Title: Helping people with pedophilic feelings
Author(s): Frans Gieles
Affiliation: Dutch Association for Sexual Reform
Citation: Gieles, F.E.J., “Helping people with pedophilic feelings,” Lecture at the World Congress of Sexology, Paris, June 2001.
For about twenty years, I have been trying to help people who wrestle with pedophilic feelings. I do this as a volunteer for workgroups of the NVSH, the Dutch Association for Sexual Reform. Just in the last two years, several young men, mostly students in their twenties, have asked for help.
The ages of twenty to thirty are the ages for making dates with lovers and forming couples. However, these men feel attracted to children, boys or girls, and do not dare to speak about these feelings, not with their fellow students, nor with their parents or family. This age is also one of living apart from the family, the age of more free choices for their free time. The Internet is also available these days.
The feeling of attraction to children, pedophilic feelings, can easily become an obsession that blocks the person and their education completely. The story we hear is often one of obsession, depression, or even suicide plans. Some of them block their feelings; others shake off all restraints and have serious problems with police and the courts as well as their social environment and family.
Note that, according to Hall, Hirschman & Oliver, more than 25% of a sample of normal men reacted with arousal to pedophilic stimuli. So, we're not talking about a small deviant minority, but about a normal variance in human beings—in an era in which anyone who reacts like this would be considered a monster by most people. Something has to happen, but what?
I want to draw a distinction between three kinds of intervention: (1) ‘treatment’, (2) self-help and (3) real therapy. I have presented a scheme to highlight the distinguishing features. It appears that every method has its strength and its weakness. One should make a distinction between the clients in order to choose the right method for each client. There is not one method that works for all.
|1. "Treatment"||2. Self-help||3. Real Therapy|
|Helper||Healthy, good and normal||A searching human being||Counselor, guide, human|
|Client||Sick, bad and deviant||A searching human being||Client, searcher, human|
|Aim||No cure but control||Help each other find his or her own way||Client feels better and finds his or her own way|
|Method|| Behavioral therapy
| (Group) Interview
Listening to each other
Exchange of conscious feelings, experiences and ideas
Mutual, tangible support
In addition, support circles can be helpful.
Acceptance of conscious and unconscious feelings
Discovering how to live with those feelings
Alienation of the self
Some recidivism: 7.4%? (Alexander, 1999)
| Recognition of feelings
Acceptance of feelings
Hope for the future
Some recidivism: 6.25%? (Kirkegaard & Northey, 2000)
Acceptance of the self
Growth of the self
Some recidivism: 18.8%? (Alexander, 1999)
|Vision||Human as a mechanical being||Human as a social being||Humanistic psychology, dynamics of the psyche|
|Clients||Only people who are not able to communicate and to control themselves||People who are able to communicate, to listen and to control themselves||People who are able to communicate, to think and to control themselves|
|Survival|| Play the game
Take the good and forget the bad
|Sometimes it’s too heavy for someone to listen to the troubles of others. Take a break, employ humor or split into subgroups||Period of uncertainty and doubt, but in the end there is usually no problem.|
The first one is the treatment of predators, based on the cognitive-behavioral approach, widely used nowadays under the slogan "no cure but control." Most of the professionals who work with this method or write about it think that it’s the only method that is possible. This method, however, has shortcomings and, besides, there is more under the sun.
Others and I have used the second one, the self-help method, for about twenty years in the Netherlands, among others within the NVSH. It seems that we could help many people with it. I want to especially highlight this method in this lecture as a possibility to help more people. This method can have support from another method, the support circles, used by some church communities, described and recommended by Kirkegaard & Northey. The self-help method is also widely used on the Internet.
The third method is the real therapy, as I call it to draw a distinction with method number one, which I call treatment. It concerns the well-known psychotherapy in its various manifestations. This third method is well-known enough, so I only mention it as a useful possibility that even can be combined with methods one and two; and to draw dividing lines between the three methods. Individual psychotherapy was the standard way of treatment until about 1980. Since then, cognitive-behavioral methods, method number one here, became the most chosen way of intervention.
Usually, recidivism rates are used to evaluate methods of treatment. Robinson concludes from research that the general recidivism rate for untreated sexual offenders on average is 20%, while the rate for treated offenders on average is 10%. So, treatment can halve the recidivism rate. But which kind of treatment or help?
Margaret Alexander concluded that men treated before 1980 (treated by more traditional methods) re-offended at a rate of 12.8%, while men treated after 1980 (treated by present day methods) re-offended at 7.4%. She did a kind of meta-analysis, reviewing 79 studies with nearly 11,000 people in the samples. So, the recidivism rate of the modern methods appears to be lower than the more traditional methods.
