Exhibitionism is the revelation of one's sexual organs to non-consenting strangers chiefly for personal erotic excitement or pleasure. Exhibitionism is also known in lay terms as “flashing".
Exhibitionism is a bona fide psychiatric disorder include in DSM IV. The diagnostic criteria for exhibitionism entail that the individual has experienced strong sexual urges/arousal when exposing his/her genitals to strangers for at least 6 months. Going to New Orleans and flashing the breasts once or twice would not be considered exhibitionism by this criteria. Moreover the individual has either acted upon these urges or they also cause significant personal distress or interpersonal difficulties.
In most cases, the exhibitionist will expose genitals to strangers but in some cases may also actively masturbate in front of the victim. It is the shock of the victim that induces the sexual arousal for the exhibitionist. Usually there is no physical contact with the victim but this also depends on circumstances. Evidence today indicates that there are also aggressive exhibitionists who will touch or grab the victim.
Exhibitionists are quite cunning individuals and usually employ tricks to attract the unsuspecting victim to a certain area. Usually isolated areas are selected but more often than not, the exhibitionist rarely makes any attempt to hide his/her identify. It is this risk factor that is critical for achieving sexual arousal.
The real number of exhibitionists in the general population is unknown but among sex offenders, it appears that almost 30% have exhibitionist tendencies. While the majority of culprits are males, there are reports that exhibitionism is also common in females. This is common at adult dancing parlors and strip tease bars. Moreover, wearing of skimpy clothes, revealing outfits or see though clothes is also considered exhibitionism-but somehow society rarely complains when it is the female who is the offender!
Exhibitionism usually first surfaces in early teenage years and peaks in the adolescence years. The victims of exhibitionists are usually adult females or children. Most exhibitioners are married or engaged in steady relationships but when closely examined, these individuals do have some degree of sexual dysfunction within the relationship. Although exhibitionism is primarily seen in the younger age groups, it also occurs in the elderly- albeit at a much lower incidence.
Often individuals with exhibitionist tendencies are involved into voyeurism frotterism and have some degree of pedophilic interests.
The majority of individuals with exhibitionism tendencies only come to treatment when they are in legal difficulties or arrested. The treatment of such behaviors is cognitive behavior therapy coupled with SSRI to decrease the sex drive. Those who are aggressive may also be considered for hormonal sex drive reducing medications.
The prognosis of these individuals is poor. The therapies often fail because the individuals are non-compliant and relapses are common. Most end up incarcerated or labeled as sexual deviants and have difficulty adjusting to normal life.
In today’s society, an increasing number of women are seeking cosmetic surgery to correct physical flaws in their body. While having a “nip and a tuck” here and there is perfectly acceptable, there are some women who are addicted to cosmetic surgery. Statistics reveal that more than 20 percent of women seek multiple cosmetic procedures and at least 15 percent never receive any satisfaction.
Studies now show that some people -both men and women, who repeatedly seek cosmetic surgery, may be afflicted with a mental disorder known as body dysmorphic disorder. In these people, the simple “nip and tuck” or “Botox” injection does absolutely nothing to satisfy their mind.
In people with body dysmorphic disorder, every minor flaw on their body is perceived as a huge imperfection that leads to a lot of anxiety and stress. These individuals become so fixated with their physical beauty that they become dysfunctional when they view their body.
Typically, these individuals become heavy users of cosmetic surgery. Unfortunately, the majority of plastic surgeons never consider the emotional component and continue to perform more procedures as it is a source of income for them. Rather than recommending these patients for some type of psychological counseling, these unfortunate individuals are sliced and diced everywhere on their body.
In a recent study done at Rhode Island and Philadelphia hospitals, doctors observed that less than 2 percent of patients with body dysmorphic disorder were relieved of their symptoms after plastic surgery. One quarter of patents did improve but in some, the symptoms of body dysmorphic disorder actually worsened after the procedures. The study authors mentioned that these people cannot be treated with a scalped or a Botox syringe, but need something else.
"Physicians need to be aware that psychiatric treatments for BDD such as serotonin reuptake inhibitors and cognitive behavioral therapy appear to be effective for what can be a debilitating disorder," the researchers wrote.
Now that we know that no drugs can improve memory, researchers have been looking at more exotic methods to stimulate the brain. Recently scientists from the famed British University, Oxford, revealed that tiny electrical current to the brain could make one better at learning maths. They observed that when the parietal lobe of the brain was shocked, the ability of volunteers to solve mathematical problems improved. They suggest that perhaps this technique may help people who struggle with numbers (dyscalculia).
There are many people who have trouble with basic numbers, and this affects their ability to perform even the most basic maths and managing money. Some neuroscientists speculate that perhaps certain chemicals within the parietal lobe play a crucial role in memory.
