Pyromania

The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, outlines the diagnostic criteria for pyromania. The symptoms of pyromania include:

• Deliberately setting a fire on more than one occasion
• Feeling tense, excited, or another heightened emotion before setting a fire
• Experiencing gratification or relief from setting a fire, watching a fire one has set burn, or participating in the aftermath of a fire one has set (fighting the fire or working through cleanup efforts)
• A fascination with and attraction to fire and all related to fire, including the way it is used and equipment involved in starting or fighting fires—for example, people with pyromania may collect matchbooks or lighters

To be diagnosed with pyromania, a person can’t be setting fires for any of the following reasons:

• Financial gain, such as insurance fraud
• To make a political statement or express a particular ideology
• As an act of anger, revenge, or sabotage
• To improve one’s living conditions (i.e., burning trash)
• In response to delusions or hallucinations
• To conceal a crime
• As a result of impaired judgment originating from substance use, intellectual disability, dementia, a manic episode, or another form of cognitive impairment
• To attract attention or recognition (i.e., creating a chance to extinguish the fire and “play the hero”)
• As a form of childhood experimentation

Other symptoms 

People with pyromania may experience the symptoms below, but not everyone with the disorder will experience these symptoms, and they are not necessary to receive a diagnosis.

• Setting off fire alarms and calling in false reports of fires
• Making complicated plans to set fires
• Spending time at local fire departments and, in some cases, becoming a firefighter
• Being indifferent toward or happy about the property destruction fires cause
• Experiencing legal consequences or injuries related to setting fires
• Having suppressed anger, sadness, and other negative emotions that contribute to the urge to start fires, which can be a method of expressing and relieving those feelings
• Burning holes in fabric, carpet, and furniture or setting fires to pieces of paper and other small, flammable objects

There is no definitive cause of pyromania. Pyromania, like other impulse control disorders, is thought to be caused by a confluence of certain psychological, biological, and environmental risk factors. The following are several risk factors researchers have identified that may make it more likely that a person develops this disorder.

Psychological risk factors

Below are some of the psychological risk factors associated with pyromania: 

• Low self-esteem
• High levels of shame and embarrassment
• Difficulty processing anger and having a low frustration tolerance
• Reduced decision-making ability
• Impulsivity
• Poor communication and interpersonal skills
• Learning difficulties, often resulting from decreased attention span and memory ability
• Presence of other mental health disorders, especially substance use disorders² like alcohol use disorder,³ gambling disorder,⁴ depressive disorders, bipolar disorder, oppositional defiant disorder,⁵ intermittent explosive disorder, conduct disorder, antisocial personality disorder (ASPD), kleptomania, and attention-deficit hyperactive disorder (ADHD)

Biological risk factors

Below are the biological risk factors for pyromania: 

• Being assigned male at birth
• Being white 
• A younger age
• A family history of mental illness, particularly mood disorders like anxiety, depression, and bipolar disorder
• Potential differences in brain structures and neurochemistry

Environmental risk factors

Environmental risk factors may contribute to pyromania, including the following: 

• Lower education levels
• History of childhood trauma, abuse, maltreatment, neglect, and family dysfunction
• Exposure to community violence
• Criminal history
• Lower socioeconomic status

The goal of treatment for pyromania is often to achieve remission, or a state in which the individual no longer sets fires. The person may continue to experience the urge to set fires but channel those impulses into a more beneficial activity. They may also learn to process the underlying emotions to no longer sense the urge. 

Therapy

According to the American Psychiatric Association, cognitive-behavioral therapy (CBT) is frequently employed to manage symptoms of pyromania. CBT is based on the theory that there is a link between a person’s thoughts and behaviors, so modifying unhealthy or problematic thoughts can lead to a reduction in unwanted behaviors. With pyromania, where setting fires is often a method of processing emotions or responding to unhappy thoughts, a course of CBT treatment may break down that pattern.

A CBT therapist can work with someone with pyromania to understand the sources of the underlying emotions that lead to the tension they attempt to relieve by starting a fire. The client may learn techniques to acknowledge the tension and identify behaviors that release the tension safely. Healthy coping mechanisms may include exercise, journaling, or talking with a trusted loved one. 

