The alcoholic used to be "the bum in the gutter" until society developed a more enlightened view of the disease. Dr. Fred Berlin, a major figure in research and treatment of sexual disorders, hopes that pedophilia will someday be viewed in much the same way as alcoholism, as a psychiatric illness, not simply as a moral failing (4).
Pedophilia is one of a group of psychological disorders called paraphilias, which are disorders of sexual attraction and include such deviant behaviors as exhibitionism, voyeurism, sexual masochism and sexual sadism. They are considered illnesses if they cause problems for the person having the urges or for others. Pedophilia is considered one of the most dangerous of these disorders because sex with a child is always criminal and exploitive. Although the term is popularly used to describe adults who are sexually drawn to children, it technically refers to urges toward pre-pubescent boys and girls (5).
The onset of paraphilic sexual interest usually occurs before the age of 18. The average age for the onset of nonincestuous homosexual pedophilia is 18.2 and 21.1 for nonincestuous heterosexual pedophilia (2).
The clinical evaluation of pedophiles reveals them to be a diverse group. They differ educationally, vocationally, religiously, and socio-economically. They vary in the amount of force or aggression used in their pedophilic acts. They also vary in the many different causes that lead to the development of their sexual problem.
For some child molesters, their sexual acting out can be explained by the presence of a psychosis or an organic brain deficit. Individuals with a history of closed or open head injuries and individuals with a diagnosis of schizophrenia may become sexually aggressive because of their unique mental disorder or because of their brain injuries. For example, there are recorded brain damaged individuals who molest children because of impaired intellectual functioning. Their pedophilic behavior is not the result of a primary sexual disorder but of an organic disorder.
No single explanation can account for all the different pathways leading towards pedophilia. Any theory of pedophilia must be multifaceted and account for the wide range of behaviors, fantasies, and organic factors that may play a role in the development of this disorder. A comprehensive theory of pedophilia must refer to psychological, familial, environmental, social, genetic, hormonal, organic, and biological factors.
Psychological theories address only those aspects of the emotional congruence, sexual arousal, blockage, and disinhibition found in pedophilia that are independent of organic causes. These theories include such diverse perspectives as psychoanalysis, social learning theory, and family systems. While it is argued that a single perspective cannot explain the complex phenomena of pedophilia, this does not mean the the psychological theories are irrelevant. Rather, an integrated approach the combines several different approaches is best(5).
Psychoanalytical theories look at deviant sexual behavior as stemming from early childhood trauma. This trauma, which may take the form of sexual or physical abuse, leaves the child in a state of overstimulation, confusion, separation anxiety, and rage. Feeling helpless, out of control, and powerless, this victim may, in turn, act out as a way of re-creating the original trauma and attempting to master the anxiety associated with it. This psychic mechanism is called a repetition compulsion.
Or, this victim may identify with the aggressor, that is, he or she may identify with the abusing adult and then act out sexually with a younger child. Identifying with the aggressor would enable the person to defend against the unwanted feelings of helplessness and powerlessness. The sexual acting out with children or makes the individual feel alive and vital; it reestablishes a feeling of control, dominance, and power, and allays the anxiety associated with the childhood trauma.
However, this is only an illusory feeling of having solved an earlier childhood conflict. The feelings of dominance, control, power and being alive soon dissipate and the reenactment has to be repeated. Because the molester's attempts at mastery and problem-solving are illusory, he/she must molest over and over again (1).
Family system theories stress the role of unresolved intergenerational family dynamics on specific family members. It is argued that deviant sexuality is learned within the family. It first arises within the nuclear family and then is unconsciously transferred in family lines. Individual members can be 'targeted' to act out family conflicts.
For example, an unconscious conflict which is unacceptable to a parent may be encouraged in a child. A parent's unconscious wish to act out sexually with children may be repressed or pushed out of consciousness because of the fear of punishment. These unresolved wishes may be projected onto a child who is vulnerable. In the context of subtle family communications, the child may be passively of actively encouraged to act out those parental wishes. In this way, parents can both repress the forbidden sexual impulse and act it out through their child's behavior (1).
Typically, family system theories focus on communication patterns within a family and regard the sexual symptom of an one family member as being influenced by the specific communication patterns of that family. These family patterns exercise a powerful influence on the child.
Behaviorism and social learning theories stress the importance of learning our behavior. For example, a child may have had sex experiences with other children or adults which were prolonged. Sexual excitement, event when it is the result of abuse, is pleasurable. Pleasure is a strong, positive reinforcer of behavior and, thus, such sexual experiences have a high probability of becoming learned behavior and/or of becoming generalized to other sexual behavior (2).
At the same time, a child who has been sexually assaulted by an adult or another child may experience a tremendous guilt over these early sexual experiences. This guilt is likely to be associated in the child's mind with sexual curiosity and sexual pleasure. The child is then vulnerable to distressing symptoms because of the internal conflict of guilt versus pleasure associated with normal sexuality. When the child becomes an adult, this internal conflict, and the resulting ambivalence, may take the form of sexually acting out with children (1).
This psychological approach, stressing the psychic, social and environmental factors that give rise to child molestation, must never lose sight of the importance of biological factors. These factors acknowledge the importance of organic issues, especially brain pathology.
