Voyeurism: behavior, paraphilia or disorder?

According to various psychoanalytic theories, of the Lacanian court, the human being is born with the need to look, to subjectify his context through the look. It is what would be called scopic drive. For these currents, humans are scopic beings, we have the need to look and we enjoy it.

When this enjoyment of looking at the other turns into sexual excitement, then we can talk about voyeurism, which is characterized by reaching sexual arousal by observing naked people or performing some sexual activity, without their knowledge.

• Related article: "The 9 main sexual and psychosexual disorders"

What is voyeurism?

The word voyeur, of French origin, derives from the verb voir (to see), together with the agent suffix -eur, and its literal translation is “the one who sees”.

Depending on the clinical setting, A voyeur or voyeurist is a person who seeks to obtain sexual arousal by observing naked people or who engage in any sexual activity, however, this conduct does not imply any subsequent sexual activity on the part of the person observing.

Voyeurism can reach the degree of paraphilia, sometimes considered as a disorder. The so-called voyeurism disorder involves carrying out voyeuristic impulses and fantasies without the consent of the other person; experiencing significant discomfort or functional impairment due to such urges or urges.

Voyeurism according to clinical practice

But not all voyeuristic practices can be considered pathological. It is true that if we stick to the traditional definition of paraphilia: sexual behavior whose main source of pleasure is outside intercourse, voyeurism can be considered as such.

However, not all voyeuristic behavior is paraphilic, not all paraphilias can be considered pathological by themselves. Everything will depend on the degree of interference in the sexual and non-sexual life of the person, and the subsequent discomfort or deterioration of this.

Most people with paraphilic interests do not meet the clinical criteria for paraphilic disorder. These criteria summarize two points:

• The behaviors, wishes or fantasies of the person cause clinically significant discomfort, functional impairment or cause harm to third parties.
• This set of behaviors must last for more than six months.

The desire to observe other people in sexual contexts is very frequent, and cannot be considered anomalous in itself. These behaviors tend to begin in adolescence or early adulthood. However, if during the course of this it becomes pathological, the person ends up investing considerable time in seeking opportunities to look at others; obstructing the rest of responsibilities or daily activities.

Symptoms and signs

Usually, a voyeuristic person or voyeur has to observe the sexual scene from a distance and, occasionally, hidden. Observing through cracks or locks or through the use of objects such as mirrors or cameras.

This behavior is occasionally accompanied by masturbatory activities; but it is not a necessary condition for the practice of voyeurism. What's more, the risk of being discovered acts as an arousal enhancer.

Often times, this voyeuristic disposition is accompanied by exhibitionistic tendencies. That is, the person enjoys showing himself, more or less openly, half-naked or completely naked. Both voyeurism and exhibitionism have a great compulsive and irrepressible component. In both, before and during each sexual behavior, the sweating rate and the heart rate increase when stimuli related to said activities increase; Effects that disappear after the performance of the voyeuristic act.

It is also necessary to distinguish between voyeurism and the mere excitement to contemplate a naked body. The main difference is that in voyeurism there is no knowledge and / or consent on the part of the observed person, while in the rest of sexual activities it is taken for granted that the there are. Being such a contemplation of nudity a part within sexual activity, and not the totality of it.

With regard to the personality characteristics of a voyeurist, these behaviors are usually related to people who have been shy during adolescence, it being necessary to emphasize that they are not subjects prone to possess traits especially pathological. Another term related to voyeurism, but somewhat different, is candaulism, a name that comes from a historical character Candaules, the last king of the Heraclid dynasty. This expression refers to a behavior in which the observer derives pleasure from observing her partner having sex with another person.

Treatment

As mentioned above, there are few people with voyeuristic tastes in whom the behavior ends up leading to disorder; since for the vast majority of them these behaviors do not pose a problem either in their daily life or for their psychological health.

Therefore, too few people are referred to psychiatric or mental health centers. In most cases, these patients are referred to these units after having broken the law and having been convicted as sexual offenders. In this case, voyeurism disorder has two ways of action:

• Psychotherapy along with assistance to support groups and selective serotonin reuptake inhibitors (SSRIs), the latter to alleviate the compulsive acts of looking.
• Anti-androgen drugs in very serious cases.

When SSRIs are not effective, due to the severity of the disorder, drugs to lower testosterone levels and inhibitors of libido are considered. This medication, better known as antiandrogens, does not directly lower testosterone levels; but by including gonadotropin-releasing hormone (GnRH) agonists and acetate depot medroxyprogesterone these initiate a hormonal chain reaction that does reduce production of testosterone.

Given the aggressiveness of this treatment and its side effects, the informed consent of the patient and a rigorous monitoring of liver function and serum concentrations of testosterone.

Criminalization of voyeuristic behaviors

In certain cultures voyeurism is considered a perversion and in several countries it is classified as a sexual offense.

• The UK added this behavior to the Sexual Offences Act of 20013, thus criminalizing the act of observing someone without her consent.
• In late 2005, Canada enacted a similar law, declaring voyeurism a sex crime.
• USA it also penalizes this practice in nine of its states.