This article was downloaded by: [UZH Hauptbibliothek / Zentralbibliothek Zürich] On: 07 January 2015, At: 02:44 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Personality Assessment Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hjpa20
Defensiveness in Exhibitionists Barton A. Singer Published online: 10 Jun 2010.
To cite this article: Barton A. Singer (1979) Defensiveness in Exhibitionists, Journal of Personality Assessment, 43:5, 526-531, DOI: 10.1207/s15327752jpa4305_16 To link to this article: http://dx.doi.org/10.1207/s15327752jpa4305_16
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
Journal of Personality Assessment, 1979,43, 5
Defensiveness in Exhibitionists
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
BARTON A. SINGER University of Pennsylvania Medical School Division of the Philadelphia V. A. Hospital Abstract: Focuses on the excessive defensiveness and the psychodynamic factors that typify many exhibitionists. After reviewing some of the literature describing the marked guardedness of these offenders, a detailed discussion follows of the Rorschach protocol of an exhibitionist revealing his core emotional conflicts. These test results illustrate the value of the Rorschach in eliciting material that in many cases would be difficult to obtain because of these patients'characteristically suspicious and defensive stance concerning their offense and their personal lives. The case demonstrates the significant role of psychological testing in the forensic process, particularly for defensive, less verbal, and unpsychologically-minded offenders.
Why a man exposes his penis to a woman for sexual gratification without further attempts at sexual contact is usually a mystery to the exhibitionist who performs this act. Typically, he is driven to perform this behavior by a force that he experiences as beyond his voluntary control. Even when he is able to discuss the problem openly, he is generally bewildered and fearful of being "crazy". More commonly, however, the offender tries to repress and deny that such an incident even occurred, in spite of overwhelming evidence that it did indeed occur. The individual who is the main focus of this paper persistently denied to everyone (including his lawyer) that he had walked into arestaurant with his zipper open and fondled himself in front of the waitress. He was subsequently taken to police headquarters where his underpants were examined and seminal fluid was found. Confronted by thisfact, the patient claimed that he had a urinary tract infection and had been to see aphysician about it; this was not substantiated. The pervasiveness and excessiveness of his denial was further reflected in his inability to cooperate with his lawyer in order to establish the most effective defense. He was convicted of indecent exposure and referred for psychological evaluation by the judge prior to sentencing. The marked and at times almost bizarre quality of the guardedness that characterizes this man seems to be typical of many exhibitionists. MacDonald (1973) presents numerous examples of the elab-
orate, peculiar, and unrealistic explanations that exhibitionists give to authorities once they are apprehended. For example, he reports about a man who stopped his car to ask a 12-year-old girl the location of a certain street. When she came close to the car, he exposed himself to her. Greatly upset by this act, the girl ran to her parents who got into their own car and pursued the exposer. When the man was apprehended, he stated that: Prior to her arriving to the car, I had my shorts unzipped. I was warm and sweating and airing my genitals. 1 had a cloth on my pants over me like an apron. I didn't expect her to come up to the car. She seemed startled when she saw me and the cloth had fallenonthe floor. She looked startled and I drove off. The next thing 1 knew 1 was being followed. I stopped and this girl got out ofthe car with her parents. 1 asked if there was a reason why they were following me.
MacDonald cites example after example of these distorted improbable explanations. A man was seen standing at a bus stop with his penis out and later sat down on a bench and held his penis in his hand. When apprehended he explained "I went to the corner to wait for the bus. I had trouble with my zipper and sometimes it comes unzipped. I don't think my penis was out. The next thing I know I was arrested." The problems that this defensiveness presents in psychotherapy with exhibitionists is described by Mathis and Collins (1970). They discuss the marked difficulty these patients havein really experiencing the threatening feelings of shame and guilt because of their readiness to
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
BARTON A. SINGER keep them out of consciousness. Even after many arrests, they quickly develop the attitude that it will never happen again. When forced to participatein psychotherapy, they usually initially believe that they no longer have any problem and therefore do not need help. The authors have found that in their group therapy with exhibitionists, it usually takes about four to six months to really break through the denial and repression so that the patients can deal with their emotional problems. Thegroup therapy setting which encourages confrontation by group mlembers is particularly useful in getting through the guardedness. Steg and Peters (Note 1) also see denial as one of the prominent issues to work on in group therapy. While they feel that the defense is oftenunconscious, they believe that the continual denial ofpublicfactsis often utilized consciously, representinga form of defiance; it has been observed that passive-aggressiveness is one of the exhibitionists' typical modes of dealing with anger towards authority figures. Many factors contribute t o the high degree of dlefensiveness typically found in these patients. The fear and shame in being arrested are unpleasant experiences that they would prefer to forget. The unexplicable nature of the act that usually seems peculiar and even "crazy" to them adds to the frighteningaspect of the symptoms. However, the most important cause of the patient's significant and massive utilization of psychological defenses seems to be the marked intensity of the conflicts that they experience. Acute castration anxiety and marked difficulties in expressing anger appropriately are the two major conflicts discussed in the clinical literature to explain exhibitionistic behavior. Fenichel(1945) explains the exhibitionist's act as a: denial of a danger that is believed to be connected with normal sexuality. Reassurance against castration can be attained by an exhibitionistic man the following way: he consciously says t o his audience, 'reassure me that I have a penis by reacting to the sight of it'. Inner doubt impels the indiv~dualto call upon objects as witnesses. He also unconsciously says t o his audience, 'reassure me that you are afraid of my penis, that
is, that you feac me; then I do not need t o be afraid of myself. (p. 345).
