How do you intervene psychologically with pedophiles?

It is not uncommon to read in the press or hear on the news that network participants have been arrested related to child pornography or cases in which an adult subject has sexually abused minors age. Most of these subjects are pedophiles, people who feel sexual attraction to minors.

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

• Related article: "Pedophilia (sexual assaults on children): in the mind of the pedophile"

Brief previous definition: what is pedophilia?

pedophilia It's a paraphilia, sexual inclination disorder. or the choice of the object in which the subject presents for at least six months a series of recurring fantasies and persistent of a sexual nature in which the object of their desire are prepubescent individuals, generally under thirteen years of age age. These fantasies generate in the subject himself a high level of tension, discomfort or alteration of the usual functionality.

For a subject to be considered a pedophile, it is necessary that they be at least sixteen years old and that they be at least five years older than the prepubescent individual. It is important Do not confuse pedophilia with pedophilia, the first being the existence of sexual attraction towards minors while the second indicates that real sexual abuse has occurred. In other words, a pedophile does not have to take action: not all pedophiles are pedophiles (nor are all pedophiles have to be pedophiles, there being sexual abuse of minors for reasons other than attraction sexual).

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

Although it is considered a disorder, in most cases the subjects who suffer from it are fully aware of their actions, enjoying freedom and will to carry out or not carry out the abuses sexual. That is why most of them are criminally imputable subjects. Despite this, there are exceptions in which other mental disorders occur.

• Related article: "The main sexual and psychosexual disorders"

types of pedophiles

There are many different types of pedophiles. Some experience deep discomfort and guilt because of the attraction they feel, while others consider that it is the right thing to do and justify their performances and even in some cases subjects with sadistic tendencies and psychopaths.

In some cases they have themselves been sexually abused in their childhood, while others have not. Sometimes the pedophile feels a romantic attraction towards the minor in question, while in other cases it is a purely sexual interest.

When establishing a treatment, all these characteristics can greatly influence the strategies to be used and their possible effectiveness.

• You may be interested in: "Differences between pedophilia and pedophilia"

Pedophilia treatment perspectives

The treatment of pedophilia is a complex reality that throughout history has received different considerations and in which different techniques have been used, acting from both psychology and medicine.

It must be taken into account that pedophiles generally They come to the consultation due to environmental pressures or by court order, there being few cases in which they do it of their own free will. This makes the treatment complex and there may be little adherence to it.

Medical treatments: pharmacology and surgery

Medical treatments for pedophilia can focus on two large groups: pharmacology and surgery. Many of the pedophiles who fear sexually assaulting minors or who do not want it to happen again request this type of intervention.

The use of pharmacology focuses on the control of sexual desire, reducing arousal, through hormonal regulation of individuals.

The two most commonly used items historically have been cyproterone acetate, which blocks androgens and therefore reduces testosterone production, and medroxyprogesterone acetate, which decreases androgens and therefore testosterone production. Psychoactive drugs such as tranquilizers and antipsychotics (highlighting haloperidol). Fluoxetine has also been used, but it only causes clear improvements in subjects with compulsive features.

As far as surgery is concerned, its use is controversial and risky, since it can mean serious permanent impairment to the normal functioning of the subject. at the same time that its effectiveness is questionable, since even if the subject cannot have erections, it is possible to carry out abusive practices that do not include the use of gonads. In this sense, either physical castration or the elimination of the nuclei of the hypothalamus ventromedially in the brain.

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

psychological treatments

The psychological treatment of the pedophile must take into account, first of all, that you are in front of a patient regardless of whether or not she has committed sexual abuse. The professional who treats them should take into account that her attitude towards the individual can be decisive at the time. Is about Maintain a non-judgmental attitude and focused on getting her back.

It is essential that the treatment carried out be adapted to each case, since there is a great diversity of factors that can influence each person and cause the treatment to be more or less cash.

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

tackling the problem

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

It is necessary to work on aspects such as the significance for the subject of fixation by minors, the existence of possible causal elements and their treatment, if any. For example, if the victim suffered sexual abuse in childhood, work should be done to restructure the cognitions that Such abuse may have provoked the pedophile and made him see what the act can mean for his own victims.

