‘I have noth­ing to keep in­side any­more’


Vancouver Sun - - NP - TOM BLACK­WELL

The Ot­tawa man had re­cently re­tired when it hap­pened: a charge of pos­sess­ing child pornog­ra­phy that de­mol­ished his com­fort­able life vir­tu­ally overnight.

The 63-year-old’s wife left him af­ter the ar­rest three years ago, his three adult chil­dren dis­owned him and his sib­lings be­came “sec­ondary vic­tims” to the shame of one of so­ci­ety’s most re­viled crimes. That was all be­fore he was sen­tenced to a 90-day jail term.

But then the for­mer civil ser­vant sought help from the Royal Ot­tawa hos­pi­tal’s Sex­ual Be­hav­iours Clinic, whose un­con­ven­tional ap­proach to pe­dophilia has made it an in­ter­na­tional stand out.

The re­sults seem strik­ing. Fol­low­ing a year or so of ther­apy that in­cluded a steady diet of adult pornog­ra­phy, he says his sex­ual in­ter­ests have set­tled ex­clu­sively on age-ap­pro­pri­ate women, and young peo­ple no longer arouse him.

“It frees me, it frees me com­pletely,” said the pa­tient about his trans­for­ma­tion, ask­ing that his name not be pub­lished. “I have noth­ing to keep in­side any­more, I have noth­ing to hide.

It’s like a weight that’s been lifted.”

In­deed, the psy­chi­atric hos­pi­tal claims not only to make pe­dophiles less of a risk to so­ci­ety, but to essen­tially cure them — help them shed for good their sex­ual at­trac­tion to chil­dren.

That boast has gar­nered wide­spread at­ten­tion and ac­co­lades for the clinic headed by psy­chi­a­trist Dr. Paul Fe­do­roff, in­clud­ing a gold achievemen­t award in 2015 from the Amer­i­can Psy­chi­atric As­so­ci­a­tion.

But many ex­perts re­main highly skep­ti­cal, say­ing sci­en­tific ev­i­dence in­di­cates pe­dophilia is un­change­able, as hard­wired for men as be­ing het­ero­sex­ual or gay. They ar­gue that Fe­do­roff’s one ma­jor study to back up his hy­poth­e­sis is flawed, and worry about the im­pact of send­ing pe­dophiles off into the world con­vinced they’ve been cured.

“There’s no prob­lem test­ing it,” said James Can­tor, a sci­en­tist at Toronto’s Cen­tre for Ad­dic­tion and Men­tal Health. “But go­ing ahead and im­ple­ment­ing it gives me the hee­bie-jee­bies.”

Can­tor and other re­searchers stress the Royal Ot­tawa has yet to back up its claims with hard data. They say Fe­do­roff’s pur­ported suc­cess at con­vert­ing pe­dophiles sim­ply de­fies logic.

“The world’s most hated kind of per­son is the child mo­lester, some­body who not only is at­tracted to chil­dren, but ac­tu­ally acts on it,” said Michael Bai­ley, a psy­chol­ogy pro­fes­sor at Chicago’s North­west­ern Univer­sity. “Why would any­body go there if it was easy enough not to, and to have some other kind of sex­ual in­ter­est?”

Fe­do­roff ’s re­sponse is that there is no ev­i­dence pe­dophilia can­not be al­tered, and plenty from his prac­tice that it can be. Mean­while, his team is work­ing on more stud­ies. “If peo­ple are no longer think­ing about chil­dren and not com­mit­ting crimes, I don’t know what you call that, but why not call it suc­cess?”

Can­tor con­ceded there is no gold-stan­dard of treat­ment to help peo­ple with pe­dophilia. The con­ven­tional ap­proach is sta­bi­liz­ing the per­son’s life: en­sur­ing they have hous­ing, a so­cial net­work, a job — a sense they have some­thing to lose if they act on their urges, he said.

