The Diagnostic Manual of the North American Psychiatric Association (DSM) includes 8 typical paraphilias and approximately 7 uns specified paraphilias, among the most common typical paraphilias are fetishism, fetish cross-dressing, exhibitionism, voyerism, pedophilia and sexual masochism.
Having an inclination or even an accomplished interest in one or more of the categories mentioned above is not in itself a clinical syndrome, that is, if a person feels desire or has an intense sexual fantasy about an atypical object, sensation or sexual practice, that does not mean that it is a problem, but what can cause a disorder is proof that paraphilia involves emotional dysfunction or conflict for the individual who suffers it.
- Exhibitionism is the exposure of the genitals themselves to an unknown person in order to obtain sexual arousal.
- This practice includes the diversion of sexual act.
- Since the feeling of pleasure is obtained by showing the genitals to third parties.
- Which in most cases are women or children.
There is almost never a subsequent attempt by the exhibitionist to engage in sexual activities abroad, so he rarely commits rape and generally does not develop a disorder.
The person who practices exhibitionism, instead of seeking a sexual encounter, represses it; finish it before it starts. Sexual arousal occurs through the mental anticipation of the situation, being a sensation similar to that of masturbation.
At this stage it is important to distinguish between exhibitionism and exhibitionism, the concept of exhibitionism, unlike the exhibitionism outlined in a criminological and medical way, does not imply an attitude of sexual content, since it consists purely and exclusively in showing something in public (Ripolles, 1982).
Exhibitionism usually begins in adolescence. Most of the exhibitionists are married men, but with an often troubled marriage. Approximately 30% of male sex offenders in custody are exhibitionists. They tend to perpetuate this type of behavior over time and between 20 and 50% are stopped more than once.
The causes of exhibitionism are in the formation of inadequate learning, replacing the expected sexual stimulus, which would be male or female, with other external stimuli.
In the development of this paraphilia, it is usually the case that an inadequate stimulus is associated with a strong sexual activation of the individual, which can become a sexually conditioned stimulus at other times, situations that usually occur in adolescence (Muse and Frigola 2003).
Subsequent experiences of conditioning through fantasies and masturbation would reinforce these sexual responses, there are even factors that predispose an individual to exhibitionism, such as difficulties in establishing interpersonal sex or lack of self-esteem.
Among the various causes, it has been discovered that exhibitionists are usually shy people, which is not easy to relate to women, for example, in some exhibitionists desire and action occur when they experience emotional crises, yet they show a normal sociocultural and intellectual level.
On the other hand, they are usually not dangerous people, nor do they try to abuse their victims, on the contrary, most people react insecurely and flee if their offer is taken care of, their desire is to surprise the victim by causing in it reactions of fear, disgust or curiosity, thus experiencing a feeling of domination. The reaction they hate the most is mockery or indifference.
According to the DSM, the criteria for diagnosing exhibitionist disorder are two indicators:
Although there are not many studies on the subject, it is thought that the exhibitionist has not been able to overcome some examples of child sexual development, it can be said that those who practice exhibitionism suffer from a certain sexual immaturity, although this may be paradoxical, it is believed that the exhibitionist suffers from certain characteristics of inferiority, self-ception and relationship disorders. They are usually impulsive and antisocial.
One thing that has been studied and validated is that exhibitors expose their genitalia to strangers by strong compulsive desires, are aware of their need to surprise, impact or impress the observer.
Most people with 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 causes the exhibitor to neutralize these compulsive thoughts by exposing their genitalia in public to strangers.
Psychological treatments for exhibitionists try to restore pleasure through other, more appropriate sexual fantasies. Treatment of exhibitionism often involves psychotherapeutic interventions based primarily on behavioral and cognitive techniques or medical treatments based on the use of hormones or certain medications.
Cognitive behavioral orientation explains the acquisition and maintenance of paraphilia through conditioning paradigms and the formation of cognitive patterns (Muse, 1996).
The vast majority of paraphilias occur at puberty, giving the impression that there may be a “window of opportunity. “Conditioning for sexual stimuli is particularly favorable during this maturation period.
Changing these paraphilic behaviors often requires a multimodal intervention that interferes with prior learning through classical, operational, and social conditioning, while modifying the basic patterns of the individual’s cognitive structure (Muse and Frigola 2003).
While male hormones are intrinsically involved in maintaining sexual motivation, it is early learning that determines the direction of sexual interest, so the use of chemicals in the treatment of paraphilia is generally reserved as complementary therapy to psychotherapy (Muse and Frigola 2003).
Psychological therapy is the only way to help those with this disorder, if it is impossible to end the desire for exposure, what is sought in therapy is to try to turn that desire into something functional, working on the compulsive and disturbing act, as well as on the guilt that normally awakens this sexual impulse.
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