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Exhibitionism: Causes of This Sexual Paraphilia
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Within this framework, exhibitionism is the paraphilic equivalent of flirting: However, as mentioned previously, many cases are never reported to the police due to embarrassment or a lack of desire to be involved in an investigation. Although exhibitionism rarely involves any coerced physical contact, it is still nothing to be taken lightly. In some cases of exhibitionism, survivors develop a deep fear of experiencing similar sexual crimes in the future—especially if the victim Exhibitionism sexual a child. Scatolophiliaalso known as telephone scatalogia, is a paraphilia in which a person derives sexual arousal from the Exhibitionism sexual or fantasy of making obscene phone calls to unwilling recipients, who are typically strangers.
As with exhibitionism, sexual pleasure from scatolophilic behavior is usually derived from the reaction of the victim, whether the caller enjoys the shock or perceives the victim to have liked the phone call. Scatolophilia is very similar to exhibitionism in that it has to do with nonphysical, but coerced, sexual behavior. Scatolophilia involves auditory exposure and stimulation while exhibitionism is a visual experience. A natural reaction for the victim in these scenarios is shock. However, it is important to remember that the perpetrators themselves derive pleasure from horror-ridden reactions. It is best to stay calm and walk away if faced with an exhibitionist.
If the victim feels comfortable enough, she should report the incident to the police so that similar incidents will not occur with other potential victims. There is another definition of exhibitionism that does not describe a paraphilic disorder. Blood and urine tests for substance abuse and sexually transmitted diseases, including an HIV screen. Assessment of sexual behaviors. This includes creation of a sex hormone profile and responses to questionnaires. The questionnaires are intended to measure cognitive distortions regarding rape and other forms of coercion, pedophilia, aggression, and impulsivity.
Treatments Exhibitionism is usually treated with a combination of psychotherapymedications, and adjunctive treatments. Psychotherapy Several different types of psychotherapy have been found helpful in treating exhibitionism: This approach is generally regarded as the most effective form of psychotherapy for exhibitionism. Patients are encouraged to recognize the irrational justifications that they offer for their behavior, and to alter other distorted thinking patterns. In this technique, the patient is conditioned to replace fantasies of exposing himself with fantasies of more acceptable sexual behavior while masturbating.
This form of therapy is used to get patients past the denial frequently associated with paraphilias, and as a form of relapse prevention. Twelve-step groups for sexual addicts. Exhibitionists who feel guilty and anxious about their behavior are often helped by the social support and emphasis on healthy spirituality found in these groups, as well as by the cognitive restructuring that is built into the twelve steps. Couples therapy or family therapy. This approach is particularly helpful for patients who are married and whose marriages and family ties have been strained by their disorder. Medications There are several different classes of drugs used to treat the patient with exhibitionism and the other paraphilias.
However, one difficulty in evaluating the comparative efficacy of different medications should be noted: Double-blind placebo-controlled studies of medication treatment of sexually deviant men raises the ethical question of the possibility of relapse in the subjects who receive the placebo. Withholding a potentially effective drug in circumstances that might lead to physical or psychological injury to a third party is difficult to justify.
As ofmedications are the only form of treatment for patients with exhibitionism that have Exhivitionism capability to suppress deviant Exbibitionism. The categories of drugs used to treat exhibitionism are as follows: Selective serotonin reuptake inhibitors SSRIs. The SSRIs show promise in treating Exhibitionixm paraphilias, as well as depression and other mood disorders. It has been found that decreased levels of serotonin in the brain result in an increased sex drive. The SSRIs are appropriate for patients with mild- or moderate-level paraphilias; these patients include the majority of exhibitionists.
Estrogens have been used to treat sexual offenders since the s. Medroxyprogesterone acetate, or MPA, is the most widely used hormonal medication in the U. Medroxyprogesterone acetate works by stimulating the liver to produce a chemical that speeds up the clearance of testosterone from the bloodstream. It is effective as long as patients are take their MPA as prescribed by their physicians. Unfortunately, MPA can cause several troublesome side effects in some patients. These include nausea, vomiting, weight gain, and headache. Luteinizing hormone-releasing hormone LHRH agonists.
These drugs are sometimes described to be the equivalent of pharmacologic castration. They work by reducing the release of gonadotropin hormones. The LHRH agonists include such drugs as triptorelin Trelstarleuprolide acetate, and goserelin acetate. These drugs block the uptake and metabolism of testosterone and reduce the blood levels of testosterone. The antiandrogens include cyproterone acetate CPA and flutamide. Cyproterone acetate has been used in Germany to treat exhibitionists since the early s, and most long-term studies of the CPA have been done by German psychiatrists. The drug appears to have minimal side effects in long-term use and significantly reduces recidivism relapse and repetition of the deviant behavior.
Surgery Surgical castration, which involves removal of the testes, is effective in significantly reducing levels of testosterone in blood plasma.
This form Exhibitionis, treatment for paraphilias, however, is generally reserved for more serious offenders than exhibitionists violent rapists and pedophiles with a Exhjbitionism of repeated offenses, for example. Other treatment methods Another method of treating patients with exhibitionism disorder, used more frequently in the s and s Exhibitonism today, is electroshock aversion. While a mild electric shock was administered, the patient was shown pictures, projected onto a screen, of men exposing themselves. Inaversion therapy involves asking the patient to fantasize a sequence of events leading up to his exhibitionism.
Then, a very unpleasant scene is inserted at a crucial point in the sequence. The patient might, for example, be asked to imagine a police officer approaching as he exposes himself, or to think of his target fighting back or laughing at him. Another treatment method that is often offered to people with exhibition disorder is social skills training.
It is thought that some men sexusl paraphilias partially because they do not know how sexua, form healthy relationships, whether sexual or nonsexual, with other people. Although social skills training seual not considered a substitute for medications or psychotherapy, it Exhigitionism to be a useful adjunctive treatment for exhibitionism disorder. Legal considerations People with Exbibitionism disorder are at risk for lifetime employment problems if they acquire a police record. An attorney who specializes in employment law has pointed out that the Americans with Disabilities Act ADAenacted by Congress in to protect workers against discrimination on grounds of mental impairment or physical disability, does not protect persons with paraphilias.
People with exhibitionism disorder were specifically excluded by Congress from the provisions of the ADA, along with voyeurs and persons with other sexual behavior disorders. Prognosis The prognosis for people with exhibition disorder depends on a number of factors, including the age of onset, the reasons for the patient's referral to psychiatric care, degree of his cooperation with the therapist, and comorbidity with other paraphilias or other mental disorders. For some patients, exhibitionism is a temporary disorder related to sexual experimentation during their adolescence.
For others, however, it is a lifelong problem with potentially serious legal, interpersonal, financial, educational, and occupational consequences. Prevention One important preventive strategy includes the funding of programs for the treatment of paraphilias in adolescents.
Sexhal work by local the local of gonadotropin hormones. The ethics appears to have its intensity before age The Motel is less famous, and the many sexual fundy Dicks probably disagree.
According to one expert in the field, males in this age group have not been studied and are undertreated, yet it is known zexual paraphilias are usually established before age Recognition of paraphilias in adolescents and treatment for those at risk would lower the risk of recidivism. A second important preventive approach is early recognition and appropriate treatment of people who have committed child abuse. Diagnostic and Statistical Manual of Mental Disorders.
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