Hardly a week goes by without yet another home video of some public figure's sexual behavior coming to light. Not only Hollywood personalities and other entertainers engage in the practice, but also sports figures and politicians. Wikipedia has an extensive of specific cases and Shine, Yahoo!'s site tailored for women between the ages of 25 and 54, has published on creating one's own prurient productions. On other sites, you'll find speculations on why celebrities make sex tapes; these usually involve amateur "diagnoses" of narcissism, exhibitionism, voyeurism, or self-destructive behavior. We'll consider the clinical definitions of these terms and behaviors below.
But before you start feeling embarrassed or guilty that you've read even this far, let us share with you something that we learned in medical school at Washington University in St. Louis during lectures from the famous sex researchers , namely that sex is a normal physiological function and human behavior and that physicians should not be reluctant to include the subject in their medical history and review of systems or when educating patients.
Next we'd like to make an important point about the use of terms like narcissism, exhibitionism, etc. which have both common meanings as well as specialized clinical and legal definitions. These terms have quite different implications when used in common discourse compared with mental health and law enforcement contexts. Calling someone an exhibitionist, for example, because of the way they dress or behave socially is quite a different thing than diagnosing someone with exhibitionistic disorder or accusing them of a criminal offense of exposing themselves in public.
Lastly, one other thing to appreciate is that whether a particular behavior is considered acceptable or not is subject to cultural norms. A particularly striking example of this is the fact that the Swedish National Board of Health and Welfare excludes fetishism, sadomasochism, and transvestism from of the International Classification of Diseases (ICD-10).
So here are the clinical definitions of some of the terms applied by non-professionals to people who make sex tapes. These definitions are derived from the standard diagnostic references, such as ICD-10 and DSM-IV/5, that we have discussed before.
Exhibitionistic Disorder (DSM-5, proposed)
A. Over a period of at least six months, recurrent and intense sexual fantasies, sexual urges, or sexual behaviors involving the exposure of one's genitals to an unsuspecting stranger.
B. The person is distressed or impaired by these attractions, or has sought sexual stimulation from exposing the genitals to three or more unsuspecting strangers on separate occasions.
Voyeuristic Disorder (DSM-5, proposed)
A. Over a period of at least six months, recurrent and intense sexually arousing fantasies, sexual urges, or sexual behaviors involving the observing of an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity.
B. The person is distressed or impaired by these attractions, or has sought sexual stimulation from observing three or more unsuspecting persons who are naked, disrobing, or engaging in sexual activity on separate occasions.
Both exhibitionism and voyeurism are paraphilic disorders (others include fetishism, sadomasochism, transvestism, and ). Pathologic narcissism falls into an entirely different category of mental illnesses referred to as personality disorders which also include paranoid, antisocial, borderline and obsessive-compulsive disorders. Narcissistic personality disorder and bullying will be the subjects of a future story.
So why do people make sex tapes? As long as the activity is consensual and causes neither party distress or impairment, it's their business and nobody else's.
Speaking of making tapes . . .
Co-founder of Celebrity Diagnosis Mark Boguski and I appeared on the local Fox news show on Tuesday morning. Thought you'd like to hear our rationale for our posts for yourselves.
Photo and credit: Echo and Narcissus by John William Waterhouse (1849-1917), Bridgeman Art Library