The significant inhibition and restriction of outlets for unusually intense emotional states iis described by Rickles (1950). He views the exhibitionist as "fixated at an infantile level due to conditioning by maternall parents who use their sons as compensation for their own lack of a male sexual organ" (p. 145). They make their sons overly dependent and overly involved with them, arousing intense incestuous wishes and exaggerated narcissism. Rickles understands the act of exposure as representing a number of drives including6a desire to relive the infantile pleasure of being viewedl and admired, a defianceof mother's possessiveness, an effort to assert masculinity, and a wish to be helped" (p. 146). Almost all authors make special note of the exhibitionist's insecurityabout his sexual identity. In addition to the classical explanation of castration anxiety, many authors have focused on the exhibitionist's inability to deal with his anger, particularly towards women. Because women are experienced as especially castrating and threatening, the patient cannot express his intense resentment in a direct, adaptive way. Instead, Ihe supresses his anger and relates to them in a passive and unassertive manner. Blooth (1975) notes that in the act of exposure, the patient cliallenges a woman with his penis, arousing a powerful react.ion, often fear or disgust. Clearly aggres&on and revenge are represented in the mt. The emotional factors that have been described as etiaracteristic of exhibitionists - the pervasive and excessive selfprotective reactions, the intense emotional confl~cts, and the lapses in impulse control -are ~distincalyand interestingly manifested in the: following Rorschach protocol: The patient was a 27-year-old black man, recently separated from his wife, wit: three children, who had a stable employment history as a muncipalmaintenance worker. He had no previous record of a sexual offense. This individual was unusually suspicious and guarded in his initid approach to the testing
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
Defensiveness in Exhibitionists
situation, questioning how the test was developed and stating a concern for organizations that "program our mind". He talked about "important people running little guys' lives". Nevertheless, in spite of his defensivenessand the fact that he openly and emphatically denied his having indecently exposed himself, his responses on the projective test revealed patterns of psychodynamic conflict which are consistent with those f ~ u n in d exhibitionists. Many of the percepts reflected the classical sexual and aggressive conflicts in a particularly graphic way. The acute emotional turmoil experienced by this man and his pattern af defending against these feelings by denial and prajection were revealed in the way he perceived one of the Rorschach cards (see Appendix); he saw it as a "face or a mask from Star Wars . . a false face". The patient then saw another part of the same card as "an airplane with fire coming out. going through thedarkatmosphere". This second response (the airp,lane) can be interpreted as representing strong phallic aggressive urges which are frustrated and lead him to be depressed and upset. The phallic aggressivesymbol of the airplane takes on extra significance and emphasis when the patient included "the fire coming out. . fire because it is red"'. Eire and red denote the intensity of the emotions (especially anger) and the mqvement conveyed inc'coming out'%ignifies the sense of frustration and bitterness at not achieving one's wishes, The patient's further elabaration that the plane was "going through the dizrk atmosphereWsuggeststhat theunresolved an er 1s also internalized and causes him to kd dep(esned; 'darknessy'on the orscbach represents depression. A way that the patient attempts to defend against his thrtatming, hostile impulses is indicated by the fearful "Star Wars mask" relpofise. This percept reveals both the hostility (Star Wars) which he projects onto theenvirlopment slo that he is inclined to see pthqrs as threatening and danqerous to h i q and a k a his parpnoid evasiveness and guar~ednressin his interactions with others (the mask). Prominent on
.
..
