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Paedophilia

A critique of the long term performance of rehabilitation and treatment programmes and an examination of the stability and immutability of paraphilias with a particular emphasis on paedophilia

This article is dedicated to the citizens of Blackball who have made a courageous stand to keep their community and their children safe.

The residents of Blackball, a small West Coast town in the South Island, were in the news in mid 2005 as a result of their determined campaign to isolate and drive out a recidivist paedophile that had moved into their midst. This had occurred without their knowledge or permission - or that of the Parole Board - but fortunately the local Police saw fit to advise Blackball's residents of what had happened so that they were able to take the appropriate actions (and also fight for a law change.)

This they duly did, causing widespread controversy and drawing criticism from the usual suspects, saying that their actions "do not help in rehabilitating offenders". Amongst those who decried their actions was John McCarthy of the SAFE Network, who said that "90 per cent of sexual offenders did not reoffend", although in other previous press articles and on their website they claim a 95% success rate for their programme of treatment.

John McCarthy and the SAFE Network no doubt do a great deal of valuable work in other areas of prevention of child abuse such as this booklet (in PDF form, requires Acrobat Reader). However, we have some reservations about this claim that 95% of paedophiles can be rehabilitated, or indeed that they can be rehabilitated at all (with the possible exception of the treatments described here)

Taking the Claim at Face Value

Firstly taking the claim at face value, and assuming that 95% of paedophiles can indeed be successfully treated so they do not reoffend - is 95% a satisfactory success rate?

Put this question a different way - if you were offered a flight to an extremely desirable destination for a twentieth of the usual price, and you were advised that this flights on this particular airline had a 95% chance of arrival without crashing - would you take up on the offer? Would anyone - even if the flight was free? Although the failure rate is low, the consequences of failure in this instance are catastrophic and likely to result in fatalities. People know this intuitively, hence this offer of a cheap or free flight would have few takers.

For that matter, most of us get irate with our telecommunications supplier if calls fail at rates well below 5%. And few of us would put up with a car that was only 95% reliable for long. Yet the consequences of these failures are unlikely to be catastrophic, merely annoying.

This is a matter of weighing risk against potential benefits. The outcomes of failure of rehabilitation of paedophiles are certainly more catastrophic than those of failure of a car to start, or a phone or internet connection to operate. Certainly the consequences for the young victims are insidious and lasting. And the benefits to society of having paedophiles back in circulation that have almost certainly been rehabilitated are in our view insignificant by comparison.

The question also arises; which 5% are the ones for which rehabilitation has failed? Until they reoffend, it appears there is no way of knowing for sure. A 5% failure rate is satisfactory for some things - fruitgrowing perhaps, but not aircraft, not automotive components (particularly brakes!), not telecommunications, and most certainly not treatment of paedophiles that are to be released back into the community.

Examining success rates for treatment in greater depth

The claim of a 95% success rate on the SAFE Network website reads in full as follows;
Without treatment, up to 25% of convicted child sex offenders will be re-convicted of another similar offence within 5 years.
With a full treatment programme, the corresponding re-conviction rate has been shown to be 5%

This is derived from this report which offers some interesting insights into the time base over which the success rates of treatment programmes were assessed. "The median time period from end of treatment to end of offence data availability was 4 years."

The success rate of 95% for the SAFE Network programme was claimed to be for the five years after treatment. Yet paedophiles are known to offend at a fairly constant rate over their lifetime, unlike other offenders whose offending tends to tail off with age. A five year period is not in our view a satisfactory guarantee of safety for the community.

Evidence for this may be found in this 2003 pdf Australasian Institute of Criminology Report on Recidivism (Requires Acrobat PDF Reader) ;

A Canadian study followed 570 federally sentenced paedophiles, rapists and incest offenders for an average of 3.5 years post-release. Paedophiles had the highest rates of sexual recidivism, but rapists had the highest recidivism rates across the three offence categories. This suggests that rapists have more generalised criminal careers, while paedophiles may be more specialised (Motiuk & Brown 1996).

Further evidence is here in this report in the detection and reporting of child abuse. ;

REPEAT OFFENDING
Paedophiles are usually long term, repeat offenders. They tend to engage in predictable sexual activity, and their past history is likely to be a good indicator of future behaviour.

Studies of offenders have shown that a small number of men are responsible for a large number of offences and that the reoffending rate for paedophiles who prefer boys is much higher than for those who prefer girls (APA 1994, p. 527).

In 1987, Abel et al. conducted a study of 232 “child molesters”. This study revealed that over their lifetime, these offenders abused an average of 76 child victims each (Abel et al. 1987).

