Cognitive Behavior Therapy (CBT) is a type of psychotherapeutic intervention aimed at altering thinking and behavior patterns focusing on a person’s thoughts, beliefs, images, attitudes, or conceptions. This therapy model ultimately aims at alleviating faulty conceptions, cognitive distortions, improving behavior and emotional regulation, and developing healthy coping strategies. As is true for psychotherapy in general, self-motivation is important for the success of Cognitive Behavior Therapy. A psychological intervention in terms of Cognitive Behavior Therapy can be very useful for people with pedophilic / hebephilic disorder to learn how to live with their sexual preference and how to control their sexual behavior.
Child Sexual Abuse
Child Sexual Abuse (CSA) is a form of child abuse wherein an adult or a late adolescent makes use of a child for the purpose of sexual stimulation or gratification. CSA is non-consensual by nature and can have long-lasting effects on the victim. Forms of CSA include indecent exposure of genitals to a child, performing sexual acts in the presence of a child, engaging a child in sexual activity either with another child or an adult, involving a child in the production of → child sexual abuse images (so-called “child pornography”), showing pornographic images to a child.
Child Sexual Abuse Images
Child Sexual Abuse Images (CSAI), frequently referred to as “child pornography”, is a critical type of child sexual abuse. CSAI are images or videos illegally produced for the consumption of adults or late adolescents for the purpose of sexual arousal or gratification. The images or videos portray children in erotic and sexual poses and acts or engaged in sexual activity with other children and/or adults. The inclusion of children in the process of production and distribution of child sexual abuse images is offensive by nature, but even watching this material is exploitative and illegal in most countries. Once the material is circulated, it is almost impossible to completely remove them from the internet again. Hence, for the victims who most of the times know or assume that the material is online, child sexual abuse images therefore represent a lifelong confrontation with the abuse they have experienced.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the current edition of the Diagnostic and Statistical Manual of Mental Disorders, first published in 1952 by the American Psychiatric Association (APA). The primary purpose of publishing DSM was to introduce a common language and standard criteria for classification and diagnosis of mental disorders. It is commonly used by clinicians, researchers and other relevant agencies.
Pedophilia is a sexual preference for pre-pubescent children. Exclusive pedophilia is a specifier mentioned in DSM-5 for individuals who are exclusively attracted towards the body scheme of pre-pubescent children and not towards the body scheme of adults.
Hebephilia is a sexual preference for early-pubescent children. Exclusive hebephilia is a specifier defining individuals who are exclusively attracted towards the body scheme of early-pubescent children and not towards the body scheme of adults. For instance, a person with exclusive hebephilia could be sexually attracted towards early-pubescent girls/boys, but not be sexually attracted towards adult women/men, or towards pre-pubescent children.
Early-pubescence describes the beginning stage of human development in children in which the puberty has just begun. The bodies show signs of development of secondary sex characteristics like growing of pubic hair for both genders or breast for females.
Hebephilia is the sexual preference for early-pubescent children who have just entered puberty. These children are generally between ages 11 and 14, and show early signs of sexual development like development of pubic hair or in case of girls, breasts. Hebephilia remains stable throughout life and cannot be altered or changed. There are individuals who may suffer greatly as a result of this sexual preference, which can cause clinically significant distress.
Similarly, a person with hebephilia might also have a clinically significant hebephilic disorder. A hebephilic disorder is present if a person with hebephilia is distressed by the preference and fantasies involving early-pubescent children, or if the person has acted out on them.
Mindfulness Therapy is widely known as Mindfulness-based Cognitive Therapy, which incorporates methods and approaches from CBT and methods from Mindfulness meditation practices. Mindfulness is a mental process of being completely aware of the self in any situation one is in. This awareness includes but is not limited to psychological and physical experiences or changes one is undergoing. One can develop mindfulness through practice of meditation and other various trainings.
Persons with non-exclusive pedophilia are individuals who are primarily attracted towards the body scheme of pre-pubescent children, but are also sexually attracted towards the body scheme of adults. For example, a person with non-exclusive pedophilia could be attracted towards pre-pubescent girls/boys and be sexually attracted towards adult women/men.
People with non-exclusive hebephilia are persons who are primarily attracted towards the body schemes of early-pubescent children, but are also attracted towards the body schemes of adults. Hence, a person with non-exclusive hebephilia could be attracted towards both early-pubescent girls/boys and adult women/men.
Pedophilia is the sexual preference for children who in terms of bodily development have not yet entered puberty (generally up to the age of 10 to 11 years). Pedophilia remains stable throughout life and cannot be altered or changed. There are individuals who may suffer greatly as a result of this sexual preference, which can cause clinically significant distress.
Primary Prevention of Child Sexual Abuse by Treatment
Primary Prevention by definition means applying interventions for people at risk before the event can ever occur. In the case of preventing → Child Sexual Abuse (CSA), “Primary Prevention by Treatment” is a proactive approach to provide psychotherapeutic treatment for individuals with → pedophilia and/or → hebephilia to support them to not act out on their fantasies and/or to use → child sexual abuse images (CSAI). The treatment contains learning how to manage one’s sexual preference, how to cope with distress, and to lead a satisfying, offense-free life.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person with pedophilia has a pedophilic disorder, when the person has experienced urges or fantasies involving pre-pubescent children for at least six months, and, when the person is distressed by these fantasies about prepubescent children, or when the person has acted out on them.
Pre-pubescence is a term explaining a stage of human development wherein children, both male and female, have not entered puberty yet. That means that their bodies have child-like characteristics, like no pubic hair, or no breast development in females.
Preference is generally known as a considerable liking for one alternative over another. Sexual preference or sexual orientation is an enduring pattern of sexual or romantic attraction, and it is closely connected to an individual's sexual fantasies. This sexual preference can relate to different aspects: for instance a sexual preference for a specific gender (for instance hetereosexuals being attracted to the opposite gender, and homosexuals being attracted to the same gender), or a sexual preference for what we call body scheme, for instance the body scheme of adults, or the body scheme of early-pubescent children. A preference is not the same as behavior.
Sexual fantasy is a pictographic image or pattern of thought that can create or enhance a person’s sexual arousal. Sometimes it is even referred to as an erotic fantasy. Such fantasies can be a result of external stimulation (such as videos) or created through the person’s imagination or memory. Each person has an individual pattern of sexual fantasies that arouses them most - and no one chooses that pattern.
In literal terms, surrogate means a substitute. In the context of child sexual abuse, the term surrogate offender describes the group of people who abuse children even though they are attracted to other body schemes, e.g. adults. Hence, they have used the children as a substitute for adults.