Exhibitionism: causes of this sexual paraphilia

The diagnostic manual (DSM) of the American Psychiatric Association includes 8 typical paraphilias and about 7 more unspecified ones. Among the most common typical paraphilias are fetishism, transvestic fetishism, exhibitionism, voyeurism, pedophilia and sexual masochism.

Having an inclination or even a consummate interest in one or more of the above categories does not in itself constitute any clinical syndrome. That is, the fact that a person feels desire or has an intense sexual fantasy towards an object, sensation or atypical sexual practice does not have to constitute a problem. However, What can cause a disorder is the verification that the paraphilia represents a dysfunction or an emotional conflict for the individual who suffers from it..

What is exhibitionism?

Exhibitionism is the exposure of one’s genitals to a stranger in order to achieve sexual arousal. This practice includes in itself the deviation of the sexual act, since the sensation of pleasure is obtained by showing the genitals to third parties, these being women or children, in most cases.

The person who practices exhibitionism instead of seeking a sexual encounter, represses it; becoming the end in itself. While sexual arousal occurs by mentally anticipating the situation, it is a sensation similar to that of masturbation.

At this point it is important to differentiate exhibition from exhibitionism. Since the concept of exhibition, unlike exhibitionism which is criminologically and medically delimited, does not imply an attitude of sexual content, since it consists purely and exclusively of showing something in public (Ripolles, 1982).

Why do some people enjoy showing their genitals in public?

Exhibitionism usually begins in adolescence. Most exhibitionists are men who are married, but with a marriage that is often conflictive. Approximately 30% of arrested male sex offenders are exhibitionists. They tend to perpetuate this type of behavior over time and between 20 and 50% are arrested more than once.

Possible causes

The causes of exhibitionism are in the formation of inadequate learning, by replacing the expected sexual stimulus, man or woman, with other external stimuli.

In the development of this paraphilia it usually happens that An inappropriate stimulus is associated with a strong sexual activation of the individual, which can become a sexually conditioned stimulus on other occasions. These situations generally occur during adolescence (Muse and Frigola, 2003).

Subsequent conditioning experiences through fantasies and masturbation would reinforce these sexual responses. Even There are factors that predispose an individual to exhibitionism, such as difficulties in establishing an interpersonal sexual relationship or lack of self-esteem.

Among the various causes, It has been found that exhibitionists tend to be shy individuals, those who don’t find it easy to relate to women. Thus, in some exhibitionists the desire and the act occur when they have emotional crises despite showing a normal level of intelligence and sociocultural level.

On the other hand, they are not usually dangerous individuals, nor do they try to abuse their victims. On the contrary, the majority react in an insecure way and run away if their offer is reciprocated. Their desire lies in surprising the victim, provoking in them reactions of fear, disgust or curiosity, thus experiencing a feeling of mastery. The reaction they hate most is mockery or indifference.

General criteria and compulsive factors in exhibitionism

According to the DSM, criteria for the diagnosis of exhibitionistic disorder, There are two indicators:

Recurrent and highly arousing sexual fantasies, sexual urges or behaviors that involve exposing one’s genitals to an unexpected stranger for a period of at least six months.Fantasies, sexual impulses or behaviors cause clinically significant distress or social, occupational impairment or other important areas of the subject’s activity.

Although there are not many studies on the subject, it is believed that the exhibitionist has not been able to overcome certain instances of childhood sexual development. It could be said that who practices exhibitionism suffers from a certain sexual immaturity. Although it may seem paradoxical, it is estimated that the exhibitionist suffers from certain traits of inferiority, self-acceptance and relationship disorders. They tend to be impulsive and antisocial individuals.

Something that has been studied and validated is that exhibitionists expose their genitals to unknown people due to strong compulsive desires. They are aware of their need to surprise, shock or impress the observer.

Most people who suffer from this paraphilia have persistent ideas, thoughts, impulses or images that they consider intrusive or inappropriate and that cause significant anxiety or discomfort. This emotional discomfort is what leads the exhibitionist to neutralize these compulsive thoughts by exposing one’s own genitals in public. in front of unknown people.

Treatment of exhibitionism

Psychological treatments for exhibitionist people try to redirect pleasure through other, more appropriate sexual fantasies. The treatment of exhibitionism usually uses psychotherapeutic interventions based mainly on behavioral and cognitive techniques or medical treatments based on the use of hormones or certain drugs.

Cognitive-behavioral perspective

The cognitive-behavioral orientation explains the acquisition and maintenance of paraphilias through the paradigms of conditioning and the formation of cognitive schemes (Muse, 1996).

The vast majority of paraphilias manifest themselves during puberty.giving the impression that there may be a “window of opportunity” through which conditioning to sexual stimuli is especially favorable during this time of maturation.

Changing these paraphilic behaviors usually requires a multimodal intervention. that interferes with previous learning through classical, operant and social conditioning, while modifying basic schemes of the individual’s cognitive structure (Muse and Frigola 2003).

Although male hormones are inherently involved in maintaining sexual motivation, is he
learning at a young age that determines the direction of sexual interest. Therefore, the use of chemical substances in the treatment of paraphilias is usually reserved as adjunctive therapy to psychotherapy (Muse and Frigola 2003).

Psychological therapy is the only way to help those who suffer from this disorder. Although it is unfeasible to remove the desire from the exhibition, What is sought in therapy is to try to make that desire functional, working on the compulsive and disruptive act, as well as on the guilt that this sexual impulse usually arouses.

Pharmacotherapy

Muse and Frigola (2003) They point out that two types of pharmacological treatments can also be administered: hormonal treatment and treatment with psychoactive medications.

Hormonal treatment. It usually applies to people who represent a real danger to society. The most commonly prescribed hormones are medroxyprogesterone acetate and cyproterone acetate. Both hormones reduce testosterone levels in the blood and thus decrease sexual desire. It has been shown that men who have taken these hormones have shown greater control of their impulses. On the other hand, when treatment is abandoned, exhibitionistic behavior manifests again.Psychoactive medications. The goal of treatment with psychoactives is to reduce libido. The most prescribed medication is fluoxetine. At the same time that it reduces sexual desire, it also reduces obsessive-compulsive symptoms that may be associated with the disorder.You might be interested…