Flash dance: A psychological overview of exhibitionism

Exhibitionism typically refers to an intense desire or compulsion to expose sexual parts of the body (i.e., genitals, buttocks, breasts) to unwilling observers in public (or semi-public) places. If the behaviour is anti-social or threatening it is typically defined as ‘indecent exposure’ and becomes a matter for the law. Non-threatening exposure of sexual body parts (such as women showing their breasts during the Mardi Gras festival) is usually termed flashing as opposed to indecent exposure. However, there is a whole range of different terms used to describe various exhibitionist acts including (in alphabetical order):

• Anasyrma: Typically refers to the lifting of a skirt or dress by a woman when not wearing any knickers and exposing her genitals.
• Candaulism: Specifically refers to those people who expose themselves to their partners in a sexually explicit way.
• Flashing: Typically the brief display of bare female breasts or the brief showing of genitals by a man or woman.
• Martymachlia: Specifically refers to a paraphilic behaviour that involves being sexually aroused by having others watch the sexual act.
• Mooning: Typically refers to the displaying of bare buttocks by pulling down trousers and/or underwear. Evidence suggests that when performed by women the primary motivation may be sexual whereas for males it may be done for the sake of mockery or humour.
• Streaking: Typically refers to running naked (usually men) or topless (usually female) in a public place (e.g., a cricket or football match).

The American Psychiatric Association defines exhibitionism as “sexual gratification, above and beyond the sexual act itself, that is achieved by risky public sexual activity and/or bodily exposure [and can also include] engaging in sex where one may possibly be seen in the act, or caught in the act.” Exhibitionism is not necessarily a compulsive or impulsive behaviour but in its most extreme and compulsive form it is called apodysophilia. Furthermore, exhibitionism is only considered a psychological disorder if it interferes with a person’s quality of life or their normal functioning capacity.

Apodysophilia, like most paraphilic behaviour, is almost exclusively male and some exhibitionists will even go as far to expose themselves and then masturbate at a later point and/or or replay fantasies while engaging in sex with partner. One recent literature review on exhibitionism found only four papers published with a total of 14 female case studies across a period of 25 years.

Because data about exhibitionists typically come from either those caught offending and/or those that are receiving treatment, the true incidence and prevalence of exhibitionism is unknown. Data from the criminal justice system, small-scale community surveys, and victim surveys, suggest that exhibitionism occurs relatively frequently. A German study published in 1999 found that over a four-year period there were 8,000 to 12,000 reports of exhibitionism to the police, and 16% of those sentenced for sex crimes were exhibitionists. Clearly, such data totally underestimate the incidence of exhibitionism, as research carried out among the general public and victims appears to indicate that most people (approximately 75% in some surveys) don’t report these incidents to the police.

Very few studies have examined the prevalence of exhibitionism among non-sex offender populations. In 1991, Terrel Templeman and Ray Stinnett (Eastern Oregon State University) found that 2% of a very small convenience sample of college males reported exhibitionism. More recently (in 2006), Niklas Långström (Karolinska Institutet, Stockholm, Sweden) and Michael Seto (Centre for Addiction and Mental Health, Toronto, Canada) reported that 3.1% of their national probability sample (2,450 people aged 18 to 60 years) had exposed their genitals to a stranger for sexual pleasure (4.3% for males and 2.1% for females) although there is a high likelihood that very few of these were genuine paraphilic behaviour. Respondents who reported exhibitionistic behaviour were also significantly more likely to report other atypical sexual behavior (sadomasochism and transvestism).

This latter finding seems to be supported by some other evidence that exhibitionists may be generally hypersexual. Dr Martin Kafka and Dr John Hennen (McLean Hospital, affiliated with Harvard University, US) reported on a sample of 143 individuals with paraphilias, of whom 37% were exhibitionists. Of these 143 individuals, 123 also reported paraphilia-related disorders, which include compulsive masturbation, protracted heterosexual/homosexual promiscuity, dependence on pornography or telephone sex, and severe sexual desire in- compatibility.

Gene Abel and Joanne Rouleau reported an American study examining 142 exhibitionists in an outpatient clinic at the at the University of Tennessee Center for the Health Sciences in Memphis, and at the New York State Psychiatric Institute in New York City. They reported that 50% of the exhibitionists reported the onset of their sexual interest before the age of 18 years and that there was little evidence that exhibitionists had high rates of physical or sexual abuse. They also reported that the average number of victims they had exposed themselves to was 500.