Medication

No medication has been approved by the US Food and Drug Administration (FDA) to treat pyromania. However, medication may be prescribed off-label to manage the underlying symptoms, such as emotional dysregulation, that could be contributing to the urge to set fires. Some of these medications include:

• Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
• Antipsychotic medications
• Mood stabilizers
• Anti-anxiety medications, such as anxiolytics 
• Sedatives, such as benzodiazepines
• Lithium
• Anti-seizure medications
• Anti-androgens
• Naltrexone

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Self-care

The DSM-V places pyromania under the disruptive, impulse-control, and conduct disorders category. The use of relaxation techniques as a form of self-care may be helpful for disorders in this class, as such techniques could reduce tension and teach clients to pause and reflect before acting in a way that may be harmful.

Below are relaxation techniques that people with pyromania may find helpful:

• Deep breathing
• Meditation
• Yoga
• Guided imagery, in which one listens to a recording of descriptions of beautiful and relaxing landscapes, such as a forest or a waterfall
• Autogenic training, which emphasizes a focus on the body’s physical sensations
• Progressive relaxation, a process in which a person repeatedly tenses and then relaxes specific muscles all over the body, producing a full-body sense of relaxation

Shame and embarrassment are common in people with pyromania. Some people with the disorder recognize that their actions are wrong and may rise to the level of criminality, which could make them hesitant to seek help. In these situations, online therapy may be a beneficial option. With an online platform like BetterHelp, people can speak with their therapist from the comfort of their home, which may make some people with pyromania more comfortable accessing treatment.  

Pyromania is a rare disorder. Most instances of fire setting and arson are for other motivations, not to relieve unpleasant feelings. Because of its rarity, a dearth of resources are available specifically for addressing pyromania. However, pyromania shares several symptoms with other mental health disorders. The urge-act-release cycle of pyromania mirrors that of addiction, so support groups for behavioral compulsions may be beneficial. 

The fire-setting impulse can also be compared to the compulsions present in obsessive-compulsive disorder (OCD). A key difference between OCD and impulse control disorders like pyromania, though, is people with the former tend to avoid harm, while those with the latter often seek novelty. According to the American Psychiatric Association, pyromania is also connected to conduct disorder, antisocial personality disorder (or antisocial personality traits), and substance use disorder. 

The US Substance Abuse and Mental Health Services Administration (SAMHSA) provides information and links to find treatment providers and other resources. Yale University’s School of Medicine hosts an Impulsivity and Impulse Control Disorder Research Program that conducts clinical trials to investigate new treatments and further understand impulse control disorders under which pyromania falls.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

Researchers examined the impact of a treatment program based on principles of cognitive-behavioral therapy in reducing emotions, thoughts, and behaviors associated with pyromania. The program, the Firesetting Intervention Programme for Mentally Disordered Offenders (FIP-MO), was implemented in an inpatient mental health treatment facility in the United Kingdom with patients who had a history of fire-setting behavior and symptoms of mental illnesses, including pyromania. 

Participants who completed the program were found to have decreased problematic interest levels in fire, positive associations with fire, and attitudes supporting the use of fire as a means of solving problems or emotional release. They also reported increased social competency, risk management, and coping skills, indicating that CBT techniques specifically tailored toward pyromania may effectively reduce symptoms of the disorder. 

Fire setting behavior in children (beyond what is considered normal “curiosity fire setting”) may predict the later development of pyromania in adulthood. While it is not clear what causes fire-setting behavior in children, one research article summarized risk factors, which included maltreatment and family stress. Methods of reducing family strain and education on prosocial child-rearing may reduce fire-setting incidents in childhood and adulthood. 

Below are several statistics on pyromania:

• While the prevalence of pyromania in the general population is unclear, it has been found to be rare among psychiatric inpatient populations, with only around 3% of patients meeting diagnostic criteria.
• Specific gender-based analyses of pyromania patients have not been conducted. Still, studies have indicated that more men than women are fascinated with fire, with two-thirds of fire starters being male.
• Fire-setting behavior is more common in those who are unmarried or unemployed. 
• Research on convicted arsonists, some of whom displayed symptoms of pyromania, found that completing a course of cognitive-behavioral therapy significantly reduced interest in fire and negative emotions associated with starting fires, including anger and hopelessness.