Pedophilia and Exhibitionism 9781487576424

Citation preview

PEDOPHILIA AND EXHIBITIONISM

Pedophilia and Exhibitionism

A Handbook by J.W.MOHR R.E. TURNER M.B.JERRY

UNIVERSITY OF TORONTO PRESS

@ UNIVERSITY OF TORONTO PRESS 1964

Printed in Canada Reprinted in 2018 ISBN 978-1-4875-7717-9 (paper)

Foreword PROFESSOR KENNETH G. GRAY,

M.D.,

Q.c.

Professor of Forensic Psychiatry University of Toronto

Many studies of sexual offences are carried on for some years and then tend to be discontinued. The studies which form the basis for this book have been conducted at the Forensic Clinic of the Toronto Psychiatric Hospital, established by the Government of Ontario in affiliation with the Department of Psychiatry of the University of Toronto. Provision was made, not only for diagnosis and treatment, but also for teaching and research on a continuing basis. The findings which are presented in this book demonstrate beyond question the social value of such endeavours. The approach to definitions and categorization, well substantiated in this work, should clarify essential problems which have beset previous studies. Psychiatrists will find a great deal of information about selection of cases for treatment. The prognosis for sex offenders is generally good but it is better for some categories of offenders than others. For example, the heterosexual pedophile who is a first offender is not likely to repeat; the outlook for the homosexual pedophile with a criminal record is much less favourable. With rare exceptions, the sex offender is not mentally ill or mentally defective, except with regard to his sexual deviation. Psychotic pedophiles are rare; they are a bad risk and should not be treated outside an institution. Judges and magistrates will find here information that is of value in sentencing a sexual offender. Research has produced data which provide a reasonably accurate prediction about the likelihood of recurrence. The prediction cannot be made about sex offenders generally because the recidivism rate varies with such factors as the type of offence, the nature of the act, and previous criminal record. Social workers and educators will be particularly interested in the description of sexual molestation of young children. They will be able to convey such information to parents whose child has been assaulted and will be better able to assess the effects on the child and to deal with them.

Preface

The primary purpose of this book is to explore the nature of two forms of sexual behaviour which represent the majority of sexual offences coming to the attention of the courts. The emphasis is less on the psychological dynamics of individual offenders than on the social significance of the deviant behaviour. The material presented emerged from empirical study and research on cases referred to a psychiatric clinic, which was specifically established to assist the courts in the assessment and treatment of offenders. The choice of exhibitionism and pedophilia was made on purely quantitative grounds, and quantitative considerations remained a leading factor throughout the study. The bizarre and exotic phenomena of sexual behaviour too frequently overshadow the far greater amount of human misery which can be observed daily in our lower courts. All too often the problems of the sexual offender are seen in terms of isolated but highly publicized cases of atrocities, with the result that the minor sex offender ( who is by far in the majority) tends to be seen as a potential fiend and maniac. In the absence of a clear picture of the natural history of the various sexual deviations and resulting offences, predictions of the subsequent behaviour of an offender are at best tenuous. The organization of the material presented major difficulties. In reviewing the literature on pedophilia and exhibitionism, we found no systematic account of pedophilia, and only one book specifically devoted to exhibitionism ( Rickles 1950) which deals mainly with clinical considerations. It therefore became necessary to expand our own researches into a handbook on the sexual offences arising out of the two deviations. Incorporating comparative data from the literature posed many problems because of the diversity of definitions, samples, and classifications used in various studies. Completeness has only been attempted in regard to actual data and not in regard to opinions and interpretation; we realize this approach may have resulted in a loss of clarity in some instances.

viii /

PREF ACE

Being a handbook, the account is not directed to any specific discipline or profession dealing with sexual offenders. Depending on the kind of information for which the reader is looking, various chapters may prove of greater or less interest. The account of both deviations follows approximately the same structure, which should facilitate cross references. The usefulness of any data, however, will depend on some familiarity with the discussion on definitions and the structure of the model we adopted. We hope that the information contained in this volume will not only assist the medical and social scientist, the judiciary, law enforcement and rehabilitation agencies but will also contribute to public enlightenment and legislative improvements. It is unavoidable in an undertaking such as this that, in spite of a considerable amount of effort, the validity of various accounts will be uneven and a number of lacunae will remain. It is our hope that further research will fill the gaps which we are conscious of in this book. In the continuing process of study one must start at some point to consolidate what has been gained and to share it, in the belief that others will derive benefits even though the last word has not been spoken.

J.W.M. R.E.T.

M.B.J.

Acknowledgments

Studies leading to this volume were supported by Canadian Mental Health Research Grant #065-5-276. Dr. J. R. B. Ball has contributed the personal follow-up data and was involved in the project from June 1960 to June 1961. We are also grateful for the support of the Mental Health Branch, Department of Health, Government of Ontario, under Dr. B. H. McNeel, and the support and encouragement of Dr. A. B. Stokes, Head of the Department of Psychiatry, University of Toronto, and Dr. J. G. Dewan, Director of The Toronto Psychiatric Hospital. The studies could not have been undertaken without the work of our colleagues at the Forensic Clinic. Dr. H. C. Hutchison, chief psychologist, and Mr. V. Hartman, chief social worker, served as consultants with regard to various facets of the study. The work of Dr. D. Paitich, senior psychologist, has helped us greatly in the difficulties of initial conceptualization and Drs. E. Markson and P. G. Thomson, consultant psychiatrists, have guided us in delineating our structurally oriented phenomenological approach from psychodynamic considerations. Dr. R. E. Stokes has read the whole manuscript and made numerous suggestions for improvements. The major contributing factor, however, was the spirit of inquiry and exchange and the high quality of work carried on at the clinic. All of this is a tribute to our mentor in forensic psychiatry, Dr. K. G. Gray. Permission to quote figures and tables was kindly granted by Macmillan & Co., Physicians Post Graduate Press for the Journal of Diseases of the Nervous System, the National Association for Mental Health for the Journal of Mental Hygiene, the International Journal of Social Psychiatry, as well as by Louise V. Frisbie, Dr. Bernard C. Glueck, Drs. Eugene Revitch and Rosalee G. Weiss. Information received from the Kinsey Institute and its staff, Dr. Bruno Cormier and his research group, the National Council on Crime and Delinquency and Dr. Ian Gregory is also gratefully acknowledged. Finally, our editors at the University of Toronto Press have painstakingly sifted the manuscript and have done a great deal to improve the presentation of the material.

Contents

FOREWORD

by Dr. K. G. Gray

V

vii

PREFACE

ix

ACKNOWLEDGMENTS

PART ONE: INTRODUCTION

3

INTRODUCI'ION

I. The Approach

3

II. Scope of the Study

5

A. Follow-up study of sexual offenders referred to a forensic outpatient clinic, 6; B. Supportive studies, 6; C. The literature, 7 PART TWO: PEDOPHILIA 1.

TIIE NATURE OF TIIE DEVIATION

I. Definitions A. Clinically oriented case studies, 12; B. Criminologically oriented group studies, 14

II. A Phenomenological Model

11 11

16

A. The object (victim), 16; B. The act, 17: (a) heterosexual acts, 18, ( b) homosexual acts, 19; C. The agent (offender), 20

2.

THE OBJECT AND THE ACT

I. The Victim (Object)

22

23

A. Age of victim, 23; B. Age difference between victim and offender, 26; C. Relationship of victim and offender, 28

II. The Offence (Act) A. Place of the offence, 30; B. The nature of the act, 32

30

xii /

3.

4.

CONTENTS

III. The Role of the Victim and Effects of the Offence A. Victim participation, 34; B. Effects, 35

33

THE OFFENDER

38

I. Age Factors A. Onset of pedophilic behaviour and first charges, 42: (a) P.het., 42, (b) P.ho., 43, (c) P.und., 45

38

II. Personal and Social Characteristics A. Intelligence and education, 45: (a) intelligence, 45, ( b) education, 48; B. Occupation and social interests, 49: (a) occupation, 49, ( b) social interests, 52; C. Country of birth and place of residence, 54; D. Religion, 55

45

III. Family Background A. Parents, 58: (a) absence of parents from the home, 58, ( b) relationships with parents, 59; B. Siblings, 64; C. Marital status: 66 (a) single pedophiles, 67, ( b) married pedophiles, 68; D. Children, 72

57

LEGAL AND CRIMINOLOGICAL FACTORS

75

I. Criminal Charges and A. Child murder, 76; C. Intercourse without acts, 80; E. Homosexual

5.

Incidence B. Intercourse with violence, 77; violence, 78; D. Non-coital sexual acts, 81

75

II. Criminal Records and Recidivism A. Previous record and recidivism, 83; B. Age and recidivism, 84

82

CLINICAL AND CORRECTIONAL FACTORS

86

I. Aetiology II. Psychiatric Diagnosis A. Psychosis and organic states, 88; B. Neurosis, 89; C. Mental deficiency, 89; D. Character and behaviour disorders, 90

87 87

III. Psychological Assessment

90

IV. Social Factors A. The adolescent pedophile, 94; B. The middle-aged pedophile, 94; C. The senescent pedophile, 95

93

V. Treatment A. Motivation for treatment, 95; B. Forms of treatment and results, 96: (a) individual therapy, 96, (b) group therapy, 97, ( c) organic treatment, 98

95

VI. Follow-up

98

CONTENTS

6.

/

xiii

101 101

SENTENCE AND DISPOSITION

I. Factors Influencing Sentence A. The adolescent offender, 102; B. The middle-aged offender, 103; C. The senescent offender, 103

II. Present Mode of Disposition A. The use of fines, 104; B. Probation and outpatient treat-

104

ment, 105; C. Imprisonment and hospitalization, 105

III. Special Legislation

106 PART THREE: EXHIBITIONISM

7.

THE NATURE OF THE DEVIATION

I. Definitions

111 111

A. Clinically oriented case studies, lll; B. Criminologically oriented group studies, ll3

II. A Phenomenological Model

115

A. The object (victim), ll5; B. The act, ll5; C. The agent (offender), ll6

8.

THE OBJECT AND THE ACT

I. The Victim (Object)

A. Age of victim, ll7; B. Relationship of victim and offender,

117 117

ll8

II. The Offence (Act)

119

A. Place of the offence, ll9; B. The nature of the act, ll9

9.

III. Effects of the Act on the Victim

121

THE OFFENDER

122

I. Age Factors

122

A. Onset of symptoms and first charges, 125; B. Exhibitionists over the age of forty, 126

II. Personal and Social Characteristics

A. Intelligence and education, 128: (a) intelligence, 128, (b) education, 130; B. Occupation and social interests, 131: (a) occupation and work records, 131, (b) social interests,

128

134; C. Country of birth and place of residence, 135; D. Religion, 137

III. Family Background

A. Parents, 138: (a) absence of parents from home, 138, (b) relationship with parents, 139; B. Siblings, 143: (a) number of siblings in family, 143, (b) birth order, 143,

138

xiv /

CONTENTS

(c) male and female siblings, 144, (d) relationship with siblings, 145; C. Marital status, 145: (a) single exhibitionists, 146, (b) married exhibitionists, 147; D. Children, 151 10.

LEGAL AND CRIMINOLOGICAL FACTORS

153

I. Criminal Charges and Incidence A. Charges, 153; B. Incidence, 154

153

II. Criminal Records and Recidivism A. Previous record and recidivism, 156 11.

CLINICAL AND CORRECTIONAL FACTORS

I. Aetiology

155 158 158

II. Psychiatric Diagnosis A. Psychosis, 159; B. Neurosis, 160; C. Mental deficiency, 160; D. Character and behaviour disorders, 161; E. Exhibitionism and voyeurism, 161 III. Psychological Assessment

162

IV. Social Factors (Summary)

164

V. Treatment A. Motivation for treatment, 165; B. Forms of treatment and results, 166: (a) individual therapy, 166, ( b) group psychotherapy, 166 VI. Follow-up

165

12.

159

167

SENTENCE AND DISPOSITION

169

I. Mode of Disposition

169

II. Special Legislation

170

APPENDIXES

Appendix A. Study Population and Follow-up

173

Appendix B. Personal and Social Data

180

Appendix C. Background Data

187

BIBLIOGRAPHY

195

INDEX OF NAMES

203

Tables ( See also Appendix for Comparative Data)

PEDOPHILIA

I. Age of Victims at Time of Offence II. Atascadero Hospital, Age and Sex of Victims of Child Molesters III. Psychological Age of Sex Offenders and their Victims IV. Age of Offender and Victim V. Relationship Between Victim and Offender VI. California Study, Offender's Relationship to Child Victim VII. Cambridge Study, Previous Association between Victims and Offenders VIII. Place of Offence IX. Acts Constituting the Offence X. California Study, Type of Sex Offences XI. Atascadero Hospital, Age Distribution of Sex Offenders comparing all Offences with Child-Molesting XII. Mean and Range of 1.Q.'s XIII. Distribution of I.Q.'s compared with Standard Data XIV. Final School Grades XV. Comparison of Offenders' Final Grades and 1.Q.'s XVI. Occupations XVII. Judgment of Work Records XVIII. Sing Sing Study, Work Effort XIX. Social Interests XX. Sing Sing Study, Active (Organized) Group Membership XXI. Country of Birth XXII. Religion XXIII. Sing Sing Study, Religious Attitudes (Beliefs) XXIV. Absence of Parents from Home XXV. Relationship with Parents XXVI. Distribution of Siblings XXVII. Position in Birth Order XXVIII. Male-Female Sibling Ratios XXIX. Marital Status

23 24 27 27 28 29 29 31 32 33 41 46 46 48 49 50 51 52 53 54 54 56 57 58 60 64 65 65 67

xvi /

TABLES

XXX. Single Pedophiles: Adult Heterosexual Relations XXXI. Age at Time of Marriage XXXII. San Quentin Study, Comparison of Maritual Status XXXIII. San Quentin Study, Comparison of Marital Status ( Adjusted Data) XXXIV. Sing Sing Study, Age at First Marriage XXXV. Length of Marriage at Time of Referral or Separation XXXVI. Children of Married Pedophiles XXXVII. Sing Sing Study, Children of Married Pedophiles

67 69 69 70 70 71 73 73

EXHIBITIONISM

XXXVIII. Range and Central Tendencies of Age at Intake XXXIX. Mean Ages at Onset, First Charge, and Intake XL. Mean and Range of 1.Q. XLI. Distribution of 1.Q.'s Compared with Standard Data XLII. Final School Grades XLIII. Offenders' 1.Q.'s, Final School Grades XLIV. Occupations XLV. Grassland Hospital Study, Occupations of Exhibitionists XLVI. Cambridge Study, Occupations of Exhibitionists XLVII. Judgment of Work Records XLVIII. Social Interests XLIX. Country of Birth L. Religion LI. Participation in Church LIi. Absence of Parents From Home LIii. Relationship with Parents LIV. Distribution of Siblings LV. Position in Birth Order LVI. Male-Female Sibling Ratios LVII. Marital Status LVIII. Adult Heterosexual Relations of Single Exhibitionists LIX. Age at Time of Marriage LX. Length of Marriage at Time of Referral or Separation LXI. Comparison of Marital Status of Exhibitionists in Six Studies LXII. Children

124 125 128 128 130 130 132 133 133 134 135 136 137 137 139 139 143 144 144 146 146 147 148 148 151

Figures

PEDOPIDLIA

1. Ages of male and female victims

2. 3. 4. 5.

Distribution of age at time of pedophilic offence Distribution of age of non-court referrals at intake Distribution of age at intake for P.het. and P.ho. Model distribution of ages of offenders at which pedophilic offences occur 6. P.ho., 25-44 years of age, distribution of age at first charge

24 39 39 39 42 44

EXIIlBITIONISM

7. Distribution of age at intake 8. Distribution of age of non-court referrals at intake 9. Distribution of age at onset of symptoms and first charge

123 123 125

Introduction

I. THE APPROACH Sexual deviation and sexual offences can be and have been studied from a variety of viewpoints using a number of different methods and theoretical structures. The terms themselves are dependent on and conditioned by cultural norms, from which a certain form of behaviour is felt to be deviant, and by legal norms, which constitute the nature of an offence. Within this cultural configuration and its legal institutionalization, sexual behaviour other than adult heterosexual coitus in marriage and in private has been considered variously as aberrant, abnormal, perverse, inverse, deviant, variant, offensive, paraphilic, and so forth. These terms carry within themselves a relationship to standards of morality, physical and mental health, social functioning, and legal culpability. Since, until recently, relatively little was known about the distribution of the various forms of sexual behaviour in society at large, these standards were, and still are, drawn almost exclusively from ideological norms. As a consequence, situations develop in various jurisdictions, as Kinsey ( 1948) pointed out, in which a high percentage of the population would face criminal charges at some time in their lives if the law were strictly enforced; by the same token, a somewhat lower, but still a very high percentage of the population would have to be considered morally, psychologically, and socially abnormal. This state of affairs, which prevails to a greater or less degree in most Western societies, has a severe negative effect on the basic conditions governing studies on the phenomena of sexual deviation. First, there is the emotional loading of the subject, which led Guttmacher and W eihofen ( 1952) to say that " ... there is doubtless no subject on which we can obtain more definite opinions and less definite knowledge." Secondly, and even more important because harder to detect, is the tendency of those reporting to generalize from insufficient material which does not bring out distinctions between the idiosyncratic features of the persons under study and common features of the symptom group which is described. Thirdly, and as a sequel to the

4 /

PEDOPHILIA AND EXHIBITIONISM

foregoing, various contradictions arise which are reminiscent of the story of the blind men and the elephant, in which each man detects a certain part of the elephant and describes the whole elephant by this experience. This is exemplified in pedophilia, which is allegedly indulged in by impotent old men on the one hand, and made equal to statutory rape on the other. Impotence and rape, however, are difficult to reconcile. Many diversities and contradictions were unavoidable for the pioneers in the study of sexual behaviour, such as Krafft-Ebing, Hirschfeld, Ellis, and others, who had to work under the greatest difficulties with whatever material they could get. Today, we are in a much more fortunate position. Not only do we have in our favour the results and guidelines of the pioneers, but a new recognition among the public that sexual behaviour is a proper field for study. This makes the collection of more consistent material possible, enabling us to compare findings and order them into a differentiated structure which permits a systematic application to legal, social, and clinical problems. However, accumulated knowledge in the social sciences presents its own difficulties. Depending on the method and theoretical structure used for the exploration and explanation of "deviant" sexuality, the phenomena can be seen as diseases, as deficiencies of one type or another, or as malformations on the physical side. They can also be viewed psychologically as symptoms of intrapsychic dynamic processes, or as maladaptations due to improper conditioning or learning. Sociologically and anthropologically, deviations can be considered as endemic features of the socio-cultural system. Those deviations that constitute offences can also be studied as criminological entities. All these approaches are to a greater or less degree important and necessary, but there is a danger that concepts as well as conclusions may be taken over from one area into another, resulting in a large amount of confusion. For instance, statements such as "sex offenders are immature and passive" become meaningless, if not misleading, because "sex offender" is a legal classification on a high level of abstraction comprising many different charges. If the statement were taken to involve psychological personality characteristics, it would suggest that sex offenders are a uniform psychological group. This is by no means the case. Our studies focused on the natural history of the deviations and their consequences as expressed by the data we were able to collect. The orientation towards the problem was strictly empirical and the method used was that of a phenomenological enquiry. We were not guided by

INTRODUCTION

/

5

specific theoretical systems, nor did we attempt to find causes and explanations for the deviations. However, we did attempt to learn everything we could about the act, the agent (offender), the object (victim), and the history and consequences of the phenomenon. II. SCOPE OF THE STUDY The core of our material was derived from studies conducted at the Forensic Clinic of the Toronto Psychiatric Hospital. This Clinic was established in 1956 to provide psychiatric consultation and diagnostic and treatment services to the courts and the probation service in the province of Ontario, particularly in Metropolitan Toronto and adjacent areas. The Clinic also accepts patients with forensic problems from mental health clinics, hospitals, community agencies, and medical practitioners. Cases of sexual deviation are also accepted on a selfreferral basis. Since its inception, research has been a primary objective for this Clinic. Every patient referred receives a thorough psychiatric, psychological, and social assessment, whether treatment follows or not. Sexual offenders constituted the largest group of offenders referred by the courts ( approximately 40 per cent) and research was, therefore, concentrated on this group. The majority of sexual offenders were pedophiles, exhibitionists, and homosexuals; offenders with other deviations such as sado-masochism, transvestism, and voyeurism appeared only in small numbers. Among non-court referrals, sexual deviants also constituted the largest symptom group, as was in part determined by the policy of the Clinic. The majority of these patients were, however, homosexuals. A comparison between court and non-court referrals shows that in the case of pedophilia and exhibitionism, more than three-quarters of the offenders came from the courts, whereas in the case of homosexuality, more than 80 per cent were non-court referrals. Within the court group, pedophiles and exhibitionists appeared consistently in rather equal numbers followed by about half as many homosexuals. Since the deviant offender rather than the sexual deviation as such is the primary social concern, the main focus of the studies was on the offender. Furthermore, additional information such as court and police records were available on this group, which made it possible to determine criminological factors. Pedophilia and exhibitionism emerged as the two most important deviations to be dealt with, and this conclusion was further reinforced by a study of the literature, which

6 /

PEDOPIDLIA AND EXHIBITIONISM

showed that these two deviations were relatively neglected. Homosexuality between adult partners has received much wider attention in the literature; moreover it is also a deviation which cannot be studied in a court population because of its wide distribution among the general population. The nature of the act, being between two consenting adults, makes detection relatively unlikely if carried out in private, and any court sample must, therefore, be a highly biased one. This is far less true of pedophilia and exhibitionism. The following represent the major sources from which this study was drawn:

(A) A

FOLLOW-UP

STUDY OF SEXUAL OFFENDERS

REFERRED TO

A

FORENSIC OUTPATIENT CLINIC

This study furnished the core of information used in this volume. It covered all patients referred by the courts or related legal agencies ( police, probation, legal counsel) and diagnosed as pedophiles, exhibitionists, or homosexuals from April 1956 to July 1959. The study group was made up of a total of 132 cases, consisting of 55 pedophiles, 54 exhibitionists, and 23 homosexuals; 9 of these cases were classified under two of the three categories. The study had three aspects: (a) a documentary follow-up which was mainly concerned with the criminal records before and after referral to the Clinic; ( b) an analysis of case records in which all the material accumulated on these cases was analysed; and ( c) a personal follow-up which included those patients who were treated at the Clinic and had finished their treatment at least one year prior to the follow-up. ( B)

SUPPORTIVE STUDIES

The foregoing study dealt with offenders seen on an outpatient basis. It was, therefore, important to gain some control information on offenders who were incarcerated. In Canada, offenders with a sentence of two years or more are sent to a federal penitentiary, whereas offenders with a sentence of less than two years are incarcerated in a provincial reform institution. A survey was undertaken of sexual offenders in Kingston Penitentiary ( March 1961). At the time of inquiry, there were 63 sexual offenders in this institution, which constitutes about 6.5 per cent of the penitentiary population. One-third of the sex offenders were rapists followed by those convicted for indecent assault and homosexual and pedophilic offences, but no exhibitionist was present.

INTRODUCTION

/

7

The majority of sexual offenders sentenced to a provincial reform institution in Ontario are detained in the Ontario Reform Institution, Millbrook. A survey undertaken in this institution (June 1961) showed that of 52 offenders, only 1 was an exhibitionist, but 43, or 85 per cent, were pedophilic offenders. In order to clarify further the position of the sample which was studied intensively at the Clinic, relevant police, court, and correctional statistics were collected and analysed.

(C)

THE LI1ERATURE

Written material on general aspects of sexual deviation and sexual offences is extensive. There are also a fair number of case illustrations and case studies of small numbers. However, with the exception of homosexuality, there is an inverse ratio between the importance of a deviation and the amount of literature available. Sexological and psychiatric literature shows more and better accounts of transvestism and fetishism than of pedophilia and exhibitionism. Although the general public concern seems to centre around pedophilia, the least material is available on this deviation. A number of accounts which discuss even such rare phenomena as zoophilia, coprophilia, and necrophilia, do not even mention pedophilia. This is reflected in the Encyclopedia Britannica, where all the major deviations except pedophilia are listed, although the contribution was written by Clifford Allen, who had given accounts of pedophilia under "infanto-sexuality" previously ( Allen 1940, 1949) . In the literature available in English, there is only one book dealing exclusively with exhibitionism ( Rickles 1950), and none on pedophilia. The sociological and criminological literature consists mostly of survey-type studies, which suffer predominantly from a disparity between the charges and the underlying deviation. This disparity is less pronounced in the case of exhibitionism, but pedophilia may be inferred from a great number of charges ranging from statutory rape to contributing to juvenile delinquency. This confusion results in diffuse classifications in which an exhibitionist may be classified as a pedophile if he exposed to a child, and conversely a pedophile may be classified as an exhibitionist if his act consisted of the exposure of his genitals. Because of the wide variety of definitions and classifications, comparative data have to be viewed with care, since different results may stem from differences in the sample. In some instances, the direction of error can be easily identified; in others it cannot. However, data

8 /

PEDOPHILIA AND EXHIBITIONISM

in general are less divergent than the generalizations derived from them. We have, therefore, attempted to include as much of the relevant data as possible on specific topics, but have neglected opinions and generalizations which are not supported by data.

1. The Nature of the Deviation

Overt sexual interaction between adults and children is the least acceptable form of sexual behaviour in modem Western society. Anthropological comparisons show that the attitude of various presentday societies to this form of behaviour differs drastically, depending on the meaning which is allocated to it and the general place of sexuality within the total cultural configuration. The same variety is true for historical times, since the attitude towards special forms of sexual behaviour, customs, and their meanings have changed from epoch to epoch. An outstanding example is the love among male youths in ancient Greece, which is today all too often considered out of context. Although studies of cultural and historical relativism are important for gaining perspective, they are of minor relevance to this study, which considers primarily the nature and consequences of sexual behaviour with children in our society today. It is important to stress this element of time and place because of the plasticity of attitudes toward sexual behaviour, which does not permit absolute pronouncements. It is, therefore, not our purpose to present a global picture of pedophilia, but to give an account of the phenomenon, to circumscribe it, and thus to make it more amenable to scientific study. We shall consider the concepts and definitions that have been proposed in the past, examine the factors which constitute the deviation or the offence, and finally, consider its legal, clinical, and social implications. I. DEFINITIONS Pedophilia-literally, love of children-is a deceptively simple term, generally implying actual or intended sexual involvement with a child. The operational assumptions and the observations which are encompassed by this term, however, are extremely complex and often contradictory and confusing. It is therefore necessary to survey the various assumptions and to deal with their basic aspects before we can present a consolidated structural approach.

12 /

PEOOPHILIA AND EXHIBITIONISM

Observations which have been made on pedophilia fall into two broad categories: (a) clinically oriented case studies, and ( b) criminologically oriented group studies. There is an unavoidable overlapping, since psychiatrists and psychologists have undertaken criminologically based studies, and, conversely, criminologists and sociologists have drawn clinical inferences. In the main, however, most observations in the first category have been drawn from psychiatric practice and in the second from studies on offenders from the courts or from correctional institutions. It will become obvious that various assumptions about pedophilia, its occurrence, distribution, and causes, have been predominantly determined by the place of work and the theoretical orientation of the investigators. A summary of definitions and concepts of pedophilia should provide some basis for understanding differences in data or assumptions in regard to specific factors concerning the offender. It will further underline the difficulties encountered in correlating the available material in the absence of a unified nosological system. (A)

CLINICALLY ORIENTED CASE STUDIES

The term pedophilia was introduced into the technical literature by Krafft-Ebing (1912), who says: ", .. there are cases in which the sexually needy subject is drawn to children not in consequence of degenerated morality or physical impotence, but rather by a morbid disposition, a psychosexual perversion, which may at present be named paedophilia erotica." He considered that these subjects were a small minority and that the largest number of cases of immorality with children could be reduced to conditions of "acquired mental weakness," such as senile dementia, chronic alcoholism, paralysis, mental debility due to epilepsy, injuries to the head, apoplexy, and syphilis. Hadley ( 1926) defines pedophilia as an "abnormally accentuated fondness for children" and Cassity ( 1927) states that "... pedophilia implies an erotic craving for a child of the same or different sex on the part of an adult, which is distinctly asocial only when it attains overt proportions." These two authors, being psycho-analytically oriented, see the causal factors in the weaning trauma, incestuous wishes, and resultant psychic impotence and psychic distortions. Their view follows Freud's formulation that the choice of an immature sexual object is a result of an unresolved oedipus complex. The mature female implies mother, and hence a child is substituted. If the immature object chosen is of the same sex, the interpretation is based on narcissism; the pedophile sees himself in the object and identifies with

PEDOPHILIA : 'IHE NATURE OF THE DEVIATION /

13

his mother. These themes were further developed by Roche ( 1950) and Socarides ( 1959). Castration anxiety, which in analytic theory can be expected to arise out of unresolved oedipal strivings, is emphasized by Fenichel (1945) and Hoppel (1925), as quoted by Cassity (1927). Hammer (1955), using the House-Tree-Person test on pedophiles, also infers tremendous castration anxiety and phallic inadequacy. Karpman ( 1950) noted phobic anxiety about pubic hair as a determinant for the choice of prepubertal children by one of his patients. Freud's ( 1920) dictum that "perverted sexuality is nothing but infantile sexuality, magnified and separated into its component parts" was also followed by Allen ( 1949, 1962) who uses the term infantosexuality and assumes a fixation on an early level of psychosexual development. This fixation is further assumed by Leppman ( 1941) who also believes it to be true for exhibitionists. Outside the psycho-analytic orientation, the major emphasis is on senility, impotence, mental and emotional retardation, and inhibitions against adult heterosexual coitus. Havelock Ellis ( 1933) states: "Apart from senility, there seems to be no congenital sexual perversion directed towards children. There may exceptionally be a repressed subconscious impulse towards unripe girls, but the chief contingent before old age is furnished by the weak-minded." Freud ( 1949), aside from his psychodynamic theories, also saw the pedophile as one who is cowardly or has become impotent. He was followed by East ( 1946), who did not consider pedophilia a major deviation. Senility and impotence are further endorsed by Selling ( 1938 ), Frosch and Bromberg ( 1939), Cushing ( 1950), and Bowman ( 1951) . In regard to psychopathology, Ellis ( 1933) quotes Hirschfeld as saying that in his wide experience he had never seen a child violator who was mentally sound. Yet Ellis himself says at another point: "Every normal man in matters of sex when we examine him carefully enough is found to show some abnormal elements, and the abnormal man is merely manifesting in a disordered, or extravagant shape some phase of the normal man." Kurland ( 1960) presents three cases of pedophilia, in all of which there was schizophrenia. It is, however, well established from larger sample studies, including our own, that pedophilic offenders rarely suffer from psychotic mental illness. Personality characteristics such as immaturity, passivity, and inferiority, which are rather unspecific, are most often named, for example by Abrahamson (1950), Bowman and Engle (1953) , Guttmacher ( 1951), and others.

