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Kleptomania - Causes, Symptoms and Therapy
contents
- The story of steal
- Causes of kleptomania
- symptoms
- Family turnouts
- The diagnosis
- Mental problems
- treatment
Kleptomaniacs are aroused from theft and feel satisfied when they succeed. Stealing is not meant to express anger or revenge, and it is not a response to mental confusion - kleptomaniacs are not in the bipolar bipolar phase, and they generally do not suffer from a dissocial disorder.
When claws become addictive. Image: cunaplus - fotolia Sometimes the victims hoard the stolen objects or give them back. While kleptomaniacs are not, if immediate arrest is the likely consequence - for example under the eyes of a police officer - but they usually do not plan their raids and also do not explore the terrain to minimize the risk. They act alone.
The story of steal
A French book on mental disorders from 1838 mentioned kleptomania - as a monomania, then was the term for individual mental disorders, such as sex addiction (nymphomania) or murder (homicide monomania).
These categories are now considered outdated. Kleptomania is now considered a disturbance of impulse control such as pyromania, the addiction to put a fire, gambling addiction or tricotilomania, the desire to tear out hair.
The disorder has been known in medicine and the law for centuries. The Swiss doctor Andre Matthey wrote of klope.anie to identify thieves who impulsively stole things without any value. French doctors Jean Etienne Esquirol and C.C. Marc later changed the word to kleptomania and characterized the behavior as an irresistible urge to steal.
They diagnosed kleptomaniacs as people who were "forced to steal," that is, mentally ill-and not, as was customary in the 19th century, as morally corrupt. Only women were considered affected, and many physicians suggested that the disease at the end of the 19th century was caused by diseases of the uterus or premenstrual stress.
Pulse control disorders almost always have social causes as well. The then known cases of kleptomania among women were therefore probably due to the oppression of women in the former patriarchy - as well as the hysteria rampant in Freud's time.
Bourgeois women lived in a corset of constraints of how a "real woman" should behave - intellectual development and equality at work denied them society. To steal, to do something forbidden, can be interpreted as a desperate resistance to the foreign determination.
In any case, the diagnosis remained unclear until the second half of the last century. Kleptomania was officially considered a failed impulse control in 1980, and this spongy definition remained until 2000. However, over the past 15 years, extensive studies have followed to narrow down the disorder as a regular psychiatric diagnosis.
Causes of kleptomania
It is still unclear how kleptomania develops. Some scientists think that kleptomania is part of an alcohol or drug addiction. In fact, alcoholics and drug addicts are repeatedly being targeted by the police for theft.
But we have to sharply distinguish between procurement crime and pathological stealing. An alcoholic who steals whiskey bottles in the supermarket to satisfy his addiction is not kleptomaniacal: a hallmark of kleptomania is that the stolen items are of no value to those affected; even a heroin user who breaks into a garden shed stealing returnable bottles to exchange them for needing money for the next shot has a rational reason to steal.
Also, substance addicts in the intoxication can not be described as kleptomaniacs: if they are not masters of their senses and do not know what they are doing, they are more akin to psychotics, who also take things that they do not own without stealing.
For the disturbance, however, the uncontrolled but conscious impulse to steal is decisive.
However, it is difficult to draw a line. For example, does a person drink courage to go on the tour and then steal unnecessary things? The exact separation between the individual disorders is hardly possible, because kleptomaniacs almost always suffer from other psychiatric disorders as well: Borderliners, for example, are often also kleptomaniacs in the clinical sense.
Depression, anxiety disorders, eating disorders and substance abuse are common in people who suffer from kleptomania.
Less than 5% of all identified shoplifters are kleptomaniacs or kleptomaniacs; the disorder is more prevalent among women than among men. However, in men, the disorder is often undiagnosed - women who steal are treated more psychologically than men who usually end up in jail.
There is no social group for which disorder is typical. The average age for kleptomaniacs is around 35, but some have reported that the need to steal them started when they were 5 years old.
symptoms
Signs of kleptomania are often misunderstood as normal thievery, but several hallmarks clearly distinguish the disorder from it.
The key is that kleptomaniacs steal things they do not need. Second, they have a massive urge to steal; Stealing relieves feelings of stress and anxiety. The act is similar to the mood of a drug addict: The urge is getting stronger, when the deed is done, they feel relieved. But soon she is again tormented by nervousness and fear, and the desire to steal becomes overwhelming.
