According to psychoanalytic theory, paraphilias are manifestations of unresolved inner conflict, which are rooted in one's childhood. It is thought that abnormal or irrational behaviors associated with each of the paraphilias are symbolic of the fear of castration.

As an example, an exhibitionist may resort to flashing his penis at people, purely for his need to confirm the presence of his genitals. The shock of being flashed is the confirmation he needs to relieve the anxiety (Rathus, Nevid & Fichner-Rathus, 2005, p.594). Several theories exist about the cause of paraphilias, and there is no one correct theory. Many treatment options are available; however, it will depend on the theoretical orientation of a particular therapist as to which treatment will be applied.