Portraits of Exhibitionism
Daniel is a respected businessman in his community. He says, “I can’t believe I did what I did. I was as shocked as they were.” He then details driving his car by two school-aged girls, hollering at them and exposing his genitals.
It was a rush for Linda the first time she mooned someone. Now she’ll do it every time she gets the chance.
Craig travels for work, so he spends a lot of time in hotels. No matter what city he is in, he always seems drawn to standing naked in front of the large hotel room window. As he stands there, he hopes someone will look up and see him.
Exhibitionism: Definitions and Key Thoughts
Exhibitionism is classified in the DSM-IV under the category of paraphilias, which are patterns of sexual behavior involving unusual and socially unacceptable practices (fetishism, voyeurism, and other abnormal sexual tendencies are also classified as paraphilias). It is a psychological disorder characterized by a pattern of behaviors that involve the exposure of body parts to others: often the genitals, buttocks, or breasts.This exposure is often of an extravagant nature, and usually involves some sexual suggestions.
Exhibitionism is known by several names including: flashing, apodysophilia, and Lady Godiva syndrome. Additionally, it has been called a “hands-off” paraphilia. This descriptive term is in contrast with the “hands-on” paraphilias that involve physical contact with others.
Some exhibitionists have a conscious desire to shock or upset the person or persons they are exposing themselves to. In contrast, a high percentage of exhibitionists hope or fantasize that the target of their exposure will become sexually aroused and want to engage in sexual activity with them. In some cases an exhibitionist will masturbate while exposing him or herself.
Causes of Exhibitionism
Several theories have been proposed about what causes exhibitionistic tendencies. While none of the following theories are conclusive, they may offer significant insight into determining the origin of a single person’s exhibitionism.
Biological Cause
It has been found that unusual levels of the hormone testosterone increases the susceptibility of males to develop deviant sexual behaviors.
Childhood Abuse
Numerous studies have shown that emotional or physical abuse occurring in one’s childhood increases the risk of a person developing exhibitionism.
Traumatic Brain Injury
A number of documented cases have shown that traumatic brain injury (TBI) can precede sexual deviant behavior (including exhibitionism) in persons with no prior history of such offenses.
Action Steps and Treatment Plan
Exhibitionism is a serious problem and can cause great discomfort to the target of the exhibitionist, and the exhibitionist as well. Hence, treating exhibitionism aggressively, with a combination of counseling psychotherapy and medication, is a recommended solution.
Individual Counseling and Psychotherapy
Individual counseling is often very helpful in that the exhibitionist learns coping mechanisms for resisting the urge to expose his or her body to others. Counseling patients are taught how their thoughts effect their emotions, and how negative emotions can lead to sexually deviant behaviors. Also, persons in counseling are encouraged to identify any reasons they are using to justify their inappropriate behavior.
One technique, known as “orgasmic reconditioning” involves the process of encouraging the exhibitionist to replace fantasies of exposing oneself to another person with fantasies of acceptable sexual behavior.
Group Therapy and Support Groups
One of the most beneficial aspects of group therapy is that the client learns that he or she is not alone in their problem with exhibitionism. With a twelve-step support group program (such as Sex Addicts Anonymous, or Sexaholics Anonymous) a person can learn from, and even be mentored or “sponsored” by others who have successfully stopped participating in exhibitionistic behaviors.
Medication
A number of double-blind and placebo-controlled studies have shown medication to be an effective tool in helping persons overcome paraphilias. Common medications include anti-depressant medications, such as Selective Serotonin Reuptake Inhibitors (SSRIs), hormone therapy, and in some cases anti-anxiety medications.
For more information on sexual health related issues and to schedule an appointment with a Thrive Boston sex therapist, visit our Boston Sex Therapy page. Appointments scheduled within 24 hours.
Resources
“Exhibitionism,” Section 15, Chapter 192. In The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.
Augustine Fellowship, Sex and Love Addicts Anonymous. PO Box 119, New Town Branch, Boston, MA 02258. 617-332-1845.
National Association on Sexual Addiction Problems (NASAP). 22937 Arlington Avenue, Suite 201, Torrance, CA 90501. 213-546-3103.
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