However there is another issue that needs to be addressed in relation to this claim. What has been measured is reconvictions for paedophilia - yet getting convictions for offences of this type is notoriously difficult, due to the furtive nature of the offending in most cases, and the youth and vulnerability of the victims.

In our view, a better measurement would be charges laid against the individuals concerned, rather than successful convictions. But even this is a flawed and unsatisfactory method of measurement - many victims of paedophiles do not manage to overcome their fears and speak out about what has happened to them for a number of years, by which time it will be too late for the purposes of measurement of reoffending.

This and other issues are addressed in this excellent article from the Crime and Consequences site. Amongst the issues adressed was that of the time base used in the studies, on which they had this to say;

Generally, the studies that examined longer time periods have shown higher recidivism rates. While this finding is intuitive, the numbers are striking. A 1997 study showed a 19% recidivism rate among child molesters during a 5 year period that ballooned to 52% during a 25 year study period. Likewise, rapists also had a 19% recidivism rate at 5 years that increased to 39%. Other studies have shown up to a 40% recidivism rate for any crime of violence over 4 years for rapists.

A Canadian study Recidivism in pedophiles (PDF) conducted over a 15 year period from 1992 found overall recidivism rates were 22.8%, 33.9%, and 45.6% for sexual, violent, and any reoffence, respectively. Unsurprisingly, no differences were found between pedophiles and nonpedophiles with respect to recidivism rates.

One of the other issues addressed was that a number of trivial offences were included in the definition of "sexual offending" such as public urination and teenage consensual sex, which would not be true of NZ. These offences when included in recidivism studies have tended to skew the figures lower than they might otherwise be, especially in some American studies.

Another possibility that needs to be faced is that what is actually happening at these treatment programmes is that the offenders are actually comparing notes and pooling their knowledge in order that they can reoffend without being caught. That is, they are learning how to avoid conviction, not avoid the offending. This possibility appears not to have been addressed, and we feel it should be.

The most reliable means of measuring the likelihood of reoffending in our view would be to directly measure physiological responses before and after treatment. This can be done by using a plethysmograph to measure response to various sets of stimuli in the form of images... we leave the rest to your imagination. This is the most direct means of assessing the probability of re-offending, far more reliable than reconvictions (and far less destructive in side effects), and it would be interesting to see the results were this means of measurement used.

What are the outcomes of other treatment programmes?

The results from other programmes appear not to be so promising - perhaps because they are measured over a longer time base. We present here a few examples;

From this extract from "Paedophiles and Sexual Offences against Children" by Dennis Howitt (Loughborough University, UK; John Wiley & Sons - Out of sale);

A cost-benefit analysis of the rehabilitation of child molesters was carried out at the Massachusetts Treatment Center (Prentky and Burgess, 1990). Using a group of inpatient child molesters for whom recidivism data were available, it was possible to compare the recidivism of this group with that of untreated offenders.

The sample was generally of long-term offenders, since a third had a juvenile record and 90% a previous adult record. Over a five-year follow-up period, 25% of the treated group offended again. This recidivism rate was based entirely on the number of criminal charges made. A small number of so-called nuisance sex charges involving non-contact offences such as voyeurism and obscenity were all excluded.

further on in the same document

It is possible that Prentky and Burgess were being generous in their estimates of non-treated recidivism. Finkelhor (1986) reviewed the available recidivism studies of paedophiles, and appears somewhat scornful of their worth, especially their relatively short follow-up periods. The 10 studies reviewed gave figures of between 6 an 35% for sex offence recidivism. While these studies involved various mixtures of treated and untreated offenders, quite obviously the range is sufficient to imply that treatment may not be so cost effective as Prentky and Burgess imply.

From this BBC Documentary

The average stay at the clinic was 11.5 months and residents were closely supervised by staff who were on duty 24 hours a day. During their stay, each offender had a strategy developed to help them deal with risk situations that could occur when they had finished their treatment. A National Probation Service report, released as the Home Office announced its plans for the new centres, found the clinic reduced reconviction rates from 30% to 10%.

further on in the same document

But Professor Christopher Cordess, emeritus professor of forensic psychiatry at the University of Sheffield, does not share the view that the residential centres will help. He said the rehabilitation figures put forward by the government were "hugely optimistic".

"Sex offenders are the most recalcitrant and intractable offenders. And, unfortunately, they are the most difficult to rehabilitate. Much as it grieves me not to support a therapeutic approach, I don't think it will work. People are right not to want these centres near their homes."