14 /

PEDOPHILIA AND EXHIBITIONISM

Stevenson and Wolpe ( 1960) suggest the hypothesis, in accordance with Wolpe's theories, that pedophilic acts may occur, not on account of a primary sexual deviation, but because of anxiety evoked by certain kinds of stimulus characteristic of the adult female, which prevents the patient from engaging in adult sexual activity. Karpman's case ( 1950) of phobic reactions to pubic hair would also tend to support this hypothesis. Among current standard psychiatric texts, Mayer-Gross, Roth, and Slater ( 1960) and Henderson and Gillespie ( 1962) make no specific reference to pedophilia, although the former noted sexual acts with children by aged men. Noyes and Kolb ( 1958) see pedophilia as a variant of homosexuality, with no reference to heterosexual pedophilia. Friedman, in the American Handbook of Psychiatry (1959), devotes half a page to the subject and supplies this definition: "A pedophile may be homosexual, heterosexual or both in his choice of objects, and theoretically his activity can take almost any forms, characteristic of heterosexual or homosexual activity with an adult partner." Although this definition might be commonly accepted, it is deficient by its very generality. Gregory ( 1962) is the only one who, in his excellent chapter on sexual offences and deviation, gives a differential breakdown of the pedophilias with some characteristics derived from recent research. ( B)

CRIMINOLOGICALLY ORIENTED GROUP STUDIES

Although most of these studies, in contrast to the foregoing, are based on samples adequate in size, two major difficulties remain. In the first place, the selection of subjects is based on legal definitions of pedophilic acts. These definitions change from country to country, and in the case of the United States, from state to state. In the second place sexual offences such as statutory rape as dealt with under American laws, and sexual intercourse with a female 14 to 16 years of age as dealt with under Canadian laws, are in most cases not offences arising out of a pedophilic deviation. Intercourse between an 18-year-old male and a 15-year-old female cannot be considered as a psychological deviation, even though forbidden by law. Similarly, sexual relations between an 18-year-old male and a 15-year-old male, although a homosexual deviation, cannot in most cases be considered as pedophilic. For the pubescent "victim" group, Glueck ( 1955) has suggested the term hebephilia, literally love of youth. However, it remains doubtful whether this can have any uniform clinical meaning.

PEDOPHILIA: THE NATIJRE OF THE DEVIATION

/

15

As we shall point out later in our phenomenological model of pedophilia, sexual intercourse is not common among pedophilic offences and it is unlikely that such an act is based on a genuine pedophilic deviation. The following studies have to be considered with these reservations. Shaskan ( 1939) reported on the first 100 sex offenders sent to the psychiatric division of Bellevue Hospital in 1937. Of these offenders, 50 were involved in sex play with minors, either male ( 17), female ( 32), or both ( 1). As in several other studies, data were not separated for the various offences, and can therefore not be assessed. Shaskan's group was defined by "sex play with minors" without further specification of the nature of the act or the age of the victim. Frosch and Bromberg ( 1939), who gathered their material during a seven-year period at the psychiatric court clinic in New York City, differentiate pedophilia from statutory rape, as did Apfelberg et al. ( 1944), who define pedophilia further as "gratification from sexual intimacies with a child." This includes exposing, manipulating, and penetration. Although Apfelberg et al. studied exhibitionists separately, it must be assumed that they included among the pedophiles the exhibitionist who exposed to children. This lack of differentiation, as we have pointed out, is a major distortion of any pedophilic sample. Ellis and Brancale (1956), examining 300 sex offenders at the New Jersey State Diagnostic Center, also differentiated their groups, partly by the nature of the charges and partly by the nature of the act and the age of victim. They distinguished a group having "non-coital relations with a minor." A further study at this Center by Revitch and Weiss ( 1962) gives the data on the age of the victims with an upper limit of 15 years. They differentiated heterosexual and homosexual pedophiles and they included in the nature of the pedophilic act noncoital contacts, exhibitionism, and coital contacts, with or without violence. In regard to age of victim as a characteristic of various samples, great fluctuations occur. Some studies simply use "minor" or "child" without further specification. Toobert ( 1959), studying pedophiles at San Quentin, used 12 years as the cut-off point; Hammer ( 1955) at the Psychiatric Institute, New York, included acts against victims up to the age of 15 years; the California Sexual Deviation Research showed victims up to the age of 16 years; and Frisbie ( 1959) gave the age of victims up to 20 years. Glueck ( 1955), at Sing Sing, defined his pedophilic group by the use of prepubertal objects, but in his

16 /

PEDOPIDLIA AND EXHIBITIONISM

tabulation of age of objects, victims over 14 are included in the heterosexual pedophilic group and over 18 in the homosexual pedophilic group. The various factors that determine pedophilia as a clinical entity as well as a criminological grouping will be examined throughout our study. It is apparent, however, that there is such a divergency of basic factors that an attempt to provide a structural clarification has to be made before we can proceed to present data. II. A PHENOMENOLOGICAL MODEL In discussing the definitions and the underlying observations, we have seen that the basic and paramount difficulty is that the term pedophilia means different things to different investigators. Before any further theoretical or practical advances can be made, it is necessary to delimit the primary factors on which the concept depends, to define them operationally, and to organize them into a coherent model. Classification is thus the necessary prerequisite for generalization. Legally, this is attempted by charges and sections, and clinically, by diagnostic categories. In any nosological approach, the important issue is how well categories and models, which are always abstracts, represent empirical facts. Empirical data will therefore be our basic determinant. The primary phenomenological factors determining the concept of pedophilia are the choice of the object (victim) and the nature of the act. These two factors define the agent (offender), who only then can be explored in his personal and social characteristics. The interaction of the three factors will permit inferences on the natural history of the deviation and its consequences. These in turn will provide the basis for considering methods of eliminating or modifying the undesirable and harmful effects of the deviation. Elimination or modification, of course, concerns us most, but they cannot be accomplished without the preliminary steps. (A) THE

OBJECT (VICTIM)

The object of sexual strivings in pedophilia is a child-either male, female, or both. According to the sex of the child we can speak of heterosexual pedophilia and homosexual pedophilia, or undifferentiated pedophilia in cases where children of both sexes are sought. In most instances the sex of the object is fixed so that the undifferentiated group represents only a small minority.

PEDOPlllLIA: THE NATURE OF THE DEVIATION

/

17

The definition of "child," however, presents problems, and because of this a number of studies were less useful as the comparability of various results had been greatly reduced. Upper age limits that have been used range from 12 to 20 years of age and it is quite apparent that if sexual strivings towards an 8-year-old are put into the same category with those towards an 18-year-old, no meaningful results can emerge. Since the deviation is related to the sexual maturity of the object, the natural break-off point would be the onset of puberty, determined by the presence or absence of secondary sex characteristics. This point, however, not only differs generally between the sexes but also with individual children. In practice, this does not present a major difficulty in heterosexual pedophilia, where the majority of victims fall between the ages of 6 to 12 years. In homosexual pedophilia it does present a problem, since the number of victims increases right into puberty, resulting in a statistical overlap with adult homosexuality. For the adolescent group, the term hebephilia has been suggested by Glueck ( 1955). Among heterosexual acts a common characteristic of a hebephilic group can hardly be expected because of the wide range of maturational stages of the objects, with a concomitant variety of sexual intentions. For homosexual acts such a group may turn out to be of special significance. There is evidence that for a number of homosexual adults, the adolescent represents the primary sexual object. This may account in homosexual pedophilia for the further increase of objects over the age of 12, where there is a sharp decrease in heterosexual pedophilia. However, whether homosexual hebephilia is a consistent category will depend on further empirical studies. (B) THE Acr Friedman, in the American Handbook of Psychiatry ( 1959), says with regard to the pedophile: "theoretically his activity can take almost any of the forms characteristic of heterosexual or homosexual activity with an adult partner." This assumption underlies a good deal of the literature and although it can be documented it is not representative of the distribution of empirical findings. As in the case of the age limit of the object, the undifferentiated inclusion of all sexual acts has tended to destroy the emergence of a meaningful category. In assessing the nature of the sexual act, two things have to be considered: the act itself, and the intentionality, or direction, of the act. For example, the exposure of the genitals of the adult male can have various intentionalities; it can be the final aim of gratification, in

18 /

PEDOPHILIA AND EXHIBITIONISM

which case it would be exhibitionistic; it can be done with the purpose of being fondled as the final preferred aim, in which case we would consider it as truly pedophilic; and it can be a preliminary stage to coital activity. Since the nature of the act differs in regard to the two sexes, they are considered separately.

(a) Heterosexual Acts Following the example given before, and considering the empirical evidence, we can distinguish three forms of the sexual act: coitus; deviantly directed acts; and immature gratification. Coitus. Penetration and intravaginal coitus are rare among sexual acts with children, if we bear in mind our definition of child as prepubertal. Not only is the act anatomically unfeasible with the majority of the young children who are being molested, but it is clearly not the intention of the offender. Cases of statutory rape or carnal lmowledge usually involve girls of 14 years and older and these offences are committed by a different group of offenders. These acts tend to represent either normal sexual activity or at best a transitional stage from pedophilia. The contra-legal and sometimes anti-social act involved should be judged in the same way as the breaking of any other legal prohibition, since the act in most cases is not sexually deviant but only legally deviant. Although socially deviant by established norms, the act is not necessarily socially deviant in practice, especially among the lower classes, as Kinsey's figures for the experience of first intercourse point out. Deviantly Directed Acts. Deviations like exhibitionism, sadomasochism, fetishism may also be directed towards children. Although sadistic acts receive great publicity because of their often gruesome nature, they are relatively rare among sexual acts with children and are atypical for pedophilia in general. In milder forms such as spanking for the purpose of sexual gratification, the sexual nature of the act is seldom recognized and prosecuted as such, unless coupled with more overt sexual behaviour. Cases of fetishism directed towards children's clothing and even transvestism are known, but have hardly any social or legal importance. This is not so in the case of exhibitionism. We have pointed out that aside from adult homosexuality, exhibitionism is the other major deviation coming to the attention of the courts. Only a minority of exhibitionists expose to children, but they still represent a significant number. Since exhibitionists and pedophiles differ in various charac-

PEDOPHILIA: THE NATURE OF THE DEVIATION

/

19

teristics and since the circumstances and possible consequences of the act are also different, it is important to draw a dividing line. From factors that will be discussed later with regard to the pedophile and the exhibitionist, it appears that the major differentiating characteristic is the absence or presence of a personal contact. The exhibitionist who exposes to a child ( like the one who exposes to an adult female) does so at a distance and without any intention of further contact. The close proximity which the pedophile desires would be frightening to the exhibitionist. As a result with pedophilia the victim is usually known to the offender, whereas with exhibitionism the objects are almost exclusively strangers. This distinction on the basis of contact will differentiate most of the cases, although some instances will remain which fall into both categories. Immature Gratification. The great majority of sexual acts in heterosexual pedophilia consist of the sex-play type found among children, such as looking, showing, fondling, being fondled. This would indicate that the nature of the sexual act corresponds to the maturity expected at the age of the victim rather than at the age of the offender. The predominant intentionality of the pedophilic act is therefore one of immature gratification. Depending on the age of the offender, according to which we distinguish three groups, the pedophilic act represents an arrested development in which the offender has never grown psychosexually beyond the immature prepubertal stage, or a regression or return to this stage due to certain stresses in adult life, or a modification of the sexual drive in old age. The definition of the heterosexual pedophilic act as immature gratification expressed in sex play is important in marking off a consistent group of offenders for scientific study, and it is especially important in regard to legal sanctions and correctional approaches. As long as every sexual act between an adult male and a female child is seen in the light of murder and rape, no rational criminal policy can emerge. We shall examine the incidence and consequences of sexual acts of adult males with female children in the chapter on legal and criminological factors , even though we do not consider some of these acts pedophilic.

( b) Homosexual Acts Sexual acts in homosexual pedophilia are deviant by the very choice of object, a male person. The homosexual pedophile is, therefore, a "double deviant" in his choice of a male person who is a child. The heterosexual pedophilic act of immature sexual gratification has been

20 /

PEDOPlllLIA AND EXHIBITIONISM

differentiated from coital acts, as well as from deviant acts such as exposing as the final sexual aim. In homosexual pedophilia these differentiations are not possible. As the data will show, the acts in homosexual pedophilia are substantially the same as those in homosexuality with adult partners, with the possible exception of anal and intercrural intercourse, which, however, seem to be also relatively rare between adult homosexuals. Despite the difficulties in differentiating clearly the homosexual pedophilic act and object, significant differences can be observed between the homosexual pedophile and the homosexual engaging in activity with adult partners. Although this study does not deal with the latter group, references are made to it and comparative data are given in the appendix.

( C) THE AGENT (OFFENDER) From the considerations concerning the object and the act, we can define pedophilia as the expressed desire for immature sexual gratification with a prepubertal child. According to the sex of the child, we can distinguish between heterosexual pedophilia and homosexual pedophilia, and, in cases where there is no differentiation in the sex of the object, we use the term undifferentiated pedophilia. Data about the agent or the offender show that most pedophilic behaviour is distributed among three distinct age groups with peaks in puberty, the mid-to-late thirties, and the mid-to-late fifties. There is a small minority of chronic agents who tend to remain pedophilic from childhood on. Thus, according to the three age groups in which pedophilia occurs, we can further classify the deviations as adolescent pedophilia, middle-age pedophilia, and senescent pedophilia. In the literature it is commonly assumed that senescent pedophilia is either the only or the predominant form of this deviation. This is by no means the case. In studies of offenders, especially institutionalized offenders, the middle-aged group consistently emerges as the largest one. However, in regard to such studies, one has to take into consideration that the real peak of adolescent pedophilia may occur in a juvenile age group and therefore not appear among reports on adult offenders. Since the young offender usually gets special consideration from the courts, he is not institutionalized. To a more limited extent, the senescent pedophile as a first offender and with an impeccable life record behind him may also receive special allowances, such as referral for treatment, which could explain the consistent and often exclusive reference to this group in clinically based studies. The

PEDOPHILIA: THE NATURE OF THE DEVIATION /

21

middle-aged group, on the other hand, is often beset with problems of general social breakdown which would tend to increase chances of incarceration. The empirical data which we shall present are derived from samples, which have not been determined by the proposed model. Even in our own studies, as various distributions will show, we have tended towards over-inclusion. At this stage, we feel, it is just as important to know what, in this model, is left out from the whole range of sexual acts with children, as it is to know what is included.

2. The Object and the Act

The model presented in the last chapter was developed from distributions of data, which now have to be substantiated. In regard to the object, or criminologically speaking, the victim, the age factor was found to be the primary determinant. Further factors will be the relationship between the offender and the victim, characteristics of the victim, and the place of offence. The nature of the act is closely related to these factors, for example, coital relations and age. It should be kept in mind that the data presented are not "pure" data in terms of our model. On the contrary, they are data from various studies, on the basis of which the model given in the previous chapter was developed. Most of the data are derived from studies of sexual offences, where the term "victim" is used for "object" and "offender" for "deviant." In order to avoid multiple usage, the criminological terminology has been adopted even though the victim is not always the one who is victimized; in some cases this might rather be the offender. Studies on pedophilia and sexual offences with children have in general focused on the offender. Notable exceptions are Rasmussen ( 1934), Bender and associates ( 1939, 1941, 1952), and the California Sexual Deviation Research ( 1953, 1954), which report observations made directly on the children. Other data, forming the bulk of the information, are derived from police and court records, from the nature of the charges and from information received from the offender. Objective, documentary data, even in themselves, give a picture in many ways different from popular notions about the circumstances of pedophilic acts and the people involved. Julian C. Davis ( 1962) has made a study of various forms of advice given to parents and children in comic books, pamphlets, and films across the United States. ( His description would apply, with some reservations, to Canada.) In general, this public information pictures a stranger, who attacks unsuspecting children in lonely places. This information is not only incorrect for the majority of cases, and therefore of little value in regard to the protection of children, but can also have a substantial

PEDOPHILIA: 1HE OBJECT AND THE ACT /

23

harmful effect in instilling a paranoid attitude in a child. This problem will be reconsidered at the conclusion of the chapter, after the presentation of the data on the victim and the act. I. THE VICTIM ( OBJECT)

(A) AGE

OF

VICTIM

In the Forensic Clinic study there were 68 victims involved in the offences of the 55 patients. Of these, the ages of 64 were known (Table I). TABLE I FORENSIC CLINIC STUDY, AGE OF VICTIMS AT TIME OF OFFENCE Total Age

0-3 4-7 8-11 12-15 Not known TOTAL Range Mean

n

%

3 12 27 22 4 68

(4) (18) (40) (32) (6) (100)

3-15 10.0

P.het.

%

n

(3) (18) (52) (21) (6) (100) 33 I 6 17 7 2

4-14 9 .4

P.ho. n

0 1 8 14 2 25

P.und.

%

m. f.

(0) (4) (32) (56) (8) (100)

2 1 4 1 1 1 0 0 5 5

5-15 12.2

3-12 6.7

Interesting differences occur in the ages of victims in the three groups. The P.ho. show the highest mean age of victims, with over half of them falling into the early adolescent group. There is a consistent increase from the age of 5 on, culminating at ages 14 and 15, at the "break-off" point. One would imagine that this increase goes on, but that the activity is then no longer considered as pedophilic. The trend is quite different in the P.het. group, where the number of victims increases steadily to the later latency period and decreases again in early adolescence, reaching a low at 14 and 15. The mean age of victims in the P.und. group is considerably lower than in both other groups, reaching its peak at ages 4 to 7. Figure 1 shows clearly the differences in the distribution between male and female victims. The levelling off at ages 12 and 13 in the male group could mean that there is some factor differentiating between prepubertal and postpubertal victims. Differences in the distribution of ages of male and female victims are borne out by most other data; however, in the case of boys, it is not clear whether the

24 /

PEDOPHILIA AND EXHIBITIONISM

%

- - Mole Victims,28coses

40 35

- - - - Female Victims,36 coses

30

25 20 15 10 5

.,, ,,. 2-3

,,.

.,, .,.

/

/

/

4-5

.,. / -

6-7

--- ,,.

\

8-9

10-11

\

\

\

'''

''

12-13

'-

14-15

age

Fig. I. Forensic Clinic study, ages of male and female victims.

higher age only expresses the later onset of puberty, whether it indicates a hebephilic group, or whether it demonstrates the early stages of adult homosexuality. The Millbrook study differentiated between children and adolescents. Among female victims, about two-thirds ( 63%) were children and about one-third ( 37%) were adolescents. The opposite was the case among the male victims, with 64 per cent falling into the adolescent group and 36 per cent into the juvenile group. TABLE II ATASCADERO HOSPITAL,* AGE AND SEX OF VICTIMS OF CHILD MOLESTERS

Sex of victims

Age of victims

Girls

Boys

0-2 3-5 6-8 9-11 12-14 15-17 18-20

7 76 228 192

0 12 44 67 108 39 1

71

18 2

*Frisbie "Treated Sex Offenders and What They Did," Mental Hygiene 43: 2, 266 (April, 1959).

A similar distribution was found among victims of offenders in Atascadero Hospital, California ( Table II). The report on the California Sexual Deviation Research ( 1953) gives data on victims. Over a two-year period ( 1949-1951), 144 adult

PEDOPHILIA: THE OBJECT AND THE ACT /

25

males were convicted and legally penalized for molesting 166 children and adolescents in San Francisco. This group made up 85 per cent of all males convicted in superior courts in the city on sex crime charges. Their victims included 124 girls ( 75%) and 42 boys ( 25%). While the majority of these victims were less than 14 years of age, the P.ho. demonstrated a trend similar to that observed in the Forensic Clinic in that 19 victims ( 45%) were in the 14 to 16 age group, 15 ( 36%) were in the 10 to 13 age group, and the remaining 8 ( 19%) were below 9 years of age. The P.het. had a wider range and a broader distribution than the P.ho. group. The older female victims, however, cannot be considered as pedophilic objects. The 1953 report states ( page 32): "Of the 124 girl victims or coparticipants with men convicted on sex offense charges in San Francisco, 1950-51: "22 35 14 6 24 16

7

(17.8%) (28.2%) ( 11.3%) ( 4.8%)

(19.4%)

( 12.9%)

( 5.6%)

were 16-17 were 14-15 were 12-13 were 10-11 were 8- 9 were 6- 7 were only 4-5

years years years years years years years

old old old old old old old

"Nearly all of the girl victims aged 14-17 engaged in mutual-consent coitus with the adult partner...." This distribution again shows the peak of heterosexual pedophilic offences at age 8 to 9, with a subsequent drop. It also shows that the nature of the offence changes with the higher age group and it is quite apparent that undifferentiated studies of offenders comprising both the non-coital pedophilic and the mutual-consent coital groups cannot yield any meaningful information. Glueck's ( 1955) material is difficult to assess. Although he separates by definition pedophilia ( prepubertal) from hebephilia ( postpubertal), the distribution of "age of object" (his Table P-24) gives no clear picture of the basis of his definitions. In addition to this, percentages do not add up to 100 and no reference is given for surplus percentage. Despite these ambiguities, however, there seems to be a tendency for the P.ho. victim to be older than the P.het. victim. Even small-sample case studies bear out the distribution of ages of victims. In Cassity's (1927) group of 4 P.het. cases, ages of victims were 7, 8, 8, and 9. Karpman's ( 1950) patient preferred immature girls about 9 years of age. Cassity's fifth example, a P.ho., and Socarides' ( 1959) patient preferred prepubescent boys.

26 /

PEDOPHILIA AND EXHIBITIONISM

Summary The data point out rather uniformly that the majority of victims in heterosexual pedophilia fall between the ages of 6 to 11. Since there is a sharp decrease after the peak, which lies between 8 and 10, the age factor discriminates well between heterosexual pedophilia and postpubertal sexual relations of adult males with girls. This differentiation will be further reinforced when the nature of the act is considered. In homosexual pedophilia, on the other hand, the peak in the age of victims comes consistently between 12 and 15, and thus coincides with puberty. The puberty of boys occurs at a later age than that of girls, as Kinsey ( 1953) points out, but this would only account for one to two years of the difference in peaks of frequency in the two pedophilias, which actually is around four years. It has to be taken into consideration, however, that the development of secondary sexual characteristics is not as dramatic in boys as it is in girls. Another explanation could be in the differences in sex play for boys and girls, especially since we found that the pedophilic act is very much like sex play between children. According to Kinsey ( 1948), sex play in boys increases up to the age of 12, with the majority of cases falling between 10 and 14. On the female side ( Kinsey 1953), the active incidence of sex play falls predominantly between the ages of 5 to 9, decreasing afterwards. ( B)

AcE DIFFERENCE BETWEEN V1cnM AND OFFENDER

An additional consideration in studying the age factor in the victim is the relative ages of offender and victim. Depending on legal classifications, on which most studies are based, the offenders included may be from ages 14, 15, or 18 upwards. Age differences between the offender and the victim may therefore be minimal in a number of cases, and this lack of difference as such would exclude the designation of a pedophilic deviation. The California study found that only in a small proportion of cases ( 6.3%) was the age difference between offender and victim less than five years. On the other hand, the study states that "the majority of the younger male offenders were involved with girls or boys 14 to 17 years old" ( 1953, p. 34) . The median age of victims in the offender group of ages 18 to 34, was 14.5 years. For offenders over 35, the median age of victims was 10.4 years. It has to be considered that the significance of age differences changes with the age and developmental stage of the victim. With girls 15 to 17 years old, a difference of 5 or even 10 years from the male partner would have little if any significance in terms of

PEDOPHILIA: THE OBJECT AND THE ACT /

27

TABLE III PSYCHOLOGICAL AGE OF SEX OFFENDERS AND THEIR VICTIMS*

Age of offenders Age of victim 3-11 12-15

16-24 11.4% 88.6% n = 88

53-76 64.0% 36.0% n = 14

25-52 37.0% 63.0% n = 117

Total n = 62 n = 157 n = 219

*Revitch and Weiss (1962), Table 1, p. 2.

a sexual deviation. With girls 7 to 10 years old, and they form the majority of pedophilic objects, a difference of 5 to 10 years from the male partner is very likely to indicate a pedophilic tendency in the latter. Revitch and Weiss (1962) give the data shown in Table III. Unfortunately, they make no differentiation between heterosexual offences and homosexual offences. However, in regard to the young offender, whose victims were predominantly between the ages of 12 and 15, it seems reasonable to assume that many of these offences cannot be considered as pedophilic acts. TABLE IV FORENSIC CLINIC STUDY, AGE OF OFFENDER AND VICTIM

Mean age of victim

Ages of offenders

P.het.

P.ho.

P.und.

15-24 25-44 45 plus

6.4 11.0 9 .6

10.0 13 .0 13.0

4 .6 8.8

The Forensic Clinic study found that the young offender group was associated with a lower mean age of victims than the older offender groups ( Table IV). This was especially pronounced in the P.het. group. Its findings agree, however, with the findings of Revitch and Weiss and the California study in the decrease of age of victims from the middle-aged offender group to the old-aged one, at least as far as heterosexual pedophilia is concerned. Summary

One can only speak of pedophilic deviation if there is a significant age difference between the offender and his object. It would seem that a 5-year difference is an absolute minimum in addition to the prepuberty-postpuberty dividing line. A difference of 7 to 10 years would be a much safer margin, and would not be likely to omit more than a

28 /

PEDOPHILIA AND EXHIBITIONISM

few cases. It is important that adolescent or young adult sexual activity, as found in charges of statutory rape, become excluded from pedophilic studies. Most of these acts, though legally forbidden, cannot be considered sexually deviant. For the older offenders, for whom the age difference is clearly established, data consistently point out a decrease in the age of the victim with an increase in the age of the offenders. ( C)

RELATIONSHIP OF VICTIM AND OFFENDER

Contrary to the common public conception to which we have referred, the victim is seldom a total stranger to the offender. This is especially true for heterosexual associations where in the great majority of cases the offender belongs to the closer environment of the child. In homosexual pedophilia, casual associations play a larger role. TABLE V FORENSIC CLINIC STUDY, RELATIONSHIP BETWEEN VICTIM AND OFFENDER Total

68 (100%)

P.het. 33 (100%)

P.ho. 25 (100%)

P.und. 10 (100%)

Own child Stepchild Grandchild Nephew/ niece TOTAL

4 3 1 2 10 (15%)

2 3 1 1 7 (21%)

0 0 0 1 1 (4%)

2 0 0 0 2 (20%)

Friend's child Own child's friend Youth Club (Sunday School) Neighbour TOTAL

3 1 4 15 23 (34%)

1 1 1 11 14 (43%)

2 0 3 2 7 (28%)

0 0 0 2 2 (20%)

11

7 18 (26%)

1 4 5 (15%)

7 2 9 (36%)

3 1 4 (40%)

17 (25%)

7 (21%)

8 (32%)

2 (20%)

Relationship

Casual acquaintance Stranger TOTAL Not known

The distribution of relationships found in the Forensic Clinic study ( Table V) is generally supported by other studies in spite of differences in the samples. Studies which do not differentiate between the sexes of the victim may show various proportions of "strangers," which can be assumed to be related to various proportions of male and female victims.

PEDOPHILIA: THE OBJECT AND THE ACT /

29

TABLE VI CALIFORNIA STUDY,* OFFENDER'S RELATION· SHIP TO CHILD VICTIM

Relationship

Number of cases

18

Neighbour Family friend Stranger Uncle Brother Stepfather Father Foster father Storekeeper Mother's boyfriend Step-grandfather

14 14 1 2

10

5 3 5 1 1 74

TOTAL

*California Sexual Deviation Research (1953) , Table 6, p. 57.

In the California study, where of 74 victims, 59 were female and 15 male, the distribution of relationships ( Table VI) corresponds more to that found in the P.het. group of the Forensic Clinic study. In this study in 30 per cent of the cases those involved were related, in 51 per cent they were acquainted and in only 19 per cent were they strangers. This compares closely with the P.het. group of the Forensic Clinic study; in 27 per cent of the known cases those involved were related, in 54 per cent they were well acquainted, and in 19 per cent they were strangers or casual acquaintances. The differences in this regard between heterosexual and homosexual offences are further borne out in the Cambridge study, even though no differentiation is made between adult and child victims (Table VII). Of these victims, however, 82 per cent were under 16 years of age and 68 per cent under 14 years of age. Except where the victims of heteroTABLE VII CAMBRIDGE STUDY,* PREVIOUS ASSOCIATION BETWEEN VICTIMS AND OFFENDERS

Relationship Relatives Friends, neighbours, etc. Youth clubs Casual acquaintances Strangers

Female victims

Male victims

14.4 37 . 9 0 .3 31.1 16.3

2 .2 17 .9 14 .2 56 . 5 9.2

%

%

*Adapted from Sexual Offenses (1957), Table 19, p. 90.

30 /

PEDOPHILIA AND EXHIBITIONISM

sexual offences were total strangers to the offenders, it can be seen that they tended more to be in the offender's family or the closer environment of his family, than was the case in homosexual offences. Davis ( 1962) reports from a Florida study that 2 out of 3 victims knew the offender previous to the offence. In his classification, 20 per cent of the victims were relatives, 38 per cent neighbours, 6 per cent casual acquaintances, and 35 per cent strangers. Revitch and Weiss ( 1962) also state that they gained a strong clinical impression that there was a frequent involvement of neighbours, friends of the family, and relatives as offenders. Summary

The data are in general agreement that the majority of victims have known the offender previous to any sexual engagement. In heterosexual cases the degree of relationship tends to be a closer one than in homosexual offences. This, of course, is the picture of known offences that came before the courts. Whether it also applies to pedophilic acts in general remains an open question. On the one hand, it can be argued that offenders known to the child are more easily detected, and, therefore, represent a greater proportion of court samples. On the other hand, it can and has been argued that parents are less likely to lay charges against family members and friends than strangers. In addition to this, children may be more likely to report to parents advances by strangers than by those closely associated with their home, from whom they often derive a good deal of personal gratification in everyday living. II. THE OFFENCE (ACT)

It has been pointed out in the model of pedophilia that the deviation is determined not only by the age of the object, but also by the nature of the act. In most studies where the age of the victim is the primary determinant for classification, a great number of acts have been included. But even so, non-coital sex play emerges as the primary act in the majority of cases. (A)

PLACE OF THE OFFENCE

Following the consideration of the victim-offender relationship, it can be expected that the majority of the offences occur in the closer environment of the victim and that this would more often be the case in heterosexual acts than in homosexual acts.

I 31

PEDOPHILIA: THE OBJECT AND THE ACT

TABLE VIII FORENSIC CLINIC STUDY, PLACE OF OFFENCE

Place Home of offender Home of offender and victim Home of victim TOTAL Place of work Car of offender Public building (theatre, etc.) Public place (street, park) TOTAL Not known

Total

P .het. 27 (100%)

P.ho. 23 (100%)

P.und. 5

15 9

9

6

0

8

0 1

55 (100% )

1

25 (45%) 2 9 3 9 23 (42%) 7

6 1 16

(59%) 2 3 1 4 10

(37%) 1

2 0 (35%) 0 5 1

1

0 1 1

3 9 (39%)

2 4

6

0

These assumptions are borne out by the findings of the Forensic Clinic study, as Table VIII indicates. More than half of the offences in the P.het. group occurred in the home of the offender or the victim, and in only 5 cases ( 19%) did the offence occur in a public place. In the P.ho. group, about one-third of the offences occurred in the homes of the participants, so that even in this group, public places played a minor role. Davis ( 1962) also found that the residence of the offender ranked highest and the home of the victim second as the place of offence. He adds that, contrary to public opinion, movie theatres and automobiles were poor third and fourth choices of places for pedophilic offences. The Cambridge study, although examining the place of offence for sexual offences in general, and therefore dealing with a greater variety of sexual acts, supports this picture. The investigators found that at least 1 in 4 offences occurred in places such as houses, buildings, and vehicles which were not under the direct supervision of police, parkkeepers, or other officials. They concluded, therefore, that an intensification of official supervision would not lead to any reduction in offences committed in such places. Summary Data on the place of the offence further emphasize the situational component of many pedophilic acts, especially the heterosexual ones. As the victim-offender relationship tended to be one that was established previous to the occurrence of a sexual act, the place of the act is usually one which is commonly frequented by the victim.

32 /

( B)

PEDOPHILIA AND EXHIBITIONISM

THE NATURE oF THE

Acr

In the majority of studies on sexual offences with children, the nature of the act can only be inferred from the criminal charges. These are discussed in Chapter 4 and the evidence there points out that the majority of acts with female children consist of non-coital types of sex play. Actual intercourse is found almost exclusively in the age groups over 13. In regard to homosexual acts with children, less information is available, since charges usually do not discriminate between various acts. Only a few studies give a detailed classification of the acts. In the Forensic Clinic study, fondling and showing of the genitalia accounted for the majority of heterosexual acts. Fondling was defined as ranging from barely touching erogenous zones to stroking and manipulating, short of masturbation. Showing the genitalia was differentiated from exhibitionistic acts as defined in Part III, below. TABLE IX FORENSIC CLINIC STUDY, ACTS CONSTITUTING THE OFFENCE

P .und. Acts Fondling victim Mouth-genital contact (fellatio, cunnilingus) Exposing (in a pedophilic context) Masturbation Anal or intercrural intercourse (sodomy) Being fondled Lying on top Looking at victim's genitals Kissing Unspecified attempt TOTAL

Total

P.het.

