Psychological Treatment of Priest Sex OffendersBy Curtis Bryant
The painful news of priest sex offenders is back, emerging with the familiar tale of suffering, shame and sorrow. Even though most of these stories are about events that took place over a decade ago, they have the effect of re-wounding.
The pressing questions: How frequent are cases of priest-offenders? What percentage of the priest population? The simple answer is that we do not know. Researchers believe that pedophiles make up about 3 percent to 6 percent of the population. While no one knows for sure the exact percentage of priest pedophiles, no serious researcher has established that there are more pedophile offenders in the ranks of the priesthood than elsewhere. The Archdiocese of Philadelphia places its percentage of priest pedophiles at 1.8 percent. While even one abusing priest is too many and does terrible damage, there is no easy way to root out pedophiles from the clergy, just as there is no easy way to eliminate them from the population at large. The statistically unusual group of priest sex offenders is that of ephebophiles (attracted to post-pubertal minors), whose target population is males between 15 and 17 years of age. Generally, it is difficult to get an adolescent male to do something he does not want to do, though priest abusers tend to prey on vulnerable or naive ones. Researchers divide offenders into two broad groups: the sex-force offender, who uses coercion or physical force and the sex-pressure offender--the "groomer," characterized by an absence of physical force, who uses enticement, persuasion and entrapment. The vast majority of priest sex offenders are "groomers."
What causes a priest to become a sex offender? The most striking characteristic of sex offenders is their apparent normality, though many priest offenders have traits consistent with narcissism or dependent personality disorders. This means that they lack the capacity for normal empathy, they are not appropriately autonomous, or they lack the normal social skills of their age group.
What further complicates the picture is that each psychological approach has its own theories to explain sexual attraction to minors. Psychodynamic psychologists see sexual abuse as a manifestation of arrested development, mastery of trauma through repetition or identification with the aggressor when one has been abused. Behaviorists interpret sexual abuse as the result of maladaptive learning, modeling or conditioning from early childhood experience. Sociological and feminist analysts blame socialization through pornography or advertising, cultural tolerance, male socialization to dominance, patriarchal norms and other repressive attitudes toward sexual behavior.
Sex offenders were themselves often sexually victimized in childhood or adolescence. Saint Luke Institute, a psychiatric hospital outside of Washington, D.C., has kept psychosocial histories of priest sex offenders for over a dozen years. These histories show that over 50 percent of the priests treated were abused as children. This is much higher than the estimates for the male abuser population at large, which is placed at about 30 percent.
Researchers suggest that the sexual abuse of boys has been vastly underestimated and that rates of abuse among girls are only slightly higher than among boys. Boys are even less likely than girls to report sexual assaults or have such assaults reported on their behalf. Boys are less supervised, which makes them more vulnerable; boys are thought to need less protection because they are judged in terms of "toughness," in contrast to the protection that girls receive.
There is no reason, therefore, to believe that priests become sexual offenders of adolescent males either because they are striving to be celibate or because of their sexual orientation. Some priests who have sex with adolescent boys have an adult heterosexual adjustment. They have sex with adolescent males for a number of reasons: social immaturity, identification with the adolescent, lack of opportunity to be intimate with women. Adolescents are seen as more "feminine" than adult men.
Since 1985, when the news of priest pedophiles came on the scene, some priests were thought to wreak havoc on minors unimpeded because church officials appeared more concerned with protecting the reputation of the institution and the clerical profession than in safeguarding its own children.
I say "appeared" because the church before the mid-80's was more naive than cynical. Initially, the church viewed sexual offenses as sins to be confessed rather than a sickness to be treated. Catholic authorities liberally forgave and trusted the offending priest (as they would any penitent) instead of pulling him out of ministry. This was reinforced by the carry-over of a medieval sense of loyalty that existed between the bishop and his priest that was analogous to that between the lord of the realm and his knight. It was also at this time when many parishes had to close because of a shortage of priests, and pulling someone out could not be done "on the hearsay of detracting individuals."
Church officials have had over 15 years to understand the gravity of priest sex offenders, the abhorrence of sexual abuse, the need to provide help to victims and the need for policies to insure protection from such practices. Part of that protection is the treatment of priest sex offenders--to do all that can be done to make sure they do not abuse again.
There has been a shift in the treatment programs for sexual offenders. Early programs often had a medical emphasis and employed physical techniques like castration, neurosurgery (lobotomy) and antilibidinal medication. The 1970's saw an increase in behavioral methods, but many of these programs were narrow in emphasis, focusing primarily on sexual deviation and often using aversive techniques. In the 1980's and 90's many programs expanded to incorporate psychodynamic, cognitive-behavioral and relapse-prevention techniques.
Treatment at Saint Luke Institute, for example, lasts approximately six months and involves three phases. The induction phase resolves any crises that might interfere with treatment--suicide prevention, medicating as necessary, attendance at the appropriate 12-step meetings and identifying denial, avoidance or manipulations that forestall treatment.
