Voyeuristic Disorder

(Voyeurism)

ByGeorge R. Brown, MD, East Tennessee State University
Reviewed/Revised Jul 2023
VIEW PROFESSIONAL VERSION

Voyeurism involves becoming sexually aroused by watching an unsuspecting person who is disrobing, naked, or engaged in sexual activity. Voyeuristic disorder involves acting on voyeuristic urges or fantasies or being distressed by or unable to function because of those urges and fantasies.

  • Most voyeurs do not have voyeuristic disorder.

  • Doctors diagnose voyeuristic disorder when people feel greatly distressed or become less able to function well because of their behavior, or they have acted on their urges with a person who has not consented.

  • Treatment, which usually begins after voyeurs are arrested, includes psychotherapy, support groups, and certain antidepressants.

Voyeurism is a form of paraphilia. Most people with voyeuristic tendencies do not have voyeuristic disorder.

In voyeurism, it is the act of observing (peeping) that is arousing, not sexual activity with the observed person. Voyeurs do not seek sexual contact with the people being observed. When voyeurs observe unsuspecting people, they may have problems with the law.

Voyeurism usually begins during adolescence or early adulthood. Some degree of voyeurism is common, more among boys and men but increasingly among women. Society often regards mild forms of this behavior as normal when involving consenting adults. Privately viewing sexually explicit pictures and shows available on the internet is not considered voyeurism because it lacks the element of secret observation, which is the hallmark of voyeurism. However, the miniaturization of surveillance cameras and the widespread use of cell phone cameras have given rise to video voyeurism, which involves the filming of nonconsenting persons disrobing or engaged in sexual activity. This activity is increasingly common and is generally considered a crime in most countries.

Voyeuristic disorder is one of the most common paraphilias and is much more common among men. The ratio of male to female voyeurs is between 2:1 and 3:1. What little is known about voyeuristic disorder is largely gleaned from people who have been imprisoned for this behavior. Many offenders may also be hypersexual and have any or a number of other mental health conditions, including exhibitionistic disorder, depression, conduct disorder, or antisocial personality disorder.

When voyeurism is a disorder, voyeurs spend a lot of time seeking out viewing opportunities. As a result, they may neglect important aspects of their life and not fulfill their responsibilities. Voyeurism may become the preferred method of sexual activity and consume countless hours of watching.

Diagnosis of Voyeuristic Disorder

  • A doctor's evaluation, based on standard psychiatric diagnostic criteria

Doctors diagnose voyeuristic disorder when

  • People have been repeatedly and intensely aroused by observing an unsuspecting person who is naked, undressing, or engaging in sexual activity, and the arousal has been expressed in fantasies, urges, or behaviors.

  • As a result, people feel greatly distressed or become less able to function well (at work, in their family, or in interactions with friends), or they have acted on their urges with a person who has not consented.

  • They have had the condition for 6 months or more.

Treatment of Voyeuristic Disorder

  • Psychotherapy and support groups

  • Certain antidepressants

  • Sometimes other medications

Treatment usually begins when voyeurs are arrested. It includes psychotherapy, support groups, and antidepressants called selective serotonin reuptake inhibitors (SSRIs).

If these medications are ineffective and the disorder is severe, medications that reduce testosteronetestosterone levels).

Drugs Mentioned In This Article

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