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Pete began therapy in November with a clinical psychologist. During the initial interview, Pete, a
34-year-old, married, white male, explained that he was coming for therapy concerning a sexual
problem that he had had for years. The immediate precipitant of entering therapy was that he had
been arrested in September for a sexual assault. He had been driving home, taking a shortcut along
some back roads, when he saw a car with its hood up and a woman looking at the engine. He
stopped to offer assistance. In response to his questions about what was wrong, the woman told
him that she had stopped because her alternator light had come on. Pete was able to correct the
problem by adjusting the fan belt. When the woman thanked him, he pulled her close to him, trying
to fondle her buttocks. As she pushed him away, he exposed himself and started masturbating. The
woman ran to her car and drove off. Pete made no attempt to follow. Later that night, the police
came to his home and arrested him. An initial hearing was held the next day and bail was set. Pete's
wife attended the hearing and paid the bail. At his subsequent trial, Pete was allowed to plead guilty
to a reduced charge of attempted assault and was put on probation for two years. Part of the
probation agreement was that Pete seek professional help.
This was not the first time that Pete had done something sexual that could get him into trouble.
He had a long history of sexual deviance, dating back to early adolescence. His deviant sexual
practices took two forms. One was getting himself into crowded places - shopping centers, subway
trains, and the like - moving up close behind a woman, rubbing his pelvis against her buttocks. This
type of activity is called frottage; the disorder is called frotteurism. Pete's other deviant sexual
practice was exhinitionism. Sometimes he would park his car in a place where many women would
be walking, remain seated behind the wheel, and masturbate as he watched them. He did not
expose himself directly but hoped that the passing woman would look into his car and see him.
Other times he would masturbate under a raincoat while in a place frequented by women.
Teenagers with "cute, little behinds" were the preferred targets for both activities.
Pete had engaged in both of these activities since adolescence. The first time he clearly
remembered doing either was as a 16-year-old high school student. He was at a football game on a
drizzly Saturday afternoon and had on a raincoat, one in which the pockets allow a hand to go from
the outside all the way through the coat to the body. Sitting next to a female acquaintance, he found
himself sexually aroused and masturbated to orgasm, apparently undetected by anyone. When he
got his driver's license later that year, he began his practice of openly masturbating in his car. Since
then he had engaged in either frottage or exhibitionism fairly regularly, an average of 15 to 20 times
per year. Pete reported that the urge to do so usually increased when he was under stress, such as