Previous studies have shown that when magnetic field is applied to certain parts of the brain, it can disrupt electrical activity and lead to temporary difficulties in solving math problems. Therefore, these investigators applied electrical current to stimulate the parietal lobe in a small number of students. The electrical current was minor and had no untoward effects on other brain function. As the current was employed, the students performed much better at mathematical problems than those who were given no electrical current. In addition, the direct of the current was also very important. When the current was given in the wrong direction, their ability to solve problems declined drastically.
The study also revealed that the positive benefits were long lasting and persisted beyond 6 months.
Dr Cohen Kadosh, lead investigator said, "We are not advising people to go around giving themselves electric shocks, but we are extremely excited by the potential of our findings and are now looking into the underlying brain changes. We have shown before that we can induce dyscalculia, and now it seems we might be able to make someone better at maths, so we really want to see if we can help people with dyscalculia. Electrical stimulation is unlikely to turn you into the next Einstein, but if we're lucky it might be able to help some people to cope better with maths."
This study is very intriguing and may perhaps open the door to the treatment of other mental and neurological disorders like addiction or memory loss following a stroke.
Said Dr Chambers of Cardiff University, "This is still an exciting new piece of research, but if we don't know how selective the effects of brain stimulation are then we don't know what other brain systems could also be affected, either positively or negatively."
Final point: While the study is exciting, one should note that electrical therapy (ECT) has been used to treat depression for several decades. So before you start lining up for electrical therapy, remember that even though the current in ECT therapy is slightly high, the majority of people have one major side effect- memory loss, which is sometimes permanent. Until further studies are done on this type of therapy, people who cannot count their money are better off asking others to shop for them.
Like all things in mental health, the cause of kleptomania remains a puzzle. It is believed to be to an abnormality in one the brain neurotransmitters called serotonin. Kleptomania is rare but the actual numbers of people affected remain unknown. Less than 5% of people caught for shoplifting are kleptomaniacs. The disorder usually starts in early childhood and peaks in the 2nd decade of life. Risk factors for kleptomania include head trauma, life stress, having a family member with a mental health disorder (mood disorder, addiction or impulsivity). Doctors use the criteria stated in DSM to make a diagnosis of kleptomania. If kleptomania is untreated, it usually leads to legal, financial and emotional problems. Most kleptomaniacs know that stealing is wrong but are powerless to resist the urge to steal. Many of them are left with residual feelings of remorse, disgrace, embarrassment and self-loathing. Often kleptomania is associated with other disorders like alcohol and drug abuse, eating disorders, compulsive gambling, social isolation, depression, anxiety and suicidal thoughts.
Kleptomania is difficult to overcome with self-treatment at home. There are no standard treatments for the disorder and doctors use a combination of medications and psychotherapy to help overcome the impulse to steal. Even though medications like anti depressants and mood stabilizers are used, there is no clinical evidence that these medications help overcome kleptomania. Moreover, the same medication does not work in all individuals. Most of the medications relieve stress, cause generalized sedation and diminish the urge to steal. The major thrust of treatment is psychotherapy. Cognitive behavioral therapy has been used to identify unhealthy negative behaviors and replace them with healthy positive attitudes. CBT can gradually help people overcome kleptomania, but the treatment is long term and expensive.
To prevent relapse, individuals are urged to develop a support system. This may means educating one's self about the disorder, adopting healthy attitudes, learning to relax and remaining focused. Since the cause of kleptomania is unknown, it is difficult to prevent it. The best way to treat it is to seek help early. Overall, the prognosis of kleptomania depends on the severity of the condition. Those in the early stages can overcome the disorder but those with a long history often end up in legal and financial problems.
Kleptomania is the overwhelming urge to steal items that one really does not need or have little value. Kleptomania is a serious social problem as it can create havoc in a person’s life if it is not treated early. The impulse to steal is very strong and people have no control over it. Unfortunately, because of the taboo associated with the diagnosis of “thief” most people with this disorder remain silent and never seek therapy. Most people only seek treatment when they are caught and in legal difficulties.
The symptoms of kleptomania may include1) an irresistible urge to steal items not needed 2) a heightened stress just prior to the steeling 3) feeling delight to fulfillment while stealing and 4) feeling intense guilt or disgrace after the theft.
What must be understood is that unlike the typical shoplifter, kleptomaniacs do not steal for personal gain nor do they commit the theft as a means of revenge. The stealing is done because of the intense urge that is beyond control. Until they steal, these individuals feel anxious, tensed, and extremely hypersensitive. To resolve these feelings they steal.
Kleptomania occurs spontaneously and is rarely a planned event. Sometimes a simple argument may trigger an episode of kleptomania. Kleptomaniacs may steal from public places, from friends and family or from work. Men tend to steal “hard” items whereas many women steal jewelry, undergarments or private letters. In many cases, the same items are repeatedly stolen and there may be an ingredient of fetishism.