Clin­ics also tra­di­tion­ally fo­cus on strate­gies to avoid trou­ble, like keep­ing out of sit­u­a­tions where the per­son is alone with chil­dren, said Martin La­lu­miere, a col­league — and critic — of Fe­do­roff’s at the Univer­sity of Ot­tawa, where Fe­do­roff is a pro­fes­sor of psy­chi­a­try

Then there are drugs, pre­scribed vol­un­tar­ily, that sup­press sex­ual drive al­to­gether — “chem­i­cal cas­tra­tion.”

In fact, many pe­dophiles never act on their de­sires, and few of the ac­tual “hand­son” mo­lesters who are caught harm a child again. Stud­ies peg the re­cidi­vism rate at around 15 per cent.

But Fe­do­roff says his clinic goes fur­ther, record­ing what ap­pears to be a zero rate of re-of­fence by ac­tu­ally shift­ing sex­ual in­ter­ests to adults.

The Royal Ot­tawa’s treat­ment course is dif­fer­ent for dif­fer­ent pa­tients, and al­ways vol­un­tary, he said. But a typ­i­cal pro­gres­sion would see a pe­dophile first pre­scribed anti-an­dro­gen drugs to smother sex­ual drive, pro­vid­ing a “va­ca­tion” as they at­tend group ses­sions and coun­selling.

They’re also taught to find sex­ual stim­u­la­tion from in­di­vid­u­als of a sim­i­lar age, us­ing re­peated ses­sions with adult pornog­ra­phy as “prac­tice,” said Fe­do­roff. He likens the process to a stu­dent be­ing im­mersed so deeply in a new lan­guage that speak­ing and com­pre­hend­ing it be­comes se­cond na­ture.

“Peo­ple al­ways come back say­ing, ‘This is much bet­ter, I en­joy this so much more than what I used to go through,’ which is feel­ing iso­lated, feel­ing guilty, shame­ful, wor­ried they’re go­ing to be ar­rested,” said the psy­chi­a­trist.

Can­tor, though, said ev­i­dence sug­gests pe­dophilia is a solidly en­trenched sex­ual ori­en­ta­tion. His own re­search has linked phys­i­cal brain anom­alies with the con­di­tion. What the Royal Ot­tawa ex­perts do is equiv­a­lent to the failed “con­ver­sion ther­apy” once prac­tised on gay men, he said.

Fe­do­roff and col­leagues pub­lished a pa­per in 2014 that used “phal­lo­met­ric” test­ing — mea­sur­ing the ex­tent of an erec­tion in re­sponse to sex­ual stim­uli — on 43 men di­ag­nosed with pe­dophilia.

Six months or more af­ter their first test, the team re­ported 21 of the men showed sig­nif­i­cantly in­creased re­sponse to adult stim­uli, and sig­nif­i­cantly de­creased arousal from child stim­uli — ap­par­ent ev­i­dence of change.

But four pa­pers sharply cri­tiqued the study. “Ex­tra­or­di­nary claims re­quire ex­tra­or­di­nary ev­i­dence, and yet Paul’s pa­per is ex­traor­di­nar­ily weak,” said Bai­ley, who wrote one of the cri­tiques.

But Fe­do­roff clearly has sup­port­ers. Dr. Gregg Dwyer, a psy­chi­a­try and be­havioural sciences pro­fes­sor at the Med­i­cal Univer­sity of South Carolina in Charleston, has col­lab­o­rated with Fe­do­roff on re­search, and shares his be­lief that pe­dophilia is a sex­ual in­ter­est, not an ori­en­ta­tion. As peo­ple grow older, their in­ter­ests usu­ally shift to part­ners sim­i­lar in age, he said, so pe­dophiles ought to also be mal­leable.

“Healthy in­ter­ests change. Why would un­healthy ones be some­how spe­cial?”

The Ot­tawa man said he has had pe­dophilic urges for most of his life, and 30 years ago was con­victed of an ac­tual hands-on of­fence against a child. He didn’t be­lieve he could change.

But af­ter un­der­go­ing treat­ment that in­cluded adult porno graphic stim­u­la­tion, he said he be­came a new man.

“When I look at a child now, I look at a child, it’s as sim­ple as that,” the pa­tient said. “Be­fore I would fan­ta­size cer­tain sit­u­a­tions. I don’t do that any more.”

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