Sexual abuse

That was the case for Jasmine, a Florida resident who asked to go by a pseudonym. On the day of her discovery, she got a call at work — the local elementary school where she taught first grade — notifying her that her husband had been arrested. It wasn’t until she arrived at the local police department and was directed toward the special victims unit that she began to understand. After being arrested, and confronted with an incriminating taped conversation he had with the victim, Jasmine’s husband confessed to molesting a young girl who lived across the street — on one occasion, in his own home.

The revelation was harrowing for Jasmine — but before she left the station that night, when a detective asked her what she was going to do, her answer was immediate: “I’m going to stay.” That isn’t to say that she instantly forgave him. When she went to court the next day for his hearing, she says, “I felt like I was going to a funeral. I was grieving for the life that we had.” They were high school sweethearts and had been married for six years at that point. “The person who I thought I knew absolutely everything about had this hidden life,” she says, her voice still carrying an air of disbelief. He revealed to her that he had experienced attraction to pre-pubescent girls in the past – in addition to adult women — but had convinced himself that “he could control it.” She says she was angry at him — not for experiencing these attractions but for not telling her about it sooner, and for putting himself in the position to act on it. Approaching the situation with that mind-set that allowed her to continue in the relationship.

Her husband was jailed for 60 days, served two years of house arrest, completed 10 years probation and is a lifetime registered sex offender in Florida. She’s stood by him the whole time and supported him financially when he was on house arrest and unable to work. “I had to think about our marriage and that he had been a good person — this was really the first thing we had gone through,” she explains. “He went through years and years of sex-offender treatment and I could see his thinking change. There weren’t so many rationalizations and excuses.”

Jasmine’s husband now tells her that he no longer experiences attraction to pre-pubescent girls, although even experts who promote sex-offender treatment doubt such a complete change is possible. “There is no evidence that a man can change from pedophilic to non-pedophilic (or vice versa),” says clinical psychologist James Cantor, the editor in chief of “Sexual Abuse: A Journal of Research and Treatment,” in an email. “A person can be taught tools to help him deal with his sexual interests, and a person’s sex drive can sometimes be suppressed, such as with testosterone-blocking medications. The overall evidence, however, is that changing from pedophilic to non-pedophilic is as impossible as changing a gay man to a straight man.” He adds: “The kind and scale of differences that we see on MRIs of pedophilic men are not the kind or scale that are known to change with training, or psychotherapy or other kinds of intervention.”

Joan Tabachnick of the Association for the Treatment of Sexual Abusers tells me, “For some, it is a good decision [to stay] and helps to keep the community safer,” she says. That’s because it gives the offender “a reason to stay connected, to not reoffend.” However, she is careful to add, “For others, it may mean that they are not looking at the reality of what is around them.”

Jasmine has been with her husband for 17 years now – in the same house where the abuse took place — and they now have a 1-year-old and a 4-year-old boy. But she says she doesn’t worry about her husband abusing their children: “I do want to point out that I have boys,” she says, adding that her husband never experienced attraction to males of any age. At the same time, though, she acknowledges that “the experts say it doesn’t really matter if it’s a girl or boy. It’s the age range that an offender is particularly attracted to.” They had their first child during the 10-year probation period; a judge ruled that Jasmine’s husband could be allowed to spend time alone with the boy.

Cantor declined to comment on Jasmine’s specific situation, but notes that “a sizable proportion — sometimes a third — of sexual offenders against multiple children committed those offenses against children of both sexes.” In general, offenders target a single sex, but it’s also true that pedophiles “distinguish between boys and girls much less” than those who are primarily oriented toward adults.

Some wives convince themselves their husband will change even without a conviction, imprisonment or treatment. Christina Enevoldsen, co-founder of the online support group Overcoming Sexual Abuse, married and had a child with her high school boyfriend, who had admitted to molesting a female relative in the past but swore he would never do such a thing again. When she found blood in her 1-year-old daughter’s diaper, her husband “tearfully admitted that he had molested her but promised it would never happen again,” she writes in a blog post. “He seemed very remorseful and I thought that since I caught him, he wouldn’t feel safe repeating the abuse. He seemed afraid of losing his family, so I thought that fear would stop him.”

But he continued to abuse his daughter for most of her childhood. “Yes, I had been fooled by my husband, but I had also fooled myself,” she says. Enevoldsen blames it in part on the repeated sexual abuse she experienced as a child at the hands of male relatives. “Finding blood in her diaper was finding blood in my diaper. I was transported to my own abuse with the same feelings and response: I froze as though my only choice was to lie still and stay quiet.”

