Exhibitionism

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KEY POINTS

• Exhibitionism is a sexual disorder. If you have this disorder, you are sexually excited by showing your genitals to strangers, or by fantasies of showing your genitals to others. Most people with this disorder do not want to touch their victims.
• Many people with this disorder do not get help until they are arrested and the court orders treatment. Both therapy and medicines may be used to treat this disorder.

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What is exhibitionism?

Exhibitionism is a sexual disorder. If you have this disorder, you are sexually excited by showing your genitals to strangers, or by fantasies of showing your genitals to others. Most people with this disorder do not want to touch their victims.

Young children may show their genitals or underwear to others. This is usually a passing phase. It calls for professional treatment only if it keeps happening.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Emotional and sexual abuse in childhood may increase your risk.
• Problems in your family when you were growing up may increase your risk. For example, lots of conflict in the family or a family history of mental illness.

Most people with this disorder are male. It often starts in the teen or early adult years. Although this disorder can be a life-long problem if not treated, it often becomes less severe in older adults.

What are the symptoms?

Symptoms may include:

• Being sexually aroused by:
  • Having fantasies that people are sexually excited by seeing your genitals
  • Showing your genitals to unwilling victims and seeing their shock
• Not wanting close sexual contact with victims
• Having fantasies, urges, or actions that upset you and cause serious problems in school, on the job, or in relationships

How is it diagnosed?

Your healthcare provider will ask about your relationships, family history of any medical and mental problems, and any substance abuse. He will also ask about your symptoms, behaviors, and medical history and examine you. You may be referred to a mental health therapist for treatment.

How is it treated?

Many people with this disorder do not get help until they are arrested and the court orders treatment. If you have exhibitionism, get help before it becomes an even bigger problem.

Both therapy and medicines may be used to treat this disorder. Several types of therapy may help.

• Behavior therapy helps you recognize that the way you act affects others. This can help you change problem behaviors.
• Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.
• Conditioning therapy helps you learn to link thoughts and actions related to your sexual disorder with something negative, such as a foul odor or an image of getting caught. Over time, the negative thoughts help you to not act on your sexual thoughts.

Medicines may include hormones or medicines to correct the balance of chemicals in your brain. Both kinds of medicine help reduce sexual urges.

How can I take care of myself?

• Get support. Consider joining a support group in your area. Twelve-step sexual recovery programs can help. You can learn from others who have similar problems.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, try to quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

For more information, contact:

• National Alliance on Mental Illness (NAMI)
  800-950-NAMI
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net