Does psychodynamic thinking still have any significance for the treatment of pedophilia?
In the current debate on the aetiology of paedophilia, biological, especially neuroscientifically based factors, are being strongly promoted. Paedophilia is constructed as a sexual orientation that should be accepted within the framework of cognitive-behavioral therapies, which are considered as evidence-based in the field. The socially accepted goal of a therapy is to avoid sexual abuse of children through self-control. An understanding and working through of the underlying dynamics and a post-maturation or even a change of paedophile interests through therapy is not a goal or at most of secondary importance. When it comes to the significance of possible real traumatic experiences, the publications mention sexual abuse that pedophilic men have experienced themselves, but question or controversially discuss the significance for the aetiology of paedophilic symptoms. This lecture examines paedophilic sexual interest and paedosexual actions on the basis of the concept of compulsion to repeat and on the background of traumatic experiences of paedophilic men. It is important to point out that it should not be assumed at the same time that the experience of sexual abuse increases the risk of becoming an abuser or of developing a paedophilic disorder. Theoretical considerations are illustrated with clinical case material and their significance for therapy is presented.
Peer Briken, MD FECSM is a full Professor for Sex Research, Sexual Medicine, and Forensic Psychiatry and Director of the institute of the same name at the University Medical Center Hamburg-Eppendorf. From 2010 to September 2016 he was the president of the German Society for Sexual Research (DGfS) and from 2012 to September 2016 vice president of the International Association for the Treatment of Sexual Offenders (IATSO). He is editor of the Zeitschrift für Sexualforschung and authored or co-authored more than 300 scientific paper. Since January 2016, Briken has been a member of the Independent Inquiry into Child Sexual Abuse in Germany.