Exhibitionism: causes and symptoms of this sexual paraphilia

People who show their private parts to strangers. What exactly happens to them?

"Fernando, a twenty-four-year-old man, arrives at the psychologist's office. Once there, Fernando says that he has come because of a problem that causes him deep discomfort. He confesses that in recent months he has had the imperious need to go out into the street, stand in a dark corner and, when a woman passes by, show her his genitals. Subsequently, after seeing her 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 convicted on one occasion, but he considers that he will do it again if he does not have help, and this causes him great anxiety as he considers it a repugnant behavior".

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

Exhibitionism as a 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, the paraphilias.

Formerly referred to as sexual deviations, paraphilias refer to the 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 self or others, or non-consenting persons within 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 serious impairment in several 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 too disabling beyond restricting sexual interest and the discomfort it may cause in the subject himself or the difficulty in being accepted by sexual partners (e.g. object-focused desires such as fetishism), other paraphilias may result in serious offenses and even crimes such as pedophilia or somnophilia (sexual desire for sleeping subjects, implying rape).

Diagnostic criteria and symptoms

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

The main symptoms are based on the existence for at least six months of recurrent and highly arousing fantasies of exposure of the genitals to an unexpected stranger. of exposure of the genitals to an unexpected stranger, which must have been carried out and/or produce clinically significant discomfort in the subject or his functioning in relevant areas of his life.

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

The excitement and pleasure achieved by the exhibitionist are obtained through the observation of the reactions of the people to whom he/she shows him/herself, generally those of fright, surprise and curiosity. It is possible that the subject masturbates during his exposure, or after it by reimagining the reactions of his victims. Generally, they do not actually intend to engage in any sexual activity with their victim, the person per se not being the motive for arousal but the fact of surprising the victim. 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 level of self-esteem.

Psychological profile of the exhibitionist

The typical exhibitionist subject is a male, generally heterosexual, often with difficulties when it comes to sexual relations.The typical exhibitionist subject is a heterosexual male, often with difficulties in establishing contact with the sex object of his desire, although it is also frequent in subjects with a partner and even in married people with apparently normal relationships.

In general, the exhibitionist subject presents a high level of withdrawal and introversion, with a high lack of self-confidence that pushes him to carry out his actions, probably as a defense mechanism. This type of subject, therefore, is not usually a real threat, and most of them do not show aggression or intent to harm in their actions.

Legal treatment

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

In the case of exhibitionism we would be dealing with a paraphilia typified as a crime against sexual freedom.It can be punished with a prison sentence of six months to one year or a fine of one to two years, depending on 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 whether it impairs the quality of life of those who experience it in their own flesh. Consideration is also given to the discomfort and inconvenience caused to third parties is also taken into consideration.This is precisely what happens in the case of exhibitionism.

Exposing the genitals to another person, with the intention of feeling pleasure from it, causes the dignity of others to be attacked and, moreover, in many cases produces fear, as it is interpreted as the beginning of a violation.

Etiology (causes) of exhibitionism

The causes of this type of paraphilic behavior are the subject of much debate in the psychological literature.

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

Imitation of models observed in infancy has also been explored as a possible cause, due to the presence of patterns of sexual arousal.The imitation of models observed in childhood has also been explored as a possible cause, due to the presence of patterns of violence and abnormal sexual behavior in some cases of individuals with little socialization, intrafamilial violence and excessively repressive education of sexuality.

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

Another hypothesis is that of McConaghy's behavioral termination, according to which if a behavior is too habitual 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 in the brain.This produces a high level of tension. This causes the individual not to stop performing the action, so that the tension does not appear. It presents some similarity with 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 it generates and because of the effects it can cause in different vital areas such as socialization and the emotional sphere.

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

Thus, what characterizes exhibitionism is that the action of undressing in view of others, on the one hand, is done simply with the intention of being seen by others, and on the other, is not consensualIt is not consensual, nor is it born out of an irrepressible need.

In the same way, behaviors such as toplessness or the vindictive use in demonstrations cannot be classified as paraphilic behavior, since they do not involve compulsive sexual gratification.

Nor can this disorder be diagnosed if the exhibition behavior is due to and appears only during an altered state of consciousness or other disorders, such as in cases of manic episodes, psychotic break, intoxication, or dementia.

Bibliographical 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). Parafilias y violación. Madrid: Editorial Síntesis.