasm.
• One variation, verbal satiation, requires the dictation on an audiotape of the deviant fantasy for at least 30 minutes after masturbation.
• Another variation requires the offender to masturbate to orgasm while imagining a normal fantasy, then to continue masturbating to his deviant sexual fantasy while unaroused. If he becomes aroused, he is told to switch to an appropriate fantasy, or perhaps exposed to an aversive stimulus such as ammonia.
• Effectiveness is not supported by controlled studies, but a few very small-scale uncontrolled studies have suggested short-term success with pedophiles.

Orgasmic reconditioning

• The goal is to transfer the patient’s anomalous arousal to normal stimuli.
• The patient is allowed to become aroused by a deviant fantasy or stimulus (visual or audiotaped), but then switches to a normal fantasy or stimulus immediately before orgasm.
• Only very small scale studies of the effectiveness of this method on homosexuals and deviants have been conducted, and have shown mixed results. When they show success, one cannot be sure that the patient is not still imagining the deviant stimulus.

Systematic desensitization

• The goal is to reduce the patient’s anxiety about sex with adult women.
• The therapist progressively describes romantic/sexual situations with women that are known to be more and more stressful for the patient. With each situation, the patient applies relaxation techniques to reduce his anxiety.
• Effectiveness with homosexuals and deviants has not been demonstrated.