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Portrait of an Exhibitionist

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Abstract

Exhibitionism has been viewed through many lenses, from the perspectives of sexual deviance, forensic psychiatry, psychopathology, psychological dynamics, feminism, behaviorism, and psychopharmacology. Starting from the description of one psychotherapy patient, the aim of this paper is to synthesize this disparate literature. The findings of the synthesis include an estimate of the lifetime male prevalence of exhibitionism, 2–4%, peaking in late adolescence. Insecure attachment, sexual abuse in childhood, substance abuse, and sexual dysfunction are acknowledged risk factors. Motives behind the act of genital exposure remain obscure, constructed of both sexual and non-sexual impulses. The usual response of women victims is alarm and disgust. Successful treatment relies on a strong therapeutic alliance with specific psychological and psychopharmacological interventions - comparative effectiveness not yet determined. In conclusion, precedents for exhibitionism vary. The frequency of the behavior usually wanes with age and, while exhibitionists may pose a risk to others, they usually do not. There is, as yet, no gold standard treatment; the recommendation for therapists is to respond to individual facets of the patient’s circumstances and history.

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  1. Department of Psychiatry, University of Toronto, 260 Heath St. W. Suite #605, Toronto, ON, M5P 3L6, Canada

    Mary V. Seeman

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Correspondence to Mary V. Seeman.

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The case described is from long ago and the patient is deceased. All potentially identifiable facts have been altered. The Research Ethics Committee of my hospital does not require committee approval for case studies as long as the persons involved are not identifiable.

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Seeman, M.V. Portrait of an Exhibitionist. Psychiatr Q 91, 1249–1263 (2020). https://doi.org/10.1007/s11126-020-09810-w

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