Letting go of the persona of priest (moving from "the one who helps" to "the one who is helped") and learning to be a patient is met with much resistance. Priests, like doctors or therapists, resist because they are used to being in control and are uncomfortable in any dependent position. They are vulnerable to career loss and therefore vigilant to any perceived threat. A feeling of "uniqueness," supported by their profession, encourages grandiosity, making the recovery process a "put-down." Their earlier seminary training, promoting intellectualization rather than feeling, becomes a liability. The very basis of their professional identity may be compulsive "helping others" and ignoring self. The competitiveness professionals experience supports secrecy and limited self-disclosure.
During this monthlong phase, art therapy and bioenergetics are utilized to neutralize both intellectualizing as a defense and the common problem of alexithymia (the inability to name feelings). During this time they write a detailed sexual history or "log" as a focus for their individual and group therapy.
The next phase is called the work phase, in which priest patients give their sexual logs to their priest peers. At a second setting the patient who has given his sex history listens while the priest patients give their feedback. It is here that the patient may get the most complete listing of the distortions, evasions, irrational beliefs and so on that support his offending behavior. Priest sex offenders are often more astute than therapists at detecting other priest offenders' attempts to minimize, deny, rationalize, justify or excuse their behavior.
They also bring into a small group process the material from their sex logs. This psychodynamic experience lasts for 90 minutes three times a week for the next five months. The issues that develop can then be re-enacted in psychodrama (in which the patient takes on the role of the protagonist who finds himself "stuck," traumatized or unable to feel) and replays the scene with its attendant catharsis.
Psychopharmacologic agents are sometimes introduced in an attempt to modify the sex offender's preoccupation, behavior and motivation. Hormones like estrogen have been used to decrease sexual arousal. The particular object of the offender's desire is unchanged, but the intensity of the desire is reportedly weakened.
The third phase is called the consolidation phase. A continuing care contract is drafted that serves as the basis for continuing therapy and external accountability for the next five years. The patient will be invited back at six-month intervals to review his performance and to update the contract for the succeeding six months. Inquiries are made as to whether any allegations have been brought to the attention of the sponsoring diocese or provincial or a law enforcement agency during the preceding period.
The treatment goals include that: 1) the priest acknowledges that he does have a sexual problem; 2) he accepts responsibility for his sexual behavior; 3) he understands the sequence of thoughts, feelings, events, circumstances or "triggers" that make up the pattern that precedes his sexually offensive behaviors; 4) he learns relapse prevention techniques to disengage from his offense pattern and call upon the procedures or "tools" in order to stop; 5) he develops alternative and more appropriate modes of self-expression, need gratification and impulse management through educational and skill-building competencies; 6) he grows in his appreciation of the serious consequences for others and himself of his sexual activity; and finally, 7) he acknowledges that his sexual disorder cannot be cured but can be treated, cannot be eliminated but can be controlled; that his disorder is chronic and must be faced and worked on indefinitely.
Is Treatment Effective?
Is there evidence that treatment programs for sexual offenders are effective in reducing rates of reoffending? Some sex offenders can be effectively treated so as to reduce recidivism. Most follow-up studies use official records to determine the incidence of re-offending, which often underestimates the true figures. Saint Luke Institute determines relapse by information provided by the sponsoring diocese or religious order, by police or other public records reported to the diocese. From 1985 to 1995, of over 450 priests treated at the institute, only three relapses were reported (and these cases did not involve physical contact).
The treatment of clergy sexual offenders is lengthy and costly. In the current economic climate, there is increasing pressure to justify such high levels of expenditure, out of a limited church treasury, when treatment will seldom enable priests to return to ministry. While there may be no return of clergy to ministry in many instances, society at large should be safer because they have been treated.
Return to Ministry
Once treatment is completed, can a priest return to ministry? Under what conditions? What controls? How monitored? Should the parish be informed? These are very difficult questions. About 15 years ago, a parish in the Midwest lost its pastor, and the bishop said that the parish would have to close. The elders of the parish went to the bishop and begged for a priest, for they lived far away from the next town and wanted to keep their parish. The bishop said that the only priest he had was a pedophile. The elders got together and caucused. They went back to the bishop and said that they would be responsible for the priest. They would train the altar boys themselves and supervise the priest as necessary. They ended by telling the bishop that they preferred a broken priest to an arrogant one.
Treating priest sexual offenders means coming to terms with the fact that the problem is complex and tenacious and that promises of rapid solutions are not likely to be fulfilled. Treatment and rehabilitation are ambitious undertakings, requiring constancy of purpose and sustained mobilization of social resources. The required degree of cooperation between the criminal justice and mental health systems has rarely been achieved. To send people who seek treatment for their sexual disorders to the criminal justice system is ineffective and inhumane. So-called zero tolerance policies can lead to conduct unbecoming a loving Christian community. We need to find ways to meet the legitimate concerns of the criminal justice system and the ability of mental health treatments to make sex offenders responsible for their behavior. Moreover, we need to make Gospel forgiveness and reconciliation available to the offending priest. To paraphrase a line The Los Angeles Times reported recently: "My fear is the church will be perceived as switching from being careless in treating abused children to being careless in treating abusing priests."
Curtis Bryant, S.J., is a licensed psychologist practicing in Los Angeles and the former Director of Inpatient Clinical Services at Saint Luke Institute, Washington, D.C.