How Overcome phobia of being Naked.

This is less uncommon than you might imagine. It generally comes from some learned behavior, and the association between nudity and sex is a common reason why this happens.

One step you can take is pretty simple: Get a full-length mirror, and practice standing naked and mindfully and actively looking at yourself in it for at least 5 or 10 minutes at a time. You'll discover that when you do this, some of your self-perception will change. You can slowly increase the level of exposure to the phobia... changing in a gym locker room, for example, where generally no one notices or cares, even if you do have an erection.

If this continues to be a persistent issue, it's something you can explore in therapy. Nearly always there are underlying childhood beliefs or values or experiences that underlie these fears, and it is simply a matter of unpacking and understanding those thought distortions.

 

There's an old saying, 'when you hear hoofbeats, think horses, not zebras'. It applies here.

The incidence of priapism is something like 1.5 per 100,000 person-years. In other words... very rare. Additionally, priapism is generally really painful. If you don't have significant pain associated with erections, it almost certainly is not priapism. So most likely, this is a red herring.

In the case of someone with unwanted erections, almost all of the time it's simply a psychological issue. And, in fact, it is often tied to the discomfort with being naked. So if you simply normalize the experience of being naked, most likely, you'll see that the problem will decrease. No reason to get worked up about something that is highly unlikely to be the issue.

 

Are you comfortable describing in some detail what happened? This may be something to explore in therapy, depending on what it is.

 

Without being present at the exam, it's hard to say whether what you experienced was appropriate, but it definitely sounds questionable.

In general, employment physicals are usually incredibly cursory... typically they check your blood pressure, weight, listen to your heart, and ask you a few questions, maybe check reflexes and a couple other things, and sometimes ask you to move a 50 pound box to demonstrate strength and mobility.

It would definitely be unusual to do detailed breast palpation on a 21 year old male who is getting a pre-employment physical. The only reason I am aware of why there would be breast palpation would be a specialty exam where there was concern about male breast cancer (which is exceedingly rare, but not unheard of.)

So yes, it does sound like what happened to you was likely inappropriate, and even if it was within the bounds of appropriate treatment, the physician's failure to discuss your concerns about the procedure was inappropriate, and the power imbalance (you effectively did not have the ability to say no) meant that the event was absolutely traumatizing to you.

I would strongly suggest you have a more detailed conversation with your therapist about this, talk about the power imbalance and how it made you feel, and the impact it has had. From what you are describing, there's no question this was traumatic for you, regardless of whether the exam was appropriate and justified or not. I can absolutely see how this could deeply impact your comfort being around a physician, and could also impact your self-image and comfort with your body. If your therapist still doesn't 'get it' after you've explained it again... you need a new therapist, as that would be a pretty major empathic failure that would jeopardize trust and ability to do future treatment with that therapist.

One step you might consider is working with a therapist (yours or a new one) and exploring the possibility of getting therapeutic massage from a massage therapist trained in working with trauma survivors. Having a massage therapist gently and appropriately do some chest massage with you, where you are in control and have the ability to stop it at any time, could be empowering and help to rebuild a sense of safety in your own body. This might be challenging for you, and may require a few sessions to feel comfortable, but I think it could go a long way to helping resolve the issues for you. And doing the other exercises I discussed above (looking in the mirror) can also be helpful.