Controversy Associated with Personality and Paraphilic Disorders

Controversy Associated with Personality and Paraphilic Disorders

Maintaining the therapeutic relationship, and ethical and legal considerations for patients with Paraphilic disorders.

Paraphilic disorders are far more common in men than in women, and are generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.

In this Assignment, you will explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.

To Prepare
  • Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
  • Select a specific personality or paraphilic disorder from the DSM-5 to use for this Assignment.
  • Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
The Assignment

In 2–3 pages:

  1. Explain the controversy that surrounds your selected disorder.
  2. Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
  3. Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
  4. Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.




Controversy Associated with Personality and Paraphilic Disorders




Student’s Name







Controversy Associated with Personality and Paraphilic Disorders

Maintaining the Therapeutic Relationship and Ethical and Legal Considerations for Patients with Paraphilic Disorders

Personality and paraphilic disorders are a subject of controversy active in mental health. Personality diseases are distinguished by facing behavior patterns, cognition, and inner encounter deviating from cultural norms, causing real distress or impairment. Paraphilic diseases entail unconventional sexual interests causing distress or impairment to an individual (Rowlands et al., 2023).  Some controversy develops from the fact that the diagnosis criteria of the disease are personalized and culturally bound, leading to topics about their validity and reliability.  In addition, there are arguments on personality and paraphilic diseases that the diseases are overdiagnosed, and others argue that the disorders are underdiagnosed. The controversy connected with personality and paraphilic diseases indicates the complications and diversification of human behavior, highlighting the ongoing requirement for research and conversation in the mental health industry. This essay will explore the controversy surrounding the dissociative disorder, professional beliefs about dissociative disorder, strategies for maintaining the patient’s therapeutic relationship, and ethical and legal considerations connected to the disorder.

The Controversy Surrounding Dissociative Disorder

The term “Dissociative Disorders” is a familiar umbrella name in the 5th edition of the Diagnostic and Statistical of mental diseases describing mental diseases featuring behavior, perceptual, and specification problems as fundamental defining features. According to Scheinost et al. (2018), dissociative identity diseases, dissociative amnesia, other specified dissociative disorders, depersonalization/de-realization disorder, and unspecified dissociative disorders are the only mental diseases being recognized under the category. Dissociative diseases are said to occur as a direct continuation of too much consequence childhood abuse or trauma (Brewerton et al., 2019). Advocates of legitimacy explain that patients need dissociation to subsist with traumatic encounters by critically repressing traumatic memories, thoughts and actions. The idea of the existence of repressed memories is specifically controversial since mental health experts do not believe in the validity of the presence of a causal relationship between oppressed memories and childhood abuse, but they hold the dissenting view that traumatic childhood encounters are rarely forgotten victims and the reemergence of the so-termed oppressed memories likely an erroneous finding by fanatic therapist and troubled clients. Dissociative diseases are sometimes regarded as socially constructive, brought by sociocultural expectations and components of modern society like mass media.

Professional Beliefs about Dissociative Disorders

Although dissociation and dissociative disorders highlight a divisive topic right away, one can hold the professional belief that dissociative diseases are real. Clinical data supports the correlation theory between dissociation and traumatic encounters (Sun et al., 2018). The rationale behind one’s choice can be further supported by occasions where individuals diagnosed with the disorder are generally in a healthcare setting and represent the clinical control population. Psychiatric patients with sub-type disorders typically indicate significant enhancement after starting the recommended treatment options. It is essential to advocate for spreading relevant information about disorders under the group to the public, supporting early intervention, and promoting further research. In addition, dissociation is a mental condition that emerges after a traumatic encounter, further supporting its position specifically as a clear departure from routine pathology accompanies it. Psychological detachment from a traumatic experience is common among victims of severe abuse as it mitigates the impacts of intrusive thoughts and memories (Aron et al., 2019). This is compatible with the idea that traumatized patients often try to segregate their awareness from the reality of past traumatic encounters. The dissociative disease must be recognized and accepted as an areal psychiatric disorder as this will improve the efforts to highlight the most effective intervention for stabilizing patients with the state. It enhances the patient’s quality of life, minimizing the probability of self-harm or engagement in self-destructive behaviors.

