Child molestation is the most common paraphilia brought to the attention of mental health providers. For this reason, it behoves the clinician to become especially knowledgeable about child molestation. Paedophilia involves sexual contact with a child at least 5 years younger than the perpetrator, with the perpetrator being at least 16 years of age or older. Paedophilia involves boys, girls, or both sexes of children; activities are limited to incest, non-incest, or both; sexual interest in children is either exclusive (only being sexually attracted to children and not being attracted to adults) or non-exclusive (attracted to both children and adults). The DSM-IV code for paedophilia is 302.2 and the ICD-10 code is F65.4. (34)

Paedophilia must be distinguished from child molestation. From an early age paedophiles have a sexual interest in children which is compulsive and recurrent in nature. Not all paedophiles are child molesters, although the majority are. Some paedophiles have fantasies and urges, but never become involved with a child. The term child molestation applies to individuals who are sexually involved with children. Not all child molesters are paedophiles. Some child molesters molest children, not because of paedophilia, but because of the absence of an appropriate sexual partner, the use of mind altering drugs, brain damage with concomitant poor impulse control, or mental retardation. In other cases, individuals sexually molest children in an attempt to cope with uncomfortable problematic feelings, or to seek revenge against a loved one of the child.

Child molestation committed by teenage or younger children is especially perplexing. Sexual exploration is common in childhood and adolescence. To explore another person's body, children frequently select younger children, since they do not resist such exploration and are less likely to report fondling or bodily examinations. The majority of child molestations by juveniles are not true paedophilic acts but, in the heat of the courtroom, such acts are frequently described by prosecuting attorneys as paedophilia, predatory acts, or rape.(5)

Paedophilia often begins in the early to middle teens and generally persists throughout adulthood. Paedophiles, like other paraphiliacs, do not plan to develop a paraphilic interest, but appear to do so by default. At younger ages they fail to appreciate the relevance of their sexual interest in young children. However, by the time they reach their early twenties, they begin to perceive that their sexual interest in children has persisted, despite their maturation, and are shocked by the realization that they are sexually aroused by children. Most paedophiles have adult sexual interest as well as sexual interest in children; in our sample of 5873 adult males undergoing clinical evaluation, only 6.6 per cent had an exclusive sexual interest in children. When that interest involves adolescent boys or girls it is called ephebophilia. When the child is 13 or younger, it is called paedophilia.

As a youth, a paedophile can easily associate with children without drawing attention to him- or herself. As the paedophile matures, however, it becomes problematic to be around children. Some paedophiles love children and attempt to help them in a variety of circumstances, without ever intending to sexually molest or harm them. Many put themselves in close proximity to children by participating in youth work. Other paedophiles establish relationships with children in their communities or neighbourhoods, and can thereby avoid detection while developing a relationship with a child.

Children are naive, making it easy to socialize with them and to determine which reinforcers motivate them to respond to adult requests. Consequently, the paedophile usually develops a non-sexual relationship with the child in order eventually to justify being alone with the child. Being alone and isolated with the child eventually allows the paedophile to initiate sexual touching without detection. Most paedophiles molest children well known to them; only about 10 per cent molest children who are strangers (Table,,!).

Table 4 Crossing of age and gender groupings by 2010 male child molesters

Paedophiles, like other paraphiliacs, develop cognitive distortions and justifications for their behaviour. These cognitive distortions may include the following: 'Children should be allowed to make decisions regarding with whom they are sexual'; 'If the child does not report you, the child is enjoying the experience and wants it to continue'; 'Fondling and caressing the genitals of a child can be a form of sexual education to the child'; 'The only way a child can be hurt is if physical force is used with the child'. Child molesters are especially adept at convincing themselves that their behaviour is appropriate and does not injure their victim.

The most problematic issue for the paedophile is evading arrest. The greatest threat of others becoming aware of his molesting is the child revealing the molestation to others. Child molesters may attempt to convince the child that it was he or she who initiated the sexual act, not the molester. As the victim becomes older, the molester may say, 'Well I didn't really want to do this, but you seemed so interested in learning about sex', or 'Yes, I thought it was peculiar that you wanted to get involved in sexual touching, but I really liked you, so I went along with it'. The child molester has to convince the child that revealing the molestation would be harmful not only to the molester, but to the child and the child's family. This is especially problematic when the child attempts to break off the relationship involving molestation.

Child molesters report molesting a variety of children of various ages, genders, and relationships to them ( Table .4). The clinician evaluating a known child molester can determine whether to suspect that the child molester is molesting other children within or outside the family by examining this table. Cases where a child molester is statistically likely to cross from one type of child victim to another, are indicated by a plus sign; when it is statistically unlikely that a child molester will molest a child in another category, this is represented by minus sign. For example, those who molest adolescent females are statistically more likely to be concurrently molesting an adolescent female in the family, but are statistically less likely to have molested a young female child under 14, a female child under 14 in the family, a male child under 14, and a male child under 14 in the family. Therefore this table will serve as a guide to the various types of child molestation that a child molester is likely or unlikely to have committed.

Of those children molested, 18 per cent are reportedly biological children, 26 per cent are stepchildren or children of a live-in partner, 2 per cent are foster children, 3 per cent are adopted children, 5 per cent are grandchildren, 11 per cent are younger brothers or sisters, 16 per cent are nieces or nephews, 36 per cent are children of neighbours or acquaintances, 4 per cent are children left in the care of the molester, and 11 per cent are strangers. In other words, child molesters infrequently molest children unknown to them but, rather, molest children in their family or children they meet through neighbours or acquaintances.

Sex between a child and an adult is always unethical, since a child cannot give informed consent to such activities. In order to give consent, one has to be on an equal power base with the sexual partner, which is impossible where children are concerned because adults seeking sexual contact with children are larger and more powerful, as well as being seen by the child as someone whom they must obey. Additionally, perpetrators often have a parental or other position of authority with respect to the child, so that the child cannot give consent. To give informed consent, a child must be knowledgeable about and understand to what he or she is giving consent, but since children are naive about sexual activities, they cannot appreciate the activities molesters want them to participate in or the possible consequences they may suffer as a result of participation. Children are not aware that, if found out, they may be questioned by police, interviewed repeatedly by victim support services, ostracized by other children for having been molested, and required to provide testimony in open court against the person who molested them. (6)

Therapists find it difficult to treat child molesters for a number of reasons. Since paedophiles have a sexual interest in children and such sexual interests are so disparate from the sexual interest of the therapist, many therapists doubt the veracity of a child's accusations and succumb to the rationalizations and justifications for false accusations used by the paedophile and/or the paedophile's lawyer. Therapists and the general public sometimes prefer to not think about the possibilities of paedophiles being around children, including the thought that paedophiles may pose a potential risk to their own children.

In contrast, some therapists view the paedophile as a devil, whose behaviour is sinful. These therapists fail to realize that true paedophiles do not plan to become paedophiles, but instead find themselves with sexual interests disparate from the society in which they live. Therefore many therapists find themselves repulsed by the paedophile and thus unable to be objective in their evaluation and treatment.

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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