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Given that we both realize that - step back a moment and look at the big picture: do you REALLY believe that exhibitionism "merits clinical assessment and therapy to correct"?
Alone? No. Is that what DSM states about exhibition alone, that it warrants clinical assessment and therapy? I haven't looked it up.
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Originally Posted by SifuPhil
What I'm saying is, the authors of DSM-IV have made the rules based upon THEIR perception of the human animal - it isn't necessarily wrong, but it isn't necessarily right, either. To me, that gives it a 50/50 chance of being a useful reference - not very trustworthy.
Things to think about...
However, they need some criteria list in order to determine, without letting their own emotions, past experience, etc., influence it, whether or not to DX a person in a certain way and whether or not the person could benefit from therapy.
What you said about personal perception is exactly why there is a DSM. And fine-tuning it is why it gets updated. Can, and should, we take part in our own self-assessments and in seeking our own help or determining if we need it? Yes. A part. The other part is the clinical side, the one that, no matter how incredibly bright we think we are, we truly do need at least a second pair of psychiatric "eyes" to say, from a step back, what their input is. And yes. If we meet a list of criteria, no matter what "great guys" or "great gals" we think we are, it definitely is possible that we should look deeper into things. It is highly likely, at least in the case of a more severe psychiatric disorder, that we're self-blinded and thinking, "oh, sure, this DX might be true for other people who do X, Y and Z. But not for me. Deep down, I'm a great guy/gal."
I'm sure it's not foolproof, but I wouldn't say there's only a 50/50 chance, either. We may each think there is in a given situation, but that's one of the problems with having a psychiatric condition. We ourselves aren't generally the best people to make that judgment. Psychs aren't infallible, so I'm not saying that. But for instance, I once knew a man who decided that age 12 was womanhood if the girl had already begun to have breasts, and therefore if he fondled her, it couldn't possibly be sexual abuse. He truly believed this. 100%. He thought that "shrinks" with their "ideas" were idiots because they just didn't understand him as a person. He was a great person, a family man who paid all his bills. If a girl had menstruated and had breasts, then why go by a ridiculous, arbitrary number--18--as the age when she "must" be "a woman"? Shouldn't his input in the matter be taken into account?
People are individuals, aren't they? If a girl feels she is a woman, and he feels she is a woman, then she is a woman. Isn't she? So in a way, he was deeply seeing the girl as the person she was, not going by some ridiculous number.
Okay, here's a link that has exhibitionism at the top.
I'm having trouble finding the actual list with details for some reason, but I am reading over and over that it's typically comorbid with other disorders so I'm thinking the majority of the time, just exhibitionism alone isn't something that makes psychs jump out of their seats and demand that the person come see them.
But even with all that aside, it doesn't just say "the person has shown his winkie. Lock him up in a ward!" It specifies that it's an intense urge, that it's thought about frequently, and for a minimum specific time (6 months) and that it has been acted upon and/or that it is interfering with aspects of the person's life (and yes, I do believe that something that interferes with someone's life--or something that interferes with someone else's life; i.e., showing a child your thang and scarring him or her--warrant some psych intervention. As do psychs, obviously. As does the law.) So you see, your description and the actual DSM-IV criteria even with the above abbreviated definition differ. The description is in fact specific and has specific parameters. It's not just whipping it out once when you were drunk at a frat party.
Alone? No. Is that what DSM states about exhibition alone, that it warrants clinical assessment and therapy? I haven't looked it up.
Oh, OK - thought that was a direct quote.
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However, they need some criteria list in order to determine, without letting their own emotions, past experience, etc., influence it, whether or not to DX a person in a certain way and whether or not the person could benefit from therapy.
When dealing with the human mind, unless you're an enlightened being some part of you - your cultural background, your upbringing, your morals and /or your religion - is going to influence what you do and say. It can't be avoided.
It's still largely an arbitrary call in most cases, bolstered by their own structures and rules.
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What you said about personal perception is exactly why there is a DSM. And fine-tuning it is why it gets updated. Can, and should, we take part in our own self-assessments and in seeking our own help or determining if we need it? Yes.
So far, so good.
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A part. The other part is the clinical side, the one that, no matter how incredibly bright we think we are, we truly do need at least a second pair of psychiatric "eyes" to say, from a step back, what their input is. And yes. If we meet a list of criteria, no matter what "great guys" or "great gals" we think we are, it definitely is possible that we should look deeper into things. It is highly likely, at least in the case of a more severe psychiatric disorder, that we're self-blinded and thinking, "oh, sure, this DX might be true for other people who do X, Y and Z. But not for me. Deep down, I'm a great guy/gal."
I'm talking about a self-aware person, not your run-of-the-mill putz. One who knows how to push aside the masks and see the REAL self, not the perceived one.