P .ho.

19

13 1 9 1 1 4 1 0 1 3 34

5 0 5 4 0 1 1 0 4

11

10 8 5 4 2 2 1 8 70

6

26

m.

3 1

f. 2

1 1

1 1 5 5

In Table IX, only the major acts in each case are listed. Masturbation, for example, would supersede fondling and showing if these led up to masturbation. However, more than one act was listed if the acts were unrelated, such as masturbation and mouth-genital contact. The data indicate that the acts of the P.het. consist mostly of mild sex play, whereas the acts of the P.ho. and the P.und. are generally more of an orgastic nature. Orgasm was sought by only about 6 per cent of the offenders in the P.het. group, but by over 50 per cent in the P.ho. group. The California study (Table X) gave a similar picture, with the exception of cases of vaginal intercourse. These cases referred to ages 13 to 16 with only 1 victim below this age ( 11 years). The proportion of intercourse is actually very high in this sample in comparison with

PEDOPHILIA: THE OBJECT AND THE ACT /

33

TABLE X CALIFORNIA STUDY,* TYPE OF SEX OFFENCES

Type Vaginal intercourse, attempted and executed Vaginal intercourse, resulting in pregnancy Fingering and fondling of genitals Anal intercourse (sodomy) Fellatio Mutual masturbation and exposure Fondling breasts TOTAL

Total 17 3 33

Female 17

Male

28

5 2 3 5

74

59

15

3 5 9 4

3

1 2 4 4

*California Sexual Deviation Research (1953), Table 5, p. 57.

larger studies (see Chapter IV). For the rest, however, it is quite apparent that fondling constitutes the majority of heterosexual offences. The distribution of homosexual offences also agrees essentially with the Forensic Clinic data. The Cambridge study, even though it includes adult offences, lists the fondling type as the most common heterosexual offence ( 54%), whereas it accounts for only 9 per cent of the homosexual offences. In this latter group masturbation is the most common act, accounting for almost half of all offences ( 48%). Summary

Although there is a lack of clear-cut data on the nature of the pedophilic act by age of victim, it is apparent that the act is similar to that engaged in by prepubertal children. Hence we have termed it immature gratification. Heterosexual acts consist mostly of fondling, showing, looking, and so forth, which are not uncommon between boys and girls at the age of female objects of pedophilia. Homosexual acts, although more aggressive and orgastic in nature, are also not uncommonly found among prepubertal and pubescent boys. In heterosexual pedophilia the age of the victim and the nature of the offence provide a clear basis for diagnosis and classification of the deviant offender. Such differentiation is less clear in the case of homosexual pedophilia. Since there is essentially no further development in homosexual acts, homosexual pedophilic acts seem to be generally the same as those of adult partners. III. THE ROLE OF THE VICTIM AND EFFECTS OF THE OFFENCE

The majority of studies on sexual deviation and sexual offences focus on the offender and only a few give information about the position of the victim in the offence and the effect of the sexual act on the child.

34 /

PEDOPIIlLIA AND EXHIBITIONISM

The common assumption that the child upon whom the act is perpetrated is solely the "victim" is true only in a legal, rather than psychological, sense. Legally, the adult is the offender by the mere reason that he is an adult, and the child is the victim by the mere reason that he is a child. Psychologically, however, as the few studies that have been made of victims show, the child may very well be a willing participant if not the instigator of a sexual act with an adult.

(A)

VICTIM PARTICIPATION

Karl Abraham ( 1907) had already noticed that children may enjoy sexual acts with adults. Bender ( 1937) and her associates examined 16 unselected successive admissions of prepubertal children sent for observation to the psychiatric division of the Bellevue Hospital following sexual relations with an adult. They noted that the children frequently had attractive, charming personalities and not only made personal contacts easily, but often required personal associations for happiness and contentment. They made more attempts to attract attention from supervising adults in the ward and were often selfish in this regard. Early emotional deprivation made the children prone to seek satisfaction from an adult relationship, to a point where the child might actually have been the seducer. In the California study, 59 girls, 15 boys, and their families were examined. Of the 74 victims, 71 were divided into accidental and participating victims. These were children who had usually had one experience, reported it immediately, and received no remuneration. Of the 71 victims thus divided, 23 were classified as accidental and 48 as participating victims. The study found that children in the participating group all showed considerable emotional disturbance in contrast to the accidental group, which seemed to contain about the number of disturbed children one might expect to find in a random selection of children. As in Bender's group, the participant victims showed an unusually strong need for affection and were flirtatious with the male psychiatrist. Among the parents of these children, there were usually serious marital conflicts, and the children felt deprived by their mothers. The study identified two major factors making participation attractive to the child. One factor was the gain in affection, attention, and approval from the offender accompanied by the feeling that their own parents did not fully appreciate them. The other factor was a need to relieve guilt by allowing themselves to be punished and mistreated. Although these studies and a number of clinical impressions agree

PEDOPHILIA: THE OBJECT AND THE ACI' /

35

that there are predisposing factors in many victims which make them prone to participate in sexual acts with adults, by way of passive toleration up to active seduction, more data are needed to clarify the extent of such participation.

( B)

EFFECI'S

The effect of a sexual act on the child depends on so many factors that, with the meagre data at hand, it is impossible to give more than an impression. If one excludes cases of violence and force, which are fortunately rare, the amount of damage-if any-would depend primarily on the child's emotional status and his security in his environment. These factors of emotional stability and security may, however, as we have seen previously, already have been deciding factors in the child's becoming a victim. In many cases, it will, therefore, be difficult to assess whether the emotional disturbance preceded or succeeded the offence. Rasmussen ( 1934) found that of 54 cases of sexual assault of children under the age of 14, 46 children made a successful adult adjustment. Of the 8 left, 3 were psychotic, 1 hysteric, 1 "very nervous," and 3 prostitutes. In these cases, Rasmussen felt that factors other than the sexual experience alone might have caused the result. Extensive work was done by Bender and her associates ( 1939, 1941, and 1952) to determine the effects of early sexual experiences, and a follow-up of treatment results was made. The first series contained three groups. Group One was comprised of 4 children involved with their parents ( 2 boys aged 6, and 2 girls aged 6 and 10). Three of the 4 made successful adjustments, but the fourth was permanently institutionalized for mental retardation. The authors concluded that while incest has been regarded by primitive and modern societies as unfailingly disastrous, this is not necessarily so. The second group included 4 girls ( who were 7, 9, 11, and 12 years) and 2 boys ( 7 and 12) who had suffered from varying degrees of parental deprivation. Their behaviour was interpreted as a search for compensation for their deprivation. The third group, 4 girls (aged 9, 10, 11, and 12), were classified as demonstrating primitive impulses. These girls were all found to have severe limitations in native endowment. Most of the children in Series One were able to abandon their sexual preoccupations and practices when improved opportunities allowed fulfilment of individual capacities. Three children whose development continued adversely had sufficiently marked psychotic symptoms to limit their potential and frustrate normal maturations.

36 /

PEDOPHILIA AND EXHIBITIONISM

Series Two contained 15 prepubescent children. Two girls aged 11, and 2 boys aged 6 and 11, showed aberrations in their psychosexual development with resulting confusion over sexual identity. This had followed defective parent-child relationships including deprivation of love and parental rejection. This series was also divided into three groups. The children in Group One had domineering homosexual parents or parent-substitutes of the same sexed parent, with the parent of the opposite sex being inadequate or absent. Those of Group Two identified themselves with parents of the opposite sex when parents of the same sex were hated, feared, ineffectual, or entirely absent. Group Three contained children who had had early institutional care followed by boarding-home care, or a period of parental deprivation during infancy resulting in delayed identification with the parentsubstitute of the opposite sex. Although there was a remarkable absence of gross sexual psychopathy in the later careers of these children, problems in social and emotional adjustment were frequent. All but one of the 15 children required extensive psychiatric or social care. Five of them stabilized in late adolescence. From the successful outcome of the majority of cases in Series One, Bender concluded that overt sexual behaviour did not lead to the retention of maladjustments in adult life specifically rooted in this experience. Overt sexual activity in childhood with adult partners was in one way a deflection of the normally developing sexual impulses and such deflection was responsive to social and clinical treatment. Bender also concluded that the largely negative outcome of Series Two was based on the serious psychopathology of the prepubescent years where problems in sexual identification seriously distorted the children's personality development. However, even in the second series, some carefully supervised institutional care in adolescence gave satisfactory results. It must be taken into consideration that Bender's cases were of such a serious nature that hospitalization was found necessary in the first place. They would not be representative of the great majority of victims of pedophilic offences in whose cases the act is of the immature gratification type. In these cases, although no specific data are available, there seems to be general agreement that the effect depends greatly on the reaction of parents and other adults upon discovery. As Davis ( 1962) expresses it, if they react with fear, anger, disgust, or hysteria, then the child is more likely to suffer lasting effects. Bowman ( 1950) also comes to the same conclusion. An additional problem is the appearance of the child as a witness in

PEDOPHILIA: THE OBJECT AND THE ACT /

37

court. Interrogation and cross examination may be as damaging, if not more damaging, than the offence itself. This factor may also prevent a number of parents from laying charges. It would be essential that help and protection be offered to the parents and the child at this stage. This is done by some juvenile and family courts but rarely by adult courts. Reifen ( 1958) describes a new method of investigation in Israel where professionally trained workers are used as youth examiners. No child under 14 is to be investigated, examined, or heard as a witness in offences against morality, except by a youth examiner who presents the evidence in court. Such a procedure seems to be eminently sensible, not only because it prevents additional damages, but also because serious problems can be identified promptly and referred for treatment. To protect children as far as possible, it would also be important to offer the public information based on facts, rather than on irrational fears. Indiscriminate distribution of material, based on such fears , can not only have a harmful effect on children, most of whom will never come in contact sexually with an adult, but also make it more difficult for parents, teachers, and others responsible for children to handle a situation appropriately when it arises.

3. The Offender

In the model proposed previously, pedophilia was defined as "the expressed desire for immature sexual gratification with a prepubertal child," and according to the sex of the object, a distinction was made between heterosexual pedophilia, homosexual pedophilia, and undifferentiated pedophilia. The pedophilic deviant is, therefore, defined by the choice of object and the nature of the act he engages in with the object. Because sexual acts between adults and children are prohibited by law, the man who acts out his pedophilic desires becomes an offender. Most of the available data are derived from persons who have been charged in court and the term offender is therefore used in preference to the term deviant. It is nevertheless appropriate for another reason: the term deviant often implies a consistent state of sexual impulses in the deviant direction. Data on the victim, the act, and the offender, however, indicate that a good number of offences are influenced by situational factors and are not likely to be repeated. Although a deviant impulse must be operative for the offence to occur, the evidence shows that in most cases pedophilia is not the persistently preferred mode of sexual behaviour. Where this is the case we have applied the term "chronic." In examining the various personal and social factors of the offender, we are in general following the data gained in the Forensic Clinic study, comparing them with the results of other studies. I. AGE FACTORS

In the Forensic Clinic study, various age factors were examined in regard to possible relationships between age and symptomatology. The ages at the time of the offence ( Fig. 2) showed an unexpected trimodal distribution, which was unlike that found in other deviations ( exhibitionism and homosexuality). The three peaks of the distribution are in adolescence, mid-to-late thirties, and mid-to-late fifties. Because this distribution was unlike that of other deviations and had not been

PEDOPIULIA: THE OFFENDER /

39

n

10 9

8 7

6 5 4 3 2

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50~4 55-59 tiQ.64 65-69 age

Fig. 2. Forensic Clinic study, distribution of age at time of pedophilic offence;

11

= 53 (2 cases over 70).

n 7 6

5 4

3 2

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-&4 65~9 age

Fig. 3. Forensic Clinic study of distribution of age of non-court referrals at intake; 11 22 cases.

=

.,.

- - P.het., n =25 ( 2 cases over 70) ---- P.ho.,ns23cases

,,,,,. .,,,---- \

20 15

//,,,,.

10 5

''

/

V

I

'

\ \ /

,, ,,,,--- _,,,

.,,

15·19 20-24 25-29 30-34 35-39 40-44 ~49 50.5455.59 6064 65-69 Fig. 4. Forensic Clinic study, distribution of age at intake for P.het. and P.ho.

40 /

PEDOPHILIA AND EXHIBITIONISM

previously mentioned in the literature, another sample of non-court referrals of pedophilic cases was drawn and essentially the same distribution was found ( Fig. 3). To check whether the P.het. were different from the P.ho. in the distribution of age at intake, both groups were plotted independently ( Fig. 4). In spite of the variations, which one can expect with the relatively small number of cases plotted, the indications are that both groups show the three modalities at approximately the same points. The similarity of the distribution of the P.ho. with that of the P.het. is especially interesting, since the distribution differs for the homosexuals, as shown in Appendix B. This is a further justification for grouping the P.ho. with the P.het., rather than with homosexuals preferring adult partners. The three modalities found among pedophiles raise important questions. For example, does the symptom have the same meaning for all three groups, or are we faced with different forms of pedophilia? The indications, which will be explored further, are that, for the P.het. at least, the offence in the adolescent period represents delayed sexual explorations with a younger object ( the age of the victims is significantly younger for this group than for the two others); in the middleaged period it seems to represent a regression after failure of sexual relations with an equivalent object; and in the older age group predominantly an escape from loneliness and impotence. The distribution of prison samples differs in regard to the adolescent and senescent peaks. In the Millbrook study, of the 43 pedophilic offenders, 19 ( 44%) had committed homosexual acts, and 24 ( 56%) heterosexual acts. The age of the offender was known in 41 cases; only 1 was under the age of 19, and it was concluded that the age group 16 to 19 was not likely to be sent to the reform institution, but rather dealt with on probation. However, there was an indication of the first peak because the Millbrook age curve also decreases from the early twenties to the late twenties. After the low in the late twenties, the next peak is again in the middle-to-late thirties whereas the last peak of the older age pedophile is absent since there were only 4 cases after the age of fifty. Toobert et al. ( 1959) found that pedophiles in San Quentin prison had a modal age between 30 and 49 years; 90 per cent of all offences had occurred after age 30. Frisbie ( 1959) found essentially the same distribution at Atascadero Hospital ( Table XI). In California as well as in other jurisdictions it also has to be

PEDOPIDLIA: THE OFFENDER

/

41

TABLE XI ATASCADERO HOSPITAL,* AGE DISTRIBUTION OF SEX OFFENDERS COMPARING ALL OFFENCES WITH CHILD-MOLESTING

Years of age

All cases

Child-molesting cases

15-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89

25 314 323 179 130 93 46 4

13 191 247 147 116 85 43 4

*Frisbie, "Treated Sex Offenders and what they did" (1959), Table 4, p. 266.

considered that the Youth Authority deals with many offenders under the age of 21. Even where no special procedure for the younger age group is available, most courts in sentencing will take age into consideration. In the Frosch and Bromberg study ( 1939), 80 per cent of the 120 pedophilic offenders were over the age of 30. Apfelberg et al. ( 1944) stated that 55 per cent of their pedophiles were in the 39 to 49 age group, but no further breakdown was given. The lack of succinct categorization and the use of broad classifications such as the ten-year age span are likely to obscure the actual distribution of ages of offenders. Where primary data are given, even a small sample like the one recorded by Conn ( 1949) bears out the distribution found in the Forensic Clinic study.

Summary The ages of pedophilic offenders indicate the existence of three groups: the adolescent group, with a peak in puberty; the middle-aged group culminating in the mid-to-late thirties; and a senescent one in the late fifties and early sixties. All data agree that the senescent group, which often has been described as the predominant one, is actually small in comparison with the middle-aged group. The adolescent group is at its height on the borderline of the definition of pedophilia, because the offender himself is likely to be in puberty. He does not appear consistently in the data, because of special provisions and considerations for this age group by the courts. Figure 5 gives a model age distribution of pedophilic offenders. In addition to those in the three age groups, there is a small group of

42 /

PEDOPHILIA AND EXHIBITIONISM

Chronic Offenders I

C

15-19 20-24 25£9 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 years

Fig. 5. Model distribution of ages of offenders at which pedophilic offences occur.

chronic offenders who remain prone to pedophilic acts, whereas for the majority of offenders pedophilic acts are more or less incidental occurrences. Recidivism rates as given in Chapter 4 indicate that there are more chronic homosexual offenders than heterosexual ones.

(A)

ONSET OF PEDOPHILIC BEHAVIOUR AND FmsT CHARGES

The age distribution of pedophilic offenders raises questions about the occurrence of the act at the various ages, and the duration of active pedophilic behaviour. With exhibitionism it was possible to determine the onset of the deviant behaviour by age and also the age of the offender at the time of the first charge. In the pedophilic group this was not possible because of the wide distribution of ages and because of the high percentage of first offenders. The Forensic Clinic study examined the cases in the three age groups and a descriptive account is given. (a) P.het.

( i) Ages 15 to 24 years, 7 cases. Of the 7 patients in this group, 2 had been charged previously at ages 15 and 19 respectively. Another was severely retarded and certified. ( He repeated a year later after discharge from a mental hospital.) The 4 others claimed that the offence which brought them to the clinic was an isolated one and had never occurred before. Two of these four ( age 15) had never had any

PEDOPIIlLIA: THE OFFENDER /

43

sexual relations, whereas the other two ( age 23, 24) had experienced the breakdown of a love affair and a marriage respectively. These two patients, therefore, actually belong to the next group. (ii) Age 25 to 44 years, 10 cases. The majority of patients in this group are characterized by severe marital and social maladjustment. In 6 cases out of the 10, alcohol played a part in the act, with at least 5 being alcoholics. None of them was charged in his adolescent years, and only 2 patients stated that the symptom had persisted since that time. In 3 cases of this group the victim was a stepdaughter, and in 1 case the patient's own daughter. Two other cases may be related to the latter three. In one, the victim was the girl friend of the patient's daughter and in the other, a daughter of the family with whom the patient was living. ( He was separated from his own family, which included a pre-adolescent girl.) Of the 2 patients who admitted previous pedophilic activities, one ( age 26) had experienced regular sex-play with intercourse from age 6 to 12. He was married, but found his wife unresponsive. ( His wife, incidentally, was a kindergarten teacher.) The other patient ( age 39) had always used any female he could persuade, regardless of age, for sexual purposes, but would differentiate between the ages in regard to the acts he would perform with them ( masturbation, fellatio, etc., with females under 18, intercourse with those over 18). These two can therefore be considered as chronic cases. (iii) Age 45 and over, 10 cases. This group as a whole is socially much sounder than the last one, but characterized by loneliness, emotional and sexual isolation, and actual impotence or concern about impotence. Only one patient had a long-standing record of exhibitionistic, pedophilic, as well as non-sexual offences, and he was the only one who was re-convicted after contact with the Clinic. Alcohol was a factor in only one case. In one case ( age 49) the victim was the patient's daughter, and in another ( age 56) the patient's grand-daughter. This latter patient had also approached his own daughter ( the mother of the present victim) in her early teens in the same fashion ( exposing and fondling), but did not seem to have any extra-familial pedophilic interests. This patient and the first one mentioned were the only ones in which previous urges were established. (b) P.ho.

( i) Age 15 to 24 years, 7 cases. Only 1 patient in this group had been charged previously, but 3 of them were re-convicted within the

44 /

PEDOPHILIA AND EXHIBITIONISM

follow-up period. In their initial contact with the Clinic, only 2 admitted a background of homosexual acts, one ( age 17) starting at age 9, engaging in mutual masturbation daily for three years, and the other one ( age 19) stating the time of onset as age 15. (ii) Age 25 to 44 years, 12 cases. Half of this group admitted previous P.ho. activities and gave the onset of their symptoms as ages 12, 12, 14, 14, 17, and 30. Five patients were repeaters before coming to the Clinic. On a plot of the age at the time of the first charge for this group ( Fig. 6), the same pattern of a high incidence in the late adolescence and a low in the early twenties appears, with the second peak in the early thirties, rather than the late thirties, as we have seen previously.

15-19

20-24

25-29

30-34

35-39

40-44

age

Fig. 6. Forensic Clinic study, P.ho., 25-44 years of age, distribution of age at 12 cases). first charge ( n

=

Half of this group were leaders in youth clubs, but this does not necessarily mean that they committed the offence with their club contacts. Most of these men expressed a quasi-parental attitude to young boys and we were struck with a similarity to the P.het. group in this age range. However, in contrast to the P.het. group, alcohol was reported to have played a part in the offence in only 2 cases and only 1 of these offenders can be classified as an alcoholic. (iii) Age 45 and over, 4 cases. Of the 4 patients in this group, 2 had previously been charged; one of them ( age 54) had been a P.ho. since his youth and had a number of imprisonments, whereas the other ( age 64) faced his first charge at age 49 and related the onset of the symptoms to a serious accident which happened at this time. Of the other 2, who claimed no previous history ( age 57, 60), one was a widower living in derelict circumstances, and the other a chronic alcoholic with marital difficulties.

PEDOPHILIA: THE OFFENDER

/

45

(c) P.und. The ages of the 5 patients classified as undifferentiated pedophiles were 15, 16, 25, 30 and 32. Of the 2 adolescents, one was retarded and subsequently admitted to an Ontario Hospital; the other a high school student of normal intelligence. The 25-year-old had been involved in pedophilic activities with both sexes at ages 15 to 16 ( he dated his first intercourse at age 5). He had been married at 19, but his marriage broke down, apparently resulting in a renewal of pedophilic activities. Of the 2 patients in their thirties, one had been in a mental hospital three times, and generally tended towards a "polymorphous perverse" orientation, while the other was diagnosed as a "pathological personality." He had, on several occasions, masturbated with his daughter and son in bed with him. This group showed pronounced social and mental pathologies. It has been shown previously that the mean age of the victims in this group was considerably lower than that for the other two groups. One wonders if this is an indication of their preference for undifferentiated sexual objects or just a feature of their general pathology. II. PERSONAL AND SOCIAL CHARACTERISTICS

In considering personal and social factors in pedophilic offender groups, an attempt was made to compare these factors with normative data to elicit similarities or differences with the general population. Showing similarities turned out to be as important as showing differences, since various hypotheses that had been made or implied were found to be not substantiated by the distribution of data. Although no dynamic interpretation was attempted, the data themselves should lead to a reconsideration of various psychodynamic formulations. (A)

INTELLIGENCE AND EDUCATION

(a) Intelligence Discussions about the intelligence of pedophiles have usually suggested that the majority, if not suffering from senile dementia, were at least mentally retarded. A different picture emerges with more widespread use of intelligence-testing instruments such as the Wechsler Adult Intelligence Scale (WAIS) which provide a greater reliability than clinical judgments. In the Forensic Clinic study, 47 of the 55 pedophiles were tested with

46 /

PEDOPHILIA AND EXHIBITIONISM

TABLE XII I.Q.'s

FORENSIC CLINIC STUDY, MEAN AND RANGE OF

n

Mean (verbal) Mean (performance) Mean (full) Range

Total 47

P.het.

P .ho.

P.und .

99.0 97.4

99.4 96 .5 98.3 53-122

100.5 99 .5 100.0 77-122

87.0 90.7 88 .0 80-97

24

98.4

53-122

20

3

TABLE XIII 1.Q.'s

FORENSIC CLINIC STUDY, DISTRIBUTION OF COMPARED WITH STANDARD DATA

Class -79 80-89 90-109 110-119 120 plus

Norm

Pedophiles

%

%

9 16 50 16 9

4 24 49 17 6

n

2

11

23 8 3

the WAIS ( Tables XII, XIII). The other 8 were assessed on the basis of social and clinical data as follows : 3 P.het., within normal range; 3 P.ho., 1 normal, 1 above normal, and 1 below normal; 2 P.und., 1 normal and 1 retarded. The distribution of intelligence is essentially a normal one, somewhat skewed towards the lower end of the scale (Table XIII) . No obvious differences can be discerned between the P.het. and the P.ho. groups ( Table XII). There were only three ratings for the P.und., two of which were below normal. If the two clinically assessed cases are included, it is found that of the 5 patients in this group, 3 were below normal, 1 was in the low normal range, and 1 was normal. It is again interesting to note that the P.ho. group is much more similar in regard to intelligence to the P.het. group than to the adult homosexuals. ( See Appendix B.) From the current literature, the general impression of the intelligence of pedophiles concurs with the findings of the Forensic Clinic. The Governor Dewey Report of 102 Sex Offenders ( 1950) stated that intelligence was for the most part equal to that of the average population. The California study ( 1954) found that intellectual ability did not differ significantly from that expected in a normal population. Ellis and Brancale ( 1956) also report an essentially nomial distribution of intelligence. Davis ( 1962) points out that intelligence test scores of the pedophiles ranged from the level of severe mental deficiency to

PEDOPIDLIA: 'IHE OFFENDER /

47

superior, with the average slightly below normal. However, he stated that in the Florida findings the deviate was about four times as likely to be mentally retarded as the man in the street. In Hammer's study ( 1955) of 84 pedophiles in Sing Sing prison, the average WAIS intelligence quotient was 101.6. In a small study of three cases, Kurland ( 1960) quoted WAIS scores of 100, 101, and 106 with a mean of 102.3. Hadley's ( 1926) case was a college graduate, which would suggest above average intelligence. Socarides ( 1959) described his case as "intelligent." Cassity ( 1927) had five cases, but gave information concerning only one person who had been diagnosed as mentally defective; in Cassity's opinion, the diagnosis had been an error. Apfelberg et al. ( 1944) had 75 pedophiles but noted that psychometric examinations were made chiefly when the individual appeared to be of inferior intelligence. Consequently, none of their data was presented. They did state that cases of borderline and dull normal intelligence were encountered in pedophilia, particularly in the shy schizoid types who had a preference for very young children. The Frosch and Bromberg study (1939) from the New York Court of General Sessions gave ratings of intellectual level of 120 pedophiles as follows: superior 1 per cent, high average 7 per cent, average 40 per cent, low average 13 per cent, inferior 23 per cent, borderline 10 per cent, and defective 7 per cent. It would appear from their report that these ratings were made by clinicians and were not based on any standardized tests. This would seem to be the explanation for the wide difference between the population of this study and that of the other authors mentioned. For instance, if the last four groups of Frosch and Bromberg are totalled, 53 per cent of the subjects fall below the average group, while in Forensic Clinic data, 28 per cent fall below the average group, and the general population norms only contain 25 per cent. Summary

In earlier studies, the pedophile was often considered defective, but frequently this conclusion was based on clinical judgment alone. As early as Cassity's report ( 1927) questions were being raised about the accuracy of this assumption. Apfelberg ( 1944) points out that the obviously subnormal offenders received more attention, and were more likely to have been given an intelligence test. Further discussion of the question of mental deficiency is found in Chapter 4 when the diagnostic categories are discussed. Finally, it would seem that more recent studies are in agreement that the intelligence levels of pedophiles are

48 /

PEDOPHILIA AND EXHIBITIONISM

essentially those of the general population, with a slight tendency to the lower end of the scale. ( b) Education

Educational achievements have been more frequently reported for undifferentiated groups of sexual offenders than for specific deviations. There is sufficient information on pedophiles, however, to suggest that their educational progress is not very different from that of the general population. In the Forensic Clinic study there was some similarity between the educational achievements of the pedophiles and of the exhibitionists. More than a quarter of the pedophiles (Table XIV) had TABLE XIV FORENSIC CLINIC STUDY, FINAL SCHOOL GRADES Total 53

n Mean final grade Final grade

-7 8-10 11 plus

n 15 28 10

8 .6

P .het. 25

%

n

(28) (53) (19)

5 15 5

9.0

P .ho. 23

%

n

(20) (60) (20)

7 11 5

8.7

P .und. 5

%

n

(30) (48) (22)

3 2 0

6.0

%

(60) (40) (0)

dropped out of school before reaching Grade 8; more than half dropped out between Grades 8 and 10; and only 10 offenders went beyond Grade 10, of whom 4 reached Grade 13. Of these 4, 2 went on to university. ( One offender completed his high school and the major part of his B.A. in prison.) The P.het. and P.ho. are about equal in their achievements ( and their level is quite different from the adult homosexual group which is higher). The P.und. fell below as can be expected from their intelligence ratings. The study of Toobert et al. ( 1959) reported that 64 per cent of the pedophiles had an educational level below the 9th grade, and only 5 per cent of the group had college experience. In Glueck's ( 1955) study, 40 per cent of P.het. had completed 6 grades or less, while 27 per cent of P.ho. were in this group. Forty-two per cent of both P.het. and P.ho. had completed 7 to 9 grades. Nineteen per cent of P.het. and 27 per cent of P.ho. completed 10 grades or more, including 15 per cent who had completed better than 12 grades. In this respect, Glueck's P.ho. group appears more like the Forensic Clinic adult homosexuals than the P.ho. group. Davis ( 1962) stated that education, like intelligence of pedophiles, showed a wide variability ranging from no schooling to four years or more in college. Sex offenders in general

PEDOPHILIA: THE OFFENDER

/

49

were about two times as likely never to have been to school and only about one-half as likely to have had a four-year college education as the average citizen .. TABLE XV FORENSIC CLINIC STUDY, COMPARISON OF OFFENDERS' FINAL GRADES AND l.Q.'s

WAIS I.Q.'s

-89 90-109

110 plus

%

Final grades

%

28 48 23

8-10 11 plus

-7

28

53

19

When the intelligence and educational levels of the Forensic Clinic study are compared (Table XV), there is a close agreement between measured capacity and achievement levels. Comments about school ranged from "hated it" to "liked it very much." There was not the same element of loneliness and aggression as the exhibitionists expressed, although offenders stated that they were laughed at, picked on, and teased. A number of self-derogatory remarks were made, such as "slow learner," "brother got all the brains," and "hard for me," etc. Some offenders regretted that they could not continue their education for financial reasons. While educational levels, as reported in the literature, when given in conjunction with the intellectual levels, were in general agreement with the Forensic Clinic study, the literature, however, did not contain any information on the qualitative nature of the educational experience of the pedophile. Summary

Educational levels of pedophiles compared closely with their measured capacity. Since WAIS scores of pedophiles showed a general distribution, it was not surprising to find all educational levels represented as well. The majority reached Grades 8 to 10 with a good number in the lower educational group, which is not dissimilar from findings for the general population. It would appear that there was nothing specific in intelligence and education which would separate pedophilic offenders from the general population. ( B)

OCCUPATION AND SOCIAL INTERESTS

(a) Occupation The Forensic Clinic study has attempted to group occupations in accordance with the type of work performed ( Table XVI). This approach, it was hoped, would give a more intimate account of the

50 I

PEDOPHILIA AND EXIIlBITIONISM

TABLE XVI FORENSIC CLINIC STUDY, OCCUPATIONS

P.het.

Total

Occupation Student Profession TOTAL Business Managerial, owner Accounting, bookkeeping Clerical Sales Storekeeper, clerk Trades TOTAL Engineering, plumbing, mechanics, etc. Painter Photographer Barber Semi-skilled TOTAL occupations Assembly, shipping, stock-keeping Commercial driving Construction Gardening TOTAL Unskilled labour Labourer, farmhand, odd jobs TOTAL Service Maintenance Kitchen, orderly TOTAL Armed Forces

P.ho.

P.und.