A 1997 study by Robert A. Prentky and others, Recidivism Rates Among Child Molesters and Rapists: A Methodological Analysis, had this to say (qoute from this abstract here);

The data indicate that: (a) both rapists and child molesters remain at risk to reoffend long after their discharge, in some cases 15–20 years after discharge; (b) there was a marked underestimation of recidivism when calculating a simple proportion (%) consisting of those who were known to have reoffended during the follow-up period, and (c) there was a marked underestimation of recidivism when the criterion was based on conviction or imprisonment

This article Sex Predators Can't Be Saved (originally published in the New York Times) yields an interesting insight;

A 1992 study of 767 rapists and child molesters in Minnesota found those who completed psychiatric treatment were arrested more often for new sex crimes than those who had not been treated at all. A Canadian survey that tracked released child molesters for 20 years revealed a 43 percent recidivism rate regardless of the therapy. The difference between those simply incarcerated and those subjected to a full range of treatments appears statistically negligible. And the more violent and sadistic the offense, the more likely it is to be repeated.

A recent review of published studies on treating sex offenders in the British Medical Journal found described in this Guardian article (and here at Ananova also) found that treatment programmes had little or no effect.

In a review of published studies on treating sex offenders in the British Medical Journal, researchers said there was huge political and institutional pressure to prove treatment worked. But the editorial's authors, Birkbeck College psychology lecturer Belinda Brooks-Gordon and University of Leicester criminology lecturer Charlotte Bilby, warned evidence from studies which had been done was "only a fraction of the knowledge we need".

Psychological treatment is often mandated in the sentencing decision for sexual offenders. Yet the effectiveness of treatments is debated, and evidence for the efficacy of sex offender treatment programmes is often to readily accepted uncritically," they said. The studies on psychological treatments were too small to be informative, although significant improvements in behaviour were recorded in some groups of offenders, they said.

The longest, largest trial, which followed 231 male offenders guilty of paedophilia, exhibitionism or sex assault for a decade, found a greater proportion who had gone through group therapy were re-arrested than those who did not, but the results were not statistically significant.

further on in the same document the conclusion was clear....

The writers said sexual offending, like many medical conditions, could not be cured.

This study titled "Pessimism on Paedophilia", reported in the Harvard Mental Health Letter, came to much the same conclusion;
There is no cure, so the focus is on protecting children.
This is reiterated in the Key Points of the article; Pedophilia is a sexual orientation and unlikely to change. Treatment aims to enable someone to resist acting on his sexual urges.

From a Hansard extract on the Australian Child Protection Alliance site;

The members of the subcommittee were informed by experts from that State's Department of Corrections and Attorney General's Office of the high level of recidivism among paedophile offenders. We were told in no uncertain terms by the Attorney General's Office that a philosophy of incapacitation is more useful than a philosophy of rehabilitation because rehabilitation does not work except perhaps with young offenders. "Incapacitation" was a euphemism for "incarceration". Of course, people cannot be kept in gaol forever; sooner or later they are released. So I am strongly committed to programs that will minimise the extent of recidivism. Certainly the committee came to the same view in its report on sexual violence. This is a controversial subject, and the committee felt that because people will be released sooner or later it is crucial that something be done to try to lessen the incidence of recidivism.

The experts of Minnesota gave the subcommittee some interesting information. It was informed that in 1993 it cost the State between $US20,000 and $US25,000 per annum to keep a prisoner in gaol, whereas, according to a Federal study, to have a repeat offender out on the street cost $US100,000 per annum. That amount does not relate merely to the cost of crimes and of pursuing and convicting offenders—indeed, there is a very low level of conviction for sexual offences. There is also the personal cost to victims, the trauma occasioned and the provision of health and welfare services. Given that Australia has a higher level of public support for people with health and mental health problems and victims of crime—considerably more support services are provided in Australia than are provided in the USA — I would venture to suggest such a study undertaken here would reveal an even higher cost of having repeat offenders out on the streets.

Is Rehabilitation even possible?

The evidence would suggest that paedophilia is biologically just another sexual orientation, much like heterosexuality, homosexuality, or bisexuality, except that it has hugely evil consequences. This implies that it will not be particularly amenable to change. All the scientific evidence points to sexual orientations - and sexual pathologies - being largely hardwired in the brain either before birth or at an early age.

