How do you intervene psychologically with pedophiles?

It is not uncommon to read in the press or hear newsletters that have detained participants in child pornography-related networks or cases where an adult subject has sexually abused minors. Most of these subjects are pedophiles, People who feel a sexual attraction to minors.

Pedophilia is a serious problem known since antiquity which can have serious effects both for the pedophile himself and for his object of desire if he manages to put his fantasies into practice. In addition, it is a problem classified as a mental disorder, and as such is related to the intervention of professionals in psychology. How do you intervene psychologically with pedophiles? Let’s start with the basics.

    Brief definition: what is pedophilia?

    Pedophilia it is a paraphilia, a disorder of the sexual inclination or the choice of the object in which the subject presents for at least six months a series of recurrent and persistent sexual fantasies in which the object of his desire are prepubescent individuals, generally under the age of thirteen. These fantasies generate in the subject himself a high level of tension, discomfort or impairment of usual functionality.

    For a subject to be considered a pedophile, he must be at least sixteen years old and at least five years older than the prepubescent individual. It is important do not confuse pedophilia and pedophiliaThe first being the existence of sexual attraction to minors while the second indicates that actual sexual abuse has taken place. In other words, a pedophile does not have to act: not all pedophiles are pedophiles (and not all pedophiles need to be pedophiles, with sexual abuse of minors for reasons other than sexual attraction) .

    Most pedophiles are middle-aged men, Usually heterosexual, who generally have ties to the victims (family, neighborhood or work) and who generally do not use violence to approach their object of desire. However, there are also pedophiles (who statistically tend to have a preference for adolescents and children under the age of three), as well as pedophilia targeting children of the same sex.

    Although it is considered a disorder, in most cases, subjects who suffer from it are self-aware of their actions, enjoying the freedom and willingness to commit sexual abuse or not. This is why they are mostly crime subjects. However, there are exceptions in which other psychic alterations occur.

      Types of pedophiles

      There are many types of pedophiles. Some feel deep discomfort and guilt by the attraction they feel, while others see it as a good thing and justify their actions and in some cases may even find themselves subject to sadistic and psychopathic tendencies.

      In some cases, they themselves were sexually abused as children, while others were not. Sometimes the pedophile feels a romantic attraction to the child in question, while in other cases it is a purely sexual interest.

      When setting up a treatment, all of these characteristics can greatly influence the strategies to be used and their eventual effectiveness.

        Perspectives on the 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 employed, acting from both psychology and medicine.

        It should be noted that generally pedophiles they go to the consultation because of environmental pressures or by court order, Having few cases in which they do it of their own accord. This makes the processing complex and there may be little respect.

        Medical treatments: pharmacology and surgery

        Medical-type treatments for pedophilia can focus on two main groups: pharmacology and surgery. Many pedophile subjects who are afraid of sexually assaulting minors or who do not want it to happen again are calling for such interventions.

        The use of pharmacology focuses on the control of sexual desire, reduction of arousal, thanks to hormonal regulation individuals.

        The two most commonly used elements historically have been cyproterone, which blocks androgens and therefore reduces testosterone production. and medroxyprogesterone acetate, Which decreases androgens and therefore testosterone production. Psychotropic drugs have also been used as tranquilizers and antipsychotics (especially haloperidol). Fluoxetine has also been used, but only causes marked improvements in subjects with compulsive characteristics.

        Regarding surgery, its use is controversial and risky, because it can constitute a serious permanent deterioration of the normal functioning of the subject while its effectiveness is questionable, even if the subject cannot have erections. It is possible to practice abusive practices that do not include the use of the gonads. In this sense, physical castration or removal of the nuclei of the ventromedial hypothalamus in the brain is used.

        A big problem with this type of treatment is that basically this is not the basic problem, but its manifestations. In fact, even if there is no sexual desire, some subjects subjected to these interventions may continue to harbor different types of abuse.

        psychological treatments

        The psychological treatment of the pedophile must take into account, first of all, whether he is dealing with a patient regardless of whether or not he has committed sexual abuse. The professional who tries to keep in mind that his attitude towards the individual can be decisive in the moment. This is maintain an attitude in which the subject is not judged and focused on his recovery.

        It is essential that the treatment given is appropriate for each case, as there are a wide variety of factors that can influence each person and make the treatment more or less effective.