DomiDomiDomiDominant Other nant Other nant Other nant Other n%

5 (9) 2 (4) 0

3

9(16) 6

3 1 0 1 0 l

2 2

3 0 2 1 0 1 3 1 10(18) 4 7 2 1 2 1 0 1 0 11(20) 15 4 2 2 3

7

6

1

1

7(13) 3 (5) 3 2 1 1 2 8(15) 10

1

0 2 1 0

0

1 1

0 4 2 0 1 0 1 2

1 0 0 0 0 0 0 0 0

0 0 0 0 0 0

3

1 1 0 0 5

0 0 0 0 1

0 0 0 0 1

1

3 2 0 0

0 0 1 0

0 0 0

1 1 1 0 1

0 0 0 1

6

1 2 1 0 2 4

6

1 0 2

4 1 1 0 7

1 1 0 0 9

0 0 1 3

3 1 1 2

3 4 1 1

1 0 1

3 0 0 0 4

1 1 0 6

3 2 1 1 3

1

0 1 3

0

1

offenders' choice of occupations. Since most offenders have been engaged in more than one occupation, the dominant occupation was separated from others. It would appear that pedophiles come from all occupational groups without any specific concentration. Differences between the P.het. and the P.ho. may indicate that the former tend more towards the middle groups of trades and semi-skilled occupations, whereas the latter have a slight gravitation towards the business, the unskilled, and the service occupations. The P.und., as one would expect from their intelligence and educational level, were found only in the unskilled occupations. One feature of the work records of the pedophilic group was that almost one-third either had their predominant work experience in the armed forces or had a significantly long period of military service. The difference in this aspect from the other deviations may be a result of

PEDOPIDLIA: THE OFFENDER

/

51

the age factor, namely, that more offenders in the pedophilic group were called up for the armed services. However, the impression was gained from the files that military service had a special significance for many offenders aside from war service. Glueck's study ( 1955) provided similar information about occupations. While fewer P.het. than P.ho. were found in the business and professional groups, the P.het. were more frequent than the P.ho. in the industrial areas. Also, 48 per cent of P.het. and 60 per cent of P.ho. had been in one of the armed services ( Army, Navy, Marines, or Air Force) at some time. However, this distribution might be influenced by compulsory military service in the United States. Of Kurland's ( 1960) 3 cases, one offender ( P.ho.) had been discharged recently from the Air Force, a second ( P.und.) was a factory worker, and the third ( P.und.) a gardener. Work records. Initially a four-point classification scale was used at the Forensic Clinic, based on the length of time a job was held. However, it was found that this scale discriminated between age groups. On the one hand, the younger offenders had not yet had time to establish job stability, if one allowed for a period of experimentation after leaving school. On the other hand, some older offenders might have had a stable work period in their twenties but had been changing jobs ever since. We therefore attempted finally to differentiate only between "good" and "poor" work records, leaving the ones that could not be determined as "undetermined" (Table XVII). Thus the "good" TABLE XVII FORENSIC CLINIC STUDY, JUDGMENT OF WORK RECORDS

n Good Undetermined Poor TOTAL

Total

%

27

(49)

55

(100)

18 10

(33)

(18)

P.het. n

P.ho. n

15 8

12 7

27

23

4

4

P.und. n 0

3 2 5

work records represent a judgment made not only on the length of time a major job was held, but also on the continuity of work engagements as well as improvement or deterioration of position when changing. "Poor" cases represent patients who had difficulties in holding any job for any length of time, and who never improved their work position by changing. The work records for the three age groups show that most of the "poor" records occur in the younger age group; the record of the

52 /

PEDOPHILIA AND EXHIBITIONISM

middle-aged group is mixed but they seem to have, on the whole, a better work adjustment than family adjustment; the oldest age group has the most satisfactory record. This is very pronounced in the P.ho. group, where the younger group has only "poor" work records and the oldest group all have "good" records. The P.und. is again the lowest group with either "poor" or "undetermined" records. The exhibitionists, in comparison, were generally conscientious, hard-working, and had difficulties with authority figures, but the pedophiles failed to present any such clear-cut picture. They generally just tried to get by in an uneventful way. This was borne out in the classification of their work records, where a third had to be left as "undetermined" since they could be classified neither as "good" nor as "poor." TABLE XVIII GLUECK'S SING SING STUDY,* WORK EFFORT

Excessive, i.e. compulsive Adequate, i.e. sufficient quantity and quality Deficient, i.e. neglectful, irresponsible, etc.

P.het.

P.ho.

Offender control group

17% 49% 34%

12% 48% 39%

8% 36% 54%

*Adapted from Glueck (1955), Table K-12, p. 192.

Glueck ( 1955) provided information about stability and quality of employment. Workers were classified as shown in Table XVIII. Glueck seems to have had more offenders in the "poor" group than the Forensic Clinic study. While qualitative data are difficult to compare, the differences could point to the poorer adjustment of the prison group. But even there, pedophiles did considerably better than other prisoners in a control group. Summary

Pedophiles came from all occupational groups without a specific concentration in one area. Slight differences were noted between P.het., where the trend was to trades and semi-skilled occupations, and P.ho., where the trend was to business and service occupations. Experience in the armed services provided an important part of many occupational records. With regard to work records, the pedophiles appeared to try to "get by" in an uneventful fashion. ( b ) Social Interests

Information on the social interests of offenders was available for 43 offenders in the Forensic Clinic study. Nine of these stated that they

PEDOPHILIA : THE OFFENDER

/

53

had no interests. The information offered was usually short and rarely went beyond the name of the activity in which they engaged. The activities are listed in Table XIX as given by the offenders; if two activities were given which fell into the same group ( for example, cycling and skating) they were only counted once. When compared with the exhibitionist group, these offenders showed less interest in sports, and the ranking was quite different. Swimming, which ranked highest with the exhibitionists, was not TABLE XIX FORENSIC CLINIC STUDY, SOCIAL INTERESTS

Sports Unspecified Car, boat, 'plane Fishing, out of doors Cycling, skating Team sports Judo, boxing, etc. House and Garden Do-it-yourself Gardening, Farming Hobbies Collections Games (chess, cards) Model building Artistic Music Books Painting Social participation Church work Adult clubs Youth Work None Not known

Total

P.het.

P .ho.

P.und.

17

13 2

3 2 1 1 12

3 2 1 1 7 2 5 2 1 1 0 2 1 0 1 8 2 3 3 5

3 2 1 0 0 0 0 5 2

1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3

4 6

4

8 4

2 1 1 9 3

4

2 13 2 3 8 9 11

4

4

3

2 1 0 1 7 2 4

1 5 0 0 5 3

4

mentioned once, although other outdoor interests such as cars, boats, aeroplanes, fishing, cycling, and skating accounted for most of the sports interests of the P.het. The P.ho. showed very little interest in sports, only two mentioning it without further specification. The P.ho. group accounts for most of the artistic interest, and in this they resemble more closely the adult homosexuals than the P.het. However, the adult homosexuals do show a pronounced interest in sports, which is absent in the P.ho. group. The increase in social participation over that shown by the exhibitionists is accounted for by activities in youth work, mainly with Sunday Schools and Boy Scouts.

54 /

PEDOPHILIA AND EXHIBITIONISM

Glueck's ( 1955) study reported "Socialization Patterns of the Adult" and includes a number of tables to illustrate them. Table XX shows trends similar to those in the Forensic Clinic data. TABLE XX GLUECK'S SING SING STUDY,* ACTIVE (ORGANIZED) GROUP MEMBERSHIP

Much (indiscriminate joining) Moderate (some selectivity) None (shyness or contempt)

P.het.

P.ho.

4%

15% 18% 67%

28% 68%

*Adapted from Glueck (1955), Table N -1, p. 271.

Summary

The interests of pedophiles seemed to differ between P.het. and P.ho.; the latter demonstrated more artistic interests and were more like the adult homosexuals than the P.het. group. One factor which seemed to emerge as common to both P.het. and P.ho. was their relative isolation from adult social contacts. Most of their social contacts were with children, in youth work and church activities.

Bmrn AND PLACE OF RESIDENCE Racial or national origin are concepts of little value in Canada, especially in a metropolitan area like Toronto, since they do not give the level of social and cultural integration that has taken place in the various generations. Therefore, the Forensic Clinic study tabulated only the country of birth (Table XXI) and found that the proportions ( C) CouNTRY OF

TABLE XXI FORENSIC CLINIC STUDY, COUNTRY OF BIRTH Total

Canada Great Britain Ireland Holland Germany

P.het.

P.ho.

P.und.

53

(100%)

26

22

5

39 9 3 1 1

(73%) (17%) (6%) (2%) (2%)

17 6 2 1 0

17 3 1 0 1

5 0 0 0 0

of native-born and foreign-born offenders corresponded essentially to that found in the general population. There were 73 per cent Canadianborn persons in the Forensic Clinic group, compared with 67 per cent in the general population. Among exhibitionists, the percentage of Canadian-born patients was slightly higher than among pedophiles

PEDOPHILIA; THE OFFENDER

/

55

and the foreign-born group represented only 4 countries as against 12 in exhibitionism. Looking at the geographical distribution of the 55 pedophiles, 26 or 47 per cent came from the city of Toronto proper, and 20 or 37 per cent came from the suburbs. That means that 84 per cent came from the Metropolitan Toronto area and only 16 per cent ( 9 cases) came from outside this area, and even these cases, for the most part, were from the vicinity of the metropolitan area. The distribution in Metropolitan Toronto was 56 per cent in the city proper and 44 per cent in the suburbs. This corresponded closely with the general population distribution of 45 per cent for the city proper and 55 per cent for the suburbs. Even when the various suburban areas were considered, the distribution corresponded with that of the general population. Frosch and Bromberg ( 1939) reported 54 per cent native-born and 46 per cent foreign-born in 120 cases of pedophilia. Comparisons are inappropriate when general population distributions are not available. A factor which is mentioned in the literature just as frequently as country of birth is racial origin, with emphasis in American studies falling on whether the offender was black or white. Frosch and Bromberg ( 1939) reported 80 per cent white, 20 per cent black. Glueck ( 1955) in P.het. had 77 per cent white, 24 per cent black, and in P.ho. 88 per cent white, 12 per cent black. In the Offender Control group 86 per cent were white, 14 per cent black. The only group in Glueck's study which showed a different distribution was the "Rape and Adult Sexual Assault" group where there were 40 per cent white and 60 per cent black. Summary

The Forensic Clinic study contained a percentage of Canadian-born offenders similar to that in the general population of the areas from which the offenders were taken. The geographical distribution also corresponded closely with the general population even in the separation of city proper and suburban areas of Metropolitan Toronto. In other studies racial origin was more frequently cited than country of birth. In Glueck's study, the distribution of pedophiles of white and black races was comparable to that of their control group, and was similar to the Frosch and Bromberg study.

( D) RELIGION The distribution of religious denominations in the Forensic Clinic study (Table XXII) was close to the one found in the general popu-

56

I

PEDOPHILIA AND EXHIBITIONISM

TABLE XXII FORENSIC CLINIC STUDY, RELIGION

n Roman Catholic Anglican United Church Presbyterian Baptist Salvation Army Gospel Hall Christian Science Hebrew "Protestant"

General population* (100%) (20%) (25%) (23%) (10%) (4%)

n 50

Total %

10 10 6

(20%) (20%) (12%) (11%) (10%)

7

5 5 2

1

1 3

P.het. n 24

P.ho. n 21

P.und. n 5

5 6 2 4 2 1 1

4 3 3 3 1 4 1 0 1 1

1 1 1 0 2 0 0 0 0 0

1

0 2

*From the Dominion Bureau of Statistics (Canada) 1951 Census: City of Toronto, based on 326,050 males.

lation. The exception was for "United Church"; however, it has to be taken into consideration that three offenders just stated "Protestant" and may have belonged to this church. The Frosch and Bromberg study ( 1939) reported the following religious breakdown for their 120 pedophiles: Roman Catholic 48 per cent; Protestant 38 per cent; Hebrew 10 per cent; Greek Catholic 3 per cent; and Christian Science, 1 per cent. Glueck's cases ( 1955) were divided as follows: P.het.-Roman Catholic 42 per cent, Protestant 55 per cent, and Hebrew 4 per cent; P.ho.-Roman Catholic 42 per cent, Protestant 52 per cent, and Hebrew 6 per cent; the Offender Control group contained Roman Catholic 40 per cent, Protestant 54 per cent, and Hebrew 6 per cent. The P.ho. group of the Forensic Clinic study who were members of the Salvation Army were all converted after being helped on previous occasions by this organization. Otherwise, offenders seemed to have retained their original denomination. Participation in church was higher in the middle-aged and senescent group of pedophiles than the younger ones. Although the proportion of pedophiles who practised their religion was only slightly higher than that among offenders with other deviations, the degree of participation seemed to be more intensive than among exhibitionists. Some pedophiles stated that their wives were the driving force in their church attendance. About two-thirds of the pedophiles claimed to be practising members of their religious groups, while the other third were non-practising. The only material from the literature which appeared to have a similar qualitative content concerning pedophiles' religious participa-

PEDOPIIlLIA : TI1E OFFENDER /

57

tion was found in Glueck ( 1955). It was noted that the Offender Control group had about one-third in the non-practising group but the pedophiles had only about one-tenth non-practising. The study classified the offenders as shown in Table XXIII. TABLE XXIII GLUECK'S SING SING STUDY,* RELIGIOUS ATTITUDES (BELIEFS)

Fanatic Devout Conventional Doubt Definite disbelief

P .het.

Offender P.ho. control

4% 15% 72% 8% 2%

6% 18% 67% 9% 0%

2% 6% 54% 32% 6%

*Adapted from Glueck (1955), Table N-38, p. 285.

Summary

The denominational groupings of the Forensic Clinic study followed that of the general population. This was also true of Glueck's study where the Offender Control group had a distribution similar to that of the P.het. and P.ho. The Frosch and Bromberg study had slightly fewer Protestants than the other studies. In the areas of religious participation, about one-third of the Forensic Clinic group were non-practising and two-thirds were practising, with the middle age and senescent pedophiles making up the larger part of the latter. In Glueck's report, the control group had one-third nonpractising while the pedophile groups had only about one-tenth nonpractising. III. FAMILY BACKGROUND

Relationships with parents, and to a lesser degree with siblings, have been seen as primary factors in the genesis of sexual deviation. The question of aetiology and of various psychodynamic interpretations is discussed in Chapter 5. This section centres on information derived from the social history of pedophilic offenders in the Forensic Clinic study and similar information from other studies. Unfortunately, in the literature, interpretations generally supersede the giving of factual accounts about the natural history of the offender. In the Forensic Clinic study information about his background was derived from the offender himself and will, therefore, contain conscious as well as unconscious distortions. In this regard no actually

58 /

PEDOPIDLIA AND EXHIBITIONISM

"objective" data were available. The other major source, Glueck ( 1955), derived its information from a prison sample, which may account for some of the differences from our findings.

(A)

PARENTS

Of the 55 offenders in the Forensic Clinic study, information on parents was available for 51. This information fluctuated in quantity as well as quality, a factor which in itself will permit some inferences about the awareness patients had of their parents. P.het. patients, for example, were extremely poor in describing their relationship with their fathers in positive as well as negative features, and we were left with the impression that, at least on a conscious level, the father had little meaning for this group. TABLE XXIV FORENSIC CLINIC STUDY, ABSENCE OF PARENTS FROM HOME Reason for absence Information available Separation Death Military service TOTAL

Father Total

P.het.

P .ho.

51 24 22 (100%) (100%) (100%) 4 0 3 8 5 3 1 2 3 15 6 8 (29%) (25%) (36%)

Mother

P.und. 5 1 0 0 1

Total

P.het.

P .ho. P.und.

51 24 22 (100%) (100%) (100%) 2 0 1 3 0 3 0 0 0 5 0 4 (10%) (0%) (18%)

5 1 0 0 1

(a) Absence of Parents from the Home For criteria in this area (Table XXIV) the term "childhood" was taken to be the period between birth and the age of 15, and "prolonged periods of time" were either separation or death of a parent, or extended military service of the father. It has to be kept in mind that some of the offenders may not have mentioned such a separation and the figures, therefore, have to be considered as minima. Less than a third of fathers and only 10 per cent of mothers were absent from the home for a prolonged period of time. These results are similar to those found for the exhibitionists. The P.ho. showed a higher rate of separation from the father, and accounted for almost all separations from the mother. None of the P.het. patients had experienced a separation from the mother. In Glueck's study (1955), 15 per cent of both P.het and P.ho. lost fathers by death. Thirty-four per cent of P.het. but only 18 per cent

PEDOPHILIA: THE OFFENDER

/

59

of P.ho. lost fathers by separation or desertion. Fifty-five per cent of P.het. and 61 per cent of P.ho. had their fathers always present. No mention was made of military service. Thirteen per cent of P.het. and 18 per cent of P.ho. lost mothers by death. Only 2 per cent of P.het. and no P.ho. lost mothers owing to separation or desertion. Seventynine per cent of P.het. and 73 per cent of P.ho. had their mothers always present. Although Glueck's proportions of absences of parents were higher than those in the Forensic Clinic study, they did not essentially differ from those for his criminal, non-deviant control group. Toobert ( 1959), who derived his information from a prison population, found that 58 per cent of the homes were broken by death or divorce before the offender's fifteenth year and 42 per cent had remained intact. In regard to family adjustment, on the other hand, Toobert found that 26 per cent of the subjects reported a good family adjustment and only 16 per cent a poor one. Differences in absence of parents from the home may be partly due to differences in samples, but also to differences in definitions of "absences" or "broken homes." Absences of the father are much more frequent than those of the mother, but this can be generally expected in our society. Glueck's control group indicates that there is essentially no difference between the pedophilic and the non-deviant offenders. ( b) Relationships with Parents Descriptions of parents by patients give at best a picture of the offenders' subjective feelings about the parents. This indicates something about the relationship the offender had with his parents, as seen from his point of view. It is very doubtful whether such information can be taken as an objective picture, unless verified by an observation of the parents, or at least by information from an independent source. Before the aetiology of a symptom is known specifically, one cannot be sure about the causal relationships of observations. In addition to the offender's unconscious distortions, it is quite possible that the parents demonstrated personality features and attitudes to the offender which they would not demonstrate to any of his siblings, and that some of the parents' behaviour may have been elicited by the very nature of the offender. The Forensic Clinic study attempted to organize the offenders' statements about parents along two basic dimensions (Table XXV): ( i) Distance-closeness. Here judgments were made about the offender's expressions of his relationship to a parent in its quantitative aspect. Such a judgment could only be made in little more than half

60

I

PEOOPHILIA AND EXHIBITIONISM

TABLE XXV FORENSIC CLINIC STUDY, RELATIONSHIP WITH PARENTS Father Nature of relationship Information available Distant Close Positive Negative Ambivalent

P.

Mother

P.

P.

Total

het.

ho.

und.

45 (100%) 11 (24%) 5 (9% ) 10 (22%) 14 (31 % ) 3 (7%)

21 4 3 3 6 1

20 7 1 6 6 2

4 0 1 1 2 0

47 8 21 16 7 12

P.

P.

P.

Total

het.

ho.

und.

(100%) (17%) (45%) (34%) (15%) (26%)

22 4 10 7 4 7

21 3

4 1 1 0 2 0

10

9 1 5

of the cases in which offenders made definite statements related to this dimension. (ii) Posi,tive, negative, ambivalent. This dimension relates to statements about the nature and quality of the offender's affective relationship with his parents. Positive and negative denote definite expressions in this regard and ambivalent means that both positive and negative attitudes have been stated. Relationship with father ( P.het. ). The outstanding feature of the records of the P.het. group is the paucity of information in regard to the offender's relationship with his father. The P.ho., the exhibitionists, and adult homosexuals saw the father as distant rather than close in his relationship to the offender, but there are indications that these groups had missed a closer relationship with him. The P.het. concept of father was generally vague and their few statements sounded like descriptions of anybody. It is, therefore, difficult to judge the P.het. fathers along the dimension of distance and closeness as well as the dimension of positive, negative, and ambivalent feelings. Offenders often described their fathers in terms of work performance, such as "hard-working," "sober," "precise," "honest," etc., or in terms of personality characteristics not directly related to the offender: "broad-minded," "quiet," "not much to say." Although negative statements outweighed the positive ones, the primary impression was one of passivity and inadequacy: "completely dominated by mother," "had not much to say," "happy," "liked him," without further qualification. Negative statements referred to him as "dominating," "interfering," "rigid." In contrast to the exhibitionists, only one pedophile stated that violence by his father was directed towards himself. In Glueck's study ( 1955), the expressed attitudes to father in 40 per

PEDOPHILIA: TIIE OFFENDER

/

61

cent of P.het. showed some warmth or spontaneous indications of feelings of affection and warmth. Thirteen per cent of P.het. expressed feelings of hatred for the father. Expressions of respect for his opinions and attitudes and acceptance of his influence were given by 51 per cent of P.het. Fifty-eight per cent of P.het expressed moderate and severe feelings of fear that the father was more powerful, and could control or hurt the subject. Relationship with father (P.ho.). In the P.ho. group, although the father was not seen generally as close, there was much more positive affect. Even where the father was seen in a negative light, the wish for his affection was often apparent. Positive feelings were most often expressed as "kind," "good," "generous," "upright," "solid." Negative statements expressed the loss of affection such as "hated him, but wanted to be close," "no affection for me," "stem, unaffectionate." Ambivalence was expressed in similar terms: "unstable but great spiritual power over me," "good but inconsistent," "solid but little time for me." The relationship of the P.ho. to their fathers was more like that of the adult homosexual group than that of the P.het. Glueck ( 1955) tabulated the expressed attitudes to father and found that 45 per cent of P.ho. showed some warmth or gave spontaneous indications of feelings of affection and warmth. Twelve per cent of P.ho. expressed feelings of hatred for the father. Expressions of respect for his opinions and attitudes and acceptance of his influence were given by 55 per cent of P.ho. Fifty-seven per cent expressed moderate and severe feelings of fear that the father was more powerful, and could control or hurt the subject. In this particular area, the P.het. and P.ho. groups were more alike than dissimilar, whereas, for the Forensic Clinic, these two groups diverged on their feelings towards their fathers. Relationship with mother (P.het. ). In regard to mother, the P.het. group presented a picture similar to that of the exhibitionists, whereas the P.ho. resembled more closely the homosexuals in the affective quality of the relationship. Positive feelings of the P.het. towards mother were expressed mostly as meeting dependency needs : "always supported me," "depended on her," "kind and understanding," and so forth. Negative expressions referred to withholding of support and affection rather than overt interference: "prudish and quiet," "rather cold," "tense," and "concerned about herself." The great amount of ambivalence for the most part combined these two aspects: "kind but high-strung," "over-

62 /

PEDOPHILIA AND EXIIlBITIONISM

protective," "still fusses over me." We gained the impression that the relationship of the P.het. with his mother, although close and dependent, did not show the strong interaction that was found in the case of exhibitionists, nor did it show the differentiated mode of experience it is possible to see in the case of adult homosexuals. In Glueck's ( 1955) study, 66 per cent of P.het. showed some warmth or gave spontaneous indications of feelings of affection and warmth; none expressed overt hatred. Expressions of respect for the mother's opinions and attitudes, and acceptance of her influence, were expressed by 77 per cent of P.het. Only 28 per cent of P.het. expressed moderate or severe feelings of fear that the mother was more powerful, and could control or hurt the subject. Karpman ( 1950) cited intense mother-son relationships and attachments as an important dynamic factor in cases of heterosexual pedophilia. Of Cassity's 5 cases ( 1927), 2 P.het. demonstrated severe weaning trauma, and two other cases had emotional crises precipitated by the death of one or both parents. Relationship with mother (P.ho.). This group showed a high positive relationship to the mother with only one negative statement. The interaction between mother and son seemed to be much stronger than in the case of the P.het., with a great deal of admiration for the mother's competence expressed in words such as "energetic," "gregarious," "refined," "clever," ''intellectual," "artistic," "kept everything rolling." Some offenders indicated that they were the preferred child, the "favourite baby," "only one allowed to care for her." Ambivalent statements expressed more over-indulgence than over-protectiveness, which was the case with P.het. The relation of the P.ho. to his mother seemed to be very similar to that of the adult homosexuals in the study. In Glueck's (1955) study, 82 per cent of P.ho. showed some warmth or gave spontaneous indications of feelings of affection and warmth; none expressed overt hatred of the mother. Expressions of respect for her opinions and attitudes, and acceptance of her influence, were expressed by 88 per cent of P.ho. Only 21 per cent of P.ho. expressed moderate or severe feelings of fear that the mother was more powerful, and could control or hurt the subject. One of Kurland's (1960) cases (P.ho.) had a mother who gave little warmth or sense of closeness, and was described by the patient as an emotionally unhappy woman who fought frequently with his alcoholic father. This patient had slept with his mother and younger sister until his tenth year.

PEDOPHILIA : THE OFFENDER

/

63

Relationships of P.und. This group had generally a poor relationship with father and mother in the Forensic Clinic study. Two of Kurland's ( 1960) cases were P.und. and the following parental relationships were described for them. The first patient had feared his mother while longing for a warm relationship, the father was described as a quiet, unobtrusive man with whom the relationship was cool and distant. In the second case, the mother, to whom the patient was very close, died in childbirth during his fourteenth year and he remained jealous of his father and new stepmother. Summary

Data on the actual occurrences of parent-child interaction in cases of pedophilia are still too crude and not sufficiently systematized to give a complete and consistent picture. There are indications that deprivation by parental absence is no more frequent in cases of pedophilia than in other psychological or social disturbances and can therefore, at best, only be seen as a generic factor. The father is more often absent from the home than the mother, which only reflects the general cultural situation. Data are inconclusive with regard to differences between the heterosexual and the homosexual group in the matter of separation from the father; consistently more separations from the mother seem to occur in the homosexual group. The relationship to the father, as seen retrospectively by the offender, indicates a lack of personal perceptions on the part of the offenders in the heterosexual group, which would further indicate a lack of identification with father positively as well as negatively. This lack of personal differentiation is also obvious in regard to the mother who is predominantly seen as somebody who does or does not meet immature dependence needs. Retardation in emotional maturation as well as in human perceptions was also found by Hammer ( 1954, 1955) in response to the House-Tree-Person Test. The homosexual pedophilic group indicates a greater awareness of the lack of closeness to the father and the need for a closer relationship. This is also expressed in a reverse way in the attitude of many offenders to their victims where they assume a pseudo-paternal role. The relationship with the mother is, according to the subject, closer, but tends to give the impression of being idealized and in this is in sharp contrast with the primary dependency relationship of the heterosexual group. In general, whereas it was found that, in personal and social characteristics, the homosexual pedophile more nearly approximates the heterosexual pedophile than the homosexual with adult partners, in regard to parental relationships the contrary is the case.

64 /

PEDOPHILIA AND EXHIBITIONISM

For both groups little is known about the interaction of the parents themselves, except for some indication that the mother tended to be considered the stronger and more competent person. (B)

SIBLINGS

The position of a subject in a sibling group was mainly determined by the number of children in the family, the birth order, and the malefemale sibling ratio. Glueck ( 1955) has tabulated these and various other sibling constellations but, as we have noticed before, reference points for his categories are not always clear. Data on the number of siblings were available in 49 cases in the Forensic Clinic study ( Table XXVI) . There was an average of 4 TABLE XXVI FORENSIC CLINIC STUDY, DISTRIBUTION OF SIBLINGS

Total 49 n Number of siblings 207 4.2 Mean Number of children in family 1 10 2 8 3 7 4 5 7 5 2 6 2 7 2 8 1 9 10 3 2 10+

P.het.

P .ho.

P.und.

22 87 4.4

23 101 4.8

4 19 4 .2

4 3

5 4 3 1 4 0 1 1 1 2 1

1 1 1 0 0 0 0 0 0 0 1

3

4 3 2 1 1 0 1 0

children in a family, which was approximately the same as in other groups. However, there were 10 only children (20%), almost twice as many as among the exhibitionists ( 12%) and also more than among homosexuals (15%). In Glueck's study, the proportion of only children was 15 per cent for the P.het. and only 6 per cent for the P.ho., with 14 per cent for the control group. His P.ho. group showed a general tendency towards more children in the rearing group than the P.het., which closely followed the control group. The Forensic Clinic study found no specific differences in regard to birth order (Table XXVII). For pedophilia, in addition to the 10 only children, 6 other patients were only sons, so that a third of the patients were the only male children in the family. This was similar in the case

PEDOPlllLIA: THE OFFENDER

I

65

TABLE XXVII FORENSIC CLINIC STUDY, POSITION IN BIRTH ORDER

n Only child Only son Both

n

Excluding only child Oldest child Youngest child Oldest son Youngest son

Total

P.het.

P.ho.

P.und.

49 (100%) 10 (20%) 6 (13%) 16 (33%)

22 4 4 8

23 5 2 7

4 1 0 1

39 (100%) 12 (31%) 8 (21%) 16 (41%) 16 (41%)

18 5 4 7 9

18 5 4 7 6

3 2 0 2 1

of exhibitionism, whereas homosexuals were the only male children in more than half of the cases. Glueck's P.het. group was similar to his control group; the P.ho. showed a tendency towards being the youngest child, which corresponded more to the adult homosexual group in the Forensic Clinic study. The ratio of brothers and sisters was equal in the Forensic Clinic study with the P.het. having more sisters and the P.ho. more brothers ( Table XXVIII). This is also true for the category "brothers only" TABLE XXVIII FORENSIC CLINIC STUDY, MALE-FEMALE SIBLING RATIOS Total

n

(excluding only child) Total number of siblings All male siblings All female siblings Number of brothers Number of sisters Have brothers only Have sisters only

39 197 118(60%) 79 (40%) 79 (50%) 79 (50%) 5 (13%) 6 (15%)

P.het. 18

83

45 (54%) 38 (46%) 27 (42%) 38 (58%) 1 4

P.ho. 18

96 63 (66%) 33 (34%) 45 (58%) 33 (42%) 4 2

P.und. 3 18 10 (56%) 8 (44%) 7 (47%) 8 (53%) 0 0

or "sisters only," in which the total group is equal but the P.het. is more often the only boy in the family than the P.ho. In comparison to this, adult homosexuals showed slightly more sisters ( 57%) and exhibitionists more brothers ( 67%). With regard to siblings, Glueck ( 1955) stated ( p. 67) that sisters figured as important sources of sexual trauma, especially for the heterosexual pedophiles, of whom 53 per cent had some contact with sisters in a sexual context. This, however, is not borne out consistently in his tabulations. Overt sexual relations occurred in only 3 per cent of both

66 /

PEDOPHILIA AND EXHIBITIONISM

groups ( Table L--31), and under "relationship with sister" ( Table G--6) only 18 per cent of the P.het. group are listed as having had a special intimate relationship with the sister, which is the same percentage as for the control group. Almost twice as many P.ho. (31%), on the other hand, fell into this category. In the Forensic Clinic study, no specific constellation emerged in regard to sibling relationships, except that the P.het. tended to talk more about their sisters and the P.ho. about their brothers. Overt sexual contact occurred only in a few instances and did not seem to be a determining factor, with the possible exception of chronic cases. Smaller case studies also do not present any consistent picture. Hadley's ( 1926) patient ( P.het.) had one married sister with whom the patient had lived for some time; this sister had three small daughters, for whom the patient had fantasies of pedophilic behaviour. Cassity ( 1927) gave information for only one ( P.het.) of five cases in which the patient was the youngest of a large family. Karpman ( 1950) described a case ( P.het.) where the patient had an infant sister who lived only a few weeks. Socarides' ( 1959) patient ( P.ho.) was the second eldest of a large family of disturbed quarrelling people whose finances were border-line. In Kurland's ( 1960) study, one patient ( P.und.) was the eldest of three, followed by a sister and brother at four-year intervals; a second ( P.und. ) was the middle of three with whom poor relationships remained a problem; in the third case, the patient ( P.ho.) was the third of five children spaced two years apart. Summary

Data on siblings in the offenders' families do not indicate any significant trend on the overt level. In regard to relationships between the offender and his siblings, data are not substantial or clear enough to permit specific deductions at this point. ( C)

MARITAL STATUS

Of the 55 pedophiles in the Forensic Clinic study, 11 were single and under the age of 20 (Table XXIX). Three-quarters of the offenders over the age of 20 were married. However, there were differences between the P.het. and the P.ho. All of the P.het. offenders over 20, with the exception of 2, were, or had been, married, and the latter, as will be shown in discussing single offenders, had intensive engagements which broke up. Of the P.ho. offenders, on the other hand, only

PEDOPIIlLIA: THE OFFENDER

67

/

half were, or had been, married and in this respect they were similar to the adult homosexual group. TABLE XXIX FORENSIC CLINIC STUDY, MARITAL STATUS

P.het.