Kleptomaniac distinguishes from Dissocial that they are ashamed of their act. That too is typical. A kleptomaniac is a notorious thief who, for example, makes a living from stolen smartphones. They feel guilty and afraid of what they did, like an alcoholic who does not dare to pick up the phone because he was afraid someone would condemn him for his actions in the drunk. The fear is getting bigger, the stress is increasing, and the kleptomaniac has to steal again to reduce the stress: the vicious circle is closed.
Typical is the lack of motives and goals. The victims have no special shop in mind in which they want to steal. They steal trivial things like lipsticks and do not even use them.
Kleptomaniacs do not steal either to gain status or as a test of courage. This distinguishes them, for example, from teenagers who steal useless things in the shopping center to stand in front of the clique as a daredevil.
Stoopers do not hype about their actions, and they do not consciously test risks: they steal when they are under stress, but they can control themselves enough to "go to another store" on withdrawal if they get the chance be, is too big.
In public, they are not noticed by unusual behavior. They are neither violent nor manic.
A hallmark is also the regular stealing: Whenever they are under stress, they go to the action. Despite their feelings of guilt, they keep repeating stealing for a short kick.
Family turnouts
Possible genetic causes of kleptomania are poorly understood. The only historical study that examined the family histories of those affected showed a high number of alcoholics among the close relatives, as well as mood swings on a pathological scale.
The diagnosis
If the symptoms are present, the doctor physically examines the person and creates a medical history. There are no tests to detect kleptomania, but tests can reveal potential physical causes - such as a head injury or a brain disorder.
The doctor usually refers those affected to a psychiatrist or psychologist; both have interviewing techniques and test procedures to detect impaired impulse control.
Mental problems
Kleptomania is often associated with other mental health problems. Sufferers regularly suffer from depression and anxiety disorders, and less frequently from eating disorders - especially bulemia. Personality disorders are also common comorbidities. The common thread is that people with symptoms of kleptomania need help - not just for this disorder, but for others as well.
However, most people with this disorder will not seek help on their own; Often, they only go into psychiatric treatment after being tried for their thefts, or when they seek psychotherapy for comorbidities such as an anxiety disorder.
The victims are in a dangerous and lonely situation until they are caught. They often collapse psychologically when they are in court or, if they are ashamed, because their family and friends have discovered what they are doing - mental collapse is often the catalyst for accepting help.
treatment
Those affected mostly distrust those who offer them help - but such help is indispensable. As with any addiction disease, those affected can rarely get out of the vicious circle alone. Without treatment, the patients sometimes steal for a lifetime.
Psychotherapy instead of prison. Image: Photographee.eu - fotolila The treatment usually includes medication and psychotherapy, sometimes self-help groups. There is no standard therapy for this disorder, and researchers are still trying to figure out what works best.
Antidepressants used in kleptomania are fluoxetines like Prozac, paroxetines like Paxil and Fluvoxamine. However, some scientists believe that these antidepressants even exacerbate the symptoms.
Psychoanalysis and psychodynamic psychotherapies have been considered a common method for decades. However, their effects are difficult to grasp, because controlled studies are lacking. Case studies indicate that some patients with these psychotherapies mastered their disorder while others remained on the up.
Cognitive-behavioral therapy has largely supplanted traditional psychotherapy treatment. She insists that those affected learn to change their behavior. In the case of kleptomania, this means that when the stress becomes overpowering, they should reveal themselves to others and ask for help, as well as adopt other strategies to relieve the stress - from autogenic training to yoga, to cycling or strength training.
The first step is to visualize the consequences of being stabbed by the thief, and, in the Aversion Therapy, to hold your breath until it hurts a little when the person is aware of the situation.
Another strategy is systematic desensitization. The patient increases specifically in a stressful condition and relaxed release through muscle exercises. So he learns to keep the situation under control in an emergency.
Controlled studies on cognitive-behavioral therapy are still lacking, but the experience with it promises to actively control kleptomania. However, there are too few clinical psychologists specifically trained for this disorder, and so far there are no publications that serve as a guide. (Somayeh Khaleseh Ranjbar, translated by Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)