.
this and other cards is a strong need to hide his emotional reactions behind some mask, some false face, or facade. Despite his excessive guardedness when relating to others and his readiness to hide from himself and others his frustration and feelings of inadequacy as a man, this core conflict is clearly reflected in an unusual and interesting response to one of the cards which he saw as "a man in a rabbit costume. . . an outfit that zippers up . . there is the zipper". This percept as well as a number of other costume responses, indicates both the patient's tendency to disguise his real feelings and his idiosyncratic sensitivity to exhibitionistic issues like the zipper and his wishes to draw special attention to himseIf. Furthermore, the response graphically portrays his conflicts about himself as as man; is he a man or is he a meek, frightened rabbit attempting to increase his low self-esteem in this pathological way? Two distinct phallic aggressive "airplane" percepts signify his intense wishes to feel potent and hypermasculine. However, other responses indicate that he experiences acute anxiety when he has sexual contacts with women. This conflict is revealed in his response to one of the Rorschach cards that often represents female genitalia and elicits the individual's reaction to sexual involvements. After a long reaction time, he described this card as "looks like snow clouds broken in some places.. .it is stretched out as if a plane went through it . . . they are black and gray and light". This response denotes the concerns over his lack of sexual potency and the extent to which the anxiety associated with sexual contact can "castrate" him, incapacitate,and overwhelm him. The long reaction time to this card indicates how disturbing sexual impulses can be; they can interrupt his cognitive efficiency. Further evidence of theamount oftension evoked by this card is revealed in his perceiving "snow clouds.. . stretched out, blackand gray and light color". The black representing depression and the texture of gray and light colors signifying anxiety plus the coldness of the snow clouds all combine to convey a picture of cold, bit-
.
529
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
BARTON A. SINGER ter dissatisfaction and resentment associated with heterosexuality. While there are no concrete indications of castration anxiety in the Rorschach protocol e.g., "appendages cut-off', the patient's reaction to this card aswellas his overemphasis on phallic-aggressive concerns, lead one to infer significant conflict in this area. The patient's psychodynamics interfere with his forming satisfying interpersonal relationships with women. Although he is very interested in relating to them, he is unable to form meaningful well integrated emotional attachments. Instead he tends to feel isolated and distant from others, as reflected in his seeing one card as "two women putting down a pot . . . black silhouettes . . . looks like a broken head going one way and then a space.. . no neck and a space between the body and the legs". This response of seeing silhouettes instead of real people and pointing out the spaces between the parts of the body conveys theisolated,detached, and poorly integrated quality of his object relations. It is also evident from the patient's inability to deal effectively with the emotionally provocative stimuli of the colored cards, that he is not able to modulate his affective experiences. On tlnb Rorschach, color reprelsents emotionality. His only response to one of the colored cards was "lots of coli~rsto it . .a mix of colors". Just as he was unable to articulate the card and produce an organized response, he is unable to handle his feelings in an adqptive way; he becomes confused and incapacitated in emotional 5nteraetions and cannot think clearly and efficiently; he would be inclined to lapse into maladaptive and poorly controlled forms of behavior in emotional situations. Some Concluding Remarks These test results underline the value of the Rorschach in allowing the €miminer to evaltlate personality and t o elicit material that in many cases would bedifficult to obtain in a clinical interview. Despite this patient's extr~melysuspicious and guarded attitude his personal life and his offense and
.
despite his relatively poor verbal skills, low intelligence (WAIS IQ of 86), and his educational background (he dropped out of school after the 8th gracle), he revealed a gre,at deal of useful information about himself on the test. Thisisdue in part to the test's capacity to penetrate psychological defenses; the patient is usually not aware of what he is disclosing; defense mechimisms are not as readily aroused and therefore the patient's special sensitivity to certain stimuli on the Rorschach and his manner of perceiving them can refllect important aspects of his inner world. The protocol reve:als the patient's core emotional conflicts, his disturbed object relations, and his poor impulse control and clearly indicates his need for treatment. This case clemonstrates the valuable role af psycholiogical testing in the forensic system, particularly for defensive, less verbal, and tionpsychologically minded offenders. Pretrial and/ or presentence evaluations can be quite useful in helping to identify those individuals whose behavior is motivated by intra-psychicproblems from tho!;e more sociopathic offenders. Recommendations can be made to the court concerning whether treatment orincasceration would be the most appropriate digposition. Furthermore, suggestions can be offered about the kind oftherapy that would be most helpful (e.g., group therapy or individual therapy) and abocit the sigrrificant emotional conflicts and the patterns of object relations that the therapist would likely encounter inthe treatment process. For example, in this case, it was apparent that there were a number of factors such as thepatient'slow IQ, poor verbal skills, defensiveness, and low frustration tolerance, especially in verbal and emotional interactions, that would make it difficult for him to establish a rne8ningful relatiofishipwith a therapist in traditional psychotherapy. A more conffontative grouporient.ed sex offender program might be the treatment of choice. Reference Note J. J. Outcome study on 39 exhibitionists. Paper presented to the A.merican Psychiatric A,ssociation, Honolulu, Hawaii, May 1973.
