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Yıl:2014; Cilt: 22; Sayı: 1-3>> Özet
TAM METİN
Kriz Dergisi; 2014;22(1-3):33-39
Gözetlemecilik Yakınması İle Başvuran Bir Erkek Eşcinselin Tanı Ve Tedavi Süreci: Olgu Sunumu
S Tetik, K Başar
Etlik Zübeyde Hanım Doğumevi, Ankara
Günümüz toplumunda gözetleme davranışı ve bu davranışa ilgi çok yaygın olmasına rağmen, gözetlemeciliğin yaygınlığı, etiyolojisi ve tedavi girişimleriyle ilgili bilimsel çalışmalar sınırlıdır. Bu olgu bildiriminde gözetlemecilik yakınmaları ile başvuran 30 yaşında erkek bir hastanın değerlendirme ve izlem süreci sunulacaktır. Hastanın cinsel ve duygusal ilgisinin kendi cinsine yönelik olduğu, ancak bunu belirgin bir şekilde baskılamaya ve kontrol etmeye çalıştığı, yoğun suçluluk düşünceleri ve kaçınma davranışları olduğu anlaşılmıştır. Olgunun değerlendirmesi bütünlüklü bir şekilde yapıldığında cinsel yönelimiyle ilgili olumsuz hislerinin ve kalıp yargılarının parafilik bozukluğun klinik görünümüne etkisinin belirgin olduğu ortaya konulmuştur. Cinsel yönelimiyle ilgili hoşnutsuzluğunun yatıştırılması yönünde terapötik girişimlerin yanı sıra çökkün duygudurumuna yönelik antidepresan ilaç tedavisi düzenlenmiştir. Parafilik davranışlar üzerinde denetimin sağlanması amacıyla bilişsel ve davranışçı teknikler kullanılmıştır. Altı aylık izlem sonucunda hastanın parafilik davranış sıklığı belirgin olarak azalmış, hastanın parafilik davranışı üzerinde kontrolü artmıştır. Parafilik bozukluk tedavisinde kabul görmüş olan yaklaşım terapötik girişimlerin ilaç tedavisiyle birlikte uygulanmasıdır. Sunulan olgu, bireyin kendi zorlanma ve imkanlarına uygun şekilde, hastayla ortaklaşılmış bir hedefe yönelik düzenlenmiş tedavi planının kısa vadede etkili olabildiğine örnek oluşturmaktadır.
Diagnostic Assessment and Management of a Gay Man Presenting with Voyeurism: A Case Report
Research on the prevalence, etiology, and treatment of voyeurism is limited, although voyeuristic behavior and interest is fairly common in the society. Evaluation and management of a 30 years-old male with voyeuristic behavior as presenting complaint will be discussed in this case presentation. During the assessment, the patient’s homosexual orientation, his feelings of guilt and shame, his relentless efforts to suppress and control his attraction and interest was noticed in the early phase of the evaluation process. Through comprehensive evaluation, the apparent association between his discomfort with respect to sexual orientation ant the clinical characteristics of the paraphilic disorder was revealed. Therapeutic interventions targeting to relieve his discomfort was initiated, alongside antidepressant drug treatment for depressed mood. Cognitive and behavioral methods were preferred in the management of paraphilic behavior. In the sixth month of follow-up, the frequency of the voyeuristic behavior was significantly decreased, and his sense of control over the behavior was increased. Current guidelines in the management of paraphilic disorders suggest utilization of pharmacotherapy with psychotherapy. The course of symptoms in this case presents an example for the short-term effectiveness of a treatment plan adjusted to the individual’s difficulties and opportunities, and a mutually agreed treatment target.

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