Quote# 137435A psychiatric perspective on pedophilia
(it applies to all paraphilias, but since the discourse is mostly focused on MAPs I’m doing it about that)
There is a spreading misunderstanding about paraphilias and specificly about pedophilia. People keep mixing and cofusing concepts, calling mental illness to things that aren’t or the opposite, trying to turn healthy people in mentally ill in some kind of twisted idea of “therapy”. So I just want to make clear the three basic concepts and how therapists work over this.
Also, I have seen tons of antis (bringing this from Tumblr, but it’s the same outside there) saying MAPs they should seek therapy but at the same time they claim that if a MAP doesn’t hate themselves then they is gross and nasty. This shows how little antis know about actual psychiatry and how therapy works, so I would like to help everyone here to understand therapy and achive with that a better understanding of sexuality, mental illness and improving our work towads increasing the number of healthy, happy people and decreasing child abuse in all its ways. So here we go, the three basics concepts:
-POCD: This is NOT pedophilia. The person doesn’t feel attracted to minors, just have intrusive thoughts that are egodystonic and totally unwanted. They know they aren’t going to hurt children but they feel awful about their thoughts and have to do compulsive actions to feel better. This is just as any other OCD, it doesnt matter what are the thoughts about, csa, get an infection, kill your family… The important thing here is treat the OCD (what sadly is really hard), but nothing to do with pedophilia. These people aren’t MAPs and this isn’t their sexuality, this doesn’t have anything to do with pedophilia, but some people mistake it for “pedophilic disorder”, another concept I’ll explain later.
-Pedophilic sexuality (or pedophilic sexual orientation): This is just the sexual attraction towards children (<13 y/o in DSM V terms). It just implies a person who has this specific sexuality. They feel aroused for children, but that doesn’t mean they are going to act over these feelings irl. In this case we consider pedophilia just as any other sexuality. It isn’t a disorder and it doesn’t have treatment. We have a person who is aroused by children but doesn’t feel bad about it and never acts over it in real life. They DON’T have a disorder and they don’t need therapy.
Pedophilia is not a mental illnes, but it isn’t a moral degeneration or abomination either. It is just a variation of human sexuality, normal and never a problem itself. In fact, quoting Dr. Fred S. Berlin (associate professor in the Department of Psychiatry and Behavioral Sciences, at The Johns Hopkins University School of Medicine):
[…] the American Psychiatric Association (APA) has stated its intention to remove the term Pedophilic Sexual Orientation from the diagnostic manual.2 Removing that term in response to public criticism would be a mistake. Experiencing ongoing sexual attractions to prepubescent children is, in essence, a form of sexual orientation, and acknowledging that reality can help to distinguish the mental makeup that is inherent to Pedophilia, from acts of child sexual abuse.
This is the source, really interesting and informative, I encourage you to read it. Also, the DSM V stated clearly the difference between a pedophilic sexuality and a pedophilic disorder.
-Pedophilic disorder: Here we have a person with a pedophilic sexuality (so, a MAP) BUT who also feels distressed about it (hates themselves, feels anxious, depressed, thinks they are awful and going to hurt children even if it isn’t true…) OR have self-control problems or some distortion that leads them to actual abuse. On DSM terms:
A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).
B. The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.
C. The individual is at least age 16 years and at least 5 years older than the child or children in Criterion A.
Note: do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old.
In first case I mention you need to treat the distress. The goal of therapy isn’t change or lesser the attraction, as some people think. And for sure, it isn’t teaching pedophiles that they are terrible and awful and should hate themselves either. Pedophilia is just a sexuality and sexualities can’t be cured (trying that is conversion therapy and that doesnt work at all). So what you try in therapy is to teach these people that their attractions are ok, treat the anxiety and depression, help them to accept themselves and have a healthy sexuality without harm anyone (like, masturbation with fantasies, consensual sex with adults if they aren’t exclusive MAPs, rp, simulated cp is used in some countries and it has showed to decrease irl csa, so that is used too, etc).
Most of these MAPs are scared of themselves and even when they know they won’t never harm a child they can be afraid to lose control due to a depressive cognitive distortion (that does not indicate a real loss of control, but an obsessive thought over loss of control itself) so you have to work over that too. And about the second group, if they have self-control problems you work in therapy and maybe with some drugs over it. Also, if they have already abused an actual child then therapy focused too in self-control and sometimes lesser their libido, but that is forensic psychiatry field, not just psychiatry and doesn’t have anything to do with non offending maps, the ones I’m focusing here.
So basically, to summarize, people who are MAPs and feel bad about it should and deserve get help. But the help is only going to treat their distress, so the goal is turning a pedophilic disorder in a pedophilic sexuality, never change the attraction, that is always going to be there. We should remember that most child abusers aren’t even MAPs, they dont feel attracted to children (2/3 child abusers are “opportunistic” offenders, so pedophiles aren’t the actual cause of csa), and the ones who are MAPs have different brains that the NOMAPSs (offending MAPs show more lack of self control, empathy, understanding of consequences of their acts, cognitive distorions… While NOMAPs don’t show this, so they dont have the main risk factors for csa).
Tumblr MAP community is really a good thing that therapists should support and encourage. Universalization is a kind of therapy, in fact (this is the awareness that their sexuality is a state shared with other human beings and that it is compatible with mental health and not offending). MAP community doesnt’ say children can consent or that we should abolish AOC or something like that. No, they are just MAPs who are trying to accept themselves and living their lifes in a harmless way. They are working to treat their pedophilic disorder (not their pedophilic sexuality, that, again, can’t be treated)
in a support group, what is really good and positive. We can’t forget that MAPs are a high suicide risk group, specially minors, and they deserve support and positivity. People can’t choose their feelings, but they can choose their actions. A MAP doesn’t choose feel attracted to children, but they can choose never harm a child and have a happy life, and that is what therapists and the ones who works in csa prevention try.
If we want to talk about the actual risk factors for csa this aren’t pedophilia. Risk factors for abuse, all kind of abuse, are lack of self-control, low empathy, cognitive distortions, sadism… Sexual attraction is not an actual risk factor because people have morals and another traits that help them to understand what is wrong irl even if they like it in fantasy. So if we want to take really effective actions to prevent csa and protect children we need to work over the actual risk factors and try to understand pedophilia as much as we can.
Hating and attacking MAPs and the MAP community is not going to help anyone, only cause harm. NOMAPs who don’t have these risks factors aren’t going to abuse a children under any circunstance, so we have to help them to understand that too and love themselves, so they can have a plenty, healthy life as we fight all together against the real problem of child abuse. Throwing innocent and mentally ill people under the bus while the actual abusers (again, mostly not pedophiles, just opportunistics) keep harming children without anyone paying attention is not going to help children.
Demonization and misunderstading aren’t going to help children. Understanding, universalization, actual knowledge, acceptation and the right therapies are the things that are going to help us to save children and that we should use as weapons on this, not the visceral, hateful speech without base that antis like to use.
Please, educate yourself in these important issues before get into them or you could be more harmful than helpful.
Aleska Kolja, Medium 2 Comments
[3/23/2018 8:02:19 AM]
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