1. Steg, J., .& Peters,
530
Defensiveness in Exhibitionists
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
References Booth, F. G. Indecentexposureandexhibitionism. British Journalof Psychiatry, 1975, Spec. ,Yo. 9, 212-222. Fenichel, 0.Thepsychoanalytic theory of neuroses. New York: Norton, 1945. Mathis, J. L. & Collins, M. Progressive phases in thegroup therapy ofexhibitionists. International Journal of Group psycho the rap.^, 1970, 20, 163-169.
MacDonald, J. M. Indecent exposure. Springfield, ''I.: Thomas, 1973. Rickles, E. Exhibitionism. Philadelphia: Lippincott, 1950.
Dr. Barton A. Singer 65 Haddon Ave ~ ~ d d ~ ~ Nkw f i ~jersey l d , 08033 Received: November 30, 1978 Revised: February 9, 1979
Appendix Rorschach Protocol 2" 1) A butterfly. (Q) The wholething. (Q) The wings, theantlers, the body, thereis a straight linegoing down the middle of the body. A butterfly with wings and with colors. (Q) The ink was faded all through it in different spots. 2) That's all. 33" 1) Something from star wars. (Q) The whole thing. (Q) The nose, the mouth, beard, the eyes. It looks like its from star trek. (Q) It had that type of look. Something from outer space. The rednesscame t o a peak, was on the top ofthe head and made it look a little different. The red at the bottom looked like a goatee. (Q) It could be any color. (Q) It is a false face, not realistic, like something that would be a mask. 2) It looks like a n airplane. The white inside and fire coming out of it. The dark is where it is going through the atmosphere. (Q) Fire because it is red. 23" 1) Acrab. (Q) Everything but the red. (Q) It hadclaws,amouthlikeacrab,little teeth. 2) Two people puttingdown a pot. I saw the people first. (Q) It isa blacksilhouette, reaching out, putting down a pot. (Q) Two women, breasts,arms, they look broken with the head going one way and then a space, no neck, there is the body and there is a break from the body to thelegs. They looklikethey are bending (Silhouette?) Because it was black, like people in a theater who wear black uniforms with white gloves. 1 0 1) A butterfly. ( Q ) A butterfly with a beetle body, a beetle that flies. (Q) It has lots of claws, the head looks like a beetle. 25" 1) It looks like a butterfly. (Q) The whole thing, two antlers and the wings. 2) It looks like a man with rabbit ears, a man's face, with a zipper, an outfit that zippers up. (Q) It's a costume that has rabbit ears and legs. (Q) Man's face has eyes, nose, mouth, and a small head. There is a zipper that runs up the body. (Q) It's like in a theater or play. 8" 1) That looks like a new plane from England. (Q) The whole thing. (Q) The narrow neck, the body. It looks like it took off from a 45' angle. 2) Also it looks like a space ship, like from star trek. (Q) The whole thing. The design, thin up front and it came to an angle at the back. VII 60" 1) It looks like snow clouds, brokenupinspots. (Q) Likeit'sinthesky, brokenin some places. (Q) It is gray and light colors and it is stretched out like something that a plane w ~ u l dgo through. (Snow clouds?) Because it is black. VIII 75" 1) It looks likea nice abstract picture of nothing. (Q) Because ofall thedifferent colors and no set pattern. 2) It looks like animals and some rocks. (Q) Two animals, likea bear on a cliff. (Q) The face, had a back leg and a front leg, on a mountain reaching over to another plane.
BARTON A. SINGER IX 70" 1)
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
X 90" 1)
53 1
It looks like some kind of weird costume, a big blouse, big round shoulders, weird nose and eyes, some kind of ears, an abstract painting. ( Q ) It makes a nice halloween costume. (Weird?) It does not favor anything realistic. You had to use your imagination. The colors are not important. (Painting?) It does have three different colors. A lot of colors to it. It's just a pretty picture of different colors, of blends of colors, black, light black, red, faded out red.
