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Paedophilia is a fate and not a choice, German doctor says

By Divya Chandrababu
Times of India
March 14, 2017

http://timesofindia.indiatimes.com/city/chennai/paedophilia-is-a-fate-and-not-a-choice-german-doctor-says/articleshow/57619901.cms

Dr Klaus Beier

Paedophilia is a diagnosis and not a crime, says Dr Klaus Beier, who leads a programme in Germany to treat paedophilically inclined adults and juveniles.

In an interview to TOI, Beier says to protect children, a healthy society must accept that "paedophilia is a reality amongst us and we need to work towards prevention."

With India's legislation mandating reporting which overrides patient confidentiality, he says those found offending must be given stringent punishment but we must simultaneously focus on preventing this crime by investing in assessing and treating juvenile offenders and reaching out to adults before they act out on their sexual urges towards children.

Beier, director of Institute of Sexology and Sexual Medicine, Berlin, was touring cities in India to train professionals and the institute is planning to roll out an online programme in India for self-referred paedophilically inclined men. He was in Chennai earlier to deliver a lecture on preventing child sex abuse and use of child sex abuse images.

Excerpts

You have been researching on paedophilia and child offenders in Germany since the 90s. From your findings, what are patterns that you see continuing and recently emerging?

I started follow up studies with convicted sex offenders, more than 25 years ago, and these studies clearly show that the recidivism rate (probability of reoffending) is very high for paedophilically inclined offenders. According to WHO, paedophilia is a diagnosis under the international classification of diseases and you can assess this very well with a cooperative person who will tell you about his fantasies during masturbation and he would say that prepubescent girls or boys (sometimes both) come up in his thoughts when he is sexually aroused. But contrary to common beliefs not every pedophile commits sex offences against children and not every sex offender is a pedophile.

But, unfortunately, more and more paedophilically inclined men are starting with the use of child abuse images. We can see this in the case of juveniles too because the sexual preference structure like paedophilia manifests during puberty and remain stable throughout life. In Germany, we have now a specialised programme for juveniles (between 12 and 18 years) with sexually conspicuous behaviour and/or fantasies, indicating preference particularities in terms of interest for prepubescent body schemes, where 15-year-old boys have confessed to using this material because they are fantasising about children.

They say, "I know what is going on in the internet. There is a lot of pornographic material concerning adults but I'm only interested in pre-pubescent body schemes and I'm looking for girls." And there is an incredibly high number of images. People use these pictures for masturbation and we have to reach out for them before they start. We need to raise awareness that paedophilia is a reality in our society and reach out to parents to inform them that we can help their sons control their behaviour.

In Germany, in the last ten years, there is growing awareness in the society. At the beginning, many were sceptical if we will reach anybody in the self-motivated voluntary programme that we are doing. Many are surprised that we have a lot of contacts at the institute. Approximately we have 2,500 people who have contacted us in Berlin since the year 2005 when we started the prevention approach for adults.

The critical voices are going down and the milestone is that German politicians are now convinced that it is a good idea and voted for a law to finance treatment for self-motivated, help-seeking pedophilically inclined individuals through the health insurance system. This is an important step and will help more people to show up in this programme.

With travelling child sex offenders and the sharing of child abuse images, these crimes are now transnational. Do you believe other governments must work together on the issue? How do you think Germany's programme to treat paedophilia can be emulated elsewhere?

I am convinced that we need to combine efforts on an international basis. I'm highly motivated to do what I can to find ways for culture adapted ways for prevention programmes as you cannot just transfer from one country to another as one model. For instance, paedophilically inclined men who have already acted out will not show up due to the mandatory report law in India as a therapist would need to report.

In Germany, we don't have that report law which is a huge advantage. But, we have to face the fact that India has this law. In my opinion, we can do two things. One, we can reach out to potential offenders. This is a small proportion, about 10-15% in the whole group. But, it really is enough and worth it as otherwise they will start to use child abuse image or abuse children.

Another point is to help at least those ones who are already known to the justice system and to run assessments in order to prevent further offences, which are very likely in the case of a not-treated paedophilia. If you offer them appropriate ways of dealing with their inclination, you can at least reduce this risk. And again, it would be necessary to start as early as possible. I would strongly recommend in investing in assessment and treatment of juvenile sex offenders.