A seminal study published in the 1970s by Graham Rooth in the British Journal of Psychiatry suggested there were two distinct groups of exhibitionists based on the case studies he had come across:

• Type 1 (80%): Aged 15-25 years; Inhibited immature and close to their mother; struggle against the impulse to expose and experience guilt; expose flaccid penis
• Type 2 (20%): Aged 20 upwards; Sociopathic tendencies taking sadistic pleasure in exposing erect penis and masturbating; may contact victims afterwards.

According to the American Psychiatric Association, exhibitionists rarely do anything else but expose themselves. However, Some victims are traumatised by the experience. Graham Rooth claims only 20% of those convicted re-offend (and they are usually the Type 2 offenders outlined above)

Although there is no evidence that exhibitionists have a preference for exposing, there is some limited evidence that exhibitionists may be generally hypersexual. A study led by one of the world’s leading experts on paraphilias, Dr Martin Kafka (affiliated to Harvard University, US) reported that in a sample of 143 paraphiliacs (of whom 37% were exhibitionists), a large majority (n=123) also reported paraphilia-related disorders, that included compulsive masturbation, protracted heterosexual/homosexual promiscuity, dependence on pornography or telephone sex, and severe sexual desire in- compatibility.

There are a number of theories as to how exhibitionism develops. Some claim it is the reinforcement of sexual arousal associated with exhibitionism that promotes maintenance of behaviour. others claim the disorder is caused by a disturbance of the pre-tactile interaction phase. More specifically, Kurt Freund, the late Czech-Canadian sexologist wrote numerous papers claiming that behaviours such as exhibitionism are caused by “courtship disorders”. According to Freund, normal courtship comprises four phases: (i) location of a partner, (ii) pre-tactile interactions, (iii) tactile interactions, and (iv) genital union. Freund claims that paraphilias such as voyeurism, exhibitionism, and frotteurism can be viewed as distortions in each of these courtship phases. Freund also proposed that obscene telephone calling, (often viewed as a variant of exhibitionism) is a disturbance of the second phase of the courtship disorder. Freund and his colleagues reported significant correlations between the presence of exhibitionism and the presence of frotteurism or voyeurism (the highest correlation being that between voyeurism and exhibitionism).

Freund also published papers examining the self-reports about the development of exhibitionists’ patterns of erotic behavior. Freund and his associates reported that among exhibitionists: (i) up to a half masturbated while exposing and during fantasies about exposing; (b) nearly two-thirds admitted they had also masturbated in a public place in a place no-one could see them; and (iii) more than half experienced the act of exposing as an invitation to intercourse and about a third as a substitute for intercourse with the target person. The study also confirmed that obscene telephone calling, which occurs also with other anomalous erotic preferences, was particularly associated with exhibitionism.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Abel, G. G., & Rouleau, J.-L. (1990). The nature and extent of sexual assault. In W. L. Marshall, D. R. Laws, & H. E. Barbaree (Eds.), Handbook of sexual assault: Issues, theories, and treatment of the offender (pp. 9-21). New York: Plenum Press.

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: Author.

Freund, K., Watson, R., & Rienzo, D. (1988). The value of self-reports in the study of voyeurism and exhibitionism. Annals of Sex Research, 2, 243–262.

Freund, K. (1990). Courtship disorder. In W. L. Marshall, D. R. Laws, & H. E. Barbaree (Eds.), Hand- book of sexual assault: Issues, theories, and treatment of the offender (pp. 331–342). New York: Plenum Press.

Kafka, M. P., & Hennen, J. (2003). Hypersexual desire in males: Are males with paraphilias different from males with paraphilia-related disorders? Sexual Abuse: A Journal of Research and Treatment, 4, 307–321.

Långström, N., & Seto, M. C. (2006). Exhibitionistic and voyeuristic behavior in a Swedish national population survey. Archives of Sexual Behavior, 35, 427–435.

Murphy, W.D. & Page, I.J. (2008). Exhibitionism: Psychopathology and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 61-75). New York: Guildford Press.

Pfäfflin, F. (1999). Issues, incidence, and treatment of sexual offenders in Germany. Journal of Interpersonal Violence, 14, 372–395.

Riordan, S. (1999). Indecent exposure: The impact upon the victim’s fear of sexual crime. Journal of Forensic Psychiatry, 10, 309–316.

Rooth, G. (1973). Exhibitionism, sexual violence and paedophilia. British Journal of Psychiatry, 122, 705–710.

Templeman, T. L., & Stinnett, R. D. (1991). Patterns of sexual arousal and history in a “normal” sample of young men. Archives of Sexual Behavior, 20, 137–150.