Journal of Personality Assessment Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hjpa20
Defensiveness in Exhibitionists Barton A. Singer Published online: 10 Jun 2010.
To cite this article: Barton A. Singer (1979) Defensiveness in Exhibitionists, Journal of Personality Assessment, 43:5, 526-531, DOI: 10.1207/s15327752jpa4305_16 To link to this article: http://dx.doi.org/10.1207/s15327752jpa4305_16
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
Journal of Personality Assessment, 1979,43, 5
Defensiveness in Exhibitionists
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
BARTON A. SINGER University of Pennsylvania Medical School Division of the Philadelphia V. A. Hospital Abstract: Focuses on the excessive defensiveness and the psychodynamic factors that typify many exhibitionists. After reviewing some of the literature describing the marked guardedness of these offenders, a detailed discussion follows of the Rorschach protocol of an exhibitionist revealing his core emotional conflicts. These test results illustrate the value of the Rorschach in eliciting material that in many cases would be difficult to obtain because of these patients'characteristically suspicious and defensive stance concerning their offense and their personal lives. The case demonstrates the significant role of psychological testing in the forensic process, particularly for defensive, less verbal, and unpsychologically-minded offenders.
Why a man exposes his penis to a woman for sexual gratification without further attempts at sexual contact is usually a mystery to the exhibitionist who performs this act. Typically, he is driven to perform this behavior by a force that he experiences as beyond his voluntary control. Even when he is able to discuss the problem openly, he is generally bewildered and fearful of being "crazy". More commonly, however, the offender tries to repress and deny that such an incident even occurred, in spite of overwhelming evidence that it did indeed occur. The individual who is the main focus of this paper persistently denied to everyone (including his lawyer) that he had walked into arestaurant with his zipper open and fondled himself in front of the waitress. He was subsequently taken to police headquarters where his underpants were examined and seminal fluid was found. Confronted by thisfact, the patient claimed that he had a urinary tract infection and had been to see aphysician about it; this was not substantiated. The pervasiveness and excessiveness of his denial was further reflected in his inability to cooperate with his lawyer in order to establish the most effective defense. He was convicted of indecent exposure and referred for psychological evaluation by the judge prior to sentencing. The marked and at times almost bizarre quality of the guardedness that characterizes this man seems to be typical of many exhibitionists. MacDonald (1973) presents numerous examples of the elab-
orate, peculiar, and unrealistic explanations that exhibitionists give to authorities once they are apprehended. For example, he reports about a man who stopped his car to ask a 12-year-old girl the location of a certain street. When she came close to the car, he exposed himself to her. Greatly upset by this act, the girl ran to her parents who got into their own car and pursued the exposer. When the man was apprehended, he stated that: Prior to her arriving to the car, I had my shorts unzipped. I was warm and sweating and airing my genitals. 1 had a cloth on my pants over me like an apron. I didn't expect her to come up to the car. She seemed startled when she saw me and the cloth had fallenonthe floor. She looked startled and I drove off. The next thing 1 knew 1 was being followed. I stopped and this girl got out ofthe car with her parents. 1 asked if there was a reason why they were following me.
MacDonald cites example after example of these distorted improbable explanations. A man was seen standing at a bus stop with his penis out and later sat down on a bench and held his penis in his hand. When apprehended he explained "I went to the corner to wait for the bus. I had trouble with my zipper and sometimes it comes unzipped. I don't think my penis was out. The next thing I know I was arrested." The problems that this defensiveness presents in psychotherapy with exhibitionists is described by Mathis and Collins (1970). They discuss the marked difficulty these patients havein really experiencing the threatening feelings of shame and guilt because of their readiness to
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
BARTON A. SINGER keep them out of consciousness. Even after many arrests, they quickly develop the attitude that it will never happen again. When forced to participatein psychotherapy, they usually initially believe that they no longer have any problem and therefore do not need help. The authors have found that in their group therapy with exhibitionists, it usually takes about four to six months to really break through the denial and repression so that the patients can deal with their emotional problems. Thegroup therapy setting which encourages confrontation by group mlembers is particularly useful in getting through the guardedness. Steg and Peters (Note 1) also see denial as one of the prominent issues to work on in group therapy. While they feel that the defense is oftenunconscious, they believe that the continual denial ofpublicfactsis often utilized consciously, representinga form of defiance; it has been observed that passive-aggressiveness is one of the exhibitionists' typical modes of dealing with anger towards authority figures. Many factors contribute t o the high degree of dlefensiveness typically found in these patients. The fear and shame in being arrested are unpleasant experiences that they would prefer to forget. The unexplicable nature of the act that usually seems peculiar and even "crazy" to them adds to the frighteningaspect of the symptoms. However, the most important cause of the patient's significant and massive utilization of psychological defenses seems to be the marked intensity of the conflicts that they experience. Acute castration anxiety and marked difficulties in expressing anger appropriately are the two major conflicts discussed in the clinical literature to explain exhibitionistic behavior. Fenichel(1945) explains the exhibitionist's act as a: denial of a danger that is believed to be connected with normal sexuality. Reassurance against castration can be attained by an exhibitionistic man the following way: he consciously says t o his audience, 'reassure me that I have a penis by reacting to the sight of it'. Inner doubt impels the indiv~dualto call upon objects as witnesses. He also unconsciously says t o his audience, 'reassure me that you are afraid of my penis, that
is, that you feac me; then I do not need t o be afraid of myself. (p. 345).