In Germany, what is your approach to treat paedophilia?

We use cognitive behavioural techniques to train and enhance victim empathy and impulse control. We can change cognitive distortions and analyse the problematic behaviour by identifying risk factors. For example, what are the emotional regulation deficits producing this behaviour and what would be the alternatives. We are concentrating on enhancing social backup to improve their relationships. Social isolation is a risk factor for acting out. We integrate acquaintances, families and partners.

Lastly, we use additional pharmaceutical options for reducing sexual urges which is necessary in approximately 20% of the patients. But please be aware -- everything on a voluntary basis without any pressure from the justice system because the participants in our programme are not known to the legal authorities. We call this "Dunkelfeld" (literally: dark field) and it is a fact that most of sexual offending against children occur in the Dunkelfeld.

Do those with paedophilic instincts know that approaching a child is wrong?

Yes, it is an important message that everybody should know that if an assessed person is paedophilically inclined it does not mean he is not fully responsible for his behaviour. For many people there is allegedly a connection between psychic disorder and irresponsibility. For sure not so in paedophilia: You can be paedophilically inclined and despite this fact, you are fully responsible and you can control you behaviour. So, in most cases of pedophilia there is no diminished culpability, in a legal aspect.

What are the stigmatisations and myths related to paedophilia that you would want people to know?

One huge myth is that one will be able to change his sexual fantasies by power of his will. Most people believe "What is the problem, the guy should concentrate on women." They think it is a choice. But it is a fate, not a choice. Another myth is that every person paedophilically inclined will act out.

If a drug addict refuses his neighbour's offer for wine, he is thought of as being smart and careful. But if a neighbour asks you to watch her son and you admit that you cannot help as you are a paedophile and this would be a socially not-controlled situation and it is a risk, you would be doing the right thing. But you would be damaged forever in the neighbourhood. These are real stories from our patients.

Even after treatment, medication, does empirical data say that they are likely to reoffend?

Those not treated have high probability to reoffend. But, the probability is very low if they are treated and that's why it is important to reach out. Working with juveniles has been extraordinary successful as they accept guidance, they would like to be part of the society, be loved by parents and social surroundings so that they try to find a way to cope with this inclination. You can train behaviour in a better way in a developing brain.

So, early signs and awareness is key. To state that paedophilia is a diagnosis and only offenders not fantasies must be condemned is controversial in societies. How do you convince societies?

We need awareness, social programmes, sex education for juveniles about the basics of sexuality. Nature likes variety but culture hates it. We have to understand it otherwise there will be high prevalence of child sex abuse. It will damage your next generation. 20% of children in India (according to ministry of women and child development) are experiencing contact offenses. That's a huge number and it will affect biographies, health, life quality, relationships and productivity.

The long-term effects of child sexual abuse is clearer from these studies. It is not a good idea for a healthy society to ignore or resist it. You have to think about how to help the victims, how to prevent sexual offences against children, reasons for these offences and how to stop. There are two types of offenders- those paedophylically inclined and those who use children as substitutes due to the lack of relationships with those their age. Maybe repression such as negative association with masturbation, low possibility of sexual relationships before marriage could create circumstances under which more young men act out against children without being paedophilically inclined. To a victim it doesn't matter whether the abuser is paedophilically inclined or not. A lot of children in India are victims within the family systems and these go unreported. And of course even as family member you can be pedophilically inclined. The prevalence of paedophila in males is according to population-based studies approximately 1 %, which would be a high number of individuals in India.

Chennai reported the most number of crimes against children in Tamil Nadu in 2015. A large number of them were under the Protection of Children from Sexual Offences (POCSO). How do you think law enforcement agencies and professional treatment can coordinate? There should be no contradiction between law enforcement and the promotion of preventive strategies - both can be done. I would vote for a good deterrence and law enforcement. You need to know that there will be consequences. But I would also vote for preventive measures, particularly primary prevention. Even in countries with mandatory report laws like India you could at least focus on pedophilically inclined potential offenders in the Dunkelfeld for preventive purposes.

Paedophilia is a diagnosis and not a crime. Those acting on it should be condemned. The German Dunkelfeld Prevention Project shows that it is possible to reach out to law-abiding pedophiles and to encourage these men to control their behaviour and not harming others - which means there will be no victims.




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