On: Unraveling the Riddle of Exhibitionism

Dear Editors,

In Dr. Tuch's thought-provoking paper (Tuch, 2008) he describes disavowal of reality and splitting as characteristic defense mechanisms in perversity. Tuch writes: “Another way in which perversion operates is by obliterating categorical differences that had served to define the nature of the particular

relationship (Chasseguet-Smirgel, 1984). The role each party had played (e.g. adult/child) and the function each had served (e.g. the one who has, the one who needs what the other has) is discarded and in its place a new reality is constructed, one in which hopelessness, frustration, and a sense of personal inadequacy are vanquished” (p. 156). I believe that this refers to the experience of envy generated from the disparity between the self that needs and the object that is able to satisfy those needs.

My patient, a 30 year-old male with a history of exhibitionism, recently presented a dream that I believe illustrates this aspect of perversion and exhibitionism very specifically in which psychic pain associated with envy is avoided by exhibitionistic activity involving a substitution of the penis for the breast. The following are examples of his history of exhibitionism: during his adolescence, he would come home after school, undress, and wait for the school bus that dropped off the neighborhood children in front of his house. Then he would walk completely naked around the outside of his home, exposing himself to the children. Or he would masturbate in his backyard while the neighbor children watched through the fence. When he first began treatment, he exposed himself to women while he was jogging.

At this time, he had a dream that revealed his struggle with conflicts involving avoidance of any sexual contact with his wife, instead preferring compulsive masturbation to pornographic masturbatory images on the Internet. The dream is as follows: I am getting out of the shower and drying myself off with a towel. There is a young woman in the bathroom with me