The significant inhibition and restriction of outlets for unusually intense emotional states iis described by Rickles (1950). He views the exhibitionist as "fixated at an infantile level due to conditioning by maternall parents who use their sons as compensation for their own lack of a male sexual organ" (p. 145). They make their sons overly dependent and overly involved with them, arousing intense incestuous wishes and exaggerated narcissism. Rickles understands the act of exposure as representing a number of drives including6a desire to relive the infantile pleasure of being viewedl and admired, a defianceof mother's possessiveness, an effort to assert masculinity, and a wish to be helped" (p. 146). Almost all authors make special note of the exhibitionist's insecurityabout his sexual identity. In addition to the classical explanation of castration anxiety, many authors have focused on the exhibitionist's inability to deal with his anger, particularly towards women. Because women are experienced as especially castrating and threatening, the patient cannot express his intense resentment in a direct, adaptive way. Instead, Ihe supresses his anger and relates to them in a passive and unassertive manner. Blooth (1975) notes that in the act of exposure, the patient cliallenges a woman with his penis, arousing a powerful react.ion, often fear or disgust. Clearly aggres&on and revenge are represented in the mt. The emotional factors that have been described as etiaracteristic of exhibitionists - the pervasive and excessive selfprotective reactions, the intense emotional confl~cts, and the lapses in impulse control -are ~distincalyand interestingly manifested in the: following Rorschach protocol: The patient was a 27-year-old black man, recently separated from his wife, wit: three children, who had a stable employment history as a muncipalmaintenance worker. He had no previous record of a sexual offense. This individual was unusually suspicious and guarded in his initid approach to the testing
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
Defensiveness in Exhibitionists
situation, questioning how the test was developed and stating a concern for organizations that "program our mind". He talked about "important people running little guys' lives". Nevertheless, in spite of his defensivenessand the fact that he openly and emphatically denied his having indecently exposed himself, his responses on the projective test revealed patterns of psychodynamic conflict which are consistent with those f ~ u n in d exhibitionists. Many of the percepts reflected the classical sexual and aggressive conflicts in a particularly graphic way. The acute emotional turmoil experienced by this man and his pattern af defending against these feelings by denial and prajection were revealed in the way he perceived one of the Rorschach cards (see Appendix); he saw it as a "face or a mask from Star Wars . . a false face". The patient then saw another part of the same card as "an airplane with fire coming out. going through thedarkatmosphere". This second response (the airp,lane) can be interpreted as representing strong phallic aggressive urges which are frustrated and lead him to be depressed and upset. The phallic aggressivesymbol of the airplane takes on extra significance and emphasis when the patient included "the fire coming out. . fire because it is red"'. Eire and red denote the intensity of the emotions (especially anger) and the mqvement conveyed inc'coming out'%ignifies the sense of frustration and bitterness at not achieving one's wishes, The patient's further elabaration that the plane was "going through the dizrk atmosphereWsuggeststhat theunresolved an er 1s also internalized and causes him to kd dep(esned; 'darknessy'on the orscbach represents depression. A way that the patient attempts to defend against his thrtatming, hostile impulses is indicated by the fearful "Star Wars mask" relpofise. This percept reveals both the hostility (Star Wars) which he projects onto theenvirlopment slo that he is inclined to see pthqrs as threatening and danqerous to h i q and a k a his parpnoid evasiveness and guar~ednressin his interactions with others (the mask). Prominent on
.
..