Total

n -20 21+ Single Married or common law• Separated , divorced, widowedt TOTAL

55 44 (100%) 12 (27%)

27 5 22 (100%) 2 (9%)

22

13

11

(69%)

(65%)

P.und.

P .ho. 23 4 19 (100%) 9 (47%) 7

5 2 3 1

(70%)

(31%) (35%) (30%) 10 7 3 32 (73%) (100%) 20 (90%) (100%) 10 (53%) (100% )

2 0 2

*One common law liaison. tSix separated, 3 divorced, 1 widowed.

(a) Single Pedophiles In addition to the 11 offenders under the age of 20, 12 offenders were single over the age of 20 (Table XXIX). Since P.het. and P.ho. differed sharply in their adult heterosexual relationships, they are better discussed separately. (i) P.het. Of the 7 (26%) single P.het. (Table XXIX), 2 had had no adult heterosexual relationships and in 3 more cases such a relationship was highly unlikely ( Table XXX). These 5 were under the age of 20. The other 2 ( ages 23 and 28) had broken off serious engagements recently. None had been involved in sporadic heterosexual experiences and it seems, therefore, that relations with adult females were an allor-none proposition for this group. Marital status also seems to differentiate the adolescent pedophile from the middle-aged one ( according to the Forensic Clinic age distribution) in so far as the adolescent pedophile is not likely to have had a sexual relationship with a woman TABLE XXX FORENSIC CLINIC STUDY-SINGLE PEDOPHILES: ADULT HETEROSEXUAL RELATIONS

n None Sporadic More than sporadic Not known

Total

P .het.

P.ho.

P .und.

19 (100%) 12 (63%) 5 (26%) 2 (11%) 4

4 2 0 2 3

13 8 5 0 0

2 2 0 0 1

68 /

PEDOPHILIA AND EXHIBITIONISM

equal in age or older. This information further supports the conclusion that the motive for members of this group is an exploratory one, coupled with their inability to choose an age-equal partner because of immaturity. In contrast to the adolescent exhibitionists, the pedophiles do not express a strong wish for intercourse. Rather, it seems that they perceive adult sexual relations as being out of their reach altogether. (ii) P.ho. There were 13 ( 75%) single offenders in this group, of whom 9 were over the age of 20 (Table XXIX). None of them had had an intensive heterosexual experience. Five of the 13 had tried heterosexual relations, but had given up. Eight had had no heterosexual experience, most of them not being interested in females and some mentioning friendly relations with females of a non-sexual character. In this regard, they were quite different from the P.het. and similar to the adult homosexuals. Of the 4 adolescents in this group, 2 claimed that the pedophilic activities resulted from the excitement they got when they found that they could share their masturbatory activities with other boys and subsequently wanted to let younger ones in on the experience they had missed. The other 2 were interested in girls during early adolescence, but felt that they could not get closer to them. The 6 middle-aged single P.ho. did not seem to be different from the married ones, who, as will be shown, tended to have indifferent relationships with their wives. Of the 3 single offenders in the senescent age group, 2 had been exclusively homosexual pedophiles and the third visited a prostitute once a month. ( b) Married Pedophiles ( i) Age at time of marriage. Three-quarters of the married exhibitionists and adult homosexuals were married by the age of 25, the median and mode in both cases falling at the age of 22 to 23. Less than half of the married pedophiles were married by the age of 25, and more than a quarter got married after the age of 30. There was a median difference of five years delay compared with the other deviations. In the case of P.het. offenders (Table XXXI), one-third married after the age of 30, whereas most of the P.ho. married around the age of 26 to 27. The undifferentiated pedophiles were an exception in so far as both offenders were married by the age of 21. Comparisons made with the general population figures from the

PEDOPIIlLIA: THE OFFENDER

I 69

TABLE XXXI FORENSIC CLINIC STUDY, AGE AT TIME OF MARRIAGE Age

Total

P.het.

P.ho.

P.und.

n -19 20--21 22-23 24--25 26--27 28-29 30+

29 2 3 4 3 6 3 8 3

18 1 2 3 2 2 2 6 2

9 0 0

2 1 1 0 0 0 0 0 0

Not known

1 1

4 1 2 1

Vital Statistics of the Province of Ontario ( 1959) showed that 59 per cent of first marriages were contracted before age 25. This was only the case in 43 per cent of pedophiles. Over age 30, there were only 16 per cent of first marriages in the general population, compared with 28 per cent in the pedophilic group. These figures seem to support the suggestion that the pedophilic group demonstrates delayed maturational processes. An assessment of the marital status of pedophiles in the Millbrook study showed that the majority of heterosexual pedophiles were married and the majority of the homosexual offenders were single. In the P.het. group 50 per cent were married, 25 per cent were single, and 25 per cent separated or divorced; in the P.ho. group, 16 per cent were married, 49 per cent single, and 16 per cent were separated or divorced. Three of Cassity's 5 cases ( 1927) were married; I ( P.het.) married to conform to the demands of society, but never experienced satisfactory sexual relations; a second ( P.het.) separated from his first wife whom he described as frigid, and later remarried; a third ( P.het.), who was impotent, was divorced by his wife when he was 45 years old. Karpman's case (1950) (P.het.) was married at 18, divorced, and remarried by age 20. To provide quantitative comparisons of marriages of pedophiles, the TABLE XXXII FORENSIC CLINIC STUDY-SAN QUENTIN STUDY, COMPARISON OF MARITAL STATUS Forensic Clinic Toobert's study (n = 55) (n = 120) Single Married: 1st partner Divorced or separated

42% 40%

18%

25% 43%

32%

70 /

PEDOPHILIA AND EXHIBITIONISM

Forensic Clinic subjects were re-grouped according to the classification of Toobert et al. ( 1959) with results as shown in Table XXXII. The apparent differences were lessened when the age factor was considered. Toobert et al. reported that only 10 per cent of their sample were below age 30. Therefore, when the adolescent group were removed from the Forensic Clinic data, the results showed considerable similarity (TableXXXIII). TABLE XXXIII FORENSIC CLINIC STUDY-SAN QUENTIN STUDY, COMPARISON OF MARITAL STATUS (ADJUSTED DATA)

Forensic Clinic (n = 44)

Toobert's Study (n = 120)

27% 50% 23%

25% 43% 32%

Single (over 20 years) Married: 1st partner Divorced or separated

In Glueck's ( 1955) study, 62 per cent of P.het. and 42 per cent of P.ho. were married while 38 per cent of P.het. and 58 per cent of P.ho. were not married. In his consideration of the age factor, the age at time of first marriage was recorded as shown in Table XXXIV. The table seemed to follow a general trend similar to that of the Forensic Clinic data. However, the ten-year age span is too broad to show the maturational delay more specifically. TABLE XXXIV SING SING STUDY,* AGE AT FIRST MARRIAGE

Less than 18 18 to 20 21 to 30 31 to 40 plus

P.het.

P.ho.

Offender control group

12% 15% 70% 3%

7% 7% 71% 14%

2% 28% 65% 5%

*Adapted from Glueck (1955) , Table M-3, p. 252. (ii) Length of Marriage. In contrast to exhibitionists, whose marriages tended to be young ones, none of the pedophiles had been married less than 1 year, and three-quarters of those whose marriages had not broken up before the time of referral had been married more than 5 years (Table XXXV). In the case of P.het., more than half had been married more than 20 years. In regard to separation, no pattern can be discerned in the P.het. group. Among P.ho. two out of the three broken marriages were separated within the first 3 years. The third was on account of death of the spouse. Marriages of separated adult homosexuals also terminated during the first 3 years.

PEDOPHILIA: THE OFFENDER

I

71

TABLE XXXV FORENSIC CLINIC STUDY, LENGTH OF MARRIAGE AT TIME OF REFERRAL OR SEPARATION Total Length

n -1 year 2-3 ye:!rs

4-5

6-10 11-20 20+

" " "

Not known

Marr. Sep.

19 0 2 3

4

3 7 3

10 1 3 1 2 1 2 0

P.het. Marr. Sep.

11 0 0 2 1 2 6 2

7 1 1 1 2 1 1 0

P.ho.

P.und.

Marr. Sep.

6 0 1 1 3 0 1 1

3 0 2 0 0 0 1 0

Marr. Sep.

2 0 1 0 0 1 0 0

0 0 0 0 0 0 0 0

In Glueck's ( 1955) study, most of the P.het. had been married more than 5 years. In the P.ho. the largest group was in the range of 2 years. (iii) Marital relationships (P.het.). In presenting the age distribution of pedophiles, it was indicated that the three age groups differed with regard to their marital relationships. The adolescent group has already been discussed under "single pedophiles." The next group, tending towards middle age, showed severe marital maladjustment. It has already been stated that the two single offenders in their twenties had experienced a close relationship which had broken down. The married offenders in this age group were either separated or lived in a disintegrated family relationship where alcohol, promiscuity on the wife's part, and serious battles were frequent. Only one offender ( aged 30) stated that his wife was good and that there was no serious conflict. Two wives had had children before marriage; one had been pregnant and had been married by the offender "to give the child a father." One offender lived in common law with a prostitute and was maintained by her; and another lived in common law with the wife of a patient in a mental hospital. Almost all of these offenders had children who were exposed to serious family conditions. The senescent group was socially much better adjusted and their statements about their wives showed two prominent features: (a) dependency: "married to a rich wife," "lived with in-laws for ten years," "wife like mother"; and ( b) lack of personal and sexual relationships in an outwardly stable marriage: "wife cold," "does not speak to me," "separate bedrooms," "often refused," "never compatible," "chronically ill," "no intercourse for four years." These people found companionship in children and a break-through of the sexual impulse occurred in this context. This is also the group, as has been stated before, which is least likely to repeat the offence. P.ho. All except two of the ten married P.ho. offenders belonged to

72 /

PEDOPHILIA AND EXHIBITIONISM

the middle-aged group. Only two of these marriages had ended; in one alcohol was a factor, in the other the offender had married a woman with two boys. The marriages where no separation had occurred seemed to be characterized by a lack of closeness: "married for pity," "wife had severe heart condition," "wife is afraid of intercourse," "sex only Friday and Saturday," "wife quiet." In the one case in which the offender stated that he was happy in his relationship with his wife, the relationship was a rather dependent one. Only two of the senescent age group were married. One had lost his wife two years previously and the other had a satisfactory relationship with his wife, although he described her as dominating. P.und. Both marriages in the P.und. group were deteriorated ones; one family was a chronic Children's Aid and Family Court case, and the other offender lived off his wife's prostitution. Summary

Offenders over age 20 tend to be married. The majority of P.het. either are, or have been, married. For the P.ho. this is only true for one-third to one-half of the cases. The adolescent P.het. tend not to have any adult sexual relationships. It seems that their pedophilic behaviour is exploratory in motivation, and that they are too immature to relate to a woman equal in age or older. If a single P.het. experiences a significant adult heterosexual relationship, he should rather be classified with the middle-aged group. The P.ho. adolescent group does not seem to have any intensive heterosexual experiences either; their interest is chiefly at the masturbatory level. In contrast to the general population and other deviations, the pedophiles tend to get married later, which may be another indication of a delayed maturational pattern. The marriages of middle-aged P.het. are characterized by severe maladjustments, whereas those of the P.ho. show an indifferent marital relationship. The length of marriages of P.het. and P.ho. differs. The P.het. marriages, in spite of maladjustments, seem to last longer than those of the P.ho. which show a pattern similar to that of the adult homosexuals.

(D)

CHILDREN

More than two-thirds of the married pedophiles had children ( Table XXXVI), including step-children, with an average of 2 to 3 children in a family. This was slightly more than in the case of the exhibitionists,

PEDOPHILIA: THE OFFENDER

73

/

TABLE XXXVI FORENSIC CLINIC STUDY, CHILDREN OF MARRIED PEDOPHILES

P.het.

Total Married patients Patients with children No. of children Mean No. of children

32 (100%) 22 (69%) 58 1.8

20 (100% ) 15 (75%) 38 1.9

P.ho.

P .und.

10 (100%) 6 (60%) 14 1.4

2 1 6

but it had to be considered that exhibitionists included a number of young couples who had been married less than a year. More P.het. had children than P.ho., and the average number of children was slightly higher in the families of P.het. In Cassity's ( 1927) report, one P.het. had a child by his first marriage, a second P.het. had a "good-sized family," and the third P.het. had no children. Karpman's (1950) patient, a P.het., had one child by his first marriage. Glueck ( 1955) provided percentages of children of both P.het. and P.ho. as well as the offender control group, which appear in Table XXXVII. TABLE XXXVII SING SING STUDY,• CHILDREN OF MARRIED PEDOPHILES

Number of children Group

None

1

2-3

4-7

8or more

P.het. P.ho. Offender control group

12% 21 %

18% 14%

30% 57%

30% 7%

9%

26%

18%

42%

13%

*Adapted from Glueck (1955) , Table M-14, p. 257.

When the relationship between the victim and the offender was examined above, it was noted that among 5 cases of P.het., the act involved the step-child or the offender's own child. In the description of the middle-aged pedophiles, it was also stated that 1 case involved the friend of an offender's child and 1 other case involved a daughtersubstitute. It seemed, therefore, that incestuous strivings played a role in the middle-aged P.het. group. This seemed also to be indicated by the fact that several offenders married women with children, or pregnant women "to give the child a father." In the P.ho. group, this striving was less apparent. First, only 6 offenders in all had children, with 4 offenders in the middle-aged group. Of the latter 1 had married a woman with two boys ( 2 and 12 years old) and 1 other was left by his wife soon after the birth of a

74 /

PEDOPHILIA AND EXHIBITIONISM

child. The fatherly attitude of many P.ho. is more apparent in the single than in the married group. Among the senescent group, only 1 P.het. was involved with a member of his family, a grandchild. The same offender had also fondled his own daughter, the mother of this child, when she was young. There seemed to be little relationship between aged pedophiles and their grown-up children, which further accounts for the loneliness of that group. Summary Two-thirds of married pedophiles had children with 2 to 3 children per family. Incestuous strivings played a part in some of the middleaged P.het. group, but were less apparent in the P.ho. group. The married P.ho. group had less of a fatherly attitude than the single P.ho. A lack of close ties between the senescent pedophiles and their own adult children was seen as a factor which contributed to their loneliness and pedophilic behaviour.

4. Legal and Criminological Factors

Most of the information on pedophilic behaviour has its source directly or indirectly in the legal process. No reliable information exists about the incidence and prevalence of pedophilic behaviour generally in society, and even for recorded offences estimates only can be made because of the variety of definitions and charges dealing with such behaviour. A criminal process which is interested in social regulation rather than in fitting the punishment to the crime depends, however, on information by which the danger of a given offender to society, and conditions and chances of change, can be assessed. Our focus in this chapter therefore will be on those factors that may serve as predictive indicators for the various groups of pedophilic offenders in the hope of assisting a rational and knowledgeable approach to the problems of judicial dispositions. The Cambridge study provides an outline of the general legal position with regard to sexual offenders in England, the Scandinavian countries, and the United States. The law in Canada has been reviewed by Mewett ( 1959) and Rodgers ( 1962). The situation in the United States is complex and general accounts have been given by Ploscowe ( 1951), Guttmacher ( 1952), the California study ( 1953, 1954), Tappan ( 1951), and others. Because of the diversity of classifications and approaches, we have not attempted to discuss the present laws, but have concentrated on the empirical evidence about the various offences against children with data on their incidence and consequences. I. CRIMINAL CHARGES AND INCIDENCE Sexual acts between adult males and children may fall under a variety of criminal charges, the incidences of which are difficult to estimate from statistical reports, since most charges do not differentiate between adult victims and children. The only exceptions in England and Canada are the charges of sexual intercourse with young females under specific age limits, which in the United States are commonly

76 /

PEDOPHILIA AND EXHIBITIONISM

termed statutory rape. Various American states also have provisions for lewd or indecent acts with children, which separate these acts from the common charge of indecent assault. In addition to criminal legislation, charges covering pedophilic acts may be found in laws protecting children and juveniles, such as the charge of "contributing to juvenile delinquency." Statistically, however, no separation is usually made between sexual and non-sexual acts that may be covered by such a charge. We have defined pedophilia as being expressed by immature sexual acts with prepubertal children, but because of the ambiguities just described all related criminal charges and their incidences have to be reviewed in order to identify actual pedophilic occurrences. In what follows, the discussion of charges is grouped according to the nature of the act involved, from child murder to non-coital contacts.

(A)

CHILD MURDER

The combination of murder and sexual assault elicits the deepest emotions and fears in the general public. When such an act is directed towards a child who is helpless and relatively free of guilt, it is understandable that public concern should be at its highest. Actually, the murder of children with a sexual motive is very rare in comparison to other sexual behaviour with children, as is indeed the case with adults, but the concomitant publicity often creates the impression that violence is closely associated with all pedophilic behaviour. Sexual homicide can arise out of various conditions and circumstances. The so-called "lust murder" arises out of sadistic impulses in which violence represents the sexual satisfaction. A classic example is that of Gilles de Rais who in the fifteenth century was alleged to have tortured and killed several hundred children. In most cases, however, the killing is not the sexual aim ( Hirschfeld 1948) but a result of the sexual act, occurring either accidentally in the heat of passion, or in a panic to cover up the sexual act. Killing can also be the result of a psychotic illness, with sexual interference as a by-product. In rare cases it can arise out of necrophilic urges. Because of the rarity of child murder on a sexual basis, we found no specific statistical accounts of it. In a number of cases a sexual basis may have been attributed to the act where, in fact, none existed. Sutherland ( 1950) tabulated all murders of females reported in the New York Times for the years 1930, 1935, and 1940, and found that of 324 such murders, only 17 (5%) involved suspicion of rape on women or children. Wolfgang ( 1958) in his extensive study on patterns of

PEDOPHILIA: LEGAL AND CRIMINOLOGICAL FACTORS

/

77

homicide does not even list sexual assault as a motive in criminal homicide in 588 Philadelphia cases. Only 3 of the homicides were connected with rape, and no age for the victim is given. In Glueck's ( 1955) Sing Sing group, homicide was involved in 1 homosexual pedophilic case and brutality in 1 other homosexual and 1 heterosexual pedophilic case. Thus, although homicide of children resulting from pedophilic offences does occur, it is so rare that pedophilic offenders cannot be considered more homicidal than any other population group. ( B)

INTERCOURSE WITH VIOLENCE

The incidence of forcible intercourse with children is extremely difficult to estimate, since the charge of rape in most legislation includes acts against adult females as well as children. Even for this composite group, the findings are that actual force is relatively rare, in spite of the fact that charges are usually screened before they are proceeded with; conviction rates are low. In the Cambridge study, of 38 persons charged with rape 47.4 per cent were acquitted. Glueck ( 1955) reported that of 1,219 persons arrested and charged with rape in New York State in 1948, 48.4 per cent were acquitted or dismissed, and only 10 per cent were convicted, of whom 6.5 per cent were actually sent to state institutions. In Metropolitan Toronto, of 78 prosecutions for rape or attempted rape between 1957 and 1960, 55.2 per cent of those charged were acquitted or dismissed. The reports of the Ontario Provincial Police for the same time show that of 191 cases, in only 38 or 19.8 per cent were there convictions. In 1958, of 45 prosecutions only 2 resulted in convictions. Although it is evident that a highly selective process is used in bringing cases to trial, it remains true that the actual use of force is relatively rare. The Cambridge study noted that with only 4 per cent of the female victims did the nature of the offence constitute intercourse or attempted intercourse involving force; Mangus ( 1954) reported that in the superior courts of San Francisco during 1951 and 1952, only 9.3 per cent of the total rape charges involved forcible rape. In some American statistics, the differentiation between rape and statutory rape is not clearly indicated, as Governor Dewey's Report (1950) pointed out : "It should be noted that it is impossible in these statistics to distinguish between the crime of rape in the first degree, which involves the use of force, and rape in the second degree, which is the carnal knowledge of a girl under the age of 18, though she is willing." The latter will be discussed in the next section.

78 /

PEDOPHILIA AND EXHIBITIONISM

In regard to forcible sexual intercourse with children, some incidental, but little statistical, material is available. Revitch et al. ( 1962), reporting on pedophilic offenders in the New Jersey State Diagnostic Center, noted that "these offences are comparatively infrequent although they have been recorded in the literature." This would suggest that they did not find such a case among the 836 offenders against children at the Center. Miriam Darwin in the survey of 74 child victims in the California study was unable to show a case in which violence was used. Glueck ( 1955), whose cases are solely from a prison population, reported the use of violence in only 15 per cent of all pedophilic offences. There is, however, no correlation with intercourse and it remains questionable how many of these cases represent forcible intercourse. We have shown previously that on a behavioural level neither intercourse nor violence are primary associates of pedophilic behaviour. Criminological evidence now shows that forcible intercourse with children as such is rare. It would seem, therefore, to be indicated that these offences should be treated as special cases of rape, rather than as pedophilic offences.

( C)

INTERCOURSE WITHOUT VIOLENCE

Among the various restrictions placed on coital activity, prohibitions in regard to sexual intercourse with minors are among the most common ones. Criminal charges resulting from coital sexual behaviour where age is a factor are distinguished as "carnal knowledge," "statutory rape," or "intercourse with a female under a certain age." It should be noted that these groupings, and the statistical information connected with them, refer to various age categories with different degrees of sanctions. Age limits in various legislations are not only interesting for the purposes of establishing the difference between coital and genuine pedophilic behaviour, but also give some insight into legal positions in general regarding sexual acts with children. We shall consider some of the most common categories, and discuss the incidence of sexual intercourse with minors and its meaning in terms of age groupings. In this way it will be possible to clarify some of the most obvious confusions that exist, and to demonstrate with criminological material what we have established previously on a behavioural level. The age at which the consent of the female partner is a defence varies widely in different jurisdictions. In the United States it ranges from under 8 (Delaware) to 21 (Tennessee) ( California study, 1954) . In twenty-three states, consent to statutory rape is no defence if the

PEDOPHILIA: LEGAL AND CRIMINOLOGICAL FACTORS

/

79

minor is under the age of 18, while in twenty-one states, the age of 16 or above is a defence. In England, the age of consent is 13, and 16 for various exceptions. Under the Canadian Criminal Code, consent is no defence if the girl is under the age of 14, except in the case of marriage. If she is between 14 and 16, she has to be of previous chaste character and the accused must not be more to blame than she is. There is further legal protection for females of previous chaste character between 16 and 18 against seduction by a male over 18, and between 18 and 21 against seduction under promise of marriage, if the male is over 21. Depending on the age of the partner, a considerable selective process is involved leading up to final convictions, as was found before in the case of forcible rape. The Cambridge study ( 1957) showed that, with girls under 13, only 7.7 per cent of the offenders were not proceeded against, and all others were convicted, whereas in the 13 to 16 age group, 45 per cent were not brought to trial, and a further 27.5 per cent were not convicted. In Metropolitan Toronto during 1957 to 1960, there were 54 carnal knowledge charges proceeded with in Magistrates' Court, and in only 35.1 per cent were there convictions. The statistics of the Ontario Provincial Police for the same charge and the same time show a conviction rate of 63.5 per cent in 159 cases. In regard to seduction ( age 16 to 21), there were only 6 prosecutions in the above four years in Metropolitan Toronto, 3 of which resulted in convictions. The Ontario Provincial Police reported 21 prosecutions during this time, resulting in 11 convictions. Although the age group 16-21 would seem logically to fall outside a study of pedophilia, it has been pointed out previously that studies and statistics on pedophilic acts sometimes do include victims up to the age of 21. The incidence of intercourse with children is generally low in comparison with other sexual offences. In the Cambridge study it amounts to 2.8 per cent of all sexual offences studied, and 11.0 per cent of all heterosexual offences with exclusion of exhibitionism. In the 56 cases of carnal knowledge, however, 11 victims were under 13 years old and 46 were from 13 to 16 years. This difference is borne out by other studies, such as the California study ( 1953 ), in which of 14 cases of actual intercourse correlated with age, 1 victim was under the age of 13, and 13 were between 13 and 16. This and other material indicates that the incidence of intercourse increases with the age of the child, which coincides with the increase of first intercourse among females in general. Victims of pedophilic acts, on the other hand, show an age peak at around 10 years of age, which then declines rapidly.

80 /

PEDOPHILIA AND EXHIBITIONISM

Prison studies provide approximately the same picture. In the Kingston study, 12.6 per cent of 63 sex offenders were involved in intercourse with a minor; however, only 2 of the 8 victims were under 14. In the Millbrook study, only 3 out of 55 cases or 5.4 per cent were involved in intercourse. Sexual intercourse with children and minor sexual acts, although separated in most legislations as carnal knowledge, or statutory rape versus indecent assault, lewdness, molesting, etc., are often not treated separately in criminological studies, in spite of the fact that it is clearly established that the majority of sexual offences against children consist of the latter minor acts. Where coital activity is involved, the degree of deviation, if any, will depend on the sexual maturity of the child. It has been shown that the incidence of this activity increases rapidly with the age of the child. From the standpoint of legal control, a separation between psychologically deviant sexual behaviour and normal but socially unacceptable sexual behaviour is important. Since the law depends on uniform classification, sexual maturity can only be stated in terms of age. Certain exceptions may be specified in addition. The most reasonable classification seems to be one which would give absolute protection to children up to the age of 13 and conditional protection between the ages of 13 and 16. Provisions under the Criminal Code of Canada ( s. 138) seem to be adequate with the exception of the age limit for absolute protection, which could be reduced from under the age of 14 to under the age of 13. For ages 14-16 the Code ( s. 138, ss. 2, 3) provides that a female person has to be of previously chaste character and the accused more to blame than the female person. Both these provisions take cognizance of the fact that a female person aged 14--16 may be sexually mature and that seduction is not necessarily the act of a male. In such cases, the behaviour should be the concern of social courts and welfare agencies rather than of criminal courts. ( D)

NON-COITAL SEXUAL ACTS

The majority of all sexual offences coming before the courts arise out of non-coital acts and, since most of them are minor offences, they are usually dealt with in the lower courts. This is especially true of sexual acts with children and exhibitionism, and these two account for the majority of sexual offences. The distinction between indictable offences and non-indictable offences, or between felonies and misdemeanours, differs in various jurisdictions. Statistics are often difficult to assess

PEDOPHILIA: LEGAL AND CRIMINOLOGICAL FACTORS

/

81

because various acts are not treated separately. In Canada, most of the non-coital sexual acts against female children are handled under the charge of "indecent assault" ( which also deals with adult women) or under the charge of "contributing to juvenile delinquency," which may also include a variety of non-sexual acts. In the Cambridge study ( 1957), 78 per cent of the 1,026 victims of "indecent assault" were under the age of 14, and this group constituted about 60 per cent of all recorded heterosexual indictable offences. In the California study ( 1954), of 59 selected female child victims, noncoital acts accounted for about 70 per cent of all sexual acts, and coital acts were concentrated in the 14 to 16 age group. In Shaskan's ( 1939) group of 100 sex offenders referred to the psychiatric division of the Bellevue Hospital, there were 32 cases of sex play with a minor compared with 3 cases of statutory rape. In the Millbrook study, 10 or 60 per cent of the "indecent assault" charges referred to children, and these together with 5 charges of "contributing to juvenile delinquency" accounted for 67 per cent of sexual offences against children. It can be expected that institutional studies will show a higher percentage of more severe sexual acts than is actually encountered in court, because minor acts have a better chance of being disposed of by suspended sentences and probation. In the Forensic Clinic study, of the 27 heterosexual pedophiles, 10 were charged with indecent assault, 15 with contributing to juvenile delinquency, 1 with indecent exposure, and 2 with attempted carnal knowledge ( this breakdown excludes cases of indecent exposure against children by exhibitionists, which were classified separately). Data given in connection with the nature of the act also indicate that non-coital sexual acts of the immature gratification type are the predominant ones. ( E)

HOMOSEXUAL ACTS

Since these acts do not seem to diHer significantly in cases where children rather than adults are involved, little distinction is possible. The incidence cannot be assessed on the basis of common statistics because the charges generally do not differentiate between adults and children. In the statistics of various studies, the incidence of homosexual offences against children is consistently less than the incidence of heterosexual offences. In the Cambridge study, 33 per cent of the victims under 14 were boys and 67 per cent girls, and in Frisbie's ( 1959) study, the proportion was 29 per cent to 71 per cent. Hammer's

82 /

PEDOPHILIA AND EXHIBITIONISM

study ( 1955) included 34 per cent homosexual pedophiles and 66 per cent heterosexual pedophiles; Glueck's ( 1955) proportion was 41 per cent to 59 per cent, the Millbrook study gave 44 per cent to 56 per cent and the Forensic Clinic study, 46 per cent to 55 per cent. Summary

Among sexual offences against children, those resulting in death or violence are extremely rare. Among heterosexual offences, only a minor proportion consist of actual intercourse and these involve mainly the age group over 14, mostly with the consent of the victims. The majority of offences are, therefore, genuine pedophilic ones of the immature gratification type. A separation of these offences from the violent ones and those involving intercourse is essential for a rational judicial and correctional procedure. Homosexual offences appear to be consistently fewer than heterosexual ones, consisting of about 30 to 45 per cent of all sexual offences against children under 14. II. CRIMINAL RECORDS AND RECIDIVISM

The chronicity of any form of offensive behaviour can be measured by the criminal records of given offender groups. This measure is, of course, incomplete because it excludes undetected offences, but it is still the best available. Statistics on criminal records and recidivism for sexual offences vary according to the distribution of the types of sexual offences included, and according to the proportion of first offenders, which is considerably higher in court studies than in prison studies. The proportion of repeaters among unselected sexual offender groups seems to be rather similar. The McRuer Report ( 1958) found 13.6 per cent of sexual offenders with a previous record of sexual offences; the Cambridge study ( 1957) rate was 12.2 per cent for heterosexual and 18.3 per cent for homosexual offences. In Denmark ( Tappan, 1951) the rate was found to be 16.8 per cent. Guttmacher ( 1951) noted in regard to the Uniform Crime Report that rape was twenty-fourth and "other sex offences" were twenty-fifth in order of recidivism among the 26 offences listed. The low recidivism rate of sexual offenders is generally recognized. However, if a study population is selected from prison, previous convictions may go up as high as 50 and 60 per cent ( Glueck 1955, Frosch et al. 1939). This simply means that prison groups are biased groups containing more recidivists. If the offences are broken down, it is generally found that exhibi-

PEDOPHILIA: LEGAL AND CRIMINOLOGICAL FACTORS

/

83

tionism and homosexual pedophilia show the highest rate of recidivism. The Danish figure for homosexual pedophiles who repeated the offence was 27.9 per cent, which is similar to the Cambridge ( 1957) finding of 27.3 per cent, and twice as high as the comparable figure for heterosexual offences with children, which is 13.4 per cent. The same ratio is reported by Frisbie ( 1959) for the Atascadero Hospital, California, with 14 per cent recidivism for homosexual and 7 per cent for heterosexual pedophiles. The Forensic Clinic study shows 11 per cent versus 13 per cent for all cases and 6 per cent versus 20 per cent for treatment cases in the two groups.