Let us look for a while at those recidivism figures. Anyone who listens to politicians and popular writers believes that sexual offenders have recidivism rates of 90% or even more. In The Netherlands, even a professor in sexology has said for years that the recidivism was that high, until he read research articles about it, then his figures went lower and lower.
An Indiana senator proposing sex offender registration in that state, declared: "Statistics show that 95% of the time, anyone who molests a child will likely do it again." A Florida senator referred to "sexual predators who start to look for their next victim as soon as they are released from prison," and a California legislator warned the public that sex offenders "will immediately commit this crime again at least 90 percent of the time."
Anyone who reads the research results will see quite different figures. The recidivism rates are not as high as have been said. This is important, because if the figures were indeed above 90%, it would not be easy to defend the self-help method here. In general, there are lots of myths about sexual offenders. An article, Myths and Facts About Sex Offenders, August 2000, by csom.org, includes a list of myths and facts.
Karl Hanson & Monique Bussičre presented the most recent meta-analysis about those recidivism rates in their article from 1998: “Predicting relapse: A meta-analysis of sexual offender recidivism studies.” They re-analyzed 61 follow-up studies with a total sample of nearly 23,400 people.
On average, the sexual offense recidivism rate was low: 13.4%. Note that the general recidivism rate, according to Hanson, is 36.3%. So, the recidivism of sexual offenders is not three times the general one, but one-third of it. It’s simply not true that 90% or more of the sexual offenders re-offend—it’s 13.4%. Treatment appears again to be helpful: "Those offenders who failed to complete treatment were at higher risk for re-offending than those who completed treatment."
I want to add a thought to these figures: these kinds of figures are gathered with statistical methods, involving thousands of persons. This is the actuarial way of working and thinking. However, if we want to help people, we can only help them one by one, so for our work as clinicians, we have to use the clinical way of working and thinking. Both ways differ.
To quote Don Grubin & Sarah Wingate: "The most crucial difficulty arises from the fact that actuarial prediction is about groups, and unless we are talking about a high-frequency behavior it can tell us little about individuals." They also write: "Sex offenders are not simply bundles of variables. Characteristics that may be important to actuaries have little inherent meaning as they indicate associations but do not in themselves imply causation. They become useful in understanding recidivism only when their possible meaning in particular individuals is clarified."
A study that is perhaps the apotheosis of the actuarial approach can be irrelevant for the clinical approach. Factors that tend to be invisible to the actuaries may be crucially important to clinicians in determining when and which intervention is necessary.
For this presentation, I will now present a critical look at the first method.
1. As Robinson says: "Generally, behavioral techniques have been found to be effective in many studies. Unfortunately, there has been concern among many experts that the methods produce only short-term changes in deviant sexual preferences."
2. The method uses much control. As long as the clients have not changed their ways of thinking, doing and even feeling, the treatment will go on until the 'correct thinking' has been reached. But ‘correct thinking’ is factually the same as ‘political correct thinking’, that is: the politically demanded way of thinking.
Thus, the clients will 'play the game' to reach the end of the horror of the treatment period. They know the politically correct answers, they have learned them, so they will give them. Consequently, the outcomes of the measurement scales are often false, and so are the outcomes of the research based on them. Also Dennis Howitt mentions this.
3. The method can result in a trauma instead of in healing. It reduces the person to a sick offender only. It aims to change the deeper ego-syntonic feelings into ego-dystonic feelings. It does not lead to self-acceptance of the whole person, including the pedophilic feelings, but to suppression and denial of those feelings. Doing so, it alienates the person from the deeper self. It's not healing but dividing the person.
This can result in a feeling of basic uncertainty and insecurity on a very deep level. Agner Fog quotes a man who said: "...rather than destroy my feelings towards boys they destroyed me as an individual, it destroyed my security." I have met clients who started this kind of treatment as warm lively people and who were changed into stiff wooden dolls after it. Others have survived by playing the game. Others have stopped it.
4. The method can be dangerous because it aims to suppress feelings, thoughts and fantasies. So it closes the safety valve of the steam boiler. Sooner or later, the bomb may burst. One does not talk and think about suppressed feelings, so one does not think rationally about their deeper feelings and does not search for a way to live with these feelings.
Usually, contacts with other people with pedophilic feelings are ended and forbidden, so talking with positive role models will be impossible. Self-help is blocked and isolation from the self and from others can be the result. Especially in the case of community monitoring, social isolation will be the next source of stress. Their inner steam boiler, under such high pressure and without a safety valve, can burst sooner or later.
5. I have many ethical objections against the formidable use of power and control in this method. Note, that the treatment program not only will change the behavior, but also the thinking and the feelings (the preferences) and even the fantasies of the clients: their mind. Plethysmography or phallometry intrudes the most private parts of the human body.