.
this and other cards is a strong need to hide his emotional reactions behind some mask, some false face, or facade. Despite his excessive guardedness when relating to others and his readiness to hide from himself and others his frustration and feelings of inadequacy as a man, this core conflict is clearly reflected in an unusual and interesting response to one of the cards which he saw as "a man in a rabbit costume. . . an outfit that zippers up . . there is the zipper". This percept as well as a number of other costume responses, indicates both the patient's tendency to disguise his real feelings and his idiosyncratic sensitivity to exhibitionistic issues like the zipper and his wishes to draw special attention to himseIf. Furthermore, the response graphically portrays his conflicts about himself as as man; is he a man or is he a meek, frightened rabbit attempting to increase his low self-esteem in this pathological way? Two distinct phallic aggressive "airplane" percepts signify his intense wishes to feel potent and hypermasculine. However, other responses indicate that he experiences acute anxiety when he has sexual contacts with women. This conflict is revealed in his response to one of the Rorschach cards that often represents female genitalia and elicits the individual's reaction to sexual involvements. After a long reaction time, he described this card as "looks like snow clouds broken in some places.. .it is stretched out as if a plane went through it . . . they are black and gray and light". This response denotes the concerns over his lack of sexual potency and the extent to which the anxiety associated with sexual contact can "castrate" him, incapacitate,and overwhelm him. The long reaction time to this card indicates how disturbing sexual impulses can be; they can interrupt his cognitive efficiency. Further evidence of theamount oftension evoked by this card is revealed in his perceiving "snow clouds.. . stretched out, blackand gray and light color". The black representing depression and the texture of gray and light colors signifying anxiety plus the coldness of the snow clouds all combine to convey a picture of cold, bit-
.
529
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
BARTON A. SINGER ter dissatisfaction and resentment associated with heterosexuality. While there are no concrete indications of castration anxiety in the Rorschach protocol e.g., "appendages cut-off', the patient's reaction to this card aswellas his overemphasis on phallic-aggressive concerns, lead one to infer significant conflict in this area. The patient's psychodynamics interfere with his forming satisfying interpersonal relationships with women. Although he is very interested in relating to them, he is unable to form meaningful well integrated emotional attachments. Instead he tends to feel isolated and distant from others, as reflected in his seeing one card as "two women putting down a pot . . . black silhouettes . . . looks like a broken head going one way and then a space.. . no neck and a space between the body and the legs". This response of seeing silhouettes instead of real people and pointing out the spaces between the parts of the body conveys theisolated,detached, and poorly integrated quality of his object relations. It is also evident from the patient's inability to deal effectively with the emotionally provocative stimuli of the colored cards, that he is not able to modulate his affective experiences. On tlnb Rorschach, color reprelsents emotionality. His only response to one of the colored cards was "lots of coli~rsto it . .a mix of colors". Just as he was unable to articulate the card and produce an organized response, he is unable to handle his feelings in an adqptive way; he becomes confused and incapacitated in emotional 5nteraetions and cannot think clearly and efficiently; he would be inclined to lapse into maladaptive and poorly controlled forms of behavior in emotional situations. Some Concluding Remarks These test results underline the value of the Rorschach in allowing the €miminer to evaltlate personality and t o elicit material that in many cases would bedifficult to obtain in a clinical interview. Despite this patient's extr~melysuspicious and guarded attitude his personal life and his offense and
.
despite his relatively poor verbal skills, low intelligence (WAIS IQ of 86), and his educational background (he dropped out of school after the 8th gracle), he revealed a gre,at deal of useful information about himself on the test. Thisisdue in part to the test's capacity to penetrate psychological defenses; the patient is usually not aware of what he is disclosing; defense mechimisms are not as readily aroused and therefore the patient's special sensitivity to certain stimuli on the Rorschach and his manner of perceiving them can refllect important aspects of his inner world. The protocol reve:als the patient's core emotional conflicts, his disturbed object relations, and his poor impulse control and clearly indicates his need for treatment. This case clemonstrates the valuable role af psycholiogical testing in the forensic system, particularly for defensive, less verbal, and tionpsychologically minded offenders. Pretrial and/ or presentence evaluations can be quite useful in helping to identify those individuals whose behavior is motivated by intra-psychicproblems from tho!;e more sociopathic offenders. Recommendations can be made to the court concerning whether treatment orincasceration would be the most appropriate digposition. Furthermore, suggestions can be offered about the kind oftherapy that would be most helpful (e.g., group therapy or individual therapy) and abocit the sigrrificant emotional conflicts and the patterns of object relations that the therapist would likely encounter inthe treatment process. For example, in this case, it was apparent that there were a number of factors such as thepatient'slow IQ, poor verbal skills, defensiveness, and low frustration tolerance, especially in verbal and emotional interactions, that would make it difficult for him to establish a rne8ningful relatiofishipwith a therapist in traditional psychotherapy. A more conffontative grouporient.ed sex offender program might be the treatment of choice. Reference Note J. J. Outcome study on 39 exhibitionists. Paper presented to the A.merican Psychiatric A,ssociation, Honolulu, Hawaii, May 1973.