The possible perceived inefficiency in maintaining relationships with adults may in some cases be one of the causes that causes the pedophile to have been interested in minors. In this case too work can be done to reinforce self-efficacy and in training assertiveness and social skills.

In order to try to modify sexual behavior, different alternatives and programs have been proposed, most of them being The techniques used are similar to those used in other paraphilias or those used in cases of addiction to substances. For example, contingency control is usually an element to use, as well as assistance to support groups and group therapy in some cases.

It has been stated that a combination of pharmacological therapy together with psychological therapy is usually the most successful methodology.

Some techniques applied in the different programs

As we have seen, one of the main ways to deal with a paraphilia from the cognitive-behavioral paradigm is the search for a development of positive links that allow potentiating sexual arousal in non-paraphilic situations. In this sense, the analysis and modification of fantasies is usually used to later carry out a masturbatory reconditioning.

In the first case, it is intended that the patient detect and classify your sexual fantasies into normal and paraphilic, so that the subject tries to maintain the former when practicing onanism. The aim is to gradually get the subject to be more attracted to more common stimulations, such as contact with adults.

Masturbatory reconditioning consists in that when the subject masturbates several times in a row with non-paraphilic stimuli indicate out loud the components of the fantasies that do include elements paraphilic. Wanted associate fixation by minors with the refractory period in which there is no excitement, so that little by little an activation is generated less and less before the image of minors.

This is usually followed by deerotize the paraphilic stimulus. To do this, an attempt is made to alter the sequence of action that leads the subject to become aroused by the idea of ​​sexually interacting with a minor. Different strategies are designed in order to generate incompatible behaviors with each of the steps that can lead to such arousal.

Aversive techniques can also be applied, such as covert aversion (in which the subject is asked or exposed to imagine situations that would stop him from acting) or the olfactory (before the excitation of the subject before paraphilic stimuli, he is subjected to unpleasant odors so that the stimulus is associated with it instead of excitation sexual). Initially, electrical aversion was used, but it is not currently a common practice.

Prevention

Prevention is essential in order to prevent the pedophile subject from taking action or reoffending if he has already committed an act of pedophilia.

Pedophiles often live in environments close to places with an abundance of children or work in environments linked to childhood. This is not recommended, since the subject is exposed to the object of her desire and puts both minors and the individual at risk. It is not about isolating the subject, but about not facilitating their access to minors while the treatment lasts.

• Related article: "Prevent and detect child sexual abuse in time"

Considerations

It must be taken into account that treating a paraphilia such as pedophilia is a complex and difficult challenge to achieve. In fact, part of the scientific community considers that pedophilia still does not have a treatment that allows eliminate it, basing it rather on modifying the behavior of pedophiles so that they do not commit no abuse. However, treating the symptoms by themselves would not treat the underlying problem, so recidivism is possible. Therefore, more research is necessary regarding this phenomenon and how to treat it effectively.

Another aspect to highlight is that there is a wide variety of cases with different characteristics: while some suffer and they feel guilty for being pedophiles others consider their actions legitimate or even hold the least possible person responsible abuses. All these elements must be taken into account and treated differently.

Finally, it is important to consider that, as indicated above, a pedophile does not have to be a pedophile. Not because he is attracted to minors, he has committed or is going to commit abuse, and he has the right to be treated without being prejudged for something you haven't done. However, if a psychologist or other type of professional does not feel qualified to work with a person with this disorder, they should refer them so that they can be treated by another professional.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Massón, Barcelona.

• Balbuena, F. (2014). Mapping pedophilia: efficacy of treatments and future strategies. Psychology Notes, 32 (3). 245-250.

• Salazar, M., Peralta, C., & Pastor, F.J. (2009). Treatise on Psychopharmacology (2nd Ed.). Madrid: Editorial Panamericana.

• Santos, J.L.; Garcia, L.I.; Calderón, M.A.; Sanz, L.J.; de los Rios, P.; Left, S.; Roman, P.; Hernangomez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE PIR Preparation Manual, 02. YIELD. Madrid.