The treatment staff intensively intrudes even upon the last bastion of freedom, the innermost mind of a human being. The method forces its clients to think and feel in a correct way—in a politically correct way. The method aims to control the thinking and feeling of people: it's thought control by thought police, as George Orwell named it. Mind control by The State... like the brainwashing in the former Soviet Union, now used widely in the 'free' Western world.
One should not call this 'therapy,' as Dennis Howitt (1995) also says: "So instead of a client-orientated ethos, psychotherapy is turned on its head when applied to sex offenders...they may be taught to control themselves rather than understand themselves;...they may be humiliated by fellow offenders and, in general, treated in ways that would cause outrage if they were applied to their victims" (pp. 250-251). That the method works by giving low recidivism rates is not the only criterion. If one murders all sexual offenders or locks them up for life, the recidivism rate will be zero. There are also ethical criteria.
6. I have also a scientific objection to this method. It's against the simplistic way of thinking behind this method. The treatment is based on a very simplistic way of thinking that equates political correctness with being right and political incorrectness with being wrong. Their way of thinking about intergenerational sexual contacts is uncritically taken from the way of thinking about the rape of women. This simplistic way of thinking is also based on sexual child abuse research that is often biased, being more politically correct than scientifically correct or to say it another way: more ideology than science. Also Dennis Howitt has said this.
Margaret Alexander had to remove 280 of the 359 studies she found from her analysis because of shortcomings. An article of Frederiksen lists the biases of the common CSA research and so does the Rind et al. team in their now famous meta-analysis. Dennis Howitt says in his well known book, reviewing the research on treatment methods: "With a situation like this, claims of therapeutic success may sometimes be wishful thinking on the part of the clinician, the client, or both" (p. 191). So, the defenders of the first method should be modest in their claims – as will I.
I want to highlight the self-help method now, but I cannot build on hard research because research about this method is scarce. My source will be twenty years of personal experience with this method. So I will be modest. The basic assumption here is that there are no helpers and clients, but that the members of the group all are helpers as well as clients. The members help each other. There is no difference—all are human beings, searching for their own way to live with their pedophilic feelings.
Clearly, the three methods are based upon entirely different views of the human being. In the first one, we see a more or less mechanical vision of human behavior. Behind it, we see a view of the human as a sinner, doing wrong things almost automatically. The second one believes that humans are primarily social beings. The third one focuses on the dynamics of the human’s psyche. Both the second and the third view do not see a sinner, but a searcher for the right way to live and both believe that the client is able to find it.
The main method is the group interview. Usually, there is a leader of the interview, but he or she is not “the therapist.” He or she is just one of the members who catalyses the group process by asking everyone to listen to each other, to speak one by one, to express one’s feelings and to exchange experiences and thoughts. They deal exclusively with the conscious feelings. The members of the group ask each other to express their feelings, including their deepest feelings, but not to go to the unconscious part of the soul.
Members give tangible support to each other in several aspects of life. This is important because many people with pedophilic feelings tend to live as an isolated minority, as Agner Fog calls it in his article. Fog talks about the “isolated minority syndrome" he sees in people with deviant sexual feelings: "The symptoms of this syndrome include a stereotypic and uncontrolled sexual behavior and several unspecific social symptoms. The cause is a lack of an appropriate identification model and non-acceptance of own sexual feelings. Group therapy in self-help groups is an effective treatment. "
Experienced members of such groups can function as positive identification models for less experienced members with the same or a similar paraphilia, and teach them how to find a style of living.
The first aim here is that the participants will be conscious of their inner feelings and that they will accept these as a part of themselves and not fight against them. New members can see, hear and feel that this is possible. Members are invited to accept themselves and each of the other members as a person, as a whole person, a Gestalt, including their inner feelings, including the pedophilic ones.
These aspects of the method are also described by Van Naerssen and by Van Zessen, both from The Netherlands. Dennis Howitt spends a few pages on what he calls "support therapies." By the way, the self-help method is widely used among people who have the same problem, illness, situation or aims or ideas, like Christians, pregnant women, parents of gay sons, blind or deaf people and many more.
Secondly, the aim is that the members see that there are various ways of living with their feelings. New members are invited to search for their own way of living; they see, hear and feel that this is possible. There are more possibilities under the sun than stereotypical ways of behaving.
Both aims, the first and the second, can diminish the features or characteristics of the isolated minority syndrome.
There is an additional method: forming support circles. A support circle is a group of people who form a circle, so to speak, around the client. Church communities do this. Community members make contact with the client at their home. They invite him or her to go places, or they cook and eat with the client. They invite him for a film or theatre, for an excursion or a trip. They stimulate the client to participate in society as much as possible and they support the client in doing so.
