by Chelsea Skinner, M.A., BCBA, The Chicago School of Professional Psychology
When speaking of paraphilias, one is typically referring to sexual disorders involving sexual arousal in response to inanimate/nonhuman objects, nonconsenting individuals, or humiliation or suffering of oneself or others. Frotteurism is one example of a set of behaviors classified as a paraphilia, defined as sexual arousal achieved by touching and rubbing against nonconsenting persons.
There is very little research on the analysis and treatment of frotteurism (Blotto & Klein, 2007) and it is rare for an individual who consistently obtains sexual arousal through rubbing against others to seek treatment on his or her own. Frotteurism may not seem like a “pressing matter” when it comes to analyzing and treating sexual disorders; however, this may provide a first step in applying behavior analytic concepts and principles to sexual disorders listed in the DSM-IV-TR, which may help facilitate further research on this particular disorder and other paraphilias.
Three main areas of behavior analysis research may contribute to the understanding of frotteuristic behavior and other sexual disorders in general: respondent conditioning (classical conditioning), operant conditioning, and Relational Frame Theory.
As the learning theory proposes, respondent conditioning may occur once or a few times, resulting in the development of frotteuristic behavior. More specifically, touching, rubbing, or any form of brushing the genital region is likely to elicit sexual arousal for most individuals. It is possible that a person may have been traveling home from work on a crowded train or bus when another individual was standing close against him/her. Possibly due to the movement of the train or bus, or the way in which the two people were moving, rubbing and stimulation may have occurred, eliciting sexual arousal feelings and quite possibly even ejaculation.
With respondent conditioning, an unconditioned stimulus (the rubbing or sexual stimulation) is paired with a neutral stimulus. In the case of frotteurism, the neutral stimulus may be a little more complicated to pinpoint, as compared to a neutral stimulus involved with a fetish.
For individuals who engage in sexual behaviors such as frotteurism, it is likely that the initial responding was elicited by a stimulus and then, through multiple exposures either directly or by engaging in covert behaviors, came under the control of operant conditioning.
There are many areas to explore within operant conditioning in which literature from outside the field of behavior analysis does not touch upon. Quite clearly there are reinforcement contingencies involved in which the sexual pleasure, or orgasm, that occurs following rubbing against another person in a crowded space serves as a reinforcer to increase the future behavior of rubbing against strangers. Outside of the primary reinforcer of sexual stimulation, though, there may be conditioned reinforcers that maintain the sexual behaviors. For example, if the victim in a situation is not aware what is occurring and turns to say, “Excuse me” or smiles, makes eye contact, and apologizes to the client, this attention may serve as social reinforcers.
In addition to reinforcement, motivating operations and discriminative stimuli may exert control over the client’s behaviors. For example, if our client experienced sexual arousal, which was elicited by rubbing against another person’s buttocks or thighs while in close quarters on public transit, the crowded bus may signal, in the future, the availability of sexual arousal/pleasure.
Another important way that empirical research within the field of behavior analysis may affect the analysis and treatment of frotteurism and other paraphilias may be found in Relational Frame Theory (RFT).
Roche and Barnes (1998) provide a theoretical account of how fetishes may develop through derived relational responding. This account may be applied to the behaviors involved in frotteurism, also. For example, most individuals learn that when another person smiles, this means that he/she is “happy.” Other words that may be in a relational frame of SAME AS with happy may include “enjoyment,” “wants more,” and “consent.” Similarly, the client may have experienced a partner smiling during sexual activity. Through derived relational responding, the client may then place the stimulus of another person’s smile (such as in a polite “excuse me” comment while on a crowded train) in the same frame as enjoyment, consent, and sexual pleasure.
Roche and Barnes also provide examples of OPPOSITE frames, including words such as dominance, power, and victim, when analyzing the behavior of rape. This may also apply to an individual engaging in behaviors of frotteurism.
Behavior analysis may provide alternative treatment options that focus on positive reinforcement and less intrusive interventions. Currently, no experimental studies have been conducted in the experimental or applied behavior analysis realms; however, future research should focus on multiple approaches to treatment. One approach could focus on transferring stimulus control from variables in the environment in which the targeted behaviors occur to a more appropriate location (the individual’s home; communities in which these behaviors may be encouraged, accepted, or consensual). Another approach could focus on implement Acceptance and Commitment Therapy (ACT) to help treat the derived relations of verbal behavior that may be involved with situations. Other treatments could include antecedent interventions, manipulations of the motivating operations (such as having the individual role play with a partner at home using a rubbing scenario that may occur or watching/engaging with pornographic material that may be similar), social skills training (to access opportunities for relationships), and masturbation training (to possibly teach more effective masturbation or expose the individual to alternatives).
Frotteurism and other paraphilias are typically considered disorders that originate within the perpetrator, either as a result of brain defects, genetic defects, or hormonal imbalances. Approaching sexual behaviors from this point of view thus far has resulted in our culture incarcerating individuals committing the behaviors deemed criminal, without attempting to treat the function of the behavior. If treatment is required for individuals, or is sought out by an individual, then there is little empirical support for any treatment. Behavior analysis attempts to predict and influence all behavior, and the field should shift to expanding the literature on sexual behaviors, also. If the field of behavior analysis is to gain the respect and “buy-in” of other psychological fields, it is important that the field share in producing experimental literature that encompasses the seven dimensions of applied behavior analysis.
Kuruvilla, K., & Joseph, S. (1983). A case of frotteurism and its successful treatment by behavior therapy. Indian Journal of Psychiatry, 25, 159-161.
Roche, B., & Barnes, D. (1998). The experimental analysis of human sexual arousal: Some recent developments. The Behavior Analyst, 21, 37-52.
Rowland, D., & Incrocci, L. (Eds). (2008). Handbook of sexual and gender identity disorders. Hoboken, New Jersey: John Wiley & Sons, Inc.
This piece was originally published as a part of the Summer 2013 STEP SIG Newsletter.