It is now largely accepted in medical circles that attempts to alter other more benign sexual orientations have had little if any long term success. Unfortunately it appears that the same will be found to be true for pathologies such as paedophilia. Only the most direct physiological interventions such as chemical castration as discussed here would appear to have any hope of long term success. The reason such interventions are more likely to work is that they do not attempt to change the direction or focus of the offenders sexual drive (which is unlikely to succeed) but simply reduce it's quantity or remove it altogether.

We present some evidence as follows;

This BBC article - "Brain wiring link to paedophilia" describes recent research using MRI scans that shows not only that there are significant physiological differences in the brains of paedophiles, but that there links to lower IQ. But, more significantly, it has also been found that paedophiles are three times more likely to be left handed - and left handedness has long been known to be purely biological in origin. The research is further described here and a connection with another purely biological trait, height, is described here and here. Doctor James Cantor who has been leading the study at the Kurt Freund Laboratory of the Centre for Addiction and Mental Health in Toronto has been investigating the neurological basis of paedophilia for almost ten years.

One of the actual research reports, "Cerebral white matter deficiencies in pedophilic men" can be found here in Adobe PDF format. This is long and extremely difficult reading, but there are some images of the MRI scans, two of which we reproduce below

......................... First image - paedophile scans....................................... Second image - non-paedophile scans
The first image is of 3D renderings representing significantly lower white matter volumes in pedophilic men, while the second is of the control subjects

The immutability of paedophilia is indicated in this research report. This report is also interesting, as it shows that paedophilia seems likely to have a physiological/neurobiological cause, demonstrated by a bizarre case of paedophilia induced by a brain tumour!

From an Abstract of research on Brain function and structure in paedophilia from the 27th Nordic Psychiatric Congress;

Background: Paedophilia is recognised as a mental disorder in International and American classification manuals, but clinicians on both sides of the Atlantic are, at best, ambivalent about any case for treatment. Recognition is in operational terms only; there is indication neither of aetiology nor prognosis.

Methods: Medline search for the period 1.1.1960 through 2002 and a PsycINFO search from 1995 until July 2002 and a manual search of selected high impact journals from the general/forensic psychiatric field; from the neuro-imaging/sexuality literature. We included only articles which fulfilled our operational criteria for paedophilia.

Results: From neuropsychological tests, EEG, CT-, SPECT, MRI and PET-scans possible involved brain regions in paedophilia appear the frontal and temporal lobes; the septal and hypothalamic nuclei; the limbic system. There are also indications for hemispheric dysfunction.

Conclusions: PET and (f)MRI in a large, homogenous sample of fixated paedophiles- compared to other subgroups of paedophiles or sex offenders and normals could yield a further insight into the aetiology of paedophilia and sex-offending.

A very interesting research paper done in 1999, Pedophilia and Temporal Lobe Disturbances studied two patients. The abstract is as follows;

Paraphilias may occur with brain disease, but the nature of this relationship is unclear. The authors report 2 patients with late-life homosexual pedophilia. The first met criteria for frontotemporal dementia; the second had bilateral hippocampal sclerosis. Both were professional men with recent increases in sexual behavior. In both, 18-fluorodeoxyglucose positron emission tomography revealed prominent right temporal lobe hypometabolism. These cases and the literature suggest that bilateral anterior temporal disease affecting right more than left temporal lobe can increase sexual interest. A predisposition to pedophilia may be unmasked by hypersexuality from brain disease. These observations have potential implications for all neurologically based paraphilias.

An article titled "Pessimism on Paedophilia", reported in the Harvard Mental Health Letter, drew a similar conclusion;
Pedophilia is a sexual orientation and unlikely to change. Treatment aims to enable someone to resist acting on his sexual urges.

This article excerpted from the Proceedings of the 9th Conference of the Australasian Society for Cognitive Science, held in Sydney in 2009 and reproduced on the Neuroanthropolgy blog; Inside the Mind of a Pedophile is not particularly optimistic about the prospects of a cure either - Pedophilia, like many types of disturbances or diseases, does not have a complete cure. The sexual urges associated with pedophilia may never permanently disappear, and a person’s sexual preference and orientation can be difficult to completely re-orient.

A quote from Dr Stanton E Samenow, author of Inside the Criminal Mind and Straight Talk about Criminals, found at the Stop Child Abuse site;

"If you've worked with sex offenders - people who have committed these offences again and again and again - you know that we do not in psychiatry and psychology have a way to change sexual orientation. People who molest kids, for example, they've done it and they've done it and they've done it and they haven't been caught for a fraction of what they've done. To turn these people back into the community knowing that we have nothing to offer that is going to ensure the safety of kids is unconscionable."

