Occasionally, you may hear about or maybe even see someone streaking nude at a sporting event or some other public activity. In these instances, the indecent exposure may seem harmless and even funny. At other times, though, the intentional act of showing one’s sexual organs in public causes harm to others, has serious personal consequences, and can be an indication of an underlying mental health problem. In fact, indecent exposure and mental health are closely linked, as evidenced by the research. We’ll explore these ties in greater detail and discuss the potential mental health impact of exhibitionist behavior–for both the victim and the perpetrator.
Understanding Indecent Exposure and Its Significance
Indecent exposure is not necessarily the same thing as one adult sending nude pictures to another adult–although it can be, according to a report by Psychology Today. It stated that if a man sends naked pictures to a woman he knows and she is not expecting it, that qualifies as exhibitionism or indecent exposure.
Why is this significant? This form of indecent exposure has become increasingly common with the rise of online dating—and, can cause real distress for those (in most cases women) on the receiving end. As illustration, the same Psychology Today report cited a study of 846 female college students, roughly one-third of whom had received photos of men’s genitalia. Many of these same women (38 percent, in this study) said the experience was moderately to severely distressing.
When Indecent Exposure May Be a Sign of a Mental Health Issue
Then there are the potential mental health aspects of an exhibitionist problem. A portion of individuals who engage in non-consensual indecent exposure may have a treatable mental health issue known as “exhibitionistic disorder.” This diagnosis is characterized by a persistent and intense urge to expose one’s self to non-consenting people, especially strangers. Exhibitionistic disorder causes the individual with the condition to feel extreme distress, sometimes rendering them unable to function because of their desires.
DSM-V 'Exhibitionism' Definition
- The person exhibits recurring fantasies of exposing themselves to unsuspecting people over a period of at least six months
- The person has followed through with these desires and causes distress or difficulty with interpersonal relationships in the workplace or social situations.
The uncontrollable urge, the distress, the lack of consent, or the desire to shock, arouse, or offend others are necessary for a person to have exhibitionistic disorder. It is this condition that is often responsible for indecent exposure. Actions that a person may perform because of this condition often cause lasting harm to witnesses—and sometimes the perpetrator.
Psychological Factors Behind Exhibitionist Behavior
Much remains to be learned about exhibitionism and the psychological factors that could be responsible for it. The topic can be difficult to research for various reasons. For example, cultural, religious, and personal differences can affect what we view as appropriate sexual expression and what we view as indecent exposure. Additionally, what research is available tends to come from men convicted of sexual misconduct, leading to biased and unreliable results.
Truthfully, nobody can satisfactorily prove what drives exhibitionistic behavior, but we can point to some of the psychological factors and conditions that may be involved.
Studies show potential links between antisocial or histrionic personality disorders and indecent exposure. There may also be ties to alcohol abuse or an interest in pedophilia.
Histories of abuse or trauma, particularly in childhood, may cause people to engage in more extreme or fringe sexual activities. This includes exhibitionism.
Some research found links to poor social perception. In the case of more personal acts of indecent exposure, the exhibitionist may genuinely believe they are flirting and that the action is appropriate.
Beyond this, experts also recognize a range of mental health conditions that occur alongside exhibitionistic disorder, including anxiety, bipolar disorder, depression, and ADHD.
While the mechanisms are still unknown, it is clear that exhibitionistic disorder and acts of indecent exposure do not stem from a healthy mind. In the case of co-morbid problems like depression, the conditions may form a cyclical relationship. Exhibitionistic disorder causes distress, which worsens depression symptoms and in turn reinforces exhibitionist urges.
Exploring the Mental Health Impact of Indecent Exposure
At its core, indecent exposure is a form of sexual assault. Though many people who experience sexual assault develop lasting effects, not all do. Child victims are particularly prone to long-term symptoms.
Some of the most common impacts that sexual assault can have on someone include anxiety and depression, guilt and shame, and anger. Individuals may also deny that the events happened, have difficulty trusting others, or develop some form of social anxiety.
As a traumatic event, victims of indecent exposure often develop post-traumatic stress disorder and its associated conditions. This includes suicidal ideation, eating disorders, addiction, or other psychopathologies. Sometimes, sexual assault also triggers bipolar or obsessive-compulsive disorders.
Additionally, while witnesses are far more likely to develop psychological or emotional effects following exhibitionistic behavior, the exhibitionist may also experience problems.
Exhibitionistic disorder already causes a person to feel extreme distress. However, their condition drives them to perform actions they know are wrong—usually uncontrollably. After the event, the exhibitionist may feel powerful shame or guilt that feed into conditions like depression and anxiety. The event may be traumatic for them, resulting in the same traumatic disorders that victims often experience. Self-harm and suicidal ideation are common as well.
Approaches to Treatment for Individuals with Exhibitionist Issues
Those with exhibitionist issues who have harmed others due to their paraphilia, feel distress because of their desires, or show signs of escalating behavior should seek treatment. Unfortunately, most people with this disorder do not seek treatment on their own, often because of their fear and shame. It is therefore up to friends and family to take an active role in referring their loved one to a treatment center that can help them.
Some of the most effective treatments involve teaching those with exhibitionistic disorder to control their urges and find safer, more acceptable ways of managing them. One of the most proven methods is cognitive-behavioral therapy. By equipping patients with the ability to recognize triggers that may encourage the behaviors and interrupt them, counselors can steadily enable patients to start managing exhibitionistic actions outside of sessions.
Many experts also utilize medications to treat the co-morbid conditions that may be causing or feeding into the exhibitionistic desires. For example, SSRIs that typically treat depression and anxiety may relieve symptoms of those conditions while also limiting sexual arousal, leading to fewer incidents of indecent exposure.
Ultimately, exhibitionism and indecent exposure are complex and hard to understand for those who do not have those same feelings. Having an expert in your corner with experience in dealing with these issues and a medical understanding of the disorder is key. If you or someone you know is struggling with exhibitionistic desires, reach out to our compassionate professionals at Restore Mental Health.