1. Steg, J., .& Peters,
530
Defensiveness in Exhibitionists
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
References Booth, F. G. Indecentexposureandexhibitionism. British Journalof Psychiatry, 1975, Spec. ,Yo. 9, 212-222. Fenichel, 0.Thepsychoanalytic theory of neuroses. New York: Norton, 1945. Mathis, J. L. & Collins, M. Progressive phases in thegroup therapy ofexhibitionists. International Journal of Group psycho the rap.^, 1970, 20, 163-169.
MacDonald, J. M. Indecent exposure. Springfield, ''I.: Thomas, 1973. Rickles, E. Exhibitionism. Philadelphia: Lippincott, 1950.
Dr. Barton A. Singer 65 Haddon Ave ~ ~ d d ~ ~ Nkw f i ~jersey l d , 08033 Received: November 30, 1978 Revised: February 9, 1979
Appendix Rorschach Protocol 2" 1) A butterfly. (Q) The wholething. (Q) The wings, theantlers, the body, thereis a straight linegoing down the middle of the body. A butterfly with wings and with colors. (Q) The ink was faded all through it in different spots. 2) That's all. 33" 1) Something from star wars. (Q) The whole thing. (Q) The nose, the mouth, beard, the eyes. It looks like its from star trek. (Q) It had that type of look. Something from outer space. The rednesscame t o a peak, was on the top ofthe head and made it look a little different. The red at the bottom looked like a goatee. (Q) It could be any color. (Q) It is a false face, not realistic, like something that would be a mask. 2) It looks like a n airplane. The white inside and fire coming out of it. The dark is where it is going through the atmosphere. (Q) Fire because it is red. 23" 1) Acrab. (Q) Everything but the red. (Q) It hadclaws,amouthlikeacrab,little teeth. 2) Two people puttingdown a pot. I saw the people first. (Q) It isa blacksilhouette, reaching out, putting down a pot. (Q) Two women, breasts,arms, they look broken with the head going one way and then a space, no neck, there is the body and there is a break from the body to thelegs. They looklikethey are bending (Silhouette?) Because it was black, like people in a theater who wear black uniforms with white gloves. 1 0 1) A butterfly. ( Q ) A butterfly with a beetle body, a beetle that flies. (Q) It has lots of claws, the head looks like a beetle. 25" 1) It looks like a butterfly. (Q) The whole thing, two antlers and the wings. 2) It looks like a man with rabbit ears, a man's face, with a zipper, an outfit that zippers up. (Q) It's a costume that has rabbit ears and legs. (Q) Man's face has eyes, nose, mouth, and a small head. There is a zipper that runs up the body. (Q) It's like in a theater or play. 8" 1) That looks like a new plane from England. (Q) The whole thing. (Q) The narrow neck, the body. It looks like it took off from a 45' angle. 2) Also it looks like a space ship, like from star trek. (Q) The whole thing. The design, thin up front and it came to an angle at the back. VII 60" 1) It looks like snow clouds, brokenupinspots. (Q) Likeit'sinthesky, brokenin some places. (Q) It is gray and light colors and it is stretched out like something that a plane w ~ u l dgo through. (Snow clouds?) Because it is black. VIII 75" 1) It looks likea nice abstract picture of nothing. (Q) Because ofall thedifferent colors and no set pattern. 2) It looks like animals and some rocks. (Q) Two animals, likea bear on a cliff. (Q) The face, had a back leg and a front leg, on a mountain reaching over to another plane.
BARTON A. SINGER IX 70" 1)
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 02:44 07 January 2015
X 90" 1)
53 1
It looks like some kind of weird costume, a big blouse, big round shoulders, weird nose and eyes, some kind of ears, an abstract painting. ( Q ) It makes a nice halloween costume. (Weird?) It does not favor anything realistic. You had to use your imagination. The colors are not important. (Painting?) It does have three different colors. A lot of colors to it. It's just a pretty picture of different colors, of blends of colors, black, light black, red, faded out red.