Denial among close family members who suspect sexual abuse is terribly common – it’s why Tabachnick wrote the guide “Engaging Bystanders in Sexual Violence Prevention.” Tabachnick attempted to explain what might have been going through the mind of Fine’s wife: “We would be asking Bernie’s wife to report her husband, bring shame onto her family and her child, lose their standing in the community and whatever love was left in that marriage,” she says. “In our society there is a very high cost for reporting — and the benefit of reporting is very small if you are truly not sure there would be a successful prosecution.” (You can find more here on the reasons why witnesses to child sexual abuse fail to call police.)

There can also be a great deal of guilt on the wife’s part about the abuse: Molesters who are discovered often place blame on their partner. “He tried to say, ‘Well, you didn’t give me a lot of attention and things weren’t so good in the bedroom,’” Jasmine says. “After years of therapy, I realized that any healthy adult male doesn’t do that with a child. It doesn’t matter how much attention your wife is giving you.”

Jasmine insists that things with her husband are good now, despite the fact that she will have to live with his sex-offender status. His registration publicly lists their home address alongside the details of his conviction for “lewd or lascivious molestation.” It isn’t what she pictured for her life, but it’s what she’s chosen, given the circumstances. “Before this happened, I was the person who picked up the paper and said, ‘Oh, what a monster!’ Until you’re in the situation, you don’t know how you’ll react.”

Some experts, like clinical psychologist James Cantor, also take aim at the ways that we’ve made it more difficult for offenders to be rehabilitated and successfully re-enter society. We’ve also made it harder for offenders to voluntarily seek treatment. Cantor, a professor at the University of Toronto and editor in chief of the scientific journal “Sexual Abuse,” says we have a troublingly distorted view of where the greatest threat of abuse comes from — it isn’t from shadowy strangers, but from within children’s own homes.

I talked with Cantor, a bitingly funny, fast-talking 45-year-old, by phone about how intervention in the Penn State case might have changed things, why Canada’s sex offender laws have it right and how brain mapping might allow us to prevent pedophilia, period.

This week, the Penn State case is getting a lot of attention. How might earlier intervention have changed things in a case like that?

For a lot of people, when they’re first confronted with how grossly inappropriate their behavior was, it’s almost like a slap of reality. Many grow up being kind of aware that they’re sexually attracted to children, but over time — because that’s where all of their psycho-social energy is pointed — they talk themselves out of the harm they could do to children. They talk themselves into believing that the rest of society underplays the amount of sexually based love that children have; they talk themselves into believing that there’s more equality in the relationship than there really is. It’s often only when they’re caught that they snap out of that, realize what they’re doing and often come willingly into treatment saying, “I really can’t do this on my own, I need help.”

If a pedophiles identifies having these desires and actually wants to prevent acting on them, can they just turn themselves in for treatment?

People used to come to clinics that I worked in — maybe not all the time, but also not infrequently — and say, “Doc, I got a problem.” But one of the early laws that was passed during the pedophilia hysteria of the 1980s was mandatory reporting. Before those days, if somebody came in seeking help, you could start therapy with them — but now, if there’s a kid in that guy’s environment anywhere, psychologists, psychiatrists and the rest of us are required to report that person. Of course, the thinking at the time was, “We have to catch the person to save the children,” but what really happens is it just stops people from seeking help in the first place. So instead of having people asking for help and getting it, we still have these people in the community — but they have no help whatsoever.

So, how effective is treatment in general?

There is a great variety in how much risk individuals pose. The predominant form of therapy is group therapy where we have many people in similar situations, and they can recognize in each other when they’re starting to fool themselves again and they hold each other accountable. On the other end of the spectrum, there are those who are psychopathic or have genuine anti-social personality disorder. They behave almost as if the part of the brain that handles empathy is damaged. These folks are the most dangerous and the least amenable to treatment.

The problem is that we try to make sex offender management one size fits all. A lot of laws require one blanket decision, rather than trying to allocate the most treatment to the people who need it the most. For example, very long incarceration is very expensive. Rather than creating a very long mandatory minimum sentence, which applies a most expensive technique to everybody, we should be saving that for the people that are least amenable to treatment and are at greatest risk of committing a new offense, and we should apply more treatment and supervision resources to everybody else.

It sounds like that’s the conclusion that came out of the recent Association for the Treatment of Sexual Abuse conference.