Strategies for Maintaining a Therapeutic Correspondence with Clients with Dissociative Disorders

A solid therapeutic association forms the foundation of clinical intervention and is essential while treating a patient with complex psychological conditions like dissociative disorders. Therefore, one would strive to develop a rapport with the patient during the initial meeting and help them feel welcomed, notwithstanding the unfamiliar environment. It is also appropriate to understand that therapeutic relationships take a long time to develop. It is usually the only guarantee that a strong, close, and trusting relationship can be forged, which is particularly essential for dissociative disorders clients haunted by past traumas (Larsen & Witoszek, 2023). A neutral environment enhances the quality of therapy sessions by enabling the client to express deep-seated thoughts and emotions while hearing. Therapists must also avoid judging the clients and focus on treating them with compassion, avoiding offering advice on sensitive matters like religion. A therapist must always take charge of each session, providing a sense of direction and focusing on managing their emotions. An open patient-therapist dialogue has to be conducted on the primary objectives of each therapy session, enabling the client to comprehend better what they need from it and how to achieve set goals (Lawton et al., 2018). Therapists must never forget that their patients are vulnerable persons requiring high-quality care and attention, which they efficiently provide. If they are unable to meet the client’s need, they must make a purposive decision to discontinue the services referring them to another therapist.

Ethical and Legal Considerations Related to Dissociative Disorders

Ethical and legal considerations must always be considered during patient treatment to guarantee adherence to the highest standards of professional practice. Basically, clients presenting the symptoms of dissociative diseases have a right to understand the preliminary diagnosis (Bailey et al., 2019). Relaying this information during the initial meeting is essential in guiding treatment based on the most nessesally treatment option. The treatment option must also be based on a client’s individual needs. Clients confessing to having frequent self-harm intellection should be placed under suicide watch as failure to do so may have severe implications for a therapist and respective healthcare provider.


Personality and paraphilic disorders are controversial in the psychology industry, with most professional beliefs and ethical considerations surrounding diagnosing and treating such conditions. Dissociative disorders display challenges for mental health professionals, with differing beliefs about their existence and suitable therapeutic strategies. Despite these controversies, clinicians must maintain a solid therapeutic relationship with their clients, considering all ethical and legal implications when treating the disorders. By staying informed and employing evidence-based practice, mental health professionals can offer effective care for individuals with complex conditions.



Aron, C. M., Harvey, S., Hainline, B., Hitchcock, M. E., & Reardon, C. L. (2019). Post-traumatic stress disorder (PTSD) and other trauma-related mental disorders in elite athletes: a narrative review. British Journal of sports medicine53(12), 779-784.

Bailey, T. D., Boyer, S. M., & Brand, B. L. (2019). Dissociative disorders. Diagnostic interviewing, 401-424.

Brewerton, T. D., Alexander, J., & Schaefer, J. (2019). Trauma-informed care and practice for eating disorders: Personal and professional perspectives of lived experiences. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity24, 329-338.

Larsen, M., & Witoszek, N. (2023). Strategies of prosociality: Comparing Nordic and Slavonic altruism toward Ukrainian refugees. Frontiers in Psychology14.

Lawton, M., Sage, K., Haddock, G., Conroy, P., & Serrant, L. (2018). Speech and language therapists’ perspectives of therapeutic alliance construction and maintenance in aphasia rehabilitation post‐stroke. International Journal of Language & Communication Disorders53(3), 550-563.

Rowlands, M. T., Morrison, F. P., Brock, E., Stocker, H., Green, D. R., Marks, D., & Castano, D. (2023). Development of the atypical sexual interests (self-report) scale: the dimensional structure of paraphilia. Psychiatry, Psychology and Law, 1-25.

Scheinost, D., Holmes, S. E., DellaGioia, N., Schleifer, C., Matuskey, D., Abdallah, C. G., … & Esterlis, I. (2018). Multimodal investigation of network level effects using intrinsic functional connectivity, anatomical covariance, and structure-to-function correlations in unmedicated major depressive disorder. Neuropsychopharmacology43(5), 1119-1127.

Sun, P., Alvarez-Jimenez, M., Simpson, K., Lawrence, K., Peach, N., & Bendall, S. (2018). Does dissociation mediate the relationship between childhood trauma and hallucinations, delusions in first episode psychosis? Comprehensive Psychiatry84, 68-74.

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