[Doc. List E9]     [Newsletter E9] 

Treatment, self-help and real therapy

By Dr Frans Gieles

Scheme

Nearly everywhere, pedophilic feelings are seen as a deviancy, as a mental disorder. In most court cases, some kind of ‘treatment’ will be enforced. Which kind of ‘treatment’ should be used?

I want to draw a distinction between three kinds of therapy for people who wrestle with pedophilic feelings.

In my article No Cure but Control, I have described the way of thinking behind this model:

People who have pedophilic feelings, are pedophiles. All pedophiles want only one thing: sex. Anything they say to the contrary is only rubbish – or to say it more politely: rationalizations that only hide an obsessive, instinctive sexual drive. This drive is a time bomb that always ticks. Thus, all pedophiles are pedosexuals. […]

By definition, pedosexuality is a severe personality disorder. Treatment is always necessary, whether the pedosexual is sexual active or not. If he doesn’t do ‘it’ now, he can do 'it' later. [..]

Thus, pedophilia is, by definition, a severe personality disorder. The cause of it is yet unknown to us. Nevertheless, treatment is always necessary. The treatment should consist of unmasking the rationalizations and breaking down the self-justification or self-legitimization. Cure is not possible, one can only learn to control it: No cure but control. […]"

Consequently, the helper and the client are seen as very different kinds of people. So, the methods used are all based on a great difference of power.

Behavioral therapy aims to change the behavior. Plethysmography is a method to measure the swelling of the penis. As far as I know, it is not used in The Netherlands, but it is used in the USA. By this method, the controller can inspect the feelings of the client by showing different pictures. As long as the penis swells at the ‘wrong’ picture, the treatment continues.

The behavior control in the open Dutch clinics requires every client to report in the morning session all he has done the evening or the weekend before, hour by hour. By the way, the clients are not allowed to go about with children in their free time. Judicial pressure will be used if the client is unwilling to avoid children or to tell everything.

Cognitive ‘therapy’ is based on the assumption that the client’s way of thinking is wrong. He has to learn to think in another way. Endlessly repeating the same words, the right thoughts, should bring the right thoughts into the minds of the clients. For example, clients should never use words like ‘child’, ‘relationship’, ‘friendship’ or ‘love’, but only words like ‘victim’ and ‘perpetrator’, ‘criminal act’ and ‘the abuse’. Group pressure is used here. I have read written reports about such sessions. Apparently the group had learned to shout "Thinking error!!" if one of the clients said the wrong words or thoughts.

The path-analysis is based on the assumption that a criminal act does not happen suddenly, but that there is a path to it. Clients should figure out their own path. The assumption is that the path begins with a distortion of the harmony of the person by problems, stress or circumstances. With this disharmony in mind, something happens or some stimulus comes into the situation. The person has a desire to diminish the negative feelings that result. In the course of his seeking a way for this to happen, he thinks the wrong way and he decides to do some things that may not seem important at first. Then, he is in a high-risk situation. The client supposedly has fantasies about the crime and then plans the crime. After they deal with the inevitable shame and guilt, they commit the criminal act. The client should analyze his own path and learn to avoid every step on his path, especially avoiding high-risk situations.

It is possible that some kind of informal self-help takes place in the group during the coffee breaks. It is also possible to add individual real therapy’ to the program.

In my article About Recidivism in Ipce newsletter E6, I have mentioned research that has shown that those who end this kind of treatment successfully have a lower recidivism rate than those who stop or refuse this kind of treatment. So, there is less recidivism.

However, the people I have met during and after this kind of treatment told me another story. Actually, there was recidivism. People appeared to be under high stress and told me they felt alienated. It appeared that way to me as well. In the case of families with children, the family was split in two parts: victim(s) and one parent on one side, the perpetrator on the other .

2. Self-help

Helpers, clients and aim.

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 (pedophile) feelings.

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, even their deeper feelings, but not to go to the unconscious part of the soul.
Members give tangible support to each other in several aspects of life.

We have used this 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 many years with 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 feeling of panic quite quickly in a feeling of hope for the future. We saw them each find his or her way of dealing with their feelings. Some disappeared after that with a "thanks!" Others remained in the group to help the next newcomers.

