amapsychologist

Basic, sensible, sexual education which focuses on consent. Not this 'abstinence only' shit some try and use in order to pretend that sexual behavior is not normative for adolescents. Understanding when consent is and is not provided should be part of that education. Understanding that consent is a moving target during activity, and that consent can be provided some part of the activity and not others would be great.

I'd also think destigmatizing abuse so others can talk about their experience, ending 'slut shaming' when females want to show their sexuality or engage in sexual behavior and end up being victimized because of someone elses inability to adequately control themselves, and also understanding males are sexually abused and are no less masculine for having this inflicted upon them would be great places to start.

This is a fairly controversial and charged question for some in the field. So, for this question, I am providing my opinion with the understanding that other colleagues probably might disagree with me.

I believe Pedophilic Disorder is a sexual orientation with individual that are attracted to child features. In other words, an individual with pedophilia has the same ingrained attraction that a hetersexual female may feel towards a male, or a homosexual feels towards their same gender. With that being said, it needs to be said that sexuality is more of a spectrum than a finite category. We know that heterosexuals may engage in homosexual behavior, and deny they are bisexual or homosexual. We know that individuals with pedophilia may engage in sexual behavior with adults. For some, they may use this as a cognitive distortion to explain away their sexualization of prepubescent children. Others may acknowledge they can engage in behaviors towards children and adults. Diagnostically, the DSM-5 allows for "Nonexclusive Type" to be diagnosed, which signifies an individual holds both sexual attraction and/or behavior toward children and adults.

Edit: So first, this is the second part of the response to the question. I previously provided this as a response to another comment, but most probably did not see it due to the original comment being downvoted. I'm a bit concerned, as some of the comments I am reading in this thread suggest that I hold a view that Pedophilic Disorder is untreatable. Not true. Treatment, to me, isn't about modifying the orientation per se, but getting the individual to find more appropriate behaviors to engage in. Second, as some others rightly point out, an individual can have pedophilic interests without ever acting on these behaviorally. However, as I am working with criminal offenders, my experience is entirely weighted to those who have engaged in this behaviorally. As such, I'm not in a position to discuss those who merely hold sexual interest in children that do not act upon them.

My reply about treatment was as follows: Yes, my apologies you are right in that I did only answer half the question. I do believe we can change the behavior of Pedophilic Disorder, with the understanding that the attraction may always remain. So the goal, as noted in this response, is to understand what the individual needs to change to ensure they are less likely to offend in the future. When working with someone who evidences Pedophilic Disorder, the three largest things I focus on in treatment is: 1. Do you understand who can and can't provide consent? How will you go through and identify this? 2. Can you identify the risks or situations which would increase when you engage in sexual activity with someone who can't provide consent? How can you avoid these or limit them? 3. What can you focus on positive in your life which can replace or mitigate when you may be most likely to offend? What are some things you can do which are adaptive and help you in the long run?

I hope this answers your question.

Second Part of Edit: In hindsight, it was an error on my part not to take some more time to discuss the varying views in the field about pedophilia. My response sort of hints at this, but under-served it. First and foremost, my view of pedophilia being an orientation is fairly controversial in itself. Some in the field hold this view, but the American Psychiatric Association had to go back on some language it originally provided in DSM-5 that indicated Pedophilia Disorder is an orientation. To myself, based on my knowledge of the literature and experience in assessment/treatment, this view I feel fits best. Others disagree. That is OK! However, I am not interested in spending time discussing views I don't hold. I acknowledge they are out there, I acknowledge my view my ultimately not be found to be correct as we keep researching this area, but I just feel that right now based on my knowledge that the orientation view towards pedophilic disorder holds the most credence. So with that being said, here are a few links that provide some more information on the view of pedophilia and its treatment in the field.

Link 1: Text from Google which I have used and clearly lays out assessment and treatment of Pedophilic Disorder

Link 2: Wikipedia (yeah, I know, but the page itself wasn't terrible and a good shotgun to the various issues concerning Pedophilia Disorder) with the section and the Development and Sexual Orientation view towards Pedophilic Disorder

Link 3: WebMD article which is another decent shotgun approach for the general public on Pedophilic Disorder

Link 4: This is an Association for the Treatment of Sexual Abusers (ATSA - highly recommend joining this organization if you have an interest in serving this population) presentation by Dr. Pamela Yates on the Self-Regulation Model to Offending. This is the broad model I subscribe to when conceptualizing sexual offending

I would say that the majority of my clients do regret what they have done. However, I must note that regret comes in 'degrees.' For some, they may regret they engaged in the behavior as they now have consequences for the behavior. For others, they may regret one or two of their crimes, but others they do not. Some only regret hurting a particular individual (e.g. their children now can't seem them easily, as they are incarcerated).

I would say the majority of those I have worked with struggle with mental health difficulties. That being said, this is a weighted view. As a psychologist, I am generally called on to meet with those who are struggling the greatest. I don't see the garden variety individual with little mental health difficulties. I see folks with long histories of substance abuse, mental health disorders, poor relational histories, etc. I believe that approximately 1/3 of individuals in the facility I work at require some form of mental health services. This doesn't mean all have 'mental illness' in the sense you probably imagine it. For example, one person I met with had his child die while he was serving his time. He was struggling with this loss, but this would be expected for just about anyone. That isn't a mental health disorder, that's struggling with life.

I hope this answers your question.

No, not really. See, for me, it is very important I am as objective as possible in serving this population. ESPECIALLY when I need to do assessments. So if I find myself experience counter-transference (which sympathizing could be evidence of) I need to consult with my colleagues and either resolve it to maintain as much objectivity as possible, or consider if the counter-transference is detrimental to my work having the client referred to a colleague. I will point out that 100% objectivity in a helping profession is impossible, and I am not attempting to suggest I approach my work in a mechanical manner. I do try and remain as impartial to what I do as possible though, and I am seeking to note when I do something that is outside of the norm for me.

With that said, there are times I find someone has drawn a bad lot in life, or seemed to have the deck stacked against them. To me, it is one thing to acknowledge this individual's circumstance, but a completely different thing to start making excuses for their behavior, or 'pulling' for them in a personal way.

Now, I do understand why most folks may have did what they did. After all, that's part of my job. So I do bring empathy (defined here is understanding another's experience) to my work. Is that sympathizing in the sense you use the word? I don't think so. I think sympathizing requires something more, like 'taking it easy' in the work, or allowing that emotion to start changing my opinions or my interventions.

I hope this answers your question.

For answering this question, I will assume we are talking about physical and sexual abuse. This is not to undermine the impact of psychological abuse, its just that psychological abuse can be harder to quantify. I'll also note I am speaking to my own experience with this population; I am certain you could pull literature that will give you some ranges for a larger number of studied individuals than who I have interacted with professionally.

In my experience, I would say at least a third of those I work with have been physically (including neglect) and sexually abused during their childhood. I would say of this third, a very large majority (~80+ percent) had the abuse perpetrated by a trusted caregiver. Now, this opens up a question. Did the abuse result in them becoming abusive/criminal themselves? For some (particularly sexual offenders when you conceptualize their offending with regards to their history) there appears to be a correlate between the abuse they experienced and their perpetration of abuse against others. However, my understanding of the literature is clear and most individuals who are abused do NOT go on to abuse others themselves. What this suggests is that while abuse may play a role in the decision these individuals made to go on to offend, it is not the sole explanation for this choice, and other factors need to be considered.

I hope this answers your question.