(A)

PREVIOUS RECORD AND RECIDIVISM

In most criminal offences, a previous record increases the chances of further recidivism. Stiirup ( 1961) found that relapses in sexual offences were two to three times greater if there was a previous sexual offence than they were with first offenders. The Forensic Clinic study showed that for exhibitionists, pedophiles and homosexuals, the rate of recidivism for first offenders was 10 per cent; for those who had more than one sexual offence previous to referral, recidivism amounted to 33 per cent, and for offenders with previous sexual and non-sexual offences, the recidivism on sexual offences amounted to 55 per cent. The Cambridge study showed a surprisingly similar picture with re-conviction rates of 10.8 per cent for first offenders, 33.3 per cent for those with previous sexual offences and 42.6 per cent for those with previous sexual and non-sexual offences. It is apparent that there is a very significant difference in the chances of repeating the offence between a person who has been charged for the first time and a person who has been convicted more than once. In regard to pedophilia, the Forensic Clinic study showed a progression from 10 per cent for first offenders to 22 per cent for persons with more than one previous sexual offence and up to 33 per cent for those who had had previous sexual and non-sexual offences. The Cambridge study ( 1957) further pointed out the greater chronicity of the homosexual pedophile: one out of three had been re-convicted for more than one subsequent sexual offence; this figure was one out of five among heterosexual pedophiles, within a period of four years. The Forensic Clinic study figures are too small to allow any conclusion in this regard; however, they point in the same direction, with one out of three heterosexual pedophiles being convicted of more than one subsequent sexual offence, and two out of three homosexual pedophiles falling into this category.

84 /

( B)

PEDOPHILIA AND EXHIBITIONISM AGE AND RECIDIVISM

Whereas recidivism in criminal offences generally declines with age, no data, except those of the Forensic Clinic study, are available on the three age groups in pedophilia. However, since the number of recidivists appearing in this study was small, no more than a summary impression can be given. Of the three recidivists in the heterosexual group ( n 27), one was an adolescent, one fell into the middle-aged group and the third into the senescent group. All three were chronic offenders: the first was severely retarded mentally; the second ( age 39) had committed sexual acts with about 100 children; and the third ( age 57) had at least ten previous convictions for sexual offences and several for non-sexual offences. On the basfa of known sexual behaviour, chronicity is difficult to establish for the adolescent group, even where there is repetition of the offensive sexual behaviour, because psychosexual maturation is still in progress. For the middle-aged group, the chronic offenders seem never to have lost the urge for contacts with children since their own childhood. In the non-chronic cases, the frequent social deterioration with alcoholism and family breakdown seems to be more a serious factor than the pedophilic urge as such. The senescent group seems to show the clearest distinction between chronic and incidental offenders. The senescent offender who has not had a previous record and who does not suffer from organic brain disorders is highly unlikely to repeat the offence again. In the homosexual group, the general persistence of the symptoms makes it more difficult to distinguish between the incidental and the chronic offender. In the adolescent group, 3 of 7 offenders had been re-convicted within the follow-up period of about three years. Of the middle-aged group, most had experienced pedophilic urges in their adolescence and 5 of the 12 patients had previous records. Half of the patients had been leaders in youth clubs, although their offences were not necessarily committed with their club contacts. There were no re-convictions during the follow-up period and the personal follow-up showed that this was owing more to an increase in the ability to control acting out than a recession of the urge. There were only 4 patients in the senescent group, of whom one had been a chronic offender throughout his life, whereas the others became pedophilic in their later years, as an accompaniment of chronic alcoholism and organic deterioration.

=

PEDOPHILIA: LEGAL AND CRIMINOLOGICAL FACTORS

/

85

The adjustment of this group remained marginal, although no further offences were recorded. Summary

The data point out that recidivism in sexual offences is low in general. Exhibitionism has consistently the highest recidivism rate, followed by homosexual pedophilia with a recidivism rate of from 13 per cent to 28 per cent. Heterosexual offences against children show about half this recidivism rate, varying from 7 per cent to 13 per cent. The chances of repeating the offence increase drastically with the number of convictions. In all sexual offences, the chances of repeating the offence increase from about 10 per cent for first offenders to 1 out of 3 in cases of previous sexual convictions and 1 out of 2 in cases of previous sexual and non-sexual convictions. There are differences between the various age groups, which will be explored further in Chapter 5.

5. Clinical and Correctional Factors

It is well recognized and in most cases also accepted, that sexually deviant offences have not only legal and social but also clinical implications. Treatment is, therefore, seen as an important tool in dealing with this problem. In order to be effective, treatment depends on knowledge of the physical, psychological, and social determinants of these offences, the methods that can be applied, and the settings in which treatment can be given. Another important consideration is the practicality of various procedures, especially in view of the limited resources of adequately trained professional persons in the field of psychiatry, clinical psychology, and social work. The assertion that every criminal offender is sick and in need of treatment, even if true, is strictly academic at a time when treatment facilities are inadequate and overcrowded in general. Battles of correctional philosophies are most often fought on a high level of generalization with an inadequate recognition that realistic solutions for sexual offences as well as others can only be found in an approach that takes account of variations. Nevertheless, although it is hopeless to think of remedies that will apply to all offenders, it is impossible to see each offender solely as an individual. The task, therefore, is to identify the applicability of various procedures to specific groups, such as the pedophilic offender. With some sexual offences, such as homosexuality between consenting adults, the need for protection is not so apparent. In contrast, the need for protection of children against sexual interference can hardly be questioned. If such an interference takes place, the factors determining adequate procedures are the nature and severity of the offence, its consequences for the victim, and the means by which the chances of a repetition of the offence can be, if not excluded, at least minimized. Since capital punishment or life imprisonment for all pedophilic offenders is neither humanly acceptable nor, in most cases, warranted by any standards, discriminatory procedures have to be developed, on the best scientific evidence available.

PEDOPHILIA: CLINICAL AND CORRECTIONAL FACTORS

/

87

I. AETIOLOGY

As we have shown, many definitions of pedophilia have been based on aetiological rather than on phenomenological considerations, that is, on causes rather than on the nature, circumstances and consequences of the deviant act. The question of aetiology, therefore, had to be raised above in our discussion of definitions and is thus partly discussed in Chapter 1. The precise identification of the aetiological factors of behavioural symptoms depends greatly on the theory to which one subscribes. Immaturity, for example, which is the problem most consistently raised with pedophiles, can be seen as an organic malfunction, as a deficient learning process, as a lack of proper conditioning, or as psychodynamic fixation or regression. Many of these concepts overlap. Their relative importance in explaining the symptom is still unexplored, and this is true for many other conditions. The test of the value of aetiological considerations therefore must lie in their implication for treatment and this we shall discuss later in relation to various therapeutic methods. Some aetiological factors have been indicated in the chapter on family background. But it should be noted that the causal relationship of the observations remains doubtful. Is the dependent relationship of the pedophile with his mother the outcome of over-protectiveness and clinging on the mother's side or of a biological retardation on the child's side? In assessing retrospective studies of parent-child relationships, one must not forget that the behaviour of parents differs in regard to the various siblings, and that not all siblings are affiicted with the same problem. II. PSYCHIATRIC DIAGNOSIS

In our examination of the definitions of pedophilia, it was shown that older clinical studies usually linked pedophilia aetiologically with severe mental disorders and mental retardation. This can be explained mainly by the fact that the cases examined in these studies were referred to a psychiatrist, not so much because the patients were pedophilic as because they had shown obvious signs of mental disturbance. A biased sample was created, which, as later studies point out, was not representative of the majority of pedophilic offenders. The proportion of actually psychotic or severely retarded pedophiles reported still

88 /

PEDOPHILIA AND EXHIBITIONISM

varies depending on whether studies are undertaken in the courts, in clinics and hospitals, or in maximum security prisons. Another factor introducing variability is the difference in the use of diagnostic categories by investigators. In spite of this, and of the bias just mentioned, the picture of the psychiatric components that emerges is fairly clear. (A)

PSYCHOSIS AND ORGANIC STATES

Ellis and Brancale ( 1956), in examining 300 sex offenders at the New Jersey Diagnostic Center, found an incidence of psychosis of 6 per cent, borderline psychosis 8 per cent, and organic brain impairment 5 per cent. In their classification of "non-coital sex relations with a minor," which included 51 cases, no incidence of psychosis was found; 6 cases ( 12%) were classified as borderline psychotic, and 8 cases ( 16%) as showing organic brain impairment. Frosch and Bromberg ( 1938) do not list psychosis in their diagnostic classification. In their sample of 120 pedophiles, 7 ( 6%) were found "organically unstable." Revitch and Weiss ( 1962) comment that in their experience, contrary to the older literature, no classical symptoms of senile psychosis were found among the senescent pedophiles. They were bright and alert, although there may have been a general deterioration of habits connected with loneliness and various frustrations of old age. In the Forensic Clinic study there was only 1 case of latent schizophrenia and the 2 patients who were certified to a mental hospital were mental defectives. This, however, was an outpatient sample, in which a lower incidence of psychotic illnesses can be expected. An interesting study was conducted by Ruskin ( 1941) among male psychiatric patients of a mental hospital. He found that of 1,932 patients, 130 ( 6.7%) were sexually delinquent. Pedophilia accounted for 34 ( 26%) of the 130 sexually delinquent cases, which was less than 2 per cent of the male population of the mental hospital. Of the pedophilic group, 29 per cent suffered from a psychotic illness and 12 per cent were senile or arteriosclerotic, a lower percentage than for most of the other groups of sexual delinquents. Ruskin points out that in 89 per cent of these 130 cases the sexual deviation developed after the onset of psychosis; only 14 were actual sexual offenders before the onset of psychosis. The only exception to the low incidence of psychotic illnesses among sexual offenders seems to appear in Glueck's study ( 1955), in which

PEDOPHILIA: CLINICAL AND CORRECTIONAL FACTORS

/

89

71 per cent were diagnosed as pseudoneurotic schizophrenia ( 16%), pseudopsychopathic schizophrenia ( 32%) , or overt schizophrenia (23%). However, the first two categories obviously differ from the usual concept of schizophrenia as a psychotic illness; and the third category of "overt schizophrenia" is defined as a "definite symptomatic schizophrenic adaptation even so not diagnosed as legally insane." This category included 26 per cent of the heterosexual pedophiles and 30 per cent of the homosexual pedophiles compared with 6 per cent of a non-sexual offender control group. That this third classification does not mean overt psychosis is borne out in the rating of the severity of illness; here pedophiles did somewhat better than the control group, with 11 per cent of the heterosexual and 15 per cent of the homosexual pedophiles classified as severe cases compared with 16 per cent in the control group. ( B)

NEUROSIS

Comparison of data referring to this diagnostic classification is even more difficult than with previous categories because of marked differences in the application of the diagnosis to clinical observations. Apfelberg et al. ( 1944) listed none of their 75 pedophilic offenders under "neurotic traits." In the Forensic Clinic study only one case was found to support an additional diagnosis of "psychoneurosis." Frosch and Bromberg ( 1939) classified 19 ( 16%) of 120 cases as "neurotic." In these studies the majority of psychiatric diagnoses fall into the category of character and behaviour disorders. Ellis and Brancale ( 1956), on the other hand, classified almost two-thirds ( 64%) of their 300 sexual offenders as neurotic and only 3 per cent were diagnosed as psychopaths. No allowance was made for other behavioural and character disorders, such as immature and inadequate personalities, which we must assume to be included under "neurotic" and seen as character neurosis. ( C)

MENTAL DEFICIENCY

The general assumption that a great proportion of pedophiles are mentally defective has already been contradicted by reports on the distribution of intelligence, which is essentially normal. Glueck ( 1955) found no defectives in his group; Apfelberg et al. ( 1944) did not list mental deficiency, and stated only that pedophiles seemed to be more often shy schizoids who were too self-centred and withdrawn to make any adequate attempts at adult heterosexual adjustment. Frosch and

90 /

PEDOPHILIA AND EXHIBITIONISM

Bromberg ( 1939) found 8 per cent defectives in their group, Ellis and Brancale ( 1956), 14 per cent, and the Forensic Clinic study found 5 per cent ( 3 cases) of which one was borderline. ( D) CHARACTER AND BEHAVIOUR DISORDERS

Under the International Statistical Classification of Diseases, Injuries, and Causes of Death, sexual deviation is classified under disorders of character, behaviour, and intelligence. Technically, therefore, every deviant falls into this classification. Aside from this, most of the additional diagnoses in pedophilia refer to pathological personality and immature personality. Frosch and Bromberg ( 1939) listed a number of personality and behaviour traits of which the ones most often named in pedophilia were immature adult ( 7%), emotionally unstable ( 5%), and schizoid personality ( 5%) . Apfel berg et al. ( 1944) classified 17 per cent of their sample as psychopathic personalities, with a further 25 per cent as psychopathic personalities with pathological sexuality. In the Forensic Clinic study, 31 per cent received an additional diagnosis of a character or behaviour disorder, predominantly in the categories of immature personality or emotional instability.

Summary Although the classification systems of different investigators vary, the data indicate that overt psychosis is rare among pedophilic offenders, and is not likely to be any more frequent than in other problem groups. Pedophilia is, therefore, not related specifically to psychotic mental illnesses. In reverse, pedophilia has been found to be rare among male patients of a mental hospital. The psychotic with pedophilic tendencies, however, should be considered carefully, since, as Guttmacher ( 1952) and Gregory ( 1962) point out, most of the bizarre offences are committed by this group. Mental defectives also account for only a small proportion of pedophilic cases. Most of the psychiatric symptoms associated with pedophilia refer to personality deficiencies; whether they are classified as neurosis, or character and behaviour disorder, depends on the system of interpretation. Immaturity, inadequacy, and schizoid withdrawal seem to be the outstanding deficiencies. III. PSYCHOLOGICAL ASSESSMENT

Intelligence testing of sexual offenders is usually carried out as part of a battery of personality tests. The test may be administered indi-

PEDOPHILIA: CLINICAL AND CORRECTIONAL FACTORS

/

91

vidually, using one of the standard methods such as WAIS, or it may be given in a group (e.g., Army Alpha and Beta). Results of intelligence tests have been given previously, in Chapter 3. In some settings, personality assessment may also be carried out in a group ( e.g., MMPI) but assessments are most commonly done individually. There are great varieties of personality tests and evaluations; Rorschach, TAT, MMPI, and HTP are most frequently used in some combination. Other tests which are sometimes used include the Blacky, Bender Gestalt, Kahn, and 16PF. Hammer ( 1954, 1955, 1957) had a number of hypotheses concerning Buck's House-Tree-Person ( HTP) test which he worked out with sexual offenders. It was his opinion that the HTP could be more valuable than any other projective tests, such as Rorschach, where the offender could resist at either a conscious or an unconscious level. In drawing, a subject seemed to lose some of his conscious control. Other problems, such as difficult verbal communication, lower intelligence, concrete orientation, or underprivileged socio-economic background were not so likely to make the test less useful. The author first used HTP for comparing rapists and pedophiles in an attempt to solve the problem of getting behind the prisoner's control and his mistrust of all prison staff. In the 1955 study, of 84 male prisoners in Sing Sing who had committed illegal acts with overt sexuality or sexual motivation involved, a more serious pathological condition was consistently found in those prisoners who on HTP described the tree as "dead" than in those who attributed life to the tree. In Hammer's investigation ( 1957) of the psychoanalytic hypothesis of castration anxiety as the motivating force for sexual offences, 60 Sing Sing prisoners were given projective examinations ( including Rorschach, TAT, Blacky, and Bender Gestalt). Blind global ratings by three psychologists of the degree of feelings of castration and phallic inadequacy on a five-point rating scale gave sexual offenders a higher incidence of such feelings than was true for 20 non-sexual offenders examined. This incidence was taken as evidence to support the hypothesis. In the final report on sexual offenders by Glueck et al. ( 1955), Appendix B contains the Psychological Worksheet by Piotrowski, Hammer, and Jack. Their psychological assessment included WAIS, Rorschach, TAT, HTP (Chromatic and Achromatic), Blacky, and the Unpleasant Concept Test. Special emphasis was given to anxiety in the Rorschach including indices of hostility, fear of others, homosexuality,

92 /

PEDOPHILIA AND EXHIBITIO:NISM

dependency, structural aspects of personality, and ego strengths. Other combinations of the tests provided data on the psychosexual area, psychosocial features of the offender, attitudes to parental figures and society, nature of anxieties, further structural personality factors, and evidence of cerebral organic damage. The psychologists administering the psychological test battery found the offenders were very suspicious of the unfamiliar test materials, and seemed to be aware that by telling what they perceived ( e.g. in Rorschach) they might be revealing what they preferred to keep hidden from themselves as well as from the psychologists. The offenders seemed to fear that by responding too freely they might "give themselves away" and they tended to withhold responses or restrict responses to the obvious or to the essentially descriptive. By preparing a psychological rating scale as a basic research instrument for handling raw unstructured psychological data, investigators could give material a quantitative form suitable for statistical analysis. Rating scales for both psychiatric and psychological evaluation included three major considerations: (a) intensity ascending, by which an attribute was rated from "not present" through degrees of being present up to a maximum; ( b) intensity symmetrical, by which the extreme of a given trait appeared at one end with the inverse of the same trait at the opposite end; and ( c) checklines using particular clinical headings, for example, dependency, homosexuality, anxiety, and defence mechanisms. Cutter ( 1957) used a group administration of the MMPI and Human Figure Drawing, plus Cards VI and VII of the Rorschach. His subjects were Sexual Psychopaths on Observation ( N-28) and controls were 12 female nurses and 16 technicians ( 14 male and 2 female). He concluded that offenders designated as sexual psychopaths did show unique characteristics that could differentiate them from control subjects. Some of these characteristics persisted while others varied with clinical status. In a further survey of the MMPI, Cutter used heterosexual and homosexual pedophiles, exhibitionists, offenders charged with incest, as well as a miscellaneous group containing voyeurs, fetishists, and rapists, but he did not provide results for each individual group. His conclusions did not differ appreciably from those of his 1957 study. Toobert et al. ( 1960) studied 120 male prisoners from San Quentin Prison who had used as their sexual objects boys or girls 12 years and under. One control group of 160 general prisoners who had no sexual offences in their records, and another of 139 Minnesota male college

PEDOPHILIA: CLINICAL AND CORRECTIONAL FACTORS

/

93

students as general controls, were used. In an item analysis of the MMPI, 72 items separated the three groups at a .05 level or better. In a second analysis of the 72 items, 24 items were found to be most significant. A second series was then tested with these items, using 38 pedophiles not included in the first group, 50 general prisoners, 65 psychiatric referrals ( from the U.S. Army), and 55 "normal" male college students. Statistical results showed significant mean differences between the pedophile groups and all control groups except in the case of the second pedophile group and the neurotic army group. A comparison of the profiles of groups showed that the higher-score groups had more over-all emotional disturbances and maladjustment with greater tendency to anxiety, reality distortion, and social withdrawal. In lower-score profiles, psychopathic elements were more pronounced. Dutton, in the California study ( 1953) , reported an investigation into Rorschach protocols to test hypotheses about the female victims of pedophiles. Subjects' protocols were ranked by three independent psychologists for five different areas and a difference was established between girls as participating victims and as accidental victims. The results of this study have been discussed in Chapter 2, section III. Summary

The increasing use of standardized intelligence tests as an integral part of psychological assessment has done a great deal to disprove the theory that pedophiles are mentally defective. A variety of interesting data has been gathered by the use of projective techniques, and some significant differences were found on various tests. However, the work in personality assessment is not yet at a stage which would allow succinct generalizations regarding the personality traits of pedophilic offenders. IV. SOCIAL FACTORS

The absence of a specific aetiology in pedophilia and a clear model of intrapsychic determinants makes psycho-social factors specially important as an influence on the balance of impulse and control. The fact that many offences are prompted by specific situations, and that treatment is primarily by way of an increase in controls rather than by the eradication of impulse gives an emphasis to the examination of social stresses. The implication of social as well as other factors for judicial dis-

94 /

PEDOPHILIA AND EXHIBITIONISM

position will be discussed further, after we have considered the applicability of various forms of treatment and their results. A detailed analysis of various social factors has been given before in Chapter 3 and no more than a summary is attempted here. Since social considerations are different for the three age groups, they are considered separately. (A) THE ADOLESCENT PEDOPHILE

Because this patient generally shows a retarded maturation, social relationships, functioning and judgment are usually impaired. Parents and other persons are seen as either gratifying or not gratifying the patient's strong dependency needs and not as persons with their own specific characteristics. Present relationships with the parents have therefore to be assessed in regard to these distortions and their potential for correction. The same comment applies to the school and work situation. It was shown earlier that patients tend to have difficulties in school and go through a period of drifting in their early attempts to establish themselves in a job. Relationships with male peers, if any, tend to be loose, and with females are virtually absent. This is true of the heterosexual as well as of the homosexual group. In the heterosexual group, an improvement in sexual aim can be expected in most cases with an improvement in general maturation, but improvement in the homosexual pedophile has to be assessed additionally in regard to the relative strength of homo- and heterosexual strivings. This complication is one of the factors which may explain the generally poorer prognosis of this group, especially in the present legal and social situation which does not accept adult homosexuality. All these factors point to the importance of possibilities for social learning in the patient's milieu, and are thus strong indicators for group therapy. ( B)

THE MIDDLE-AGED PEDOPHILE

Since most of the patients in this group are married, an assessment of marital and family relationships is of primary importance. It was shown above that family relationships have usually deteriorated, resulting in severe marital conflicts and difficulties with children. Complicating social factors are dissatisfaction with work and alcoholism. The wife will often show personality and behaviour features which tend to reinforce the patient's pedophilic impulses. Her role should thus be taken into consideration in regard to treatment, because

PEDOPHILIA: CLINICAL AND CORRECTIONAL FACTORS

/

95

she may sabotage the patient's progress. Since many pedophilic acts are performed largely in response to situations, the patient's contact with children in his work as well as in his private life should be examined in order that he can avoid conditions from which a strong stimulus could arise. It should not be forgotten that most pedophiles in this group, as well as in the senescent group, have also a genuine liking and concern for children. The patient's involvement in teaching and youth work often constitutes an attempt to sublimate his pedophilic impulses; the benefits accruing from such situations have to be carefully weighed against the dangers they present. ( C) THE SENESCENT PEDOPHILE The predominant social factor for a member of this group is his loneliness and isolation. Excluding the chronic group and those with specific clinical symptoms of aging, most patients show a psychologically intact personality, but are without any outlet for their emotions. The possibilities of personal and social contacts in the environment of the patient should therefore be assessed; supportive casework and alterations in the environment should be of help in the majority of cases.

V. TREATMENT The treatment of pedophilia, as of most other behaviour disorders, has to be discussed in reference to the various methods available. It should further be noted that the effectiveness of most of these methods of treating behaviour disorders is still a matter of debate. We shall limit our consideration to the effects of various methods on the mental, social, and behavioural factors which we have previously identified. Most of the methods discussed are of a psychotherapeutic nature, derived from various theoretical systems and empirical knowledge. It is not possible to consider them in detail, but their specific application can be further advanced by a consideration of the implications of data given in the previous chapters. (A)

MOTIVATION FOR TREATMENT

It has been said that sexual deviants and sexual offenders in general show a low motivation for treatment. Motivation, however, depends on a number of factors. The patient who comes to a clinic of his own volition, already shows by this step that he wants some kind of help, even if he does not accept treatment later on. The patient who is ordered to take treatment is often anxious about what treatment will

96 /

PEDOPHILIA AND EXHIBITIONISM

mean to him. In a number of cases the symptom is either ego-syntonic, and a need for change is not felt, or ego-dystonic, and then it is often denied. The encouragement of motivation towards treatment has to be part of the beginning of therapy and a judgment of the patient's willingness should not be made too early. Hartman ( 1961) has found in group treatment with chronic pedophiles, which are most difficult cases, that members of the group who had experienced urges for a long time and acted out without thought of treatment developed motivation within the group process. Calder ( 1955) considered it a problem that dullards were asking for treatment, when, in his opinion, they would not benefit from it. In the Forensic Clinic study of 55 patients, 34 ( 62%) received some form of treatment at the Clinic. Of the 21 not treated, 3 were incarcerated ( pre-sentence cases), 2 were certified to a mental hospital, and for 12 probation was considered to be sufficient; therefore only 4 patients did not appear for treatment. The average length of treatment was 8 months for heterosexual pedophiles and 18 months for homosexual pedophiles. Heterosexual patients received a mean of 16 treatment sessions; homosexual patients had more than double this number, about 37 sessions. The difference was partly because more homosexual patients were involved in group treatment than heterosexual patients, and as in other deviations ( homosexuality and exhibitionism), patients tended to stay longer in group therapy than in individual therapy. As will be shown later, the outcome is not related to length of therapy, since heterosexual patients did much better than homosexual ones. The homosexual pedophile, as a whole, tended to accept treatment more easily because his symptoms were more ego-syntonic and less anxiety-provoking than those of heterosexual pedophiles. ( B)

FORMS OF TREATMENT AND RESULTS

As we have suggested previously, the choice of the method of treatment will be influenced by general psychotherapeutic indications as well as by the theoretical persuasion of the therapist. It should be noted that most of the literature deals with the treatment of sexual offenders in general and does not isolate specific recommendations for pedophilia. (a) Individual Therapy Psycho-analytic treatment of pedophilia was reported by Hadley ( 1926), 1 case; Cassity ( 1927), 5 cases; Karpman ( 1950), 1 case; and Socarides ( 1959), I case. The studies concentrated on psychodynamic

PEDOPHILIA: CLINICAL AND CORRECTIONAL FACTORS

/

97

factors in the individual patients and their relation to the pedophilic symptom. Outcome is reported only by Karpman ( 1950), in whose case ( an adolescent heterosexual pedophile with pubic hair phobia) a lasting cure was achieved. Socarides ( 1959) reported remission of symptoms in a chronic homosexual pedophile while still under treatment. Conn ( 1949) reports excellent results in the use of brief psychotherapy, with which he effectively treated 7 out of 8 heterosexual pedophiles and 3 homosexual pedophiles. None of the pedophilic offenders referred to him refused treatment. Stevenson and Wolpe ( 1960) applied behaviour therapy to sexual deviation, by dealing with the anxiety-arousing stimuli, and report the successful treatment of a heterosexual pedophile. ( b) Group Therapy Glover ( 1960) expressed a conviction about the value of group psychotherapy for sexual offenders and Kopp ( 1962) believed that it was the treatment of choice because of the help offenders gained from sharing problems with others in a similar position. Kopp divides his patients into two groups, the consonant type, for whom the act fits into their character structure, and the dissonant type, for whom the act runs counter to the accepted self-image and usual defence system. In a mixed group of both types he found that resistance was minimized and members acted as auxiliary therapists. Hartman ( 1961) also reports that the group situation tended to motivate patients in favour of therapy. In his experience, homosexual and heterosexual pedophiles did not do well together in one group, because of lack of acceptance of each other's symptomatology. In a group of heterosexual pedophiles he found that, after a slow integration period of about 4 to 5 months, a sudden intensification and exploration of the deviant sexual impulses was achieved. When treatment had progressed even further wives of group members tended to be retarding elements and their involvement in the therapeutic process was indicated. Mohr ( 1962d) found that adolescent pedophiles made significant gains in their development in a therapeutic group. They went through a stage of extreme regression to infantile behaviour, from which they progressed through stages of self-identification to personalized relationships with other group members. This progress made it possible for them to apply a more adequate judgment to their actions which in turn permitted better socialization.

98 /

PEDOPHILIA AND EXHIBITIONISM

( c) Organic Treatment Glueck ( 1955), in his study on offenders in Sing Sing, assumed that a high proportion of patients were suffering from a schizophrenia-type illness. He applied a modified form of electro-shock treatment with supportive therapy and found this to be effective. Kurland ( 1960) also reports three cases in which he found an undifferentiated schizophrenic illness, which he treated with supportive therapy and medication ( moderate doses of phenothiazine derivatives) . In spite of the severe pathological configurations, his prognosis was a favourable one. An extensive review of the literature on castration and asexualization is given by Bremner ( 1959) with a follow-up study of 244 cases. The question of castration is full of problems, medical as well as legal and philosophical. Data, especially those collected by Stiirup ( 1953) and Bremner, indicate that recidivism in sexual offences can be reduced by this method. However, Sti.irup and Bremner, as well as many others, warn against abuses of this type of irreversible operation. The question of castration should become acute only with severe chronic offenders, where the only alternative is long periods of institutionalization. In such cases, which should be a very small minority in pedophilia, it may be more humane to offer the offender himself the choice. Tappan ( 1951b) reports a preference for non-terminal hormone treatment, as used in the Netherlands along with psychotherapy. VI. FOLLOW-UP

Measuring the results of psychotherapeutic treatment is extremely complicated. There are hardly any common standards of measurement and almost every study devises its own classification schemes. Statistical comparison in this area is therefore questionable in most instances. For the criminal offender, the rate of recidivism, or re-occurrence of a charge, although influenced by many uncontrolled variables, is still the best measurement available, especially for comparative purposes. It is true that many offences occur without a resulting conviction, and apprehension of the offender depends on the offender's caution, police surveillance, the readiness of victims to report, and so on. Incidence of offences must, therefore, be assumed to be much higher than the number of convictions. However, in comparing the relative rates of convictions, many of the uncontrolled variables can be assumed to be equalized and some credence can be given to the figures. In the discussions of rates of recidivism, a number of consistent factors emerged from which base rates can be deduced. The re-con-

PEDOPHILIA: CLINICAL AND CORRECllONAL FACTORS

/

99

viction rate for a fairly unselected group of sexual offenders falls consistently around 15 per cent, with exhibitionists showing the highest rate, around 25 per cent, followed by homosexual pedophiles with around 20 per cent. First offenders and repeaters are sharply divided in their succeeding record. The re-conviction rate for first offenders is less than 10 per cent; for offenders with a previous sexual offence, around one-third; and for those with more than one previous conviction, sexual and non-sexual, about one-half. In a given sample the expected failure rate in terms of re-conviction for a sexual offence will depend primarily on the nature of the deviation and on the proportion of first offenders and repeaters. A random sample from the courts in the case of heterosexual pedophilia should contain about 90 per cent first offenders, and of homosexual pedophiles, about 75 per cent to 80 per cent first offenders. The expectancy of further offences for such a sample would again be around 10 to 15 per cent for heterosexual offences and around 20 to 30 per cent for homosexual offences. We have shown that the re-conviction rate for offenders with previous sexual convictions is about three times as high as that for first offenders, and four to five times as high for offenders with previous sexual and non-sexual convictions. It can be estimated that for heterosexual pedophilia the re-conviction rate for first offenders would lie between 5 and 8 per cent, with the adolescent and middle-aged group on the higher, and the senescent group on the lower side. For previous sexual offenders, the repeater rate should lie around 20 per cent and for previous sexual and non-sexual offenders, around 30 per cent. For homosexual pedophilia the best estimate would be twice these figures. These calculations show the difficulty in assessing the effects of treatment in terms of re-conviction rates. For first offenders, the rates can hardly be improved and it would be almost impossible to get statistically significant numbers of re-convictions for measuring change. For recidivists, especially in the homosexual pedophile group, improvement from the base rate could be measured, but recidivists are only a small proportion of the pedophilic offenders. In the Forensic Clinic study follow-up, 34 (62%) of the 55 pedophiles were treated at the Clinic. Since there were only 8 recidivists altogether, no statistically meaningful comparison between the treated and non-treated cases can be made. Of the cases which received treatment, only 1 of 12 heterosexual pedophiles repeated the offence ( a chronic case with a long record) whereas 3 out of 10 homosexual pedophiles repeated.

100 /

PEDOPHILIA AND EXHIBITIONISM

In a personal follow-up, approximately two-and-a-half years after treatment had ended, only 6 homosexual and 6 heterosexual pedophiles could be interviewed. The impression gained from the documentary data was further borne out. Of the 6 heterosexual pedophiles, 4 had lost their impulses, 1 still experienced pedophilic impulses but was able to control them, and 1 had acted out on one occasion. Marked improvements were also noted in social and family relationships. In contrast to this, 4 of the 6 homosexual pedophiles still experienced impulses; 2 had acted out and were incarcerated. Of the 2 who were free of pedophilic impulses, 1 had progressed to adult homosexuality. The social maturation of this group was also found to be very limited.

