A number of other forms of therapy are available that focus primarily on the intrapsychic conflicts that have led the pedophiliac individual to commit sexually offensive acts. The goals of such therapies are frequently idiosyncratic to the individual, given that the intrapsychic conflicts of one pedophiliac patient will vary from those of another.
Psychodynamic psychotherapy focuses on unresolved psychosexual conflicts that produce castration anxiety, which in turn is reflected in pedophiliac behavior. Free association, dream interpretation, and psychoanalytic interpretations help pedophiliac patients to resolve various conflict issues. As with other forms of therapy, considerable time is spent in motivating patients to stay focused on the importance of psychodynamic conflict resolutions that will lead them to nonpedophiliac behavior. Readers are referred to Lorand and Balint (1956), Pacht et al. (1962), and Saunders et al. (1986) for further information.
The family systems approach holds that the family is a balanced system based on certain roles and processes assumed, consciously and unconsciously, by individual members of the family. As long as these roles and processes are in place, regardless of how dysfunctional they may be, the family is in a state of equilibrium. Any deviation, depending on its degree of severity, can place the family in a state of disequilibrium. Family systems therapy is especially appropriate for treating incest offenders.
Although it may be necessary for family members to become involved to some extent in the offender’s treatment by providing support, encouragement, or surveillance, dysfunctional families may be extremely resistant to any change brought about by therapy. Despite family members’ awareness of the need to change and to adjust their family arrangements, the fear of confronting these arrangements, which have been sustained by families for extensive periods of time, results in resistance to therapy (Kane 1989).
Although it is advisable and even necessary in many instances for family members (and victims) to become involved in the therapeutic process, some doubt exists about whether a family systems approach is the best way to deal with pedophilia. While some see family systems therapy as state of the art (Lanyon 1986), others question its effectiveness (Mrazek 1984). For example, in a small but promising pilot study, Schlank and Shaw (1996) reported the efficacy of family systems techniques (paradoxical intervention) in treating sex offenders who denied their guilt. Thus, there exists a great deal of controversy regarding whether family systems therapy is the best way to treat sex offenders and their families. Readers are referred to Friedman (1988), Hoffman (1981), and Lanyon (1986) for further information regarding family systems approaches.
Revision date: June 20, 2011
Last revised: by Jorge P. Ribeiro, MD