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Helping persons with pedophilic feelings

Lecture at the 15th World Congress of Sexology, Paris, June 2001
& the congress of the
Nordic Association of Clinical Sexology, Visby, Sweden, September 2001
 by Dr Frans Gieles.


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. (Cfr. Sandfort's list of Constructive questions)

Note that, according to Nagayama 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?

Three kinds of intervention

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.

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, gives rise to some critical thoughts and, besides, there is more under the sun.

Others and I use 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 # 1 here, became the most chosen way of intervention.

Recidivism rates

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) reoffended at a rate of 12.8%, while men treated after 1980 (treated by present day methods) reoffended at 7.4%. She did a kind of meta-analysis, over viewing 79 studies with nearly 11,000 people in the samples. So, the recidivism rate of the modern methods appear 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." 
I Quoted Eric Lotke here who gives the sources in his footnotes # 1, 2 & 3. 

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 easily to defend the self-help method, #2 here

In general, there are lots of myths about sexual offenders. An article, Myths and Facts About Sex Offenders, August 2000, by csom.org., gives a list with myths and facts.

Karl Hanson & Monique Bussière 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 3 times the general one, but one-third of it.   I'ts simply not true that 90% or more of the sexual offenders reoffend - 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." 

Their articles are in full on the cdRom I present to you here, some of their articles in French; the article of Wakefield & Underwager gives a good summary of Hanson's research. On my list of references, you will find more links to research done in this field. Twenty minutes is not enough time to present them all. The Cd-Rom and the web site I have made have enough room for many bytes of research reports. 

I want to add a thought to these figures: these kinds of figures are gathered with statistical methods, over viewing 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 behaviour it can tell us little about individuals." 
They also write: "Sex offenders are not simply bundles of variables. Characteristics that may be important to actuarials 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 F.G.] intervention is necessary."

There are more myths about pedophilia. I have written a background article and have put it on this CD and the web site with many background references. To mention two of the questions that are in the background of this lecture: 

Even in the flyer made for this congress [Paris, WCS], the issue of pedophilia was mentioned under the heading "Sex and Violence". If pedophilia should be violent per se, I could not defend the self-help method. But it is not, says Tom O'Carroll in an article that over views much research and other literature. The article was rejected by the Committee of this congress - Thou shalt not know this - but here it is.

The question if sexual experiences with adults or adolescents in childhood are always harmful, is also mentioned in the background article. If this should be true, it is difficult to defend the self-help method. But there is far less harm then many people have thought, according to the research of the team of Dr Rind. Negative effects were reported in about 25% of the cases, especially for girls - not 100%, which is widely thought. This research has its own section on the CD. 

For this presentation, I will now present a critical look at the first method. 

A critical view of the 'treatment' 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." (Italics are from me)

2. The method uses much control. As long as the clients not have 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 will the outcome 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 suppress and deny 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 cites 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 a warm lively person and who have been changed into 'a stiff wooden doll' 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 of the former Soviet Union, now used widely in the 'free' Western world.
One should not call this 'therapy' as also Dennis Howitt says (1995, pp 250-251): "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."
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. So I say in my article  No cure but control: "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 (by some women of the first group of feminists) about the rape of women. Women and children, both are only the victims of the wrong men." 

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, over viewing the research on treatment methods (Ch. 7, page 191): "With a situation like this, claims of therapeutic success may sometimes be wishful thinking on the part of the clinician, the client or both."

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 can not 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 self-help method

Helpers, clients and vision

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 names it in his article. Fog talks about "The isolated minority syndrome" that he sees by  people with deviant sexual feelings. "The symptoms of this syndrome include a stereotypic and uncontrolled sexual behaviour 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 aims

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 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". BTW, 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. The website of the group JON gives twenty styles of living and asks the visitor to search for the 21th: their own style of living. 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. BTW, JON does not advise to have sexual contacts with children.

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. 

Support circles

A support circle is a group of people who form a circle, so to speak, around the client. Church communities do this, the JON group does also. 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 he calls it "Circles of support and accountability". "The goal of the Circle", they say, "is not to be therapeutic but to provide support and accountability."
Reverend Hans Visser, from The Netherlands, describes the support that a church community can give. 

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. Like all the articles I mention, it is on the cdRom and the web site I have made.


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 behaviours, continues long after the formal Circle has ended."

Two reoffenders 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 reoffence, 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. Over the course of time, we have given it the name "the four principles and the P.S." This is described in my article "I didn't know how to deal with it", in an article by the Dutch psychiatrist Gerard Roelofs and in Dutch psychiatrist Frank van Ree's article "Are there criteria for a positive experience?" 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 reoffended, 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 reoffence, like most researchers do, the figure is 6.25%: one person in 20 years of working with the self-help method. Further, we can not say that the reoffence is a result of the self-help method per se, because one of them, the sexual reoffender, 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 reoffending. 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. 

Final remarks

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 have 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.

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