NOTA News Newsletter July 2018 1

Conceptualising adolescent
exhibitionism in the context of a YOI:
what does it mean to be ‘seen’?
– Dr Celia Sadie and Dr Sarah Allen
A common response from professionals (and lay
people), when we talk about our work with teenage
boys in custody, is an expectation of extreme sexual
frustration and arousal in the relational environment.
Adolescent boys are seen as manifesting a kind of
uncontrollable and intense sexuality (Ott, 2010).
The strictures of being locked up
and denied the opportunity to
work through this developmental
phase in a ‘normal’ environment
might well be seen as intensifying
or distorting these feelings. The
effects of these kinds of dynamics
on staff groups have been
described incisively by Adshead
(2012) and others, and it is an
ongoing process for those of us
who work with these dynamics to
make sense of them in ourselves
and in our teams.
In our work in youth custody
settings (predominantly with boys
aged between 15 and 18), we are
often asked to work with young
people whose sexualised behaviour
is troubling to prison staff. Typically,
our referrals are for incidents
of exposure, where boys show
their penises to (usually female)
prison staff, masturbate in front
of them, or ask what are felt to be
‘inappropriate’ questions about sex.
Appreciating each boy’s unique
developmental stage and
understanding of sexuality is, of
course, key. Our research mapping
the variance in experiences
and understandings of sexual
relationships in this specific
custodial population is in its infancy,
so much of our understanding is
impression-based and anecdotal. I
present this understanding here as
an exploration of current thinking
which guides our approach.
Adolescent boys are working
through developmental tasks which
include, among many others,
coming to terms with physical
change; experiencing and reflecting
on themselves and others as whole
people with complex feelings,
intentions and beliefs; and, moving
from an experience of their own
sexual feelings to recognising
the relational dimension of these
and the complexities of intimacy.
This developmental process
would ideally be facilitated by
opportunities for experience,
guidance, and a secure, responsive
and loving environment through
which to make sense of change.
The boys with whom we work
are a heterogeneous group
in most senses, but there are
distinct commonalities in terms
of chronic relational insecurity
and high levels of stress in their
home environments. Most have
witnessed violence at home and
beyond and many have absent
fathers and experiences of abusive,
neglectful and violent caregivers.
Often, they tell us that their main
source of information about
sex has come through viewing
pornography, which we can
reasonably assume has presented
unrealistic, ritualised, extreme
and emotionally disconnected
images of sexual relationships.
Having missed much of their
schooling, usually for reasons of
exclusion or neglect, many of the
boys have had very little statutory
sex education. Furthermore, very
few remember real or trusting
conversations with adults in their
lives about sex and relationships.
Fonagy and others have
described the ‘epistemic trust’
that arises in the experience of
secure attachment relationships
(defined as ‘trust in the authenticity
and personal relevance of
interpersonally transmitted
information’ by Fonagy and Allison,
2014). Epistemic trust, between
a caregiver and a child, enables
information to be assimilated and
held as personally meaningful.
We can speculate that this quality
has been intermittent, at best, in
the attachment relationships of
many of our patients. Relational
understanding, on a deep and
intimate level, is an area of
absence or great difficulty and
confusion for them.
22 | www.nota.co.uk conference@nota.co.uk @notaevents