How Do You Intervene Psychologically With Pedophiles?
It is not uncommon to read in the press or hear on the news that participants in networks linked to child pornography have been arrested or cases in which an adult has sexually abused minors. Most of these subjects are pedophiles people who feel sexual attraction to minors.
Pedophilia is a serious problem known since ancient times that can have serious effects both for the pedophile himself and for his object of desire if he puts his fantasies into practice. Furthermore, it is a problem classified as a mental disorder, and as such it is related to the intervention of psychological professionals. How do you intervene psychologically with pedophiles? Let’s start with the fundamentals.
pedophilia It is a paraphilia, disorder of sexual inclination or the choice of the object in which the subject presents for at least six months a series of recurrent and persistent fantasies of a sexual nature in which the object of his desire is prepubescent individuals, generally under thirteen years of age. These fantasies generate in the subject himself a high level of tension, discomfort or alteration of usual functionality.
For a subject to be considered a pedophile, he or she must be at least sixteen years of age and at least five years older than the prepubescent individual. It is important Do not confuse pedophilia with pedophilia, the first being the existence of sexual attraction towards minors while the second indicates that real sexual abuse has occurred. That is to say, a pedophile does not have to take action: not all pedophiles are pedophiles (nor do all pedophiles have to be pedophiles, since there is sexual abuse of minors for reasons other than sexual attraction).
Most pedophiles are middle-aged men, generally heterosexual, who usually have ties with the victims (family, neighborhood or work) and who do not usually use violence to get closer to their object of desire. However, there are also pedophiles (who statistically tend to have a preference for adolescents and children under three years of age), as well as pedophilia oriented towards minors of the same sex.
Although it is considered a disorder, in most cases the subjects who suffer from it are fully aware of their actions, enjoying the freedom and will to carry out sexual abuse or not. That is why the majority of them are criminally attributable subjects. Despite this, there are exceptions in which other psychological alterations occur.
Types of pedophiles
There are many different types of pedophiles. Some experience deep discomfort and guilt because of the attraction they feel, while others consider it to be correct and justify their actions and even in some cases there may be subjects with sadistic and psychopathic tendencies.
In some cases they themselves have suffered sexual abuse in their childhood, while others have not. Sometimes the pedophile feels a romantic attraction towards the minor in question, while in other cases it is a purely sexual interest.
When establishing a treatment, all these characteristics can greatly influence the strategies to be used and their possible effectiveness.
Prospects for treatment of pedophilia
The treatment of pedophilia is a complex reality which throughout history has received different considerations and in which different techniques have been used, acting from both psychology and medicine.
It must be taken into account that pedophiles generally They go to consultation due to pressure from the environment or due to a court order, there are few cases in which they do it of their own free will. This makes the treatment complex and there may be poor adherence to it.
Medical treatments: pharmacology and surgery
Medical treatments for pedophilia can focus on two large groups: pharmacology and surgery. Many pedophile subjects who fear sexually assaulting minors or who do not want it to happen again ask for this type of intervention.
The use of pharmacology focuses on the control of sexual desire, reducing arousal, through hormonal regulation of individuals.
The two most used elements historically have been cyproterone acetate, which blocks androgens and therefore reduces testosterone production, and medroxyprogesterone acetate, which decreases androgens and therefore the production of testosterone. Psychotropic drugs such as tranquilizers and antipsychotics (highlighting haloperidol) have also been used. Fluoxetine has also been used, but it only causes clear improvements in subjects with compulsive characteristics.
With regard to surgery, its use is controversial and risky, given that it can lead to a serious permanent deterioration in the subject’s normal functioning, while its effectiveness is questionable, since even if the subject cannot have erections, it is possible to perform it. of abusive practices that do not include the use of the gonads. In this sense, either physical castration or the elimination of the nuclei of the ventromedial hypothalamus in the brain is used.
A big problem with this type of treatment is that basically I don’t know the underlying problem, but rather its manifestations. In fact, even if there is no sexual desire, some subjects subjected to these interventions may continue to maintain different types of abuse.
Psychological treatments
The psychological treatment of pedophiles must take into account, first of all, that we are dealing with a patient regardless of whether or not they have committed sexual abuse. The professional who treats them must take into account that her attitude towards the individual can be decisive at the time. Is about maintain an attitude in which the subject is not judged and focused on obtaining your recovery.
It is essential that the treatment carried out is adapted to each case, since there is a great diversity of factors that can influence each person and cause the treatment to be more or less effective.
