Exhibitionistic Disorder: Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Exhibitionism is characterized by an individual's tendency to expose his or her genitals in public. The behavior is usually done with the intent of sexual arousal or gratification. It is a paraphilic disorder in which the person experiences sexual urges to show their genital organs to random strangers. Studies show a prevalence of about two to four percent of the population is affected by the exhibitionistic disorder. However, studies also conclude there might be unreported cases as this condition is associated with guilt and an offensive act. Exhibitionistic disorder is considered an act of misconduct, and researches show about one-third of sex crimes involve incidents of exhibitionism.

What Is Exhibitionistic Disorder?

Exhibitionism is a rare paraphilic disorder (a disorder characterized by unusual behaviors). People with exhibitionistic disorders are prone to exposing their genitals to random strangers or unknown people in public places like malls, parks, and streets. Some people with the exhibitionistic disorder may deny exposing themselves to non-consenting others. Exhibitionists are people who show their genitals to people, strangers or not, to sense and feel more dominant and powerful. The act can be done for the purpose of arousal, or it can be done for attention-seeking reasons. Some people with exhibitionistic disorders may prefer to show their genitals to prepubescent children, adults, or both.

What Are the Causes of the Exhibitionistic Disorder?

There is no specific reason why a person may expose his or her genitals in public to get sexually aroused, but some doctors believe it to be caused as a result of some mental health conditions like:

• Antisocial personality disorder.

• Alcohol abuse and overconsumption of drugs and marijuana.

• Heavy consumption of hard drugs and drug addicts.

• An interest in pedophilia.

• Hypersexuality (sex addiction).

• Sexual and emotional abuse in early childhood.

• Some doctors believe exhibitionists get sexually aroused by the shocked expressions of the people on exposing their genitals. The shocking behavior is believed to cause a sexual interest in exhibitionists. This gives a sense of flirting to the person affected by this disorder.

What Are the Signs and Symptoms of Exhibitionistic Disorder?

Signs and symptoms usually come to notice during adolescence to the early twenties. Signs and symptoms may begin to reduce as the person gets older. This may be due to self-control or the fear of committing a crime. In addition to meeting these criteria, someone with an exhibitionistic disorder will likely exhibit other symptoms. These can include:

• Persistent avoidance of people in public places (such as airports, department stores, and shopping malls) because of fear of being seen or recognized by others.

• Obsessive preoccupation with thoughts about exposing oneself to others.

• Over-preoccupation with thoughts about exposing oneself to others.

• A persistent desire for public exhibitionism (exposing genital organs to strangers).

• Strong sexual arousal from exposure of one's genitals to another person in public spaces.

• Failure to achieve sexual arousal without exposing genitals to strangers.

• Severe impairment, stress, anxiety, discomfort, and helplessness on not experiencing sexual arousal without exposing their genitals in public.

• Underlying medical and psychiatric disorders like bipolar personality, attention deficit, sex addiction, antisocial personality disorder, and other paraphilic disorders.

How Is an Exhibitionistic Disorder Diagnosed?

Exhibitionistic disorder is a complex condition, and the diagnosis can be challenging. To diagnose an exhibitionistic disorder, the person usually shows the following:

• Sexually arousing behavioral patterns and urges that are recurring and intense in nature involve exposing the genitals to an unsuspecting person for six months or over.

• Acting on these sexual urges without the consent of the person.

• Urges or fantasies that cause severe impairment or interpersonal difficulty in the workplace or everyday social situations.

• People are unable to distract themselves from sexual thoughts and focus on their work.

• Failure to achieve sexual arousal without exposing genitals to strangers.

What Is the Treatment for Exhibitionistic Disorder?

Treatment for exhibitionistic disorder usually involves a combination of medication therapy and psychotherapy.

• Talking to a Therapist - Therapists and psychiatrists approach various methods to treat different kinds of paraphilic disorders. Ultimately, it all boils down to what works best for the person suffering from the exhibitionistic disorder. Therapists try to dig for more information and find the root cause of these behaviors. Deep-rooted fears are first addressed to make the patient more comfortable discussing their problems. They also try to understand the signs and symptoms associated with them and help the patient act on them accordingly.

• Therapeutic Treatments - Therapeutic treatments work in a way to teach the person to control their urges and find other alternative ways to cope with their impulses other than exposing their genitals.

• Cognitive Therapy - These therapies may help patients identify their triggering factors and manage their urges more healthily.

• Relaxation Therapy - Relaxing therapies help the patient calm his mind, have better self-control, and prevent impulsive actions.

• Empathy Training - The patient is made to realize the impact his or her behaviors can have on others that might affect their mental health.

• Coping Skills Training - The patient is put in different situations and asked to implement his coping mechanisms to prevent himself from indulging in exhibitionistic behaviors.

• Cognitive Restructuring - It helps identify and alter the thoughts that lead to exhibitionistic disorders.

• Medications - Medications are usually the last mode of treatment adopted to treat exhibitionistic disorders. Medications to reduce sexual drive, testosterone-suppressing hormones, and medications to treat mental health disorders like anti-depression medications and anti-anxiety medications.

What Are the Consequences of Exhibitionistic Disorder?

• Some people indulging in exhibitionism may continue the act to the extent of committing crimes such as rape.

• Some people may also affect the minds of innocent children in their early childhood ages, creating a scar in the minds of young boys and girls and affecting their mental health.

• Indulging in such activities can get one arrested and put behind bars.

• If the person engages in further misconduct, such as rape, sexual assault, or sexual harassment, they are punished for those acts.

Conclusion:

People with paraphilic disorders or sexual disorders and mental health conditions usually do not seek treatments independently. Similarly, people suffering from exhibitionistic disorder also do not seek help and treatment due to severe shame, guilt, embarrassment, and fear of being judged or put behind bars. Most people suffering from the disorder do not seek treatment unless they are caught and some legal action is taken against them. However, seeking treatments at the right time can save one from experiencing the consequences of indulging in such activities.