April 25, 2011
We wish to respond to the article "Pessimism About Pedophilia" published in your July 2010 issue http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2010/July/pessimism-about-pedophilia
A broader examination of the facts demonstrates that pessimism as a professional response to pedophilia and hebephilia is unjustified and leads to serious undesirable consequences.
People who are attracted to children or adolescents can and do contribute positively to their communities and to society. The non-profit organization B4U-ACT, based in Maryland, consists of such people working together with mental health professionals to promote dialog, the dissemination of accurate information, and the accessibility of compassionate mental health services. The people who are attracted to minors that we know deal with their sexuality in responsible ways and live within the law. They care about the well-being of children and adolescents as much as other people; many are parents themselves.
Most available information about minor-attracted people is inaccurate and incomplete. Most minor-attracted people do not come to the attention of the criminal justice or mental health systems, or when they do, their positive characteristics and contributions are not acknowledged. As a result, descriptions are based solely on non-representative forensic samples and inaccurate assumptions about their feelings and motives. Non-forensic research presents a more hopeful picture, finding that they may be similar to the general population in personality and psychological functioning (Okami & Goldberg, 1992; Wilson & Cox, 1983). In addition, there is strong evidence that their feelings of attraction may be similar to those of people attracted to adults: they may involve feelings of affection, tenderness, and romantic attraction (Blanchard, 2009; Li, 1990b; Sandfort, 1987; Wilson & Cox, 1983).
Treatment can be very effective. Some minor-attracted people connected to B4U-ACT have experienced therapy that helped them to find ways of coping with their sexuality and society's response to it, and to develop fulfilling relationships while living within the law. Such treatment is only effective when the therapist has an accurate understanding of pedophilia or hebephilia, shows empathy and compassion for the patient, and works cooperatively with the patient to develop treatment goals and approaches.
Pessimism, inaccurate and negative characterizations, and a reliance on law-enforcement rather than therapeutic approaches by the mental health profession seriously discourage minor-attracted people from seeking services. Such responses strongly suggest to potential clients that mental health professionals will not understand them, will respond to them with suspicion or hostility, will ignore their mental health needs, or will report their feelings to authorities. In a recent survey of minor-attracted people conducted by B4U-ACT, one respondent said, "I have no way of knowing if they'll call the cops just for telling them my attraction. I wouldn't want to see a psychologist unless I can be truly open and honest. So that's out." Another said, "I can never reveal the fact that I am a pedophile. At least now, they do not know that they hate me, and that is the best that I can ever hope for." Altogether, 54% of 166 respondents cited fears that therapists would report their feelings to authorities or others, 63% feared negative judgmental reactions, and 48% feared they would be treated unethically by therapists. Minor-attracted people learn that they must remain in hiding. This does not protect children.
In short, negative stereotypes and reliance on law-enforcement approaches by mental health professionals intensify stigma, causing serious negative consequences. The very same issue of the Harvard Mental Health Letter also contained an article on this topic: "The Evolving Understanding of Stigma" (http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2010/July/the-evolving-understanding-of-stigma). The article noted that "the constant background noise of stereotyped or inaccurate information contributes to the persistent stigma about mental illness...stigma is important because it contributes to delays in seeking treatment for mental health disorders and problems in accessing care." In B4U-ACT's survey, 40% of respondents said at some point they had wanted services to deal with issues related to their sexuality, but never received them due to fear or stigma. In addition, 27% said they wanted services for other reasons but did not seek them because they could not be honest with a therapist about their sexuality. Sixteen percent also said they had received such services, but these services were inadequate for the same reason.
Adolescents and young adults just realizing they are attracted to minors are especially vulnerable to stigma. Feelings of hopelessness can lead them to depression, substance abuse, and suicidal thoughts. Some of the volunteers at B4U-ACT have experienced this in their youth. Others have been contacted by youth who abused alcohol, engaged in self-harming behavior, or were suicidal due to the stigma of their attraction to children. In the B4U-ACT survey, 44% of respondents had thought seriously about suicide due to their sexuality; the most common age for such thoughts was 16.
Inaccurate stereotypes lead to dehumanization. As the stigma article notes, "people who are stigmatized experience social death when others in society hold attitudes and behave in ways to turn the stigmatized person into an ‘other,’ or a non-person...This leads to dehumanizing treatment, such as making psychiatric patients in China wear outfits like those of prisoners, [or] prohibiting them from participating in family gatherings...If stigma is primarily psychological, then eradicating it may involve psychotherapy to help patients boost self-esteem. If it is more of a social construct, the way to fight it is through awareness campaigns to change public opinion and policies. And if stigma is a moral issue, then it may be necessary to advocate for basic human rights."
We urge mental health professionals to reject pessimistic responses and to join in a hopeful effort both to protect children and to promote the well-being of people who are attracted to minors. Such an effort would involve reducing stigma, conducting non-forensic research on pedophilia and hebephilia, making accurate information available to professionals, the public, and minor-attracted people, and providing visible therapeutic services to minor-attracted people.
Russell Dick, LCSW-C, Chair, Board of Directors, B4U-ACT, Inc.
Richard Kramer, Director of Operations, B4U-ACT, Inc.
Tom Scott, MSW, LCSW-C, Executive Director of Clinical Services, National Center on Institutions and Alternatives
Kevin J. McCamant, Ph.D., Private Practitioner, Clinical and Forensic Psychology, Sex Offender Treatment Provider
Wayne Bowers, President of the Board, Sex Abuse Treatment Alliance
Eric Anderson, Sociologist and Professor, University of Winchester, U.K.
Lee Beckstead, PhD, private practitioner
Marjorie Diehl, ACSW
Amy Craig-Van Grack, LCSW-C
Blanchard, R. (2009). Paraphilia scales from Kurt Freund's Erotic Preferences Examination Scheme. Retreived April 22, 2011 from http://individual.utoronto.ca/ray_blanchard/index_files/EPES.html.
Li, C.K. (1990b). Some case studies of adult sexual experiences with children. Journal of Homosexuality, 20 (1-2), 129-144.
Okami, P. & Goldberg, A. (1992). Personality correlates of pedophilia: Are they reliable indicators? Journal of Sex Research, 29, 297-328.
Sandfort, T. (1987). Boys on their contacts with men: A study of sexually expressed friendships. New York: Global Academic Publishers.
Wilson, G. & Cox, D. (1983). The Child-Lovers: A Study of Paedophiles in Society. London: Peter Owen Publishers.