6. Sentence and Disposition

Implications of the various findings we have been reporting for the judicial process are manifold. The definition of pedophilia as immature sexual gratification with a prepubertal child, and the supporting data for this, will differentiate most pedophilic offenders from others engaging in sexual acts with children under a given statutory age. The rate of recidivism reported and the various factors found to influence the possible commission of another offence should permit an adequate determination of sentences and indicate a desirable form of disposition. A great amount of special sex-offender legislation has grown up over the last half-century in various countries, all of which seems to have the basic deficiency of not taking sufficient cognizance of differences in offensive sexual acts. Its usefulness has, therefore, been limited; it has also led to formidable problems of inequalities in disposition, as the Report of the American Bar Foundation on the Rights of the Mentally Ill ( Lindman and McIntyre 1961) and many other studies have pointed out. The need for changes in the philosophy and structure of the criminal law process is not limited to the law which deals with sexual offenders, but pertains to most groups of criminal offences. In the case of sexual offenders, however, there does seem to be a wider acceptance of the fact that there is an underlying psychological problem and there is therefore a greater readiness to gear dispositions to the exigencies of treatment and rehabilitation. In view of this situation, we feel it will be helpful to discuss implications of our findings for the mode of disposition and special legislation. I. FACTORS INFLUENCING SENTENCE

The use of a pre-sentence report on the social and psychological condition of the offender, as an aid in sentencing, has found more and more acceptance. The report may be made by an officer of the courts, such as a probation officer, or a designated clinic or hospital. The need

102 /

PEDOPHILIA AND EXHIBITIONISM

to give sexual offenders a psychiatric examination is supported by most authorities in the field and it is indeed carried out to a greater or less extent in various jurisdictions. Yet although a psychiatric examination of every sexual offender may be the ideal, the availability of psychiatric facilities for such a purpose is often limited and sentencing may have to be based on less than a full clinical appraisal. Guidance for an adequate disposition, however, may be derived not only from assessments of the individual involved; predictive factors which are common to a group of offenders can also yield the basic information needed by the courts for them to arrive at an appropriate disposition. For example, the rate of recidivism for heterosexual pedophilic first offenders ( see Chapter 5) has been found to be between 5 per cent and 8 per cent, which means that of 100 such offenders, 92 to 95 will not appear in court again. No clinical assessment, psychological test, or any other means as yet known can make a valid identification of what persons would make up the five or eight per cent; nor could any form of treatment improve on the general outcome. The great majority of these offenders would needlessly tax clinical facilities, which are in most cases already overcrowded. Those who do become recidivists, on the other hand, are sufficiently few in number that they could be subjected to an intensive treatment programme. In addition to factors of recidivism, common psycho-social characteristics of offender groups should also influence dispositions. Such characteristics can be summarized for the purpose of pre-sentence reports by the three age groups. A.

THE

ADOLESCENT OFFENDER

Adolescents who fall under a juvenile jurisdiction are generally accorded a privileged position and are thought to be in need of treatment and rehabilitation. For the older adolescent who comes before an adult court, a pre-sentence report should be mandatory. Because adolescent pedophilia is predominantly a result of retarded psychosexual maturation, such a report should examine factors that contributed to this retardation as well as the psycho-social conditions under which the offender lives. Since this is the first age group in which pedophilia is manifested, and since it is generally a time of sexual upheaval, it is difficult to assess the strength and duration of the pedophilic impulse. A period of observation on probation, preferably with diagnostic appraisal and treatment at a clinic, is indicated. Patients who are severely retarded or certifiably mentally ill should be cared for in the appropriate institutions. Where pedophilia is complicated by elements of aggression

PEDOPHILIA: SENTENCE AND DISPOSITION /

103

or sadism, institutionalization may also be necessary, although such cases would be rare. Unless otherwise indicated, institutionalization should be avoided with this group because of the inclination of its members towards dependency, their lack of self-assertion, and their impaired social judgment. When a pedophilic offence has been repeated, and there are adverse psychological and social conditions, institutionalization may become necessary for a small group. In this case the institution should be a therapeutic milieu in which social demands are made of the offender and he is allowed some latitude in making decisions and facing their consequences ..

B. THE

MIDDLE-AGED OFFENDER

In discussing this group ( in Chapter 2) it was found that here pedophilia tends to occur in connection with severe family and social problems; this is especially true of heterosexual pedophilia. This group is usually excluded from the special considerations afforded to the young offenders and also to the senescent offenders. It is, therefore, the largest group of pedophiles found in correctional institutions. And yet first offenders in this age group have a better chance of not repeating the offence than the adolescent group; this is implicit in the fact that they have had more time to establish a criminal record but have not done so to date. Since many charges in this group arise out of a deteriorating marriage, an assessment of the total family situation is of paramount importance. The possible effect of alcohol, which diminishes control over the pedophilic impulses, also has to be taken into consideration. Probation and treatment in an outpatient clinic give this offender a chance to re-evaluate and to improve his social situation. Unless there are complicating psychological conditions, the first offender should be given such a chance. In the case of the recidivist, the procedure could be reversed by recommending that unless there are very favourable psychological and social conditions, special institutional treatment is indicated. Incarceration alone will not prove to be of benefit. C. THE

SENESCENT OFFENDER

First offenders in this group who are not subject to any senile deterioration are least likely to repeat the offence. In most of these cases, the traumatic effect of the court appearance is a sufficient guarantee against further involvement in sexual acts, most of which have been incidental in the first place. If there is any doubt about the psycho-

104 /

PEDOPIIlLIA AND EXHIBITIONISM

logical or social condition of the offender, a period of supervision may be indicated. The chronic offenders in this group will have been in and out of hospitals and reform institutions and an improvement can only be hoped for in a general abatement of the sexual impulses. II. PRESENT MODE OF DISPOSITION

It has already been indicated that in the past as well as at present a variety of dispositions have been used, the criteria for which are not easy to ascertain. It would not be profitable to discuss the relative severity or leniency of this variety of sentences. It is necessary, however, to examine the implications of various forms of dispositions for the pedophilic offender as well as for the society in which he lives. A.

THE

uSE

OF FINES

In the Cambridge study, somewhat less than half ( 43%) of the 1,981 convicted sexual offenders were fined. Statistics from the Metropolitan Toronto Police from 1957 to 1960 show a similar picture with a little more than half ( 53%) of the offenders convicted in Magistrates' Courts receiving a fine. The Cambridge statistics show that fines were employed predominantly in the case of adult homosexual offences ( 90%). For all heterosexual offences, fines were imposed in a quarter of the cases (23%) and in only 14 per cent of offences against females under 16. Gri.inhut ( 1959) shows a similar picture for 2,000 male persons convicted of sexual offences in England and Wales in 1954. About onequarter ( 24%) of heterosexual offenders were fined, and the same percentage of homosexual offenders when cases of homosexual importuning were excluded. Fines are therefore largely employed in cases of homosexual offences between adults, apparently in the absence of any other solution to this problem. In heterosexual offences, fines are most often employed in cases of exhibitionism ( Cambridge, 39%; Gri.inhut, 55%; Ontario, 59%) . In pedophilic offences, the use of fines can be assumed to be small and likely somewhat higher in homosexual than in heterosexual cases ( Cambridge figures for offences against females under 16, 14%; against boys, 19%). The use of fines in cases of true pedophilia, except for the purpose of atonement, remains questionable. However, if punishment must be effected, then this would be one of the least destructive forms, yet not necessarily painless if sufficient amounts are imposed.

PEDOPHILIA: SENTENCE AND DISPOSITION

B.

/

105

PROBATION AND OUTPATIENT TREATMENT

Ellis and Brancale ( 1956), from their experience with the New Jersey Diagnostic Center, reported that a deviated offender should be recommended for: (a) probation, with a provision for psychiatric treatment in his community, or ( b) institutionalization, with a provision for psychiatric treatment in the institution to which he is committed. The advantages of permitting the offender to stay in his community, if this is justifiable, are obvious. His social adjustment, often a tenuous one at best, is not further disrupted; clinically, treatment can proceed in the context of life stresses and re-learning experiences and the total costs to society are greatly reduced. With the exercise of appropriate discrimination based on probabilities arising out of criminological and clinical findings, the aim of protection of the community, especially the children, will be better served by probation, supervision, and treatment, than by a relatively short removal of the offender from society. Moreover, as has been shown, immature dependency needs are a major factor in pedophilia, yet institutionalization tends rather to increase dependency than decrease it. Statistical evidence indicates that relatively little use is made of probation in cases of sexual offences, despite the great proportion of first offenders. In the Cambridge study, 16 per cent of the offenders were placed on probation. Griinhut's figure ( 1959) is 17 to 25 per cent, and statistics for Metropolitan Toronto from 1957 to 1960 also show 17 per cent. Statistics for subgroupings cannot be compared because of varying criteria for exclusion and inclusion of offences. Heterosexual pedophiles seem to be granted probation less often than homosexual pedophiles ( Cambridge figure for offences against females under 16 is 11%, for offences against boys, 18%). Considering that 85 to 90 per cent of sexual offenders coming to the courts are first offenders, and considering the low recidivism rate for pedophilic first offenders, it is evident that insufficient use is made of probation in these cases, especially when one compares this disposition with the proportion sent to prison. C.

IMPRISONMENT AND HOSPITALIZATION

Opinion on the purpose and use of detention, whether in a maximum security prison, a hospital, or a work camp, is in such a state of flux today that it is difficult to assess the effects of various kinds of provisions on the pedophilic offender. General considerations for sexual

106 /

PEDOPHILIA AND EXIIlBITION1SM

offenders have been given by East ( 1946), Cushing ( 1950), Stiirup ( 1961), and others. Hospital provisions have been described by Curvant ( 1950) in regard to the sexual psychopath programme at St. Elizabeth Hospital in Washington and by Frisbie ( 1959) for the Atascadero Hospital in California. There is a general stress on the need for a therapeutic milieu in institutions and for provisions for treatment. The use of preventive detention and the indeterminate sentence in the various sexual psychopath legislations can indeed be assessed only in relation to the provisions made for the offender thus sentenced. It does seem that, where more than a minimal use is made of these provisions, major inequalities tend to arise in regard to length of detention, even if these are cloaked by therapeutic considerations. From the Cambridge study, it appears that more than a necessary use of imprisonment was made in the case of pedophilic offenders, of whom more than half were imprisoned (heterosexual, 59%; homosexual, 53%). Since most of these sentences were of short duration, the protection of society by the removal of the offender was minimal. More than half of the heterosexual offenders ( 52%) and somewhat less than half of the homosexual offenders ( 42%) in the prison group were first offenders. The proportion of pedophilic offenders who are imprisoned seems to be higher than for sexual offenders in general, which is 26 per cent in the Cambridge study, 14 to 35 per cent in Gri.inhut's ( 1959) study and 28 per cent for Metropolitan Toronto statistics in 1957 to 1960. Hospitalization has been largely an outcome of special sex offender legislation. There can be no doubt that offenders who are mentally ill or mentally defective should be cared for in an appropriate mental hospital. However, these are only a small proportion of pedophilic offenders. Those offenders whose only demonstrable symptom is that of the sexual offence usually do not fit into ordinary mental hospital programmes. As in the case of other forms of consistent antisocial behaviour, the "sexual psychopath" or chronic offender should be dealt with in special institutions, such as Herstedvester in Denmark and Atascadero Hospital in California. It should be pointed out again that this would legitimately involve only a small proportion of pedophilic offenders. III. SPECIAL LEGISLATION

Because of the emotions aroused by sexual offences in general and because of the widely publicized cases of atrocities in particular,

PEDOPHILIA: SEN'IENCE AND DISPOSITION

/

107

various jurisdictions have attempted to introduce legislation to minimize the possible repetition of such offences. These laws are generally known as "sexual psychopath laws" and deal with the preventive detention of sexual offenders. The report of the American Bar Foundation on the Rights of the Mentally Ill ( Lindman and McIntyre, 1961) gives a detailed survey of these laws in the United States. With the exception of Michigan and California, these statutes have not been used widely and, in general, seem to have produced more problems than they have solved. In Canada, a Royal Commission reported on the Criminal Law Relating to Criminal Sexual Psychopaths ( 1958) and arrived at substantially the same conclusions as the American Bar Foundation. The Canadian Statute, first enacted in 1948 ( 11-12 Geo. VI ( 1948 ), c. 39, s. 43 ), was applied in only 23 cases prior to the investigation of the Royal Commission ( 1956 to 1958). The records showed that of the 23 offenders, 3 had no previous criminal record, 4 had a record of nonsexual offences only, 8 had previous sexual offences, and another 8 had previous sexual and non-sexual offences. The Commission stated ( p. 59) : "It appears to us that there is no reason why a convicted sexual offender who suffers from no mental disorder impairing his free will and ability to restrain his sexual impulses should not be treated as any other criminal." The Canadian statute was not abandoned, however, but in 1961 was re-worded so that "criminal sexual psychopath" became "dangerous sexual offender"-a somewhat more concrete formulation. The vagueness of the term "psychopath" has been generally criticized and found to be of limited use for legal purposes. The Canadian situation, however, remains essentially the same, since no special provisions for treatment are made for offenders detained for preventive purposes. The development and consequences of these special sex offender statutes point out clearly the lack of empirical knowledge in regard to sexual offences. The special statutes, indeed, make even fewer distinctions in their applications than the laws covering various non-sexual offences. In regard to sexual acts with children, it should not be difficult, on the basis of the data presented here, to differentiate the various offensive acts as well as the offenders, and to institute adequate procedures for them. Classifications built on empirical data and used to discover appropriate measures of prevention and treatment may well become the cornerstone for a modern criminal process. Any uni-dimensional approach, as well as any uni-causal explanation of criminal behaviour is suspect and likely to further confusion rather than knowledge.

7. The Nature of the Deviation

Exhibitionism has received more attention in the professional literature than pedophilia. Since Lasegue coined the term in an article entitled "Les Exhibitionistes" ( 1877), the deviation has been described more uniformly, and consequently it presents less difficulties on the operational level than does pedophilia. Although aetiological considerations, interpretations, and conclusions about the nature of the deviation vary widely, the phenomenon as such is more succinct and therefore data from different studies are more comparable than for pedophilia. A historical background of the deviation was given by Rickles (1950), to which little can be added. Moreover, the focus of this study is not on anthropological considerations, such as the relationship of phallus worship to the symptom of exposure as seen in our society today. As in the study of pedophilia, our main focus is on the deviation as an offensive act, on the offender, and on the social, legal, and clinical consequences of male genital exposure. In general, the same outline has been followed below as in the case of pedophilia, except where the nature of the data demanded a change. Methodological considerations and data on sexual offences in general which have been reported above will not be repeated unless this is necessary to illustrate a particular point. I. DEFINITIONS

(A)

CLINICALLY ORIENTED CASE STUDIES

Krafft-Ebing ( 1912) said that: "The cases thus far recorded are exclusively those of men who ostentatiously expose their genitals to persons of the opposite sex, whom in some instances they even pursue, without, however, becoming aggressive." This basic definition of the act still holds true. Krafft-Ebing then divided exhibitionists into the following four main categories : ( 1) Exhibitionists with acquired states of mental weakness, owing to causative cerebral disease. He stated that the majority of reported

112 /

PEDOPHILIA AND EXHIBITIONISM

cases fell into this category. Significantly, the cases given involved exposure to children by older men. Although exposure can occur as one aspect of a general personality deterioration in organic states and functional psychosis, this is relatively rare and in the majority of exhibitionists no such aetiological basis is present, as the data on psychiatric diagnosis show. ( 2) The epileptics. With this group, Krafft-Ebing described the impulsive and compulsive states seen in most exhibitionists. But although epileptoid components such as excitation, clouding of consciousness, and automatism of actions can often be observed, no link to organic epilepsy has so far been established. One also has to consider that these are symptoms of heightened forms of sexual excitation in general. ( 3) and ( 4) The neurasthenic and the periodic impulsive exhibitionists. These two categories are rather closely related to the second one, if one discounts any link to organic epilepsy. They share the impulsive-compulsive nature of the act. We can therefore reduce Krafft-Ebing's four categories to two: in the first, exposure is a symptom of a recognized mental illness leading to a general behavioural deterioration, and in the second exposure arises out of an impulsive-compulsive drive. Ebing's cases show that he did not differentiate between exposure to children and to adults, and in a number of instances he leaves it uncertain whether exposure was the central issue, or whether it occurred in a pedophilic context. We have discussed Krafft-Ebing thus extensively because his classifications and organic bias have influenced many investigators after him. Havelock Ellis ( 1933), although stressing the psychological symbolic nature of the deviation, classifies exhibitionists into two groups: those suffering from congenital abnormality and those with a mental or nervous disorder with such causes as alcoholic degeneration or senility. Similarly, Hirschfeld ( 1948) adopts three classes: the weakminded and silly, the epileptic, and the neuropathic persons with nervous and compulsive features. Hirschfeld pointed out that the last group was the largest one. He represents an intermediate attitude between the older authors with their stress on organic pathology and moral judgments of "degenerates," and the later ones, who give most stress to psychogenic factors. Karpman ( 1926) undertook a study of the psychopathology of exhibitionism and found that it was a disease observed in the neurotic person who has compulsive personality characteristics. In 1948 he

EXHIBITIONISM: THE NATURE OF THE DEVIATION /

113

reviewed the literature and stressed the difference between normal exhibitionistic behaviour in children and abnormal psycho-sexual development. Rickles, in his book on the subject ( 1950) and in a later article ( 1955), still maintains the following categories : ( 1) Depraved exhibitionists, who use exposure for sensual pleasure and have other areas in their lives in which behaviour may be unconventional. In this case exposure is only part of the act whose ultimate purpose is complete sexual gratification. ( 2) Exhibitionists suffering from organic brain disease, which expresses itself in carelessness, loss of sense of social amenity and ability to tell right from wrong. This category would include the feebleminded, epileptics, and schizophrenics. ( 3) Those who are neither depraved nor organically sick, but whose behaviour is that of a compulsive psychoneurotic. It is unfortunate that Rickles retains the moral classification "depraved" and aligns it with clinical categories. It can be assumed that with his first group he would include the multiple perverse and also the pedophile, who exposes for the purpose of being touched and fondled. Rickles, however, confines himself essentially to the third group, which represents the majority of cases of exposure. Guttman ( 1953) assumes that exhibitionism is a term applied to a symptom found in the majority of various clinical mental syndromes and not a disease entity at all. This overlooks the fact that in most cases the impulse to expose is the outstanding primary symptom and that other mental factors are secondarily associated with it. To avoid basic confusions, Christoffel ( 1956) extends the terms to "male genital exhibitionism" ( MGE), which excludes any application to females and to general non-genital behaviour. Spitz ( 1956) defines exhibitionism broadly as an act of restitution which satisfies at the moment of exposure particular needs of the exhibitionist. This definition is also provided by Maclay ( 1952) who says that there is a numerically significant group of persons for whom the act of exposure is of a compensatory nature. ( B)

CRIMINOLOGICALLY ORIENTED GROUP STUDIES

In 1924 East prepared one of the first large-scale studies of sexual offenders. These were admitted during a twelve-month period to Brixton prison. Of 209 cases, there were 107 cases of indecent exposure. East classified the offenders into two main groups, the psychopathic

114 /

PEDOPIIlLIA AND EXHIBITIONISM

and the depraved. The first category, comprising altogether 101 cases, included psychotics ( developed and underdeveloped), psychoneurotics, mental defectives, visionaries, and alcoholics. The second, the depraved, referred to exposure as a preliminary to carnal knowledge, a preliminary to being masturbated by a child, or an attempt to attract a female. Since this group totalled 49, a number of offenders must have been placed in more than one category. It is obvious from the classification that the legal category of "indecent exposure" included various deviations, especially pedophilia. In a later statistical study, East ( 1946) listed 449 males and 81 females under "indecent exposure." This would further underline the limited usefulness of legal and criminological statistics as indications of clinical entities, since clinically the term exhibitionism only applies to males. Taylor ( 1947) revised East's dual classification of "the psychopathic" and the "depraved" and arrived at six groupings. The first one included "true" exhibitionists, who practise exposure as a means of sexual relief in preference to all other means. The other groups included those who practise exposure as an invitation, those who are afraid of, or unable to obtain, normal sexual intercourse, isolated incidents, defectives, and those who exposed at the commencement of ordinary sexual life. None of Taylor's 98 offenders fitted this last group. Most of the other studies either take the charge of indecent exposure or a similar wording as a basis for determining further variables, or adopt Lasegue's original formulation, with slight variations, of a deliberate exhibition of the sexual organ to persons of the opposite sex. It must be remembered that the charge of indecent exposure may be laid against incidental offenders, such as someone found urinating, especially when under the influence of alcohol, or those in whom a general personality deterioration has taken place because of an organic or functional mental disease. However, these cases are a small minority. Also, statements by offenders that exposing was used to attract females have to be weighed with great care, since in most cases this explanation is the only one the offender can give for his bizarre behaviour. We have encountered cases of intelligent men who, having exposed more than one hundred times without attracting a female, still clung to this explanation. The pedophilic group may distort to some extent samples based on the charge of indecent exposure. A differentiation between a pedophile showing his genitals to a child and an exhibitionist exposing to

EXHIBITIONISM: 1HE NATURE OF 1HE DEVIATION

/

115

a child has been provided in Chapter 2. Other offenders, such as females or homosexuals who were apprehended before bodily contact took place, are easily identified and excluded from a sample. II. A PHENOMENOLOGICAL MODEL

The need for a coherent model determining the classification of a deviation has been discussed in relation to pedophilia. In the case of exhibitionism less is known about specific characteristics of the object (victim), but there is a greater uniformity in the nature of the act and its intentionality, which helps to identify the agent (offender). (A)

THE OBJECT (VICTIM)

The object of the exhibitionistic act is a female-child, adult, or both. Exposure to other males ( except as a prelude to homosexual activity) is extremely rare and seems to occur only in the context of a personality deterioration due to mental illness or organic conditions. The female objects are predominantly unsuspecting strangers. (B) THEACT

The exposure of the male genitals can occur in a variety of circumstances for different purposes ( intentionalities). It can be a prelude to sexual contact, either coital, pedophilic, or other; it can occur in the context of urinating; or it may be a by-product of a severe personality deterioration. Exposure is, however, not a determinant of clinical exhibitionism unless it represents the final sexual gratification without any intention of further sexual contact. Again, the act is only indicative of exhibitionism if it occurs at a place where it is not expected to occur and if it is directed to a female who has no reason to expect that it will occur. The criminal charge of "indecent exposure" may include any form of exposure. The nature of the offence and the circumstances show that the great majority of occurrences of genital exposure arise out of exhibitionistic impulses, with the exception of pedophilic acts in which the offender goes no further than showing the genitals, although there is an intention of further contact. The two deviations can be differentiated when one realizes that in heterosexual pedophilia the victim is most often known to the offender, which is not the case with exhibitionism, and that the pedophilic act occurs in close bodily proximity, whereas in exhibitionism there is usually some distance between victim and offender. Moreover, in pedophilia the place of the offence

116 /

PEDOPHILIA AND EXHIBITIONISM

tends to be private and in exhibitionism it is almost always public. In short, factors of a personal relationship or interaction are absent in exhibitionism. ( C) THE AGENT

(OFFENDER)

Exhibitionism can therefore be defined as the expressed impulse to expose the male genital organ to an unsuspecting female as a final sexual gratification. The man who acts out this impulse becomes an offender, since the act is considered "indecent" and is prohibited by law. The exhibitionist derives his gratification from the reaction of the object (victim) to the sight offered, but does not attempt any further contact. The deviation is not a symptom of mental illness or mental defectiveness nor is it necessarily indicative of general immoral behaviour.

8. The Object and the Act

Information on the victim and the act in exhibitionism does not lend itself to the kind of quantification which has been possible for pedophilia. The victim is far more unspecific; at the same time the exhibitionistic act does not show the variety which needed to be clarified in regard to pedophilia. I. THE VICTIM (OBJECT)

The non-specificity of data on the victim is a reflection of the way an exhibitionist chooses his victim. Not only is the victim in almost all cases a stranger, but more than one female may be present at the time of the act. The Cambridge study found it difficult to ascertain the victim when the offender exposed himself to a group of girls playing in the school grounds, or when he walked down a crowded street and exposed himself to a number of females. Taylor ( 1947) tabulated on the basis of whether exposure occurred to a single female, two, or groups. He found that, of 67 exposures to adults, 34 victims were alone; in 14 cases there were two victims, and in 19 cases more than two victims. In regard to adolescents and children, he found that, of 31 cases of exposure, 9 were to single victims, 8 to two, and 14 to more than two. Similarly, the Cambridge study and the Forensic Clinic study found that exhibitionists exposing to adult women tended to expose to them individually, whereas those exposing to children did so more commonly to groups. (A) AGE OF VICTIM Lasegue ( 1877) had stated that victims were usually young innocent persons, often children. Arieff and Rotman ( 1942) found that of 100 cases of exposure, 80 involved adult women and only 20 involved children. Taylor ( 1947) found a similar distribution among 98 cases, in which 67 involved adult victims, 13 adolescents, and 18 children. Of the 54 offenders in the Forensic Clinic study, 32 exposed to adults only,

118 /

PEDOPHILIA AND EXHIBITIONISM

17 to children, and 6 others to adults and children. The Cambridge study found almost half the victims were under the age of 16 and the other half over 16. The proportion of children as victims of exhibitionists thus varies from about one-half to one-fifth. Differences may be partly due to varying definitions of "child" and partly to varying degrees of inclusion of pedophiles among the exhibitionist group. The proportion of children may be higher among those charged as offenders than among others because exposure to children is taken more seriously and is therefore more likely to be prosecuted. The age of victims in the Forensic Clinic study ranged from 8 years to old age. Often a perception of the age of the victim was found to be lacking in the offender and only a few showed a particular preference for a certain age range. East ( 1946), although saying that the age of the victim must be fairly constant, also states that girls of a particular age are sometimes essential. It seems that in the majority of cases the choice of victim is determined more by situation and impulse than by stimulus. ( B)

RELATIONSHIP OF VICTIM AND OFFENDER

There is general agreement in the literature that the victims of exhibitionists are strangers. In the Forensic Clinic study, only 4 of the 54 cases involved a neighbour. In three of these the neighbour was the victim inadvertently: one offender was a retarded adolescent, one was involuntarily seen by the neighbour when he was exposing before a window, one was under the influence of alcohol. In only one case did a habitual exhibitionist consciously expose to a neighbour. Specific stimuli, if any, are derived from part objects of the victim rather than the whole person. But even these part objects, such as ankles, legs, breasts, colour of hair, seem to express individual psychodynamics rather than common elements in exhibitionism. This is illustrated by an offender in the Forensic Clinic study whose wife did not want to have children and who exposed once to a pregnant woman and another time to a woman pushing a baby carriage. The study of stimulus characteristics of victims should yield insights into particular problems of a given offender, even though they are not common determinants for exhibitionism as such. Not only is the victim commonly a stranger, but the offender does not seek any further relationship. The expected response from the victim will be discussed in the next section.

EXHIBITIONISM: THE OBJECT AND THE ACT /

119

II. THE OFFENCE (ACT) (A)

PLACE OF THE OFFENCE

The commission of the act of exposing in a public place has become part of most definitions. This conclusion is generally borne out by the data. The Cambridge study found that 47 per cent of exhibitionistic offences were committed in the streets, 30 per cent in parks and open spaces, 16 per cent in and from buildings, and 7 per cent in and from vehicles. Of the 16 per cent who exposed in and from buildings, less than 3 per cent exposed to a female in a private house. In Arieff and Rotman's study ( 1942) 15 per cent of the offences occurred in the offender's home but it is not specified how many of these offenders exposed before a window into the street. In the Forensic Clinic study, 74 per cent of the exposures occurred in an open place, mostly from the offender's car ( 30%), in public buildings ( 13%), and through a window, either from the offender's home or through a store window ( 11%). Cultural differences can be seen in the fact that in the Cambridge study the largest group of offences occurred on the street with passersby, whereas in the Forensic Clinic study they occurred from the offender's car to passers-by. The incidence in parks and open spaces was much higher in the Cambridge study ( 30%) than in the Forensic Clinic study ( 8%) . Eilis's ( 1933) assertion that the offence usually occurs at a quiet spot is not generally borne out. Karpman ( 1926) had already mentioned that the offence is carried out without regard for public decency, irrespective of the setting, and Christoffel ( 1956) found that the compulsion to exhibit is greater than the fear of police or court. This was also the impression gained in the Forensic Clinic study. Offenders exposing from a car leave a visiting card behind them in the form of their licence number. ( B)

THE NATURE OF THE

Acr

The act of exposure can range from a partial showing of the flaccid penis without a conscious experience of sexual satisfaction to a full exposure of the genitalia with erect penis, masturbation, and an intense experience of sexual satisfaction. The nature of the act not only differs from offender to offender but may also differ in one and the

120 /

PEDOPHILIA A.t'sD EXHIBITIONISM

same case on various occasions. The urge to expose sometimes arises suddenly and irresistibly; at other times the urge increases gradually until it is stronger than the inhibitions. The impulsive-compulsive nature of the act has been observed by most investigators. Peck ( 1924) described the case of a compulsive exhibitionist and Karpman ( 1926) came to the conclusion that exhibitionism is a compulsive neurosis. Hirning ( 1947) states that there is a compulsive character to the behaviour of the exhibitionist and Guttman ( 1953) speaks of a compulsive drive. Rickles ( 1955) and Christoffel ( 1956) also underline this fact. Floch ( 1946) and Bowman ( 1951) state that exhibitionism is an automatic behaviour pattern. East ( 1924), Karpman ( 1926), Sperling ( 1947), and Kopp ( 1962) describe the offender as experiencing an urge which so overcomes him that he can no longer control his behaviour, in spite of the fact that on some occasions the act may appear to be premeditated and carefully planned. Compulsive characteristics and a diminished ability to tolerate stress also appear in other areas of the lives of offenders, such as their occupation. The intentionality of the act is to arouse an emotional expression in the victim. Ellis ( 1933) described three kinds of reactions: (a) the girl is frightened and runs away; ( b) she is indignant and abuses the culprit; ( c) she is pleased or amused, and laughs or smiles. He felt that it was the last reaction which afforded the exhibitionist most satisfaction. Hirning ( 1947) and Hirschfeld ( 1948) state that the victim must give some reaction, preferably one of being impressed. Arieff and Rotman ( 1942), Apfelberg, Sugar, and Pfeffer ( 1944), and Allen ( 1949) go further by saying that the victim must appear shocked. Although all authors agree that some reaction is sought, it is not clear what this reaction actually is. It is very doubtful whether the expected reaction is one of pleasure. On the contrary, an amused reaction may even elicit a depressive state in the exhibitionist. In many cases there is an aggressive-defiant element in the act which seems to be intended to evoke fear and shock rather than pleasure from the victim. The main difficulty in distinguishing their expectations is that exhibitionists themselves cannot give a valid account of their feelings at the time of exposure. Rickles ( 1942, 1950) found that his patients did not appreciate the powerful effect their behaviour had on the victims. In the Forensic Clinic study it emerged that, since patients could not understand the nature of their impulse, they tended to look for plausible rationalizations, one of them being the most "normal"-seeming explanation, that they wanted to attract females.

