Exhibitionism: causes and symptoms of this sexual paraphilia

“Fernando, a twenty-four-year-old man, comes to the psychologist's office. Once there, Fernando reports that he has come due to a problem that causes him deep discomfort. He confesses that in recent months he has the urgent need to go out, stand in a dark corner and, when a woman passes by, show him his genitals. Later, after seeing his reaction, he proceeds to flee and when he gets home he masturbates thinking about the surprise of the person to whom he has shown himself, a fact that causes him great excitement and reduces his stress. For this fact, Fernando has been arrested and sentenced on one occasion, but he considers that he will return to do it if he does not have help, and this causes him great anxiety when he considers it a behavior disgusting".

The case cited here is an invented example of one of the best known paraphilias, exhibitionism.

Exhibitionism as paraphilia

In order to have a better understanding of exhibitionism, it is necessary to understand the main characteristics of the group of disorders of which it is a part, paraphilias.

Formerly called sexual deviations, paraphilias refer to the repeated presentation of intense sexual fantasies in which the object of desire is atypical. Generally, these desires are focused on non-human objects or entities, suffering and humiliation of their own or others or people who do not consent in a period of six months. These behaviors may or may not be understood as alteration by those who present them, being in many cases considered immoral by the subjects themselves. In any case, paraphilias cause a serious deterioration in various vital areas of the individual, and there may or may not be discomfort on the part of the subject.

While some of these paraphilias may not have legal repercussions or be overly disabling beyond restricting sexual interest and discomfort that it can cause in the subject itself or the difficulty to be accepted by sexual partners (for example, focused desires towards objects such as the fetishism), other paraphilias can result in serious crimes and even crimes such as pedophilia or somnophilia (sexual desire for sleeping subjects, which implies rape).

Diagnostic criteria and symptoms

Having visualized the type of disorder we are talking about, we can then make a more coherent explanation of what exhibitionism implies as a paraphilia.

The main symptoms are based on the existence for at least six months of recurring and very exciting fantasies of exposure of the genitals to a stranger who does not expect it, also having to have carried out and / or produce clinically significant discomfort in the subject or her functioning in relevant areas of her his life.

It is the most common paraphilia, and is frequently accompanied by others such as voyeurism. This problem usually appears around the age of majority, having a maximum prevalence between the ages of twenty and thirty and decreasing after the age of forty.

The excitement and pleasure achieved by the exhibitionist are obtained through the observation of the reactions of the people to whom it is shown, generally those of shock, surprise and curiosity. It is possible that the subject masturbates during or after his exposure by reimagining the reactions of his victims. Generally they do not actually intend to have any sexual activity with their victim, not being the person per se the reason for arousal but the fact of surprising her. In fact, it is not uncommon for the exhibitionist to escape if the victim responds positively to his reaction. However, reactions of indifference or mockery can be extremely painful for these subjects, due to their low self-esteem.

Psychological profile of the exhibitionist

The typical exhibitionist subject is a generally heterosexual male, often with difficulties in establishing contact with the sex that is the object of his desire, although it is also frequent that it appears in subjects with a partner and even married having apparently normal partner relationships.

In general, the exhibitionist subject presents a high level of withdrawal and introversion, with a high lack of self-confidence that pushes you to carry out his performance, probably What Defense mechanism. These types of subjects, then, are not usually a real threat, with the majority not having aggressiveness or intention to harm in their performance.

Legal treatment

As mentioned above, some paraphilias can constitute serious crimes punishable by imprisonment.

In the case of exhibitionism, we would be facing a paraphilia classified as a crime against sexual freedom, and may be punished with a prison sentence of between six months to a year or with a fine of one to two years, assessing the circumstances of the exhibitionist in question.

It should be taken into account that when considering the possibility of creating a diagnostic category to refer to a mental disorder, it is not only taken into account if it affects the quality of life of those who experience it on their own meat. It is also taken into consideration the discomfort and inconvenience generated to third parties, and this is exactly what happens in the case of exhibitionism.

Exposing the genitals to another person, with the intention of feeling pleasure for it, makes the dignity of others is attacked and, in addition, in many cases it produces fear, being interpreted as the beginning of a violation.

Etiology (causes) of exhibitionism

The causes of this type of paraphilic behavior is the subject of a wide debate in the psychological literature.

Many of the theories in this regard indicate the participation of learning processes in the acquisition of these behaviors, proposing that these are behaviors learned through accidental conditioning between sexual arousal and a stimulus atypical, conditioning reinforced by the repetition of the situations and the beginning of the application of the stimulus in the imagination during masturbation.

Imitation of models observed in childhood has also been explored as a possible cause, due to the presence of patterns of violence and anomalous sexual behaviors in some cases of individuals with little socialization, domestic violence and excessively repressive education of the sexuality.

In the same way, the presence of deficits in social and communication skills, due to the presence of difficulties in courtship in many of the cases studied. In these subjects the existence of a high inferiority complex, low self-esteem, impulsivity and few skills has been observed communicative, which can lead to conduct considered immoral, unethical, surprising or bizarre as a mechanism defense.

Another of the hypotheses considered is that of McConaghy's behavioral termination, according to which if a behavior is very common a mechanism is created in the brain which is activated when stimuli associated with the behavior in question are perceived, producing a high level of tension. This causes the individual to not stop performing the action, so that the tension does not appear. It presents some similarity to the mechanism of action of obsessive-compulsive disorder.

Caution: not everything is paraphilia

Exhibitionism is a paraphilia that can be a serious problem for the sufferer, both because of the discomfort that generates as well as the effects that it can cause in different vital areas such as socialization, the affective.

However, exhibitionism as a paraphilia should not be confused with sexual fantasies and behaviors occasionally used as a sexual stimulus. Erotic games and fantasies with the couple such as striptease or the use of one's own anatomy to provoke the desire to the couple will not be included as paraphilia, which implies the need to present this type of behavior in a compulsive way to obtain sexual gratification, for at least six months and causing discomfort or alterations in normal life significant.

Thus, what characterizes exhibitionism is that the action of undressing in front of others, on the one hand, is done simply with the intention that others see it, and on the other, it is not consensual, in addition to being born from an irrepressible need.

In the same way, neither behaviors such as topless or protest use in demonstrations are classifiable as paraphilic behavior, since they do not suppose sexual gratification compulsive.

Nor can this disorder be diagnosed if the exhibition behavior is due and appears only during an altered state of consciousness or other disorders, such as manic episodes, Psychotic attack, poisoning or dementia.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Belloch, Sandín and Ramos (2008). Manual of Psychopathology. McGraw-Hill. Madrid.
• Cáceres, J. (2001). Paraphilias and rape. Madrid: Editorial Síntesis.