Voyeurism

More commonly known as being a "Peeping Tom."

Description
The object of voyeurism is to observe unsuspecting individuals who are naked, in the process of undressing or engaging in sexual acts.  The person being observed is usually a stranger to the observer.  The act of looking or peeping is undertaken for the purpose of achieving sexual excitement. The observer generally does not seek to have sexual contact or activity with the person being observed. 

If orgasm is sought, it is usually achieved through masturbation. This may occur during the act of observation or later, relying on the memory of the act that was observed.  Frequently, a voyeur may have a fantasy of engaging in sexual activity with the person being observed.  In reality, this fantasy is rarely attempted or consummated.

Causes
There is no scientific consensus concerning the basis for voyeurism.  Most experts attribute the behavior to an initially random or accidental observation of an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity.  Successive repetitions of the act tend to reinforce and perpetuate the voyeuristic behavior.

Demographics
Voyeurism is apparently more common in men, but does occasionally occur in women. However, the prevalence of voyeurism is not known.  Contemporary U.S. society is increasingly voyeuristic (as in the example of "real" television); however diagnosis is made only when this is a preferred or exclusive means of sexual gratification. 

The onset of voyeuristic activity is usually prior to the age of 15 years.  There are no reliable statistics pertaining to the incidence of voyeurism in adulthood.

Diagnosis
According to the mental health professional's handbook, Diagnostic and Statistical Manual of Mental Disorders (“DSM-IV”), two criteria are required to make a diagnosis of voyeurism:

• Over a period of at least six months, an individual must experience recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors that involve the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity.
• The fantasies, sexual urges, or behaviors to watch other persons must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning; it must be disruptive (mentally or physically) to his or her everyday functioning.
  

Treatments
Behavioral therapy is commonly used to try to treat voyeurism.  The voyeur must learn to control the impulse to watch non-consenting victims, and just as importantly to acquire more acceptable means of sexual gratification.  Outcomes of behavioral therapy are not known.  There are no direct drug treatments for voyeurism.

Prognosis
Once voyeuristic activity is undertaken, it commonly does not stop.  Over time, it may become the main form of sexual gratification for the voyeur.  Its course tends to be chronic.

The prognosis for eliminating voyeurism is poor because most voyeurs have no desire to change their pattern of behavior.