No pshrink past or present can pull THAT off.
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I'm sure it's not foolproof, but I wouldn't say there's only a 50/50 chance, either. We may each think there is in a given situation, but that's one of the problems with having a psychiatric condition. We ourselves aren't generally the best people to make that judgment. Psychs aren't infallible, so I'm not saying that.
But in the end, when you leave their office, you go out in either one of two ways - free or in handcuffs. That, to me, makes it 50/50. If they dope you up, you're still in bondage - just of a chemical sort. But I do agree that, given the "average" Joe or Jane, they might benefit from having someone to bounce their ideas off. Again, the problem there is the background of the therapist.
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But for instance, I once knew a man who decided that age 12 was womanhood if the girl had already begun to have breasts, and therefore if he fondled her, it couldn't possibly be sexual abuse. He truly believed this. 100%. He thought that "shrinks" with their "ideas" were idiots because they just didn't understand him as a person. He was a great person, a family man who paid all his bills. If a girl had menstruated and had breasts, then why go by a ridiculous, arbitrary number--18--as the age when she "must" be "a woman"? Shouldn't his input in the matter be taken into account?
People are individuals, aren't they? If a girl feels she is a woman, and he feels she is a woman, then she is a woman. Isn't she? So in a way, he was deeply seeing the girl as the person she was, not going by some ridiculous number.
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Would I date a stripper, sure why not. Could be in for some good times, might even learn a thing or two. Would I date a stripper, with no one on the side or on the side ready, definatly not. You gotta have your insurance when dating a stripper, and you gotta be ready for what is most likley the inevitable. I'd imagine it being some-what similar circumstances for a woman who is considering dating a porn star.
Okay, here's a link that has exhibitionism at the top.
ThankyouthankyouTHANKYOU for not quoting Wikipedia!
Notice how they define exhibitionism in the first line?
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Recurrent, intense sexually arousing fantasies, urges, or behaviors involving the exposure of one’s genitals to unsuspecting strangers
So I guess that leaves out the woman who bares her breasts in public or shows some stocking tops and garters...
Or the guy who goes around all day without a shirt and just a pair of short-shorts with his package leading the parade?
Half the young girls I see these days would also fit most definitions of exhibitionism, yet they're "fully" dressed.
EDITED TO ADD: And if I just THINK or DREAM for six months, every once in a while, about exposing myself in front of the Mormon Tabernacle Choir, WITHOUT FOLLOWING THROUGH, and it causes me to lose some sleep ("distress"), THAT fits their definition also. Scary.
When you label something, you become a prisoner to that label. That's one of the major faults I find in clinical psychiatry / psychology.
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I'm having trouble finding the actual list with details for some reason, but I am reading over and over that it's typically comorbid with other disorders so I'm thinking the majority of the time, just exhibitionism alone isn't something that makes psychs jump out of their seats and demand that the person come see them.
OK - that's sounds more reasonable.
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But even with all that aside, it doesn't just say "the person has shown his winkie. Lock him up in a ward!" It specifies that it's an intense urge, that it's thought about frequently, and for a minimum specific time (6 months) and that it has been acted upon and/or that it is interfering with aspects of the person's life (and yes, I do believe that something that interferes with someone's life--or something that interferes with someone else's life; i.e., showing a child your thang and scarring him or her--warrant some psych intervention. As do psychs, obviously. As does the law.) So you see, your description and the actual DSM-IV criteria even with the above abbreviated definition differ. The description is in fact specific and has specific parameters. It's not just whipping it out once when you were drunk at a frat party.
What is "intense"? How do you quantify it? Is it more than "extreme" but less than "pretty heavy"?
Same with "frequently" - once a day? Every waking moment? A few times a year?
How do they determine the minimum time? I'm not aware of any clinical time trials involving exhibitionism (although I might be wrong - sounds like it would be a wonderful government grant project )
See the problem here? Totally open to prejudiced interpretations. Sorry, to me it isn't specific at all.
As for interfering with one's life - there you open a huge can of worms (Freud would have loved that imagery). The only way to determine interference in another's life is to judge based upon the effects on the REST of society, NOT the individual themselves. That makes the docs tools of society, enforcers of "the common good" - Mind Police, if you will.
Now interfering with another's life is more properly a function of law or ethics, but I agree that at a certain point action must be taken. I just disagree with the frequent practice of slapping disease labels on people based upon non-valid criteria, and yes, I know they can point to reams of research and trials - I've studied some of this stuff, so I know their justifications - but that still doesn't make it right, because once again they're playing in THEIR ballpark with THEIR equipment - we're just the visiting team. You might be surprised to see how shoddy some experimental design is even to the present day.
By any chance do you have a long black raincoat in the back of your closet that you wear occasionally?
LOL Fat.. good one.. I cant wait to hear that answer!!
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