This is the more classic form of psychotherapy. Here, the helper is a professional counsellor. The roles of helper and client are different, however. The professional may be the guide and the client the searching one, but both are human beings and both realize their right for respect and for equality of power. The aim is not to change the behaviour, but to work with the client’s feelings so that he or she can find out his or her own way of living in harmony with their deeper feelings and with the environment.

The main method here is the individual interview – sometimes group interviews. The helper will ask the client to express all his feelings. Here, attention is paid to the unconscious feelings as well. The client should dare to feel those feelings, which were originally banned to the cellar of the human soul. This may stimulate a period of feeling uncertainty and fear. The client has to go through this phase and will be freer afterwards. Now he or she can search for new ways of living with his or her feelings.

From what people have told me, from what I have experienced, and from what is written in the literature about psychotherapy, insight can grow. The client begins to accept himself or herself. The entire self can grow now. Consciousness grows – and this is a strong human force.

Clearly, the three methods are based upon entirely different views of the human being. In the first one, we saw a more or less mechanical vision of human behaviour. More in the background, we see a view of the human as a sinner, doing wrong things nearly 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.

Whoever wants so have success in a self-help group should logically be able to communicate with others, to listen to others and to speak from his inner world. He also should be able or at least willing to help others. Because the group does not control its members, the control should come from within. So, only clients who have these abilities can expect help from a self-help group.

The same holds more or less for the real therapy method. Here, also an ability to think about one’s feelings and a willingness to be open to the unconscious ones will be required.

In my opinion, the second and third method works well for most of the people who have pedophilic feelings. If some kind of treatment is deemed necessary, these methods should be offered first. The first method should only be used for people who are not able to communicate with others or to control themselves.

In practice, there is not only the question: which kind of treatment will work for this client and how does it work? For the client, there is another question that comes to mind: how to survive?

For the self-help groups, the problem can arise that for some members it is a bit too heavy to listen to the troubles of other members. Some humour should be used then, a break will help also. Otherwise, the group can split itself into subgroups: the more heavy problems in the one, a more light chat in the other.

For the real therapy, this question occurred during the period of uncertainty and doubt that the client has to go through. In the end, there was usually no problem of how to survive.

The question is urgent for the clients who are forced to undergo the first kind of ‘treatment’. This method is felt as a powerful invasion of one’s soul. This is very threatening for the client. It raises intense feelings of fear and anxiety.
Some accept the program and go through it. When I met these persons , it felt like I was talking to a machine rather than with a living human being. Others stop this kind of treatment, but in that case they are not seen as co-operative and are sent back to court. Others have played the game. I did not see real changes – and I also saw recidivism. Maybe the best way is to take the good and forget the bad.

What if you try to subvert?
Then you are seen as not co-operating. The staff will report this to the prosecutor, who will claim that you should go back to jail. The court will enforce this immediately.

Why does self-help not address the problems that real therapy does?
In real therapy, you go to the unconscious level; the self-help method does not. The expressed feelings are also more superficial.

Do you need a professional to uncover these unconscious feelings?
Yes. You should find a good therapist who accepts your real feelings.

Shouldn’t people who go into real therapy have the benefit of having self-help before, during and after?
Surely yes.

Do they follow DSM-4 in The Netherlands?
DSM-4 says that you have a mental distortion only under certain conditions. These are that the client has had sexual contacts or obsessive fantasies in the former six months and/or that he feels distressed by the pedophilic feelings. So, people who have no sexual contacts, have no obsessive feelings and who are not distressed by these feelings are not mentally ill.
The helpers should follow DSM-4 but in practice, they do not. If you should be condemned for events that occurred say 15 years ago and not for recent events and if you say that you can live in harmony with yourself and with society, the court will still send you to a clinic.

Why did The Netherlands change from a far more objective and reasonable climate into the present one?
Because of influences from the English speaking countries.

If you have no choice than to accept ‘treatment’, how does one survive?
Supposedly with a combination of ‘play the game’ and ‘take the good and forget the bad’.

What good is it?
For some people some parts of the program are good: choosing a profession, starting an education, learning to cook, learning to keep order in your budget, choosing free time activities, learning some arts & crafts, creating more harmony in your family relations and your soul, etceteras.

In the case you mentioned, the person refused the ‘treatment’ and yet was not sent to jail: why not?
The Higher Court accepted the refusal in the appeal. The reason for the refusal was that the person refused to send his foster child back to the streets where the kid had come from. In the meantime, the person had started real therapy privately and this was accepted.