These treatments, which are carried out in the form of various programs, must take into account not only the modification of sexual preferences but also the connection of the pedophile and the search for cognitive changes. The most used paradigm in this type of case is usually the cognitive-behavioral one, although other approaches have also been used, such as the psychodynamic one.
One of the first approaches that must be taken into account is the development of positive linkers through training in social skills and empathy. The use of cognitive restructuring and stress management training is recommended (because in some cases impulsive behaviors are linked to impulses linked to anxiety).
It is necessary to work on aspects such as the significance for the subject of the fixation on minors, the existence of possible causal elements and their treatment, if any. For example, if the victim suffered sexual abuse in childhood, work must be done to restructure the cognitions that said abuse may have caused in the pedophile and make him see what the act may mean for his own victims.
The possible perceived inefficiency in maintaining relationships with adults may in some cases be one of the reasons why the pedophile has become interested in minors. In this case too work can be done to reinforce self-efficacy and in training in assertiveness and social skills.
In order to try to modify sexual behavior, different alternatives and programs have been proposed, most of the techniques used being similar to those used in other paraphilias or those used in cases of substance addiction. For example, contingency control is usually an element to use, as well as attendance at support groups and group therapy in some cases.
It has been shown that a combination of pharmacological therapy together with psychological therapy is usually the most successful methodology.
Some techniques applied in the different programs
As we have seen, one of the main ways to deal with a paraphilia from the cognitive-behavioral paradigm is the search for the development of positive connections that allow sexual arousal to be enhanced in non-paraphilic situations. In this sense, the analysis and modification of fantasies is usually used to subsequently carry out masturbatory reconditioning.
In the first case, the patient tries to detect and classify your sexual fantasies into normal and paraphilic, so that the subject tries to maintain the former when he indulges in the practice of onanism. The aim is to gradually make the subject more attracted to more common stimulations, such as contact with adults.
Masturbatory reconditioning consists of when the subject masturbates several times in a row with non-paraphilic stimuli, he indicates out loud the components of the fantasies that do include paraphilic elements. Wanted associate fixation on minors with the refractory period in which there is no excitement, so that little by little an increasingly less activation is generated when faced with the image of minors.
This is usually followed by de-erotize the paraphilic stimulus. To do this, an attempt is made to alter the sequence of action that leads the subject to become excited by the idea of interacting sexually with a minor. Different strategies are designed to generate behaviors incompatible with each of the steps that can lead to said excitement.
Aversive techniques can also be applied such as covert aversion (in which the subject is asked or exposed to imagine situations that would stop them from acting) or olfactory aversion (in response to the subject’s excitement in the face of paraphilic stimuli, they are subjected to odors). unpleasant so that the stimulus is associated with it instead of sexual arousal). Initially electrical aversion was used, but it is not common practice today.
Prevention
Prevention is essential in order to prevent the pedophile from taking action or reoffending if he or she has already committed an act of pedophilia.
It is common for pedophiles live in environments close to places with an abundance of children or work in environments linked to childhood. This is not recommended, since it exposes the subject to the object of her desire and puts both the minors and the individual themselves at risk. It is not about the subject isolating himself, but about not facilitating his access to minors while the treatment lasts.
Considerations
It must be taken into account that treating a paraphilia such as pedophilia is a complex challenge and difficult to achieve. In fact, part of the scientific community considers that pedophilia does not yet have a treatment that allows it to be eliminated, based rather on modifying the behavior of pedophiles so that they do not commit any abuse. However, treating the symptoms alone would not treat the underlying problem, so recidivism is possible. More research is therefore necessary regarding this phenomenon and how to treat it effectively.
Another aspect to highlight is that there is a wide variety of cases with different characteristics: while some suffer and feel guilty for being pedophiles, others consider their actions legitimate or even hold the minor responsible for possible abuse. All these elements must be taken into account and treated differentially.
Finally, it is important to consider that, as indicated above, a pedophile does not have to be a pedophile. Not because he is attracted to minors has he committed or is going to commit abuse, and he has the right to be treated. without being prejudged for something he has not done. However, if a psychologist or other type of professional does not feel qualified to work with a person with this disorder, he or she should refer the person to be treated by another professional.
Bibliographic references:
Balbuena, F. (2014). Mapping pedophilia: effectiveness of treatments and future strategies. Psychology Notes, 32 (3). 245-250.
Salazar, M., Peralta, C., & Pastor, FJ (2009). Treaty of Psychopharmacology (2nd Ed.). Madrid: Panamericana Editorial.
Santos, J.L. García, LI; Calderon, MA ; Sanz, LJ; de los Ríos, P.; Izquierdo, S.; Roman, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE PIR Preparation Manual, 02. CEDE. Madrid.
