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п»ї<title>Exhibitionism: causes of this sexual paraphilia</title>
The Diagnostic Manual (DSM) of the American Psychiatric Association includes 8 typical paraphilias and 7 unspecified paraphilias. Among the most common typical paraphilias are fetishism, transvestite 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 a clinical syndrome. That is, that a person has an intense sexual desire or fantasy for an atypical sexual object, sensation, or practice need not constitute a problem. However, what can cause a disorder is the verification that the paraphilia involves 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 for the purpose of 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. Being these women or children, in most of the occasions.
There is almost never a subsequent attempt to maintain a sexual activity with the stranger by the exhibitionist, so they rarely commit rape, nor do they usually develop a disorder.
The person who practices exhibitionism, instead of seeking a sexual encounter, represses it, making it the end in itself. While sexual arousal occurs by mentally anticipating the situation, being a sensation similar to masturbation.
At this point it is important to differentiate exhibition from exhibitionism. 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).
Some people are characterized by producing noise. It is like an innate condition in them and it is also part of their exhibitionist condition; they do not know how to enjoy or suffer in silence, but rather by disturbing others.
Why do some people enjoy showing their genitals in public? Exhibitionism usually begins in adolescence. Most of the exhibitionists are men who are married, but with a marriage that is usually conflictive. Approximately 30% of male sex offenders arrested are exhibitionists. They tend to perpetuate this type of behavior over time and between 20 and 50% are arrested more than once.
Possible causesThe causes of exhibitionism are in the formation of inadequate learning, by substituting the expected sexual stimulus, male or female, by other external stimuli.
In the development of this paraphilia, it usually happens that an inappropriate stimulus is associated with a strong sexual arousal of the individual, which can become a sexually conditioned stimulus on other occasions. These situations usually occur during adolescence (Muse and Frigola, 2003).
Subsequent conditioning experiences through fantasies and masturbation would reinforce these sexual responses. There are even 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, who do not find it easy to relate to women. Thus, in some exhibitionists the desire and the act occurs 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, most of them react insecurely and run away if their offer is reciprocated. Their desire lies in surprising the victim, provoking in her reactions of fear, disgust or curiosity, thus experiencing a feeling of dominance. The reaction they hate the most is that of mockery or indifference.
The thrill of exhibitionism is to look at your naked body in the mirror and think: if someone calls the elevator now, I won't have time to get dressed.
General criteria and compulsive factors in exhibitionismAccording to the DSM, the criteria for the diagnosis of exhibitionistic disorder, are two indicators:
Recurrent, highly arousing sexual fantasies, sexual urges, or behaviors involving exposure of one's genitals to an unwaiting stranger for a period of at least six months.
The fantasies, sexual urges, or behaviors result in clinically significant distress or impairment in social, occupational, 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 infantile sexual development. It could be said that the person who practices exhibitionism suffers from a certain sexual immaturity. Although it may be 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 subjects.
Something that has been studied and validated is that exhibitionists expose their genitals to strangers because of strong compulsive desires. They are aware of their need to surprise, shock or impress the observer.
Most people suffering from this paraphilia have ideas, thoughts, impulses or images of a persistent nature that they consider intrusive or inappropriate and that cause them significant anxiety or discomfort. This emotional discomfort is what leads the exhibitionist to neutralize these compulsive thoughts by exposing one's genitals in public before strangers.
Sensuality and exhibitionism are two concepts that teenagers and young people of our time have confused. A look and/or a sensual smile is worth more than a thousand photos of a cleavage.
Treatment of exhibitionismPsychological treatments for exhibitionist people try to redirect the 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 perspectiveThe cognitive-behavioral orientation explains the acquisition and maintenance of paraphilias through the paradigms of conditioning and cognitive schema formation (Muse, 1996).
The vast majority of paraphilias manifest at puberty, giving the impression that there may be a "window of opportunity" whereby conditioning to sexual stimuli is especially conducive during this time of maturation.
Changing these paraphilic behaviors usually requires a multimodal intervention that interferes with previous learning by classical, operant and social conditioning, while modifying basic schemas of the individual's cognitive structure (Muse and Frigola 2003).
Although male hormones are inherently involved in the maintenance of sexual motivation, it is the learning at a young age that determines
learning at a young age that determines the direction of sexual interest. Therefore, the use of chemicals 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 for exhibition, what is sought in therapy is to try to make this desire functional, working on the compulsive and disruptive act, as well as on the guilt that this sexual impulse usually awakens.
It values the discreet in relation to the exhibitionists; for these will be sober in relation to the arrogant, convinced in relation to the insecure, generous in relation to the selfish, striving in relation to the comfortable, and committed in relation to the distant.
Pharmacological treatmentMuse and Frigola (2003) note that two types of pharmacological treatments can also be administered: hormonal treatment and treatment with psychoactive medications.
Hormonal treatment. It is usually applied to individuals 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 impulse control. On the other hand, when treatment is discontinued, exhibitionist behavior returns.
Psychoactive medications. The goal of psychoactive treatment is to reduce libido. The most commonly prescribed medication is fluoxetine. At the same time that it reduces sexual desire, it also reduces the obsessive-compulsive symptoms that may be associated with the disorder.
BibliographyArteaga Vera, R. B. (2014). Tipificar la penalizaciГіn de conductas delictivas que identifican las parafilias criminales, dentro del capГtulo ii, del tГtulo viii, del libro ii, del cГіdigo penal del ecuador (Bachelor's thesis).
De Dios Blanco, E. (2007). The paraphilias: From Krafft Ebing to Kafka.
Diez Ripolles, J. L. (1982). Exhibitionism, pornography and other provocative sexual conduct: The frontier of sexual criminal law.
Gamboa, I. (2006). The constitution of sexual disorders in psychiatry. DiГЎlogos Revista ElectrГіnica de Historia, 7(1).
Giordano, E. (2004). Notes for a critique of interactive media. From cultural degradation to technological exhibitionism. Revista Iberoamericana de EducaciГіn, 36, 69-88.
Herrera, J. L. (2014). A look at" La tupida copa de un ГЎrbol," by Julieta GarcГa GonzГЎlez: between voyeurism, pareidolia and exhibitionism. Romance Notes, 54(4), 131-141.
JimГ©nez, C. G. T. Thematic Seminar: Paraphilias.
Diagnostic and statistical manual of mental disorders: DSM-5. Editorial medica panamericana, 2014.
Marshall, W. L., & Fernandez, Y. M. (1997). Cognitive-behavioral approaches to paraphilias: the treatment of sexual offending. Handbook for the cognitive-behavioral treatment of psychological disorders, 1, 299-331.
Molina de la Cueva, M. F. (2017). Anteproyecto de ley reformatoria al artГculo 175 del cГіdigo orgГЎnico integral penal, que establece la obligatoriedad de tratar psiquiГЎtricamente a los agresores sexuales.
Muse, M., & Frigola, G. (2003). The evaluation and treatment of paraphilic disorders. Cuadernos de Medicina PsicosomГЎtica y PsiquiatrГa de Enlace, 65, 55-72.
Romi, J. C. (2008). Sexual disturbances. Critiques of their inclusion as mental disorders in the DSM IV-TR. Journal of Forensic Psychiatry, Sexology and Praxis, 6(1), 24-49.
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