Treating child abuse and paedophilia

Paedophile is not a synonym for child molester. While abusing children is a choice, suffering from sexual attraction towards children is not. Many paedophiles are simply born that way, and struggle with their sexual desire throughout their adult lives. Some give in to the desire, and offend, while others never harm children. Drawing this distinction is important for the prevention of child abuse—and recent research has shown that, if you want to understand their behaviour, you need to start with their brains.

Last year, scientists in Germany performed a simple test on paedophiles who had and hadn’t committed sexual offence: they asked the men to press a button as quickly as they could every time the letter ‘X’ flashed on a screen, but not to press when the rarer ‘+’ symbol appeared. As they did this, an MRI scanner took pictures of their brains. Paedophiles who had never harmed children were much better than the sexual offenders at holding back their finger from the button. Interestingly, their brain scans also lit up in certain areas that were not activated in the brains of offending paedophiles. The authors of the study, published in Human Brain Mapping, concluded that these areas influence the men’s ability to suppress an impulse, whether that is pressing a button or, possibly, abusing a child.

Lead researcher Christian Kärgel, from the University of Duisburg-Essen, says studies like these serve to identify patterns associated with offending behaviour, which can be useful predictors in risk assessment and may aid with clinical treatment. Germany is a pioneer of paedophilia treatment: a nationwide project running since 2005 offers voluntary treatment for paedophiles regardless of their offence status. The country is unique in this regard because patient confidentiality protects even people who have committed a direct sexual offence from being reported to the police, provided they are in treatment.

In the UK, there is no mandatory report law. However, NHS workers are bound by their contract of employment to report child abuse, says Juliet Grayson, a psychosexual therapist who treats paedophiles. As a private practitioner, she is guided only by her best judgement and her organisation’s code of ethics. Ms Grayson is chair and co-founder of StopSO, the UK’s only organisation offering treatment to paedophiles who are concerned about their thoughts or behaviour. StopSO’s focus is on preventing paedophiles from acting out, as opposed to treating them once the damage is done. “You treat a rapist very differently from someone who has troubling thoughts,” she says. In her experience, ‘troubling thoughts’ can be cured if the patient became paedophilic through childhood trauma or sexual dissatisfaction. However, many of her clients were born paedophilic, or in rare cases, became paedophilic through a head injury; for them a cure is not possible, but treatment can help them control their desire.

This kind of prevention is only effective if people who are at risk of offending seek help. Unfortunately, paedophilia is only part of the child abuse problem: just as all paedophiles are not necessarily offenders, all child molesters are not necessarily paedophiles. In fact, Dr Kärgel points out, no more than half of child abuse legal cases involve paedophiles. Many non-paedophilic child molesters fit the diagnosis for antisocial personality disorder, he says, which makes them even less likely to seek help.

In a study published last month in the Journal of the International Neuropsychological Society, Dr Kärgel and co-workers found that paedophilic and non-paedophilic child abusers share several psychological impairments not found in non-offenders, whether these were paedophiles or not. This is evidence that some people may be at heightened risk of abusing children due to biological circumstances that have nothing to do with sexual attraction. Understanding what predisposes people to abuse children is a necessary first step towards targeting potential criminals—and providing the treatment they need to avoid that fate.

Bruno Martin is studying for an MSc in Science Communication at Imperial College London

Banner image: MRI scan, Atthapon Raksthaput

Related Posts

Leave a Reply

Your email address will not be published. Required fields are marked *