Exhibitionism

What is exhibitionism?

Exhibitionism is a sexual disorder. People with this disorder are sexually aroused by showing their sexual organs to strangers. People who have this disorder may masturbate while they expose themselves, but do not usually try to touch their victims.

While often joked about, this disorder is very serious and can be frightening to the victim.

What is the cause?

The exact cause of this disorder is not known. Experts think it may be caused by differences in the brain or nervous system. It might also be related to things such as child abuse or a family history of mental illness.

Most people with this disorder are male. Although this disorder can be a life-long problem if not treated, it often becomes less severe by age 40.

What are the symptoms?

Symptoms of this disorder include:

• being sexually aroused by the shock of victims
• seeking unwilling victims
• not wanting further sexual contact

How is it diagnosed?

Your healthcare provider will ask about your symptoms, relationships, medical history, and substance abuse history. He or she will also ask if you or someone close to you has a history of mental illness. Your provider may also do a physical exam and order tests to rule out medical conditions as a cause of your symptoms.

You may be diagnosed with exhibitionism if:

• You have fantasies, urges, or behaviors that cause distress.
• The disorder causes problems in school, on the job, or in relationships.

How is it treated?

Both therapy and medicines may be used to treat this disorder. Different kinds of conditioning therapy may be used to treat this disorder:

• Biofeedback therapy. You are connected to a machine that gives you feedback with light or sound. You try to keep feedback within a certain range while you are exposed to sexually exciting material.
• Covert sensitization. You first relax and picture scenes that excite you. Then you imagine something negative, such as getting your penis stuck in the zipper of your pants.
• Assisted aversive conditioning. In this form of therapy, the negative event is real rather than imagined. For example, your therapist sprays a bad smell such as ammonia in the air. The goal is for you to link your actions with something negative and avoid both.
• Empathy training. This can help you understand how your victims feel.

Two kinds of medicines may be used to treat this disorder:

• Antiandrogens reduce male sex hormone levels.
• SSRI medicines such as fluoxetine (Prozac) increase the brain chemical serotonin. Low levels of serotonin in the brain result in an increased sex drive. SSRI’s help to reduce obsessive thoughts and compulsive behaviors. SSRI’s also help reduce sexual impulses.

When should I seek help?

Young children may try to shock others by showing their genitals or underwear. This is usually a passing phase. It calls for professional treatment only if it keeps on.

If your symptoms are seriously interfering with your daily life, seek help from your healthcare provider or a mental health therapist. Many people with this disorder do not get help until they are caught by the police and the court orders treatment. If you or someone you care about is an exhibitionist, get help from a mental health professional early.

What can I do to help myself?

The following may help you:

• Do not use illegal drugs or alcohol. Drugs and alcohol can make your symptoms worse. If you are taking medicine, using drugs or alcohol could be very dangerous.
• Follow exactly the directions for prescribed medicine.
• Tell your provider if your symptoms seem to be getting worse or if you are having trouble dealing with them.

For more information, contact:

• National Alliance for the Mentally Ill (NAMI)
  Phone: 1-800-950-NAMI
  Web site: http://www.nami.org
• Mental Health America
  Phone: 1-800-969-6642
  Web site: http://www.mentalhealthamerica.net