Hugh Kirkegaard & Wayne Northey describe this model. First, they describe the scapegoating process in the community. They then describe how faith communities worked to stop this scapegoating process and to start support given by, as they call it, "circles of support and accountability." The goal of the circle, they say, "is not to be therapeutic but to provide support and accountability." In addition, several web sites function nowadays as virtual groups or support circles. Several web sites work from a Christian point of view. Heather Elizabeth Peterson wrote a long article about these web sites.
Kirkegaard and Northey write about the results of their support circles:
Over the last five years the initial project based in Toronto has created thirty-two Circles in Toronto and Hamilton. Of the ‘core members’ involved in these only two have re-offended to date, one for a property offense and one has been charged with another sexual offense. As a result of the success of this approach, in the past year another six local Circles initiatives have been established across Canada and the total number of Circles created is now forty-five. While most of the Circles continue for eighteen to twenty-four months, the longest have been in place for five years. For core members who are low functioning and have high needs, this kind of intentional community is necessary for their healthy functioning in the community for the long term. For others, the assistance a Circle offers in getting re-established in the community is a more short- term need. Yet the supportive relationships with the friends they have met there, who know their history and can call them on their behaviors, continues long after the formal Circle has ended.
Two re-offenders out of 32 core members (one offender in each circle), that's a recidivism rate of 6.25%. That is low. If you only count the sexual re-offence, like most researchers do, it's 3.13%. That's very low.
We have used the self-help method for many years in some of the Dutch local workgroups of the NVSH (not in all groups; some of them don’t offer much support at all). I have worked for about twenty years and for several groups using this method. What we saw is that the members gradually recognize and accept their deeper feelings. An atmosphere of comradeship develops in the group.
People who came in with "Oh! I have a great problem! I seem to have certain feelings! What do I do?" changed their feelings of panic quite quickly into a feeling of hope for the future. We saw them each find his or her own way of dealing with their feelings. Some disappeared after that with a "thanks!" Others remained in the group to help the newcomers.
Another result is that in each group, and gradually in broader circles, an ethical code has been developed. Also Heather Elizabeth Peterson describes the ethics that gradually are developed on the self-help web sites. So, ethical codes and principles are the results of self-help groups. Peterson mentions a growth of celibacy and socializing the desires. I can mention the same about the groups I am speaking about. Almost all members live in celibacy.
I estimate the number of people helped in this way to be around a hundred people in a period of nearly twenty years. As far as I know, 16 people offended once and 2 of these 16 re-offended, one sexual, the other nonsexual. That's a 12.5% recidivism rate, double Kirkegaard's result, but just below Hanson's average of 13.4%; just above Robinson's figure of 10% for treated people, but below his rate of 20% for non-treated people. If you only count the sexual re-offence, like most researchers do, the figure is 6.25%: one person in 20 years of working with the self-help method.
Further, we cannot say that the re-offence is a result of the self-help method per se, because one of them, the sexual re-offender, has also had the other kinds of treatment, numbers 1 and 3—and because of the length of time that there was between membership in the self-help group and the re-offending. Moreover, these figures do not come from 'hard research' because, quite frankly, we have failed to set up and do this research. These are modest estimations, made as honestly as possible. Note that the sample for a practical experience is not too small and the time is reasonably long, 20 years.
No method can claim a 100% success and a zero recidivism. Each method appears to have its own strengths and weaknesses, especially if we differentiate between our clients, as I do in one of the rows of the scheme I have presented. As you see there, I want to use the first method only for clients who are not able to communicate and to control themselves. For clients who can communicate, to listen and to control themselves, the self-help method appears to be a good alternative. It is a far more humane method than the first one. It is less expensive and, within its limits, possibly quite effective.
The method deserves to be tried out and to be evaluated, then developed by research. It could especially be helpful, combined with support circles, for people who are released from prison and who come back into the community. Instead of only registering and controlling them, we should first support them. If we let them alone, social isolation will soon be the next source of pressure for their inner steam boiler.
I want to repeat that I intended everything I have said to be unobtrusive and modest. I've spoken only “in my humble opinion.” I will end by saying: let's all be modest and unobtrusive. Once upon a time, but not very long ago, masturbation was seen as a heavy and dangerous evil, causing much illness—and so was homosexuality until recently. Nowadays, it is the people with pedophilic feelings that are seen as The Great Evil of humanity. As noted above, more than 25% of the normal men appeared to have these feelings.
Once upon a time, long, very long ago, sexologists said things that later on appeared to be untrue... It appeared that ideology, religion or politics misled them in those days. Nowadays, we are scientists who see through ideologies. Nowadays, today and during this congress, we talk with each other in a rational, polite and modest way. I will continue to do this and I invite you to do the same.