On Paedophilia

Cosimo Schinaia, Psychiatrist and Training and Supervising Analyst of SPI (Italian Psychoanalytic Society) and full member of the IPA.

The profiles of paedophiles differ both in terms of behaviour and from a psychopathological perspective. It is necessary to make distinctions between different cases, identifying the right diagnosis, the prognosis and a possible treatment. Some paedophiles, in a totally narcissistic and destructive way, do not show feelings of compassion towards their victims, who become inanimate objects of their pleasure. Others transform their victims into accomplices, attributing to them attractions, feelings or passions that are not part of their emotional baggage. 

The possible condescension, passive or not, is sometimes related with the need for protection or, in other cases, with the need for attention, affection, or the need for someone who takes care of them. It is common to say that children would do anything to be loved, sometimes even forgiving the worst mistakes of adults (e.g. their parents). 

The psychological mechanisms that underlie the experiences of non-offending paedophiles do not necessarily differ from those of other paedophiles. In some cases, the fear of a social disapproval, interiorised as moral law, prevails; in some other cases, the child is idealised as someone who is ready to receive and enjoy sexual attentions; in other cases, however, the child is seen as a suffering creature with whom the paedophile identifies themself and, therefore, someone that they would like to protect, comfort, or love through their actions, not realising that the sexualization of emotional needs leads to an unrealistic perception of the child. I think that it is correct  paedophiles identify themselves .

It is specifically with non-offending paedophiles that the prevailing image is that of a suffering child, not loved enough, in need of care, to whom the paedophile thinks it is necessary to give an affective response, tinged with sensuality. However, if the affective response has characteristics of sexual excitement, there is not a real recognition of the child’s needs, but only a distortion of them. 

While it is true that the stories of many paedophiles are characterised by past violence, traumas or micro traumas, both at the physical and the mental level (indeed, today we can also talk about family mental abuse or developmental trauma disorder (DTD), because the trauma is pervasive in the first ten years of development), it is not automatic to assume that someone who has been abused as a child will turn into a paedophile. In this respect, it is important to avoid stereotypes that can violate the abused child twice. That said, it is clear that family, as well as the micro-social and socio-cultural environments or negative encounters, can foster the development of the disorder.

Many scholars have tried to identify a biological factor (someone identifies an alteration of the production of serotonin or dopamine, or an alteration of the blood concentration of testosterone or of prolactin as a cause), but the gene (or bacterium) of paedophilia was never found. The facts that the interplay between environment and genetic makeup and biological and psychological mechanisms is inextricable and that environment can influence the genetic makeup and vice versa should be the starting point for any multifactorial reflection.

It is all about defensive modes, somehow specular, depending on how the subject has incorporated ethical models of socio-cultural order. Let me be clear. The dogmatic regarding the building of a paedophilic desire deemed to be legitimate is a powerful defence against the guilt for not recognising the generational difference. Paedophiles often compensate for the pain (and, sometimes, guilt) towards their inclinations with a sort of biological or pathological explanation for the nature of their urges. If the guilt prevails, the response of paedophiles is to accentuate the characteristic of rightness of their guilt; if the biological explanation prevails, the urgency and unsustainability of the feelings is emphasised, although paedophiles are well aware of the abusive aspect of the matter. One of my patients used to say: “I would want to oppose these insane ideas, but I cannot do it, it is something inherent to my person.”

There is no absolute answer, as the psychopathological picture of the paedophile is very important. It is fundamental to establish if the paedophile’s mental framework is neurotic or psychotic, or if aspects of perversion or perversity prevail. Certainly, the non-offending element is a good starting point for the possibility of undertaking a potentially successful treatment. It happened to me to have patients who, despite having expressed abhorrence towards child-abuse, have then succumbed to their urges. But I also had patients who did not manifest tendency towards seductive abuse or child molestation, but who then acted violently towards other people or towards themselves (serious suicide attempts). In these cases we can see the transformation of the paedophile’s aggressiveness. These experiences should make us think twice about treatments such as castration (chemical or physical), as the problems of these people, as I would say in Italian, are “nella testa, non nei testicoli”, which means the problems are in their psyche rather than in their testes. 

Just recently, I read articles regarding how the American legislation does not foster the treatment of non-offending paedophiles, as they risk losing their jobs if they declare their disorder in order to have access to treatments. If a school bus driver admits to being addicted to drugs, they can be cured, while being moved to another job in the meanwhile. On the other hand, if a preschool teacher declares  his/her own paedophilic feelings,  he/she is suspended from  his/her job, than fired and not assisted into being moved to another job. Part of this failure stems from the misconception that paedophilia is the same as child molestation. Without legal protection, a paedophile cannot risk seeking treatment or disclosing  his/her status to anyone for support. In western societies, the treatment of paedophiles, offending or not, is underestimated, while giving the opportunity to be treated to someone who admits to having certain inclinations would favour an essential secondary prevention. I say secondary, because the primary prevention should be to protect the role of children in our society, in advertising, in the wrong sexualisation of the child as an object, in the oscillation between the angelic and the diabolic child that characterises particularly the Catholic religion, in the underestimation of the effects of violence in the media, etc. I know of some virtual communities, e.g. the community of Virtuous Paedophiles. I think that it can be a good emotional supporting experience, but also that there is the risk of the first step for a sort of social and cultural recognition of paedophilia, not as a serious mental disorder that has to be treated, but as a natural state that calls for visibility like what historically happened for homosexuality. But the two existential and psychological conditions are completely different; in any case paedophilia is a mental disorder, homosexuality is an existential condition like heterosexuality.  What is required, therefore, is a joint effort by many scholars in the various fields involved: together with the psychiatrist and the psychoanalyst. The participants must definitely include the sociologist, the educationalist, but above all the politician and the legislator. In interpreting new social phenomena and proposing new laws, it is the task of the latter two categories to protect the individual and the community, dynamically harmonising individual needs with those of community life.