Reference no: EM133305922

Question 1. Discuss culturally-bound understandings of sexuality and sexual deviancy - how might we better understand present DSM-5 diagnoses for sexual deviancy if we contextualize them within our own culture?

Question 2: Luna thought back to the first time she and Miguel "sexted" each other, that is, exchanged text messages of an erotic nature. "I really liked the guy," said Luna, "so I came out swinging." She liked thinking about Miguel getting an alert on his phone that a picture had arrived and opening an image that would take his breath away. Luna followed it up with a text message that she thought would put him over the edge. When he texted back, Miguel agreed that the picture was one of the most erotic that anyone had ever sent to him. And the text message was blazing hot, too. The picture had been of Luna's perfectly pedicured feet protruding from a bubble bath, her bare legs visible up to her mid-thigh. The text that followed, Miguel would say, drove him out of his mind: I am out of the tub and rubbing lotion on my feet.

"At the time I did not think it was weird that Miguel liked that," said Luna, referring to her former boyfriend. "We were at that stage where we had hooked up a few times and gone out on a couple of dates, and I really liked him." It was not the first time that Luna had exchanged texts and pictures of a sexual nature with a guy. "Compared to what some guys have asked me to do, his asking for a shot of my feet in the bath seemed tame." Luna said that she believed a healthy sex life was interesting and adventurous. "About the third time we got together, he seemed to spend a lot of time on my feet," said Luna. "It started with a foot rub, which I really liked." From there, she said, it progressed to his kissing and sucking on her toes. "It tickled," said Luna, "but he was really into it, and it turned him on so much that I went along with it." For the most part, Luna continued, Miguel would eventually progress to more common kinds of sex play that she enjoyed and found satisfying. "During those early months, I indulged his interest in my feet," said Luna. "We both got what we needed to be satisfied."

Six months into their relationship, Luna and Miguel were living together, but Luna was having reservations about the long-term prospects for the relationship. "There were lots of things about Miguel I really liked," she said. Their friends got along. He had a great job. They were interested in the same activities and music. "Even my mom and sisters liked him," said Luna. But, she added, "Miguel's thing for feet was becoming weird." What had started as something that she found kind of kinky and harmless had blossomed into a problem in their relationship. Miguel had started off being content playing with her feet about every third or fourth time that they had sex. As time went on, "Miguel wanted my feet to be the center of our sex life." Luna said that she wanted to be a giving partner, but she was not getting her needs met. "The areas that I need to have my lover interested in are not in my feet," Luna said. Still, she had to consider other things about their relationship that were very good. "I didn't want our sex life to derail what was otherwise a good thing."

The couple reached an agreement. Once a month Luna would indulge Miguel. She would be supportive, loving, and understanding while he went all out with her feet. "All of the other times we had sex, it had to be like other couples do it," she said. Luna soon regretted this arrangement. Miguel would spend weeks preparing for "Foot Night," buying her shoes or sandals. He would become impatient with her when she struggled to use her feet to pleasure him. "Eventually," said Luna, "those nights were basically Miguel masturbating with my feet, and the rest of me was irrelevant." During their other romantic times, Miguel seemed to be detached from what the couple was doing together. "Miguel would go through the motions the other times we had sex," said Luna. She confronted him about this, and he admitted that he was often fantasizing about her feet during these times. "Looking back," she said, "I should have known the relationship was doomed when the only way he could get sexually aroused and climax was when my feet were involved."

Luna knew that when couples became exclusive and had been together a long time that their sex lives changed. For example, intercourse is not as often nor as intense. "But most couples figure it out," she said, "and we didn't." Their daily lives were fine. They rarely argued and were a good team. They had a circle of friends who enjoyed their company. "There were a lot of reasons to stay with Miguel," said Luna. "We loved each other." One day, Luna accidentally opened a package that had been addressed to Miguel. Inside was a pair of ladies pumps along with a pair of panties that looked like they had been worn. "I freaked out," said Luna. She checked the browser history on his computer. She found a number of pornographic web sites dedicated to women's feet. There were links to fetish web sites where women sold their used underwear and shoes. One woman was even selling jelly that she had squished between her toes. Disgusted, Luna shut down the computer.

When Miguel came home, she confronted him about the package and what she had seen on his computer. He said that he could not help himself; the only thing that could bring him to orgasm was feet. "I have to give him points for honesty," she said. She pleaded with him to attend counseling, but he refused. "He did not think he had a problem," said Luna. The two became distant, and the rest of their relationship began to crumble. Luna said she struggled with leaving a guy she loved over sex. "But his kink had just crossed a line and I told him to leave."

The two stayed in contact for a short time. Mutual friends updated Luna on Miguel's life. It sounded like he had not taken the breakup well. "That was the most frustrating part," said Luna. "If he just would have gone to counseling and gotten back to his old self, we could have been happy." Miguel lived with friends after moving out of Luna's place. Months later, Luna would learn that Miguel had lost his job. "I was surprised to learn he was working at a department store at the mall," she said. "I had always worried about my decision to leave Miguel," said Luna, "but when I heard he had gotten a job working in a shoe store," I knew I had made the right decision." A few months later, she heard that Miguel had lost his job helping women with their shoe purchases. "Women were complaining that he made them feel uncomfortable."

1. What disorder do you think characterizes Miguel?

2. DSM-5 Criteria For each criterion, either paste in indicative quote(s) and/or explain with specific evidence why that particular point is met for the diagnosis. Please include as many symptomatic quotes or as much evidence as you can find.

3. explaining what treatment(s) you would provide for Miguel, what that treatment would involve, and why this treatment would be useful