        These treatments, carried out in the form of various programs, must take into account not only the modification of sexual preferences but also the link between the pedophile and the child. looking for cognitive changes. The most widely used paradigm in this type of case is usually the cognitive-behavioral paradigm, although other approaches have also been used, such as psychodynamics.

        Solve the problem

        One of the first approaches to consider is the development of positive connections through social skills and empathy training. The use of cognitive restructuring and stress management training is recommended (since in some cases impulsive behaviors are linked to anxiety impulses).

        It is necessary to work on aspects such as the importance for the subject of fixation by minors, the existence of possible causal elements and their treatment if necessary. For example, if the victim suffered sexual abuse as a child, work should be done to restructure the cognitions that this abuse may have caused in the pedophile and make him see what the act may mean for his own victims.

        The possible perceived ineffectiveness of maintaining relationships with adults can in some cases be one of the causes that lead the pedophile to take an interest in minors. Also in this case work can be done to build self-efficacy and in assertiveness and social skills training.

        In order to try to modify sexual behavior, various alternatives and programs have been proposed, most of the techniques used being similar to those used in other paraphilias or to those used in cases of drug addiction. For example, emergency control is generally an element to use, as well as participation in support groups and group therapy in some cases.

        It has been shown that a combination of pharmacological therapy and psychological therapy is generally the most effective methodology.

        Some techniques applied in the different programs

        As we have seen, one of the main ways to approach a paraphilia from the cognitive-behavioral paradigm is the search for the development of positive links that help promote sexual arousal in non-paraphilic situations. In this sense he usually uses the analysis and modification of fantasies later to achieve masturbatory reconditioning.

        In the first case, we try that the patient detect and classify your sexual fantasies into normal and paraphilic, So that the subject tries to maintain the first when he presents himself to the practice of onanism. The goal is to gradually make the subject more attracted to more common stimuli, such as contact with adults.

        Masturbatory reconditioning consists in that when the subject repeatedly masturbates followed by non-paraphilic stimuli aloud indicates the components of the fantasies which yes include paraphilic elements. is being sought associate the fixation of minors with the refractory period in which there is no excitement, so that little by little less and less activation is generated in front of the image of the miners.

        Then usually go to deserotize the paraphilic stimulus. To do this, he tries to modify the sequence of actions that leads the subject to arouse the idea of ​​interacting sexually with a child. Different strategies are designed to generate behaviors incompatible with each of the steps that can lead to this excitement.

        Aversive techniques can also be applied, such as covert aversion (in which the subject is invited or exposed to imagine situations that would slow him down when he acts) or olfactory (in the face of the subject’s excitement to paraphilic stimuli is subjected odors so that the stimulus is associated with it instead of sexual arousal). Initially, electric aversion was used, but today it is not a common practice.

        Prevention

        Prevention is essential to prevent the pedophile from acting or relapsing if he has already committed an act of pedophilia.

        This is common for pedophiles live in environments close to places with many children or work in environments related to childhood. This is not recommended, as it exposes the subject to his object of desire and endangers both the child and the individual. It is not a question of isolating the subject, but of not facilitating its access to minors for the duration of the treatment.

          considerations

          It should be remembered that treating paraphilia as pedophilia is a complex and difficult challenge. Indeed, part of the scientific community considers that pedophilia does not yet have a treatment to eliminate it, based rather on modifying the behavior of pedophiles so that they do not commit any abuse. However, treating the symptoms alone would not address the underlying problem, so recurrence is possible. Therefore, more research is needed on this phenomenon and how to deal with it effectively.

          Another aspect to note is that there is a wide variety of cases with different characteristics: while some suffer and feel guilty for being pedophiles, others regard their actions as legitimate or even hold the minor responsible for possible abuse. All of these must be taken into account and treated differently.

          Finally, it is important to consider that, as stated above, 1 pedophile should not be a pedophile. Not because he is attracted to minors, he has committed or will commit abuse, and he has the right to be treated without being harmed by something he didn’t do. However, if a psychologist or other type of professional does not feel able to work with someone with this disorder, they should be referred for treatment by another professional.

          Bibliographical references:

          • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
          • Balbuena, F. (2014). Mapping of pedophilia: effectiveness of future treatments and strategies. Notes on Psychology, 32 (3). 245-250.
          • Salazar, M., Peralta, C., and Pastor, FJ (2009). Treatise on psychopharmacology (2nd ed.). Madrid: Pan-American Editorial.
          • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.

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