That issue probably more than any other is finally getting more airtime. Being up here in Canada brought the issue to greater light because it was an opportunity to compare the American system with the Canadian system, and to acknowledge that the latter is almost unanimously considered the more appropriate and more efficient way to go.

What does the Canadian system have so right?

The largest difference is that Canadian systems are much more consistent with what we know scientifically and epidemiologically about how forensic systems and criminology work. For example, it’s been very well determined that longer and longer and longer sentences don’t actually decrease crime rates. However, a common response in many different jurisdictions in the U.S. has been to increase and increase and increase the sentence length, even though we know that doesn’t help.

Another example is residency restrictions. There’s no evidence that preventing people from returning to whatever neighborhoods they came from actually works, and there’s some evidence that indirectly suggests that might actually make the problem worse. Essentially, these are communities that are trying to kick out every sex offender and to make the living situation so intolerable that the sex offender leaves. Well, “leaves” really just means “goes to another community” — and then another community, until finally the offender, who’s already served their time and been released after treatment, is driven underground and nobody can supervise them. So instead of having a person that the police know about and that the parole officers can check up on, we have people who we can’t supervise at all.

So, although we have this gut reaction of punitive, punitive, punitive, we may be working backward and making it more difficult and more expensive to provide any kind of supervision.

When we talk about shifting the emphasis to treatment, what does that look like in terms of actual sentencing and length of incarceration?

The literature is complicated, but going through the system appears to be the major effect. Jail doesn’t seem to have a  deterrent effect at all — of course, jail isn’t meant only to be a deterrent, it’s often meant to be pure punishment, retribution. But as a method for actually preventing future offenses, there is very little data suggesting that it’s effective. Instead, people appear to commit sexual offenses when they feel like they have nothing else to lose. These are generally people who know that they’re sexually attracted to children and society, of course, is asking for them to live a completely abstinent life. But when they come to feel that they’ve been excluded from communities, banned from their own families, they can’t get a job, they can’t get a place to live, we create a situation where they have nothing left to lose.

It isn’t a matter of, “We need 50 percent punishment and 50 percent treatment.” What we need is an overall response for in what types of cases do we need to engage in what kinds of interventions.

Do we know anything about how public registries affect offenders’ rehabilitation?

Essentially, they prevent the reintegration. There have been a series of follow-up studies that show that having open registries also fails to decrease recidivism. They also, as a side effect, create very, very difficult situations for the victim’s families. People often envision strangers who pull a kid from a park or a school playground, because of course that’s what appears in the media the most. But the predominant types of offenses actually happen within families. It’s often a step-parent and a step-child or an older sibling and a younger sibling. A side effect of having the registry public is that it actually makes public the entire family. So rather than the family being able to move past, heal, do whatever it needs, some of them feel victimized once again.

Moreover, if a parent discovers that one of their children is abusing one of their younger children, when there are very long sentences and very public labeling, it’s going to make parents think twice about calling the police and asking for help. So, though I more than appreciate the gut reaction that the public has, it’s very rarely the most scientifically sound reaction. This is one of those situations where we need to swallow our emotions and do our best to think rationally. It’s not just that the irrational arguments have no effect and are costing money, it’s that they’re also making the problem worse.

One criticism of the push to emphasize treatment is that the research is based on convictions rather than actually offenses, and that that distorts the actual, real world rate of repeat abuse. Is that a legitimate concern?

It’s a legitimate concern, in theory. We don’t know to what extent it’s true, because we’re talking about, by definition, offenses that we don’t know about. But it would be a mistake to say that everything we know based on the apprehended offenders is wrong, because very often we’re comparing a group that did go through treatment to a group that didn’t go through treatment. The idea that we’re not learning about all future offense is true, but that holds true for both groups. So it cancels out as a difference between the groups. There’s no reason to think one of these groups would be more underestimated than the other.

Is it true that thanks to brain mapping we might be able to one day identify pedophiles before they offend?

Yes and no. We’re quickly getting to the point technologically when that might be possible, but when we think about how we might apply that technology, we run into familiar problems. We can’t force a person into a brain scan any more than we can force them into psychological screening.

My greatest hope is that it tells us when in development pedophilia starts. So far, it suggests that whatever the chain of events, it starts before birth. If we can identify what happened and when it happens, then we might be able to prevent pedophilia from developing at all. It could be something like stress on the mother, some congenital factor, so my greatest hope is primary prevention.