We have seen that a very common symptom of severe and protracted childhood trauma in adults is a deep and pervasive sense of shame. According to Silverstein (1996), exhibitionism is an example of a maladaptive repetition compulsion unconsciously motivated by an overwhelming need to overcome the shame and humiliation associated with traumatic experiences and to replace these adverse emotions with feelings of power.
Emotional Abuse And Family Dysfunction
According to Lee et al. (2002), the types of trauma that constitute the greatest risk of traumatized individuals developing exhibitionist tendencies in later life are childhood emotional abuse and family dysfunction and, therefore, addressing such issues is of theoretical importance when treating sex offenders.
Exhibitionistic disorder is more common in males than females and research suggest that it affects about 3% of the population. It normally begins during adolescence or early adulthood but sometimes starts in preadolescence or middle age.
Not all people who carry out exhibitionistic behavior are diagnosable of suffering from exhibitionistic disorder. For those who are interested, a complete list of symptoms psychiatrists use to diagnose exhibitionistic disorder can be found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5).
According to Abel and Rouleou (1996), it is frequently the case that exhibitionists are also prone to other paraphilias (a paraphilia is an emotional disorder involving sexually stimulating fantasies, impulses, or behaviors that are intense and have recurred over a period of over six months, cause distress and interfere with the individual’s functioning socially, at work or in another important area of life).
Endorsing this view, Kafka (2001) is of the opinion that paraphilia such as exhibitionism very frequently occur comorbidly alongside hypersexuality and stated that: ‘paraphilic disorders may be the proverbial tip of the iceberg of a broader range of sexual disorders characterized by excessive sexual appetite, sexual preoccupation and repetitive impulsive enactment of sexual behavior despite adverse consequences.’
Cognitive therapy may be useful for the treatment of exhibitionism and therapists are most likely to be successful at helping exhibitionists curb their behavior if they are empathetic and accepting with a directive but non-confrontational approach (Morin and Levenson, 2008).
David Hosier BSc Hons; MSc; PGDE(FAHE)
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