Voyeurism

What is voyeurism?

Voyeurism is a sexual disorder. People who have voyeurism have sexual fantasies, urges, or behaviors that involve watching someone else who is naked, undressing, or having sex. The voyeur may masturbate while watching or later while remembering. The person who is being observed is not aware that he or she is being watched. Victims often feel frightened or dirty if they become aware that someone is watching.

How does it occur?

The exact cause of this disorder is not known. Experts think it may be caused by differences in the brain or nervous system. It might also be related to things such as sexual abuse or a family history of mental illness. Most voyeurs are male.

What are the symptoms?

Some degree of voyeurism may be normal. You may enjoy R-rated and X-rated movies, or pornographic magazines. You may have fantasies or be sexually aroused when you accidentally see someone naked or having sex.

Unless you seek out these experiences repeatedly for more than 6 months, you are not a true voyeur. These fantasies, urges, or behaviors cause distress. They can keep voyeurs from being able to function in school, on the job, or in relationships.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, relationships, medical history, and substance abuse history. He or she will also ask if you or someone close to you has a history of mental illness. Your provider may also do a physical exam and order tests to rule out medical conditions as a cause of your symptoms.

How is it treated?

Different kinds of conditioning therapy can be effective ways to treat this disorder. In covert sensitization, you first relax and picture scenes that excite you. Then you imagine something negative, such as getting your penis stuck in the zipper of your pants.

With assisted aversive conditioning, the negative event is real rather than imagined. For example, your therapist sprays a bad smell such as ammonia in the air. The goal is for you to link your actions with something negative and avoid both.

Empathy training can help you understand how your victims feel. Two kinds of medicines may be used to treat this disorder:

• Antiandrogens reduce male sex hormone levels.
• Medicines such as fluoxetine (Prozac) increase the brain chemical serotonin and reduce obsessive thoughts and compulsive behaviors.

When should I seek help?

Voyeurism is illegal. According to some psychiatric studies, 20% of voyeurs go on to commit more serious sexual assault offenses. If you are a voyeur, consider getting into therapy. If you continue, you take the risk of getting arrested and forced into treatment. Call your State Board of Mental Health for a referral to a specialist. What you say will not be shared as long as you pose no threat to yourself or others. If someone you care about is a voyeur, encourage him to seek treatment.