Understanding Voyeuristic Disorder
Voyeuristic disorder is a mental health condition characterized by a pattern of conduct that centers on watching others in order to achieve sexual gratification. It belongs to a group of conditions in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders called paraphilic disorders. Not all people who engage in voyeurism have voyeuristic disorder. In order to meet the criteria for the condition, affected individuals must experience personal anguish as a result of their behavior, or alternately, must produce anguish in other people and/or violate other people’s rights.
Voyeurism Basics
Voyeurism is one specific example of patterns of behavior known among mental health professionals as paraphilias. People with paraphilias receive sexual pleasure from activities that fall outside of behavioral norms established by a culture or society. In some cases, these behavioral standards are intended to protect the well-being of children and other people who, for one reason or another, lack the capacity to give consent to their participation in a sexual act. In other cases, the norms that define paraphilias come primarily from traditional views about the limits of acceptable sexual conduct between consenting adults.
The specific paraphilia involved in voyeurism is sexual gratification that depends upon seeing other people taking off their clothes, seeing people completely naked, or seeing people participating in some sort of sexual act. In some instances, the target of a voyeur’s behavior is aware of the voyeur’s presence and consents to this behavior. However, in many other instances, voyeurs purposefully act without the consent of their target. Generally speaking, voyeurs experience sexual release without ever touching the object of their sexual interest. Most voyeuristic conduct begins in a person’s teen years or first years of adulthood, the Merck Manual for Health Care Professionals reports. Although it stems from a natural urge to see others naked, this conduct can easily turn into an unhealthy or pathologic pattern of behavior.
Most of the people involved in illegal paraphilic behavior are likely voyeurs, according to the results of a combined study review and study published in 2009 in the journal Archives of Sexual Behavior. Men participate in voyeurism much more frequently than women. Although the specific figures vary from study to study, some research indicates that as many as 40 percent of men not convicted for sexual misconduct participate in a voyeuristic activity at one time or another. Still, research on the subject is fairly limited and no one knows for sure how many people have voyeuristic tendencies.
Voyeuristic Disorder Basics
In the now outdated fourth edition of the Diagnostic and Statistical Manual (DSM IV), voyeuristic disorder was known simply as voyeurism. Because of the use of this general term, there was no clear way for doctors and the general public to distinguish between voyeuristic behaviors that qualify as a form of mental illness and voyeuristic behaviors that don’t rise to the standard for an illness diagnosis. The American Psychiatric Association changed this situation with the release of the fifth edition of the Diagnostic and Statistical Manual (DSM 5) in May 2013. DSM 5 now specifically differentiates between voyeurism itself as a form of paraphilia and voyeuristic disorder as a mental health condition.
According to the DSM 5 criteria, a person with voyeuristic disorder must participate in voyeuristic behaviors that cause harm to self or others. The standard requirement for a self-harming voyeuristic behavior is a behavior that causes personal anguish in the affected individual above and beyond the social stigma of voyeurism. Voyeuristic behaviors that harm others do such things as cause mental anguish, result in some sort of physical injury, or violate other people’s rights (and/or the laws that protect those rights). As a rule, people harmed by voyeuristic behaviors are either unaware of their participation in voyeurism or decline to give their consent for participation. In order to qualify for a voyeuristic disorder diagnosis, an affected individual must also engage in voyeuristic behaviors, fantasize about voyeuristic behaviors, or experience voyeuristic urges for at least half a year.
Treatment Options
Potential initial treatment options for a person with voyeuristic disorder include some sort of one-on-one psychotherapy or group therapy, and use of medications called selective serotonin reuptake inhibitors (SSRIs). In some cases, men who don’t benefit from these treatments receive medications called antiandrogens, which reduce libido by reducing the amount of testosterone in circulation in the bloodstream. People with voyeuristic disorder who break laws face prosecution; these individuals commonly don’t receive treatment until their legal status has been determined.