Quoted in Obsession by former FBI agent and profilers, John Douglas and Mark Olshaker

From an article on the clinical implications of paedophilia well down the page with a reference to the World Health Organisation definition ;

Perhaps nothing is so damaging for psychiatric patients than the misconception of child molesters (paedophiles) as being mentally ill. While most of us feel that paedophiles must be 'sick' in the colloquial sense, they are almost never sick clinically.

Paedophiles are no more likely than others to experience being mentally ill: "Paedophilia is not a mental illness, but is regarded as a 'disorder of sexual preference', to quote the World Health Organisation formulation" (Innocence in Danger, 2001). Essentially, paedophilia is just a sexual orientation. People with this orientation have the same moral choices as anyone else i.e. to behave with decency and restraint or to force onto others their preferred type of sex (Szasz, 2002).

Paedophiles frequently claim that they themselves were abused, but as a leading forensic psychologist pointed out: "People do not become abusers and criminals because they were abused" (Samenow, 1998; p.39). According to NSPCC research huge numbers of people have experienced abuse or other victimisation in childhood (Clarke, 2000); however only a tiny percentage later choose to abuse other people.

While we applaud efforts to stop paedophiles re-offending (it seems that a cognitive-behavioural approach - psycho-babble for getting offenders to change their thinking and acting - does meet with some success; although the statstically-aware will note that 're-conviction' is not the same as 're-offending' - see Player, 1992) we deplore the portrayal of sexual deviancy as mental illness.

Significantly, the Wolvercote clinic - Britain's major 'treatment' centre for paedophiles - did not accept as patients people who were mentally ill: "Wolvercote does not accept men for intervention with current active mental illness..." (National Probation Service, p.2).

Victims of Crime Trust spokesman Norman Brennan has reportedly said: "There is no medical cure of paedophiles. It beggars belief why they are released in the first place" (Hull, 2004).

Paedophiles themselves have sometimes expressed scepticism about the feasibility of 'treatment'. As one convicted paedophile commented: "There has been a considerable amount of discussion recently about rehabilitating, even curing paedophiles. I do not believe this is possible. I am a paedophile" (Atherton, 2001).

This suggests that sometimes sex offenders are more realistic than 'experts' about changing their behaviour: jailing for life sex-sadist Paul Beart (who horribly tortured a woman to death) Mrs Justice Hallet said she was "...astonished Beart managed to fool experts into believing he was not a risk". Beart had previously been jailed for five years but released after three, having "passed a sex offenders' rehabilitation course and posed as a model prisoner" (Lakeman, 2001).

Fred Berlin, a psychiatrist and paedophilia expert who has been working in the field for over 30 years "has come to view pedophilia as a kind of innate sexual orientation, not unlike homosexuality or heterosexuality, but fundamentally different in that it must never be acted upon." - from this interview

Another recent piece of news from New South Wales in Australia here has implications that would suggest a genetic basis for paedophilia at least in part. The most pertinent part of the article as follows;

NSW police have uncovered what they believe to be "family networks" of pedophiles operating around the State. A confidential report reveals "a significant number" of child sex offenders in NSW share the same surname. Police have specifically identified three groups with the same last name. They are trying to work out how many of them are related, and how.

The report says an examination of the NSW pedophile register in September showed "a significant number of offenders ... could be grouped into subsets of three with the same last name, presenting the first indications of trends associated with family networks of child sex offenders."

Finally, some last words from the excellent MAKO site in Australia;

"(PAEDOPHILES) DON'T CHANGE THEIR SPOTS. THEY TEND TO REPEAT THEIR PATTERNED BEHAVIOUR..." - Psychiatrist- Dr William Kingswell.

further on in the same document

"Although much is known about paedophilia, paedophiles themselves are difficult to treat and recidivism rates are high."

All in all, it is not the optimistic picture presented by those who expect communities like Blackball to accept recidivist paedophiles in their midst. Ideally we would like to see such offenders isolated from society for life. Our database is a poor substitute for this ideal, but nevertheless having public information on some offenders is an improvement upon having none at all.

Ultimately we feel that it is everybody's best interests to have these offenders locked up permanently, not only the community, and our children, but even the offenders themselves, who will always need to resist the temptation to commit this most foul of deeds.

This article is by Peter Jenkins (the webmaster here). It was an absolutely revolting job doing the research... I had to resist the urge to wash out my DSL modem and my hard drive afterwards... ick ick ick :-(
If you wish to use it in your own work, go right ahead, help yourself. Some acknowledgement of the source i.e. Sensible Sentencing Trust would be appreciated.