The search for a biological explanation of pedophilia is compelling and has attracted many researchers. The central question its: What effect does the brain have on perverse sexual behavior? Can deviant sexual behavior be attributed to brain illness or damage? This is an important question, the answer to which might link sexually deviant behavior to brain disease or abnormalities. Research in this area has taken several paths as well, linking certain kinds of brain damage and especially hormonal problems to sexual deviance.
Is there a relationship between hormones and pedophilia?
Pedophilia is mostly seen in males, and it has been shown that male sex drive and male aggression are mostly regulated by the male hormone testosterone. It has been suggested that there is a direct relationship between male hormone levels and aggression/sexuality, although the relationship is not that simple (4).
It has also been suggested that catecholamines and serotonin may play a role in the pathophysiology of paraphilias. Catecholamines are compounds occurring naturally in the body that serve as hormones or as neurotransmitters in the sympathetic nervous system. The catecholamines includes such compounds as epinephrine (adrenaline), norepeinephrine, and dopamine. Epinephrine and norepeinephrine are secreted principally by the medulla of the adrenal gland, and norepeinephrine is also secreted by some nerve fibers. Secretions of these hormones is stimulated when and animal is excited or scared, and causes such things as heightened heart rate, increase in blood sugar, increased blood flow, and changes to prepare for an emergency (3).
An experiment was conducted to measure epinephrine and norepeinephrine concentrations in the normal men and in pedophiles. The results showed a significantly greater concentrations of the catecholamines: epinephrine and norepeinephrine, in the pedophilic men. There was an especially high concentration of epinephrine in these paraphilic subjects. There is evidence that points towards a positive relationship between catecholaminergic activities and peripheral sympathoadrenal system activation. So, the results suggest that pedophilia may be caused by an increased peripheral sympathoadrenal activity, in connection with increased catecholaminergic activation. The peripheral side of the nervous system is that which carries impulses to the central nervous system from sensory end organs in peripheral tissue. The Sympathoadrenal system deals with igniting the 'fight or flight' condition in the body. This study showed that the increased presence of epinephrine may lead to greater activity in the sympathoadrenal system (3).
Other experiments have tested groups of pedophiles using newer technologies of imaging the brain to reveal abnormalities, such as the MRI and PET scans. There have not been any outstanding or consistent results from these experiments.
Overall, there is no biological conclusive evidence suggesting the real reasons for pedophilia, and the answer continues to lie in the combination of the before mentioned theories. Until there is more conclusive neurobiological evidence, the evidence has to manifest itself in behavior of the pedophiles.
Power and control are critical factors for the pedophile. The child is pliant and yielding, unlike an adult who may be rigid and unyielding. The child can be coerced and brought under control through simple requests and demands; the child will yield to the adults power and control because he or she still lacks autonomy and self-initiative to that extent. If the adult is in a more influential role such as a priest, coach or teacher, the child is particularly vulnerable.
For a pedophile, the emotional congruence factor is critical. The perpetrator is often developmentally arrested and may be at the same pyschosexual age as his victims. The pedophile may emotionally and sexually identify with the child who becomes his or her victim. Pedophiles may even engage in sexual acts appropriate to their arrested pyschosexual age such as just showing or touching (1).
During the sexual molestation, the aggressor's thinking is disturbed. Many sex offenders speak of the molestation as taking place in a hypnotic-like trance from which they awaken only after orgasm. This trance seems to be the mind's way of separating the rage from consciousness. Some researchers argue that this behavior may be the result of damage to the frontal and temporal lobes of the brain, leading to poor judgment, blunted anxiety, and impulsivity. Moreover, the disappearance of sexually motivation fantasies in the post-ejaculatory phase suggest even more strongly the link between the body's hormonal system and cognition (4).
Pedophilia remains an aggressive act. The perpetrator's apparent lack of awareness of this aggressive component in the relationship is akin to disavowal or denial and it is a delusional suspension of reality. Such persons may rationalize their molestation as serving a caretaker or parental role, performing and educational function, or providing friendship.
The establishment of and aggressive relationship give the perpetrator, as has been suggested, power, control, and dominance over the child and provides a connection to a real individual in order to overcome feelings of isolation and loneliness. During the "courtship" phase, the perpetrator disguises the aggression in order to coerce the child into participating in the "game" or "play".
The child's adoring or admiring attitude, or the teenager's idealization, is critical to the deception. This adoration and admiration feeds the narcissistic grandiosity of the perpetrators, provides them with a modicum of self-esteem, and confirms their self-image as loving and caring. Essentially, the victim unwittingly provides the pedophile with and important narcissistic balance to an otherwise depleted and depressed personality. The sexual encounter seems to provide a feeling of cohesion to a psyche which is in danger of disintegrating.
Given the perpetrator's obvious lack of self-assertion, psychosexual and psychosocial immaturity, and inability to form gratifying peer relationships, the child is an ideal object for sexual exploitation. Because the abuser lacks genuine empathy and connectedness to others, the child is viewed as a pliable object that can be persuaded to relate sexually to the adult.
The issue still remains as to whether pedophilia is an actual disorder within the chemical norm of the body and the brain, or whether it is simply deviance from a social norm. How are social norms defined? There have been many, many pedophiles discovered, and pedophilic acts occur every day. As atrocious as it may sound, could pedophilia and sexual afflictions like it be present more commonly and perhaps normally than our society allows?
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