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A: No. It’s just really a paraphilia. It’s not an orientation of any kind.

Q: How does voyeurism develop?

A: There’s a lot of theory.

In my experience, one of the things I’ve noticed is that most people who have very much engaged in voyeurism, they have some early childhood experience or young-adult experience … of seeing something that they shouldn’t have seen, and it was very erotic to them. And so they kind of carry that thought around with them. And that becomes what we call a “sexual template,” and that is they start to develop in their mind [a concept of] “what’s exciting.”

Q: What kind of treatment can you offer to people struggling with voyeurism?

A: The first part of the treatment is to really understand what is going on with them … what is their sexual history, how they first learned about sexuality, how sexuality is talked about in the home. One of the problems we have, and I don’t want to be preachy, is that we don’t talk about sexuality very much in the home.

If I am working with a 20-year-old, [I will be] doing a very good history, understanding where they are coming from before I try to develop any kind of treatment plan with them. And then also, figure out how they cope with other things. You want to understand - do they have good coping skills? Or, is [voyeurism or engaging in sexual behavior] one of the primary ways they cope with society, stress, depression? Like other addictions, this is very, very common.

Then I move into developing a behavioral-cognitive plan … really taking a look at the behaviors and what are some of the ways we can intervene and change those behaviors. … As we start there, we’ll be developing new ways to cope.

Q: So if someone has an obsession about store dressing rooms, you would have some guidance for him about that?

A: Right. One of the first things you do is identify all of those high-risk situations. If you look at an alcoholic, I would say to an alcoholic, “You are not going to avoid all the triggers in your mind, but you shouldn’t be hanging out in a bar.” So if you’re a person who repeatedly has problems with going to a dressing room at [a particular store], you can’t go to [that] dressing room.

You have to have interventions in place. And then we have to talk about how are you going to manage that when you have the urge. Because you’re going to have a craving, and that’s very normal. You’re going to sit there and think, “I’m lonely, I’m tired, I’m frustrated, and I need to go pick up a pair of shorts from [that department store].” How are you going to manage that?

Also, if someone is truly addicted to sex … there are various 12-step groups and other types of treatment as well.

Q: Final thoughts?

A: I think, in general, we’re seeing more and more people struggling with pornography, and more and more people struggling with addictive sexuality.

There are plenty of people who don’t have an issue at all. They can look at pornography and it’s not an issue for them; it’s not a problem. I’m not here to talk about the moral aspects of pornography.

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