Related Case Studies
Exhibitionistic Disorder Case Study: Helping a 28-Year-Old Regain Control and Confidence
Patient Information:
- Age: 28
- Gender: Male
- Background: A quiet and soft-spoken software engineer from an urban, middle-class family. Lives with his parents and younger sister.
History or Cause:
When he entered Jagruti Rehab Centre doors for the first time, he looked just like any other young professional—courteous, dressed well, and a little nervous. But behind that presentable facade was a painful secret he had carried for many years all by himself.
At age 24, he began acting on persistent thoughts and impulses to show his genitals in public. What had initially been a thrill he was unable to explain became a habit he couldn't stop. His public exposure wasn't intended to cause any harm; he just felt the strong pulls of his compulsions and felt powerless. Each time there was an excitement rush, then guilt, shame, and isolation.
While he had never been arrested, his life was quickly becoming unbearable because of the whispers in his workplace and his neighbourhood. He started to withdraw from friends and wouldn't make eye contact at home. In our earlier sessions, he mentioned that he had grown up without any emotional connection to his parents and with no romantic relationships. He mentioned being bullied in school for being quiet and withdrawn. By the time he was in his late teens, he turned to pornography to fill the emotional void. And eventually his use of pornography developed into dependency, and he became numb to typical sexual content, and increasingly moved toward extreme sexual fantasies.
Diagnosis:
Following a thorough evaluation by our clinical psychologist and psychiatrist collaborators—interviews, personality assessments, and problem behaviour observations—we diagnosed him with Exhibitionistic Disorder using the DSM-5.
His clinical presentation met the central features of Exhibitionistic disorder: he experienced recurrent and intense urges to expose his genitals to an unsuspecting person, acted on these urges on multiple occasions (at least two), and the behaviour occurred over time. And it caused clinically significant distress in his social, academic, and other important areas of functioning. However, what struck us the most was his desire to change and the sincere remorse he expressed for his actions.
Treatment:
- Our process was based on compassion, structure, and accountability. We focused on understanding not only how to stop the behaviour but also identifying why they were enacted to provide tools to establish a new, healthier emotional and sexual identity.
Program:
He participated in an outpatient recovery program, which lasted 12 weeks and was dedicated to individuals who wished to stop compulsive sexual behaviours.
The steps to treatment included:
- Stabilisation and Awareness
- Cognitive Restructuring and Therapy
- Recovery, Maintenance, and Social Reintegration
Medical interventions:
- SSRIs (Selective Serotonin Reuptake Inhibitors) were prescribed to control their anxiety and reduce their sexual obsessions.
- Anti-androgen medication was identified, but in the end, they were engaged with their therapists and did not demonstrate any propensity towards acting aggressively.
Therapy:
Cognitive Behavioural Therapy (CBT):
- Helped the individual work through distorted belief systems and create healthier thought patterns.
- Used role-playing to manage their impulses and in situations where they had challenges.
Relapse Prevention Planning:
- We worked together to identify triggers such as loneliness, stress, and boredom, and create positive coping mechanisms.
Group Therapy (Men's Sexual Health Circle):
- At first, he was reluctant, but ultimately felt good to know that he was not alone.
- Hearing other stories made him feel seen and able to share.
Family Therapy:
- His parents, especially his mother, attended family therapy with him.
- Family therapy allowed them to share feelings, fully understand and check misconceptions.
Improvements/Recovery Point:
Week 1-2:
- Admitted to significant guilt and fear of judgment; New medication was prescribed; counselling focused on emotional regulation; Disclosed triggers and behaviours for the first time with 100% truthfulness.
Week 3-4:
- Attended therapy with greater consistency; Started a private journal; Reported a noticeable drop in urges.
Week 5-6:
- Discontinued access to all triggering porn and upped stakes by moving back to a flip phone; Was much more animated in group therapy even initiating conversations;
Week 7-9:
- Family therapy started. Father's emotional distance waned and expressed pride in their son and his progress; New routines learned: gym, cooking for self, mindfulness meditation and grounding emptiness;
Week 10-12:
- No exhibitionism or urges were reported; He also mentored a newcomer to the group; the Last 3 sessions focused on confidence and a plan for long-term recovery.
Our Success:
He comes into Jagruti Rehab Clinic today with his head held high. His confidence is authentic—it is not derived from flights of impulse, but from self-awareness and inner strength. He has gone back to work in a remote job role and is feeling respected again. He is also beginning new healthy friendships and is contemplating joining a community writing group.
What made the biggest difference? In his words:
“For the first time, someone saw me as more than just what I had done. They saw me as a person worth helping. That has changed everything.”
Family and Community:
His mother tells me that their home is “peaceful again.” His sister says he laughs more. His father now goes for walks on the weekend with him—something once a silent father has discovered words to express something that almost felt lost.
Not everyone is aware of the details of his journey, however, those who are close to him can see his pivot and have supported it. He is also helping others understand that exhibitionistic disorder is not a “moral failing” through anonymous advocacy; exhibitionistic disorder is a mental health condition, and it can be treated.
Patient’s Voice: In His Own Words
During his last therapy session with us, we asked him to write a short note to his "past self"—the self that felt lost, ashamed, and trapped in secrecy. With his permission, here is what he wrote: "You are not broken. You are not evil. You are a person who wanted help and didn't know how to ask for it. Stop hiding. Let people in. The shame seems unbearable now, but it does not last forever. There is a way out—and you deserve it. Thank you for not giving up."
His words represented what we are always trying to cultivate in Jagruti Rehab Centre recovery programs: the transformation of self-esteem, not just behaviour.
Bottom Line
The exhibitionistic disorder case study is a meaningful testament to the possibility of healing, even when the subjective experience of shame seems overwhelming. With the appropriate support system, a caring treatment team, and the courage to face the uncomfortable truth, people can find a way to value themselves and resume their lives with dignity.
Dr. Amar Shinde, founder of Jagruti Rehab, is a renowned psychiatrist in India with over two decades of experience in mental health, addiction recovery, and neuropsychiatry, dedicated to holistic, compassionate patient care.