EXHIBITIONISM: THE OBJECT AND THE ACT

/

121

That this was an obvious rationalization appears in cases where offenders exposed in numerous instances and were "unsuccessful." It is also generally agreed that the exhibitionist does not seek further contact with the victim; on the contrary, he is afraid of it. III. EFFECTS OF THE ACT ON THE VICTIM

It has already been shown that closer contact or pursuance of any more intimate sexual purposes is not the aim of the exhibitionistic impulse. The act is therefore considered by most authors to be a nuisance rather than a danger to the victim. This is also recognized by the law, which treats exhibitionism in most instances as a minor offence. Allen ( 1962), however, feels that although the effects of exhibitionism on adult females are probably exaggerated, it can frighten children and produce a sexual trauma. He does nevertheless affirm that he had not found the sadistic element in exhibitionism which Freud suggested, except inasmuch as patients liked to observe reactions of shock or horror in their victims. The effects on the victim will depend on her own psychological health, her attitude towards sexual matters, her knowledge of the deviation, and especially her realization that no further contact is desired and that there is no impending danger of rape. The fear of an attack is likely to produce a stronger effect than the act itself. Since exhibitionism is not an uncommon deviation and since many women are likely to encounter an exhibitionist sometime in their lives, a general knowledge of the deviation should reduce the possible negative effect of fright.

Summary An exhibitionist's choice of victim does not show any common characteristics. His act is determined more by situation and impulse than by a special stimulus. Where a specific stimulus appears, it tends to be more significant for the individual offender than for exhibitionism as such. The victim is almost always a stranger. The act occurs in a public place to one female alone or to several. In nature, it ranges from partial exposure to open masturbation and is intended to arouse in the victim a strong emotional response to the sight offered. No further relationship is sought. The victim generally regards the offence as a nuisance but its effect depends on the emotional health of the victim and whether she is aware that no further danger is impending.

9. The Offender

The act of exposing in a public place is prohibited by law and the male engaging in such behaviour becomes an offender. Most studies on exhibitionism have, almost inevitably, been carried out on males who have been charged for indecent exposure ( charges and incidences are discussed in chapter 10). However, in considering data on the offender, it has to be remembered that not all persons charged with indecent exposure or a related charge are exhibitionists. The Cambridge study estimated that about 80 per cent of their offenders were true exhibitionists; the rest represented cases of an accidental nature and incidents which had been interrupted before bodily contact occurred. Other samples based on a charge of indecent exposure may contain various other forms of sexual behaviour, but it can be assumed that the majority of cases represent true exhibitionists. Data on offenders who have exposed are therefore not pure data on exhibitionism. This applies to the Forensic Clinic study, even though the pedophile who showed the genitals to a child has been excluded. Accidental and questionable cases were nevertheless left in the sample in order to offset any preconceived bias. In what follows data on the offender are generally drawn from the Forensic Clinic study, accompanied by a comparison with data from the literature. I. AGE FACTORS In the Forensic Clinic study, the age factor has been considered from two aspects, one of which is the actual age distribution of the offenders, and the other, a possible relationship between age and symptomatology. The data indicate that the majority of the exhibitionists studied ( 65%) in the Forensic Clinic were in their twenties. Some information in Fig. 7 is lost in regard to the adolescent period, since there were more cases at age 15 ( 4 cases) than from 16 to 19 ( 3 cases). After the twenties there is a sharp drop in the number of cases, which remains the same until the mid-forties; there were only 2 cases ( 57, 60) in the older age ranges.

EXHIBITIONISM: TIIE OFFENDER

/

123

n

20

18 16 14 12 10 8 6 4

2

1~19 20-24 25-29 %

13

33

28

30-34 7

35-39 7

40-44 45-49 50-54 age

7

0

0

Fig. 7. Forensic Clinic study, distribution of age at intake; n=54 (2 cases over 55).

In order to check on a bias that might have been introduced by the court's selection, the ages of non-court referrals from approximately the same time period were also plotted ( Fig. 8). ( The period was somewhat extended to gain more cases.) These non-court referrals were not examined in regard to inclusion and exclusion under the n 10

9 8 7 6 5 4

3

2

•.,.,

15-19

20-24

16

29

25-29 30-34 35-39 40-44 45-45 50-54 age 23

19

6

6

0

0

Fig. 8. Forensic Clinic study of distribution of age of non-court referrals at intake; n=31 cases.

124 /

PEDOPHILIA AND EXHIBITIONISM

terms of the study proper, but taken as diagnosed and listed in Forensic Clinic files. The age distribution of non-court referrals in the Forensic Clinic study is similar to that of the court referrals, with the exception of the age range from 30 to 35. The greatest number of cases again occurs in the twenties and there is no case over the age of 45. The median is also 25. ( See Table XXXVIII.) TABLE XXXVIII FORENSIC CLINIC STUDY, RANGE AND CENTRAL TENDENCIES OF AGE AT INTAKE

n Median Mean Range

Total

ExA.

ExC.

ExAC.

54 25 27.2 15-60

24 26.7 15-60

31

17 26 27.1 15-57

25

6

29.8 21-43

Findings from some studies would lend support to the statement that the exhibitionists' age is young. Seventy-four per cent of cases at the Forensic Clinic occurred before age 30. In Arieff and Rotman's study ( 1942), of 100 cases, 62 fell between 17 and 30 years. Other large studies had fewer cases in the earlier age range. East ( 1924) had 38 per cent in the 19 to 25 year range at Brixton prison; Taylor ( 1947), in attempting to duplicate East's study, had 38 per cent between 23 and 29 years. Apfel berg et al. ( 1944) had 31 per cent of 88 cases between 20 and 29 years. The Cambridge study ( 1957) had the following age range for 490 cases of indecent exposure; none under 14 years, 14 and under 17, 6.5 per cent; 17 and under 21, 6.5 per cent; 21 and under 30, 31.6 per cent; 30 and under 40, 29.3 per cent; 40 and under 50, 14.9 per cent; 50 and under 60, 6.3 per cent; 60 and under 70, 2.9 per cent; and 70 and over, 2.0 per cent. Smaller samples seemed to agree quite closely with Forensic Clinic data; Spitz ( 1955), in a sample of 20, had an age range of 20 to 40 years. Riming ( 1945) stated that after age-clusters in the early twenties there was a gradual drop-off. Rickles ( 1950) reported seven cases with the following age distribution: 22, 26, 27, 29, 30, 35, and 45. Conn ( 1949) gave ages of four cases at times of treatment which followed court proceedings as 21, 29, 30, and 32. Three of six cases quoted by Guttman ( 1953) were in the 20 to 29 age range; this was also true for all three case illustrations given by Henninger ( 1941). Curvant et al. ( 1950) had two cases aged 25 and 29. Sperling ( 1947) and Caprio ( 1949) each had one case with ages 29

EXHIBITIONISM: THE OFFENDER

/

125

and 30 respectively. Peck ( 1924) stated his case was "young" and Karpman ( 1926) said that it was his opinion that exhibitionists were "generally young."

(A)

ONSET OF SYMPTOMS AND FIRST CHARGES

Data on the onset of symptoms were derived from the offender; the first charge for exposing was checked against the criminal record. Classifiable information was found in 34 cases in regard to onset of symptoms and in 53 cases for first charges. ( See Fig. 9, Table XXXIX.) n 20 18

16

/

14

- - 0nset,n = 34 cases - - - First charge,n=53cases

,, \

\ \

12

\ \

10

\

8 6 4

2 6-10

11-15

''

' ' ,_

---

16-20 21-25 26-30 31-35 36-40 41-45 46-50

age

Fig. 9. Forensic Clinic study, distribution of age at onset of symptoms and first charge.

TABLE XXXIX FORENSIC CLINIC STUDY, MEAN AGES AT ONSET, FIRST CHARGE, AND INTAKE

Onset First charge Intake

Total

ExA.

ExC.

ExAC.

19.4

18.3 24.2 26 .7

19 . 4 25.1 27 . 1

24.0 27 .3 29 .8

24.8 27 . 1

The distribution of age at onset shows two peaks, the mid-teens and the mid-twenties. The most common ages for the teens were 14 and 15 ( 11 cases); no patient gave either 17 or 18 as the age of onset. After the twenties there was only one patient, who gave the onset at 37 and in whose case the symptoms were clearly established; another one at 43 was a doubtful case. Whether in the former a repression of adolescent urges had occurred, or whether the onset was really at this late age, cannot be determined.

126 /

PEDOPHILIA AND EXHIBITIONISM

Another factor which would support the impression that exhibitionism appears strongly at the height of puberty, then declines, and again increases in the twenties, is that a number of persons who have a long record of indecent exposure show a cluster of charges in the mid-teens, only a few in the late teens, and again a close succession of charges in the twenties. It is too early to state the possible reasons for the bi-modal distribution of the onset of symptoms. One must also look at other data concerning the history of the offenders. However, there is one impression which could be noted. The onset seems to occur at a time when a strong relationship with a female with sexual (genital) connotations threatens the offender, such as with the mother in the midteens, and the wife, or wife-to-be, in the twenties. No doubt a number of other factors will have to be considered in clarifying the proposed phenomenon of a bi-modal onset, as, for example, general endocrine factors precipitating the sexual urge at different stages of development, and psycho-sexual factors related to the significance of sexual adequacy at different ages. The age at the time of the first charge was determined for the Forensic Clinic study in 53 cases. The accuracy of the data depended on the adequacy of the criminal records. Again it was found that more offenders were charged at 15 than at any other time in the teens. However, the peak occurs in the mid-twenties (median 24, mode 25) and only 10 cases ( 19%) were charged for the first time after the age of 30. Caprio ( 1949) reported that his offender had his first arrest at age 30. Karpman ( 1926) suggests that the onset can vary from age 5 anywhere up to senility. Rickles ( 1955) stated that one of the frequent characteristics in his stories of exhibitionists was that they had carried on some sort of exhibitionistic activity during childhood. In Floch's case ( 1946), the onset was at age 9 or 10 during acute conflict between the offender and his mother. Christoffel ( 1936) observed that genital exhibitionism only occurred when puberty was drawing to a close, or manhood had just been attained. ( B)

ExmBITIONISTS OVER THE AGE OF FoRTY

From the data presented, it thus appears that exhibitionism occurs essentially from early puberty to the mid-thirties, with the greatest intensity around the mid-twenties. It will therefore be of added interest to examine the patients that reached the Forensic Clinic after age 40; there were 3 such persons, at ages 60, 57 and 43. Case A. A 60-year-old Macedonian immigrant was apprehended in drunken condition on the streetcar with his fly open. The man had never

EXHIBITIONISM: THE OFFENDER

/

127

been charged before for this offence and denied any intent. On clinical examination, organic deterioration was found. Case B. The offender was 57 years old, and drunk at the time of offence. He had a long criminal record including indecent exposure and pedophilic activities. The offence, before referral, consisted of exposing to and being fondled by a young girl, known to him to be promiscuous. The incident therefore was more pedophilic than exhibitionistic. (He was also included in our pedophilic group.) This was further borne out by a subsequent pedophilic offence. Case C. The offender, aged 43, gave the onset of his exhibitionistic urges at age 37 and was first charged at 39. His urges appeared after a deterioration in his sexual relationship with his wife. He was a successful business man with good standing in his community. His urges were very pronounced and he had many charges from the time of onset until the time he reached the Clinic. He was treated and discharged as improved and a follow-up interview showed that there was no return of his exhibitionistic urges.

It is rather obvious that the patient of Case A is not an exhibitionist in the clinical sense. The one described in Case B was an exhibitionist when younger, but had developed into a pedophile, which is a rather rare occurrence. The third, Case C, who shows definite symptoms of exhibitionism, can be considered the only one where the symptoms persisted over the age of 40. Of the three offenders who fall into the age range between 35 and 40, I ( 40 years) was polymorphous perverse and an alcoholic; another was an immigrant ( 39 years) who exposed for the purpose of obtaining intercourse ( the only one who had ever been "successful" in this); and the third one was apprehended in a drunken condition on a streetcar. Alcohol, as will be noted later, is not often a factor in true exhibitionism. On the basis of this sample, it would appear that over the age of 35 exhibitionism rarely occurs and appears usually in connection with other factors, such as alcoholism, organic deterioration, or other deviations. Summary

The peak of exhibitionism is in the twenties, and it decreases rapidly in the thirties; over the age of 40 the symptom occurs only in rare instances. Although the peak of the exhibitionist's behaviour is around age 25, the onset of symptoms has two major periods, one in midpuberty, and the other in the early twenties. Exhibitionists as a group are young; offences occurring at an older age frequently indicate other factors, such as alcoholism, organic deterioration, or another sexual deviation, especially pedophilia.

128 /

PEDOPHILIA AND EXHIBITIONISM

II. PERSONAL AND SOCIAL CHARACTERISTICS

(A)

INTELLIGENCE AND EDUCATION

(a) Intelligence The Wechsler Adult Intelligence Scale (WAIS) was administered in 47 cases ( Table XL) The other 7 persons in the Forensic Clinic study either did not appear for testing, or testing with the WAIS was ruled out by language difficulties. Estimates of these cases show that one offender was an imbecile and the others fell within the normal range. The distribution of 1.Q.'s is essentially a normal one (Table XLI), somewhat skewed towards the higher end of the scale, with a slightly higher mean. The ExAC. group differs from the others considerably; however, there are only 6 cases in this group, too few to allow any TABLE XL FORENSIC CLINIC STUDY, MEAN AND RANGE OF 1.Q.

n Mean

Verbal Performance Full Scale

Range

Total

ExA.

ExC.

ExAC.

47

26

15

6

103 .2 103 .5 103 .6 72-134

101.0 102 .6 101 .8 72-134

103 .8 102 .3 103.3 98-130

111.5 110 .3 111.8 72-134

TABLE XLI FORENSIC CLINIC STUDY, DISTRIBUTION OF 1.Q.'s COMPARED WITH STANDARD DATA Class

-79 80-89 90-109 110-119 120 plus

Norm

%

9 16 50 16 9

Exhib.

%

n

3

1 5 25 13 3

10

53 28 6

conclusions. We may note, nevertheless, that they also differ in age, education, and occupation. But intelligence, education, and occupation are related factors and if the group differs from the others in one factor, we may also expect a difference in the other factors. While other studies do not always state clearly their methods of assessment of intelligence, most findings are in agreement with the Forensic Clinic data. Larger studies such as Ellis and Brancale ( 1956)

EXHIBITIONISM: THE OFFENDER /

129

report an essentially normal 1.Q. distribution. Hirning ( 1945), who reported data on 48 of 60 cases, found 37 per cent with I.Q. scores of less than 80, 19 per cent with 80 to 109, and 44 per cent above 110. The Cambridge study ( 1957) reported only the numbers of offenders who were mentally defective, with 23 or 4.7 per cent of 490 exhibitionists in that category. Smaller studies provide similar information; Spitz ( 1956) gave 20 exhibitionists a psychological battery and found them within the normal range of intelligence. Henninger ( 1941) had 17 cases with 1 as borderline and 1 slightly below normal, 7 in the average range, 2 slightly above normal, 1 high normal, and 5 in the superior range. Curvant et al. ( 1950) had a group of 4 exhibitionists of whom one was of low intelligence. In the single case studies, Peck ( 1924) described his case as "intelligent"; Himing ( 1941) described his as average; Caprio's ( 1949) was above average; Sperling's ( 1947) case, as assessed by his educational achievement, was above average. Single case studies, it should be noted, tend to involve patients with better intelligence, education, and occupation. A number of other authors gave general opinions about the intelligence of exhibitionists. Bowling ( 1950) stated that exhibitionists' intelligence was comparable with that of the general prison population. Floch ( 1946), also working with prison groups, refused to treat exhibitionists with I.Q. scores below 110. Pollock ( 1960), whose single case report came from a prison setting, was of the opinion that the majority of exhibitionists who appeared in court were of below average intelligence, but that there was another type-the neurotic offenderwho was intelligent enough to avoid being caught; he thought the numbers of these would be small. Apfelberg et al. ( 1944), working from a prison sample, stated that cases of borderline and dull normal intelligence were encountered with greater frequency in exhibitionists than homosexuals, especially in those who did not demonstrate neurotic traits. Hirning ( 1941), as well as Apfelberg ( 1944), commented that in the intelligence testing of sexual offenders, the more normal-appearing offenders were less likely to be sent for psychological testing than either dull or brighter-appearing offenders. Finally, Karpman ( 1926), Bejke ( 1952), and Rickles ( 1942, 1950) all stated that exhibitionists generally had good intelligence.

Summary Clinical observations and results of intelligence tests provide general agreement that exhibitionists have an essentially normal distribution

130 /

PEDOPHILIA AND EXHIBITIONISM

of intelligence, with a slight tendency towards the above average group.

( b) Education It has been shown that the intelligence of the group studied follows essentially the same distribution as the normal population-if anything, it tends to be slightly higher. On the grounds of intelligence, it could be expected that the school achievement level would be the same as that found in the general population. Looking at the final grades attended ( Table XLII), the Forensic Clinic study observed that more than a quarter had not progressed beyond Grade VII, 15 per cent went further than Grade X, and only 2 of the 54 reached university. These achievements were compared TABLE XLII FORENSIC CLINIC STUDY, FINAL SCHOOL GRADES Total

ExA.

ExC.

ExAC.

54

31

17

6

8.7 n % 15 (28) 31 (57) 8 (15)

8.5 n % 9 (29) 19 (61) 3 (10)

8.4 n % 5 (29) 9 (53) 3 (18)

10 . 7 n % 1 (17) 3 (50) 2 (33)

n Mean final grade Final grade

-7 8-10

11 plus

TABLE XLIII FORENSIC CLINIC STUDY, OFFENDERS' l.Q.'s, FINAL SCHOOL GRADES

I.Q. Class

-89 90-109

110 plus

Final Grade

%

13 53 34

Grade

-7

8-10

11 plus

%

28 57 15

with the offender's intelligence. From this comparison (Table XLIII) it appears that the exhibitionists were under-achievers in regard to education. School drop-outs, however, do not entirely depend on level of intelligence but also on a number of other psychological and social factors. In estimating the significance of the proposed under-achievement as a symptom of exhibitionism, one would have to assess other factors in the personality and social background of the offenders to see in what way the early school drop-out is related to exhibitionism. It can be pointed out that the average school-leaving age of the

EXHIBITIONISM: 'IHE OFFENDER /

131

exhibitionists coincided with the height of onset of symptoms in the mid-teens. Comments of offenders concerning their school days were most frequently indicative of loneliness and isolation. They hardly ever had friends and were either afraid of being bullied or were constantly engaged in fights. It seems that almost all of them had difficulties in their social relationships and in handling aggression. From the younger offenders still going to school, it is also known that a great amount of sexual phantasy interferes with their school work. Older offenders stated generally that they were not interested in school and went to work at the first opportunity. Arieff and Rotman ( 1942) reported that, in 100 cases, 29 per cent reached Grade VIII, 46 per cent Grades VIII to X, and 25 per cent reached Grade XI or more. Henninger ( 1941), in 19 cases, had 21 per cent up to Grade VIII, 47 per cent to Grades VIII to X, and 32 per cent to Grade XI or more. Apfelberg et al. ( 1944) reported 24 per cent of 88 cases reaching between Grades VIII and X, with 3 per cent having college education. "Higher education" was found in 9 per cent of 490 cases of indecent exposure in the Cambridge study. Individual case studies suggested slightly higher levels of attainment. These cases, however, came mainly from private psychiatric practice and were therefore highly selective.

Summary Educational achievements of exhibitionists tend to be below their intellectual capacities, although data vary on this point. The school experience of exhibitionists is characterized by loneliness and difficulties with aggression in either an active or a passive way, and seems to be generally an unhappy one. The high drop-out rate between Grades VIII and X is likely to be influenced by the first peak of onset of symptoms. ( B)

OCCUPATION AND SOCIAL INTERESTS

(a) Occupation and Work Records As for pedophilia, the organization of data in this area was primarily determined by the type of work the offenders performed. It was hoped that this approach in the Forensic Clinic study would give a more intimate account of the offenders' choice of occupation. Since most offenders had been engaged in more than one occupation, an attempt was made to separate the dominant occupations from others.

132 /

PEDOPHILIA AND EXHIBITIONISM

TABLE XLIV FORENSIC CLINIC STUDY, OCCUPATIONS

Occupation TOTAL Student TOTAL Profession Business TOTAL Managerial, owner Accounting bookkeeping Clerical Sales Storekeeper, clerk TOTAL Trades Engineering, plumbing, mechanics, etc. Printing, painting, dyeing Bricklaying, tile-setter Upholsterer Furrier Barber Semi-skilled Occupations TOTAL

Assembly, shipping, stock-keeping Commercial driving Unskilled Labour

Total

ExA.

ExC.

ExAC.

Dominant n % Other

Dominant Other

Dominant Other

Dominant Other

5(9) -

3

0

0

0

0

0

0

9(17) 11 1 5

4 0

5 2

2

0 0

3

0

6 3

0

0 0 3

1 0

1

0

0 0 0 1

0 0

2

1 0 2

0

13

4

9

2

0 1

1 0 0

1

2

5

2

0 2

23(43) 6

2

1

0

0 0

2

0

2

0

11

2

7

1

4

1

0

0

6 2

4 0

4 0 0 1

1 2 2 0

1 0

1

3 0 0 0 0

0

0 0 0

1 0 0 0 0

0 0 0 0 0

6

0

2

4

1

1

4 2

0 0

1

1

2 2

0

0

0 0 0 0 1

0 0 0 0

2 1 1

0 0 0

9(17) 5

6 3

3 2

1

1

TOTAL

Labourer, farmhand odd jobs TOTAL Service Maintenance Cook, waiter, bartender Armed Forces

4(7) -

2

2(4) 2 1 1

2 1 1 1

1

1

2(4) 6

2

2 1 1 2

0 0 0 0

0 0 0

4

The data in Table XLIV indicate that the majority of the exhibitionists were engaged in trades. None of them belonged to a profession or were employed in clerical work. The preferred occupation in business was in the sales field. A number of offenders had attempted ownership in business or managerial positions but were unable to sustain this role, with the exception of one who, however, was also troubled by the responsibility he had to carry. In the trades, too, offenders who tried to work on their own were usually unsuccessful. On the other hand, the group seemed to have difficulties in a work situation which involved superiors. They seemed to be generally hard-working and conscientious, even compulsively so, but were very sensitive to criti-

EXHIBITIONISM: THE OFFENDER

/

133

cism and easily upset if anything went wrong with their tools or machinery. This was sometimes given as the precipitating factor for exposing. Another observation made by offenders and implied by their occupations was the preference for what they felt were "manly" occupations. A number of instances could be cited; for example, an insurance salesman of high intelligence looked with envy at his brothers who were skilled workers; or offenders said that they could not stand being "shut up" in an office, wearing white shirts and a tie. A rough work shirt, preferably open, with breast hair showing, was much more attractive. One sample of occupational distributions is given by Hirning ( 1945) for 60 cases as shown in Table XLV. TABLE XLV GRASSLAND HOSPITAL STUDY, OCCUPATIONS of EXHIBITIONISTS

n School boys Executives (white collar) Skilled artisans Labourer and odd jobbers Farmer Service work (chauffeurs) Unclassified

5 10 11

15 1 11 7

% 8

17 18 25 2

18

12

TABLE XLVI CAMBRIDGE STUDY, OCCUPATIONS OF EXHIBITIONISTS

% Group A Group B

Professional occupations, business managers, own business, etc. Office workers, shop assistants, commercial travellers and dealers, etc. Group C Skilled trades, factory and warehouse workers, railway and mine workers, etc. Group D Labourers, casual workers, caretakers, park keepers, and cinema attendants, etc. Group E Vehicle drivers, messengers, postmen, etc. Group F Domestic workers, hairdressers, cooks, waiters, barmen, actors, musicians, and artists

3 . 2% 11 .9%

48 .2% 27.0% 7 . 2%

2 .5%

Occupational choices for the exhibitionists of the Cambridge Study ( 1957) are given in Table XLVI. Of Henninger's ( 1941) 2 subjects, 1 was a high school graduate who lacked any purpose in life and 1 a labourer whose frequent job leavings were accompanied by marked feelings of inferiority.

134 /

PEDOPHILIA AND EXHIBITIONISM

In the reports of individual cases, Peck's ( 1924) patient was a missionary and Sperling's ( 1947) a medical doctor. Rickles ( 1942, 1950) found that exhibitionists came from a wide range of types of work, including skilled employers, engineers, insurance salesmen, and chemists. Individual and small number case studies tend to show a disproportionately high number of upper level occupations. Work Records. The work records of the exhibitionists were grouped in the same way and using the same criteria as for the pedophiles. The majority tended to have a satisfactory work record, while many of the younger offenders were listed as "undetermined" since no meaningful decision could be made. ( See Table XL VII.) TABLE XLVII FORENSIC CLINIC STUDY, JUDGEMENT OF WORK RECORDS

Total n % Good Undetermined Poor TOTAL

33

(61) (20) 10 (19) 54 (100) 11

ExA. n

ExC. n

ExAC. n

19 6 6

11

3

31

3 3

17

2 1 6

The only other qualitative statement noted about the occupational aspects of the exhibitionists was by Bejke ( 1952) who commented that exhibitionists were good at their work.

Summary The majority of exhibitionists are engaged in skilled trades or as labourers with a preference for "manly" occupations. On the whole, their work records are satisfactory, and while they seem to have difficulties with their work supervisors, generally they are hard-working and conscientious. ( b ) Social Interests Information on the interests of exhibitionists was available in 43 cases of the Forensic Clinic study ( Table XLVIII). Of these 43 patients, 8 stated that they had no interests, or interests were so general ( such as television and newspapers) that they were discounted. The predominant interest was in sports, with swimming and body-building mentioned most often and team sports coming last. Among hobbies, only photography was mentioned and in artistic interests, music ranked highest. ExA. and ExC. were rather similarly distributed in interests. The 6 ExAC. patients showed their highest concentration of interests in the

EXHIBITIONISM : THE OFFENDER

I

135

TABLE XLVIII FORENSIC CLINIC STUDY, SOCIAL INTERESTS Interests

Sports TOTAL Unspecified Swimming Judo, boxing, weightlifting Car, boat, 'plane Cycling, skating Fishing, hunting Team sport (baseball, soccer) House and Garden TOTAL Do-it-yourself Gardening, farming Cooking Hobbies TOTAL Photography Artistic Interests TOTAL Music Books Painting TOTAL Social Interests Church work Clubs No interests Not known

Total (43)

ExA. (22)

ExC. (15)

28

16

9 1

3

7 6

4 3 3 2

2 5 4 2

0

2

2

0 1 3

1

1

1 0

2 2

2 2

1 1 1 0 0 1 0 0

11

2 2

3 2

6

4

7

1

4 3

3

1

0 0

3 2

2 2

1

8 11

0 6 9

1 0 0 0 0

2 2

ExAC. (6) 3

0 0

2 1

0 0 0 1 1 0 0 0 0 6 3 2

1 1 0 1 0 0

arts and in this were similar to the homosexuals. This similarity occurred in almost all factors, including age, intelligence, education, and occupation; however, only one of these exhibitionists is known to have had homosexual contacts. In relation to interests, offenders frequently mentioned that they were lonely and it was apparent that, on the whole, their social contacts were few and far between. Summary Exhibitionists seem to be lonely, having few social contacts, with their predominant interest being in individual sports such as swimming or body-building. ( C) COUNTRY OF BIRTH AND PLACE OF RESIDENCE

As for pedophilia, national and racial origins were found in the Forensic Clinic study to have little meaning in a metropolitan area and only country of birth was tabulated ( Table XLIX). It was found that 64 per cent of exhibitionists were Canadian-born compared with 67 per cent among the general male population of Toronto in the 1951 census. Even the 10 per cent born in Great Britain corresponded

136

I

PEDOPHILIA AND EXHIBITIONISM

TABLE XLIX FORENSIC CLINIC STUDY, COUNTRY OF BIRTH

n Canada Gt. Britain Ireland South Africa U.S.A. Holland Denmark Switzerland Italy Malta Macedonia Latvia Ukraine

Total

ExA.

ExC.

ExAC.

50(100%)

30

14

6

32(64%) 5(10%) 1 1 1 1 1 1 3 1 1 1 1

21 2 1 1 0 0 0 1 2 0 1 1 0

3 0 0 0 1 1 0 1 1 0 0 0

7

4 0 0 0 1 0 0 0 0 0 0 0 1

closely with the 15 per cent (United Kingdom) in the general population. However, there was a wider variety of countries represented by the foreign-born exhibitionists than by the pedophiles. As with pedophilia, studies originating in the United States place more emphasis on racial than on national origins. Arieff and Rotman (1942) showed 74 per cent of subjects were born in the United States, but no general population figures were provided. Only 4 of 100 subjects were Negro while the ratio of Negro to white population in Chicago at the time of the study was 1 to 10. In regard to residence, 48 of the 54 exhibitionists in the Forensic Clinic study came from Metropolitan Toronto. The distribution of the 48 subjects corresponded closely with that of the general population. Dividing the Metropolitan area into city proper and suburbs, 21 ( 41%) of the exhibitionists lived in the city and 27 ( 56%) in the suburbs. The corresponding proportions of the general population are 45 per cent and 55 per cent. No concentration of offenders was noticed in deteriorated areas. Summary

The exhibitionists follow the general population trends in regard to proportions of native- and foreign-born offenders. The foreign-born represent a wide variety of countries. In an American study where racial factors were included, it was found that white exhibitionists appeared more frequently than Negroes when compared with the general population. Exhibitionists were found in the Forensic Clinic study in equal

EXIIlBITIONISM: THE OFFENDER

I

137

TABLE L FORENSIC CLINIC STUDY, RELIGION General population*

%

n

n

Total

%

ExA. n

ExC. n

ExAC. n

(100)

47 (100)

29

12

6

(20) (25) (23) (10) (4) (2)

12 (25) 11 (23) 7 (15) 2 (4) 2 (4) 3 (6) 1 3 1 1 1 3

5 6 7 1 2 1 1 1 1 1 1 2

5 3 0 1 0 1 0 1 0 0 0 1

2 2 0 0 0 1 0 1 0 0 0 0

Roman Catholic Anglican United Church Presbyterian Baptist Lutheran Salvation Army Pentecostal Church of Christ Jehovah's Witnesses Greek Orthodox Protestant

*Dominion Bureau of Statistics, 1951 Census: City of Toronto, based on 326,050 males.

numbers by population in both suburbs and city proper but no data were available on rural areas. ( D) RELIGION The distribution of religious denominations among exhibitionists in the Forensic Clinic study, as in the other deviations, was essentially the same as in the normal population ( see Table L) . It can be assumed that the religion given was also the one in which the offender was reared, since only 2 patients stated that they had changed their religion. The slight differences between the clinic group and the general population that appear in Table L cannot be seen as significant in any way, because of the small number of cases in each category. Two-thirds of the 60 cases cited by Hirning ( 1945) involved Roman Catholics. The author interpreted the high percentage of Roman Catholics among the exhibitionists in terms of a strict background and upbringing, rather than the number of Roman Catholics in the comTABLE LI FORENSIC CLINIC STUDY, PARTICIPATION IN CHURCH

n n Practising Non-Practising Not known

Total

%

n

ExA.

%

n

ExC.

ExAC. n

%

33 (100)

19 (100)

10 (100)

4

19 (58) 14 (42) 14

12 (63) 7 (37) 10

6 (60) 4 (40) 2

1 3 2

138 /

PEDOPHILIA AND EXHIBITIONISM

munity ( unfortunately no general population figures accompanied this study). In the single case discussed by Riming in 1947, the exhibitionist was also Roman Catholic. Arieff and Rotman ( 1942) provided a religious breakdown for 78 cases with Roman Catholics 46 per cent, Protestants 44 per cent, and "others" 10 per cent. Participation in the church ranged from serious and intensive involvement to antagonism (Table LI). From those subjects who stated their participation, it appeared that more than one-half practised their religion in a major or minor degree. Essentially the same percentage was found among the pedophiles and homosexuals studied. In the area of religious practice or church attendance, Arieff and Rotman ( 1942), with 66 cases, had 71 per cent claiming "regular or occasional church attendance" and 29 per cent stating "no attendance." Information was not available for 12 additional cases. Rickles ( 1950) reported that 4 of 7 subjects came from religious homes. Summary The distribution of religious denominations among exhibitionists in the Forensic Clinic sample is essentially the same as for the general population. Other studies show higher percentages of Roman Catholics but no comparative data from the general population are provided. Participