Fernando, a twenty-year-old man, arrives at the psychologist’s office. Once inside, Fernando mentions that he left due to a problem that causes him great discomfort. He admits that in recent months he has had a need. urgent to get out, stands in a dark corner and, when a woman walks by, shows her genitals, then after seeing her reaction she runs away and when she comes home she masturbates thinking of surprise of the person to whom it was shown, which causes great excitement and decreases his stress.For this reason, Fernando was arrested and sentenced on one occasion, but considers that he will do it again if he does not. didn’t help, and that makes him very anxious to see it as disgusting behavior. “
The case cited here is an invented example of one of the most famous paraphilias, exhibitionism.
Exhibitionism with 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 called sexual deviations, paraphilias they refer to the repeated presentation of intense sexual fantasies in which the object of desire is atypical. Usually, these desires are focused on objects or non-human beings, the suffering and humiliation of oneself or of others or of people who do not consent within six months. These behaviors may or may not be understood as an alteration by those who exhibit them, being in many cases considered immoral by the subjects themselves. In all cases, paraphilias cause severe deterioration of various vital areas of the individual, with or without discomfort on the part of the subject.
While some of these paraphilias may not have legal repercussions or be too disabling beyond the restriction of sexual interest and the discomfort it can cause in the subject himself or the difficulty of be accepted by sexual partners (for example, focused desires towards objects such as fetishism), other paraphilias can lead to serious crimes and even crimes such as pedophilia or somnophilia (sexual desire of sleeping subjects, this which involves rape).
Diagnostic criteria and symptoms
By visualizing the type of disorder we are talking about, we can then make a more coherent explanation of what exhibitionism implies as paraphilia.
The main symptoms are based on the existence for at least six months of recurrent and very arousing fantasies. exposure of the genitals to an unexpected stranger, having in addition to having been performed and / or producing clinically significant discomfort in the subject or his functioning in relevant areas of his life.
It is the most common paraphilia, often accompanied by others such as voyeurism. This problem generally appears around the age of majority, with a maximum prevalence between twenty and thirty years old and decreasing from the age of forty.
The excitement and pleasure achieved by the exhibitionist is obtained by observing the reactions of the people to whom it is shown, usually those of fear, surprise and curiosity. It is possible for the subject to masturbate during or after the exposure by reinventing the reactions of their victims. They usually do not really intend to have sexual activity with their victim, and it is not the person per se that is the reason for the arousal but the fact of surprising her. In fact, it is not uncommon for the exhibitionist to escape if the victim responds positively to their reaction. However, reactions of indifference or ridicule can be extremely painful for these subjects, due to their low self-esteem.
The psychological profile of the exhibitionist
The typical exhibitionist subject is a generally heterosexual maleOften with difficulty in establishing contact with the sexual object of their desire, although it is also common to appear in subjects with a partner and even married people with apparently normal relationships.
In general, the exhibitionist subject presents a high level of withdrawal and introversion, with a strong lack of self-confidence which pushes him to achieve his performance, probably as a defense mechanism. Such subjects therefore generally do not pose a real threat, most of them having no aggression or intention to interfere with their performance.
As mentioned above, some paraphilias can constitute serious crimes punishable by imprisonment.
In the case of exhibitionism, we would be faced with a paraphilia classified as a crime against sexual freedom, May be punished with imprisonment 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 borne in mind that when evaluating the possibility of creating a diagnostic category to refer to a mental disorder, it is not only taken into account whether it is detrimental to the quality of life of those who experience it. their own flesh. It is also considered discomfort and inconvenience generated to third parties, And this is precisely what happens in the case of exhibitionism.
Exposing the genitals to another person, with the intention of feeling pleasure for them, causes an attack on the dignity of others and, in addition, in many cases, produces fear, to be interpreted as the beginning of ‘rape.
Etiology (causes) of exhibitionism
The causes of this type of paraphilic behavior are widely debated in the psychological literature.
Many theories in this regard indicate the participation of learning processes in the acquisition of these behaviors, proposing that they are behaviors learned by accidental conditioning between sexual arousal and an atypical stimulus, conditioning reinforced by the repetition of situations and the start of the application. from the stimulus to the imagination during masturbation.
Imitation of patterns seen in childhood has also been explored as a possible causeDue to the presence of patterns of violence and abnormal sexual behavior in some cases of poorly socialized individuals, domestic violence and overly repressive sex education.
Likewise, the presence of deficits in social and communication skills was also explored, due to the presence of follow-up difficulties in many of the cases studied. In these subjects, it was 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 of the hypotheses studied is that of the behavioral ending of McConaghy, according to which if a behavior is very frequent a mechanism is created in the brain which is activated when stimuli associated with the behavior in question are perceived, Producing a high voltage level. This causes the individual to stop performing the action, so that the tension does not arise. It bears some resemblance to the mechanism of action of obsessive-compulsive disorder.
Warning: not everything is paraphilia
Exhibitionism is a paraphilia that can be a serious problem for the patient, both for the discomfort it generates and for the effects it can cause in different areas of life such as socialization, the environment emotional.
Exhibitionism, however, should not be confused with paraphilia along with sexual fantasies and behaviors. occasionally used as a sexual stimulus. Erotic games and fantasies with the partner such as stripping or using one’s own anatomy to provoke the partner’s desire will not be included in paraphilia, which implies the need to present this type of behavior in a way compulsive for sexual gratification., For at least six months and causing significant discomfort or alterations in normal life.
Thus, what characterizes exhibitionism is that the act of undressing in full view of others, on the one hand, is done simply with the intention that others see it, and on the other hand, it is not consensual, In addition to being born out of an uncontrollable need.
Likewise, behaviors such as topless or vindictive use in manifestations cannot be classified as paraphilic behavior, as they do not involve compulsive sexual gratification.
This disorder also cannot be diagnosed if the display behavior is due and only appears during an altered state of consciousness or other disorders, such as manic episodes, psychotic epidemics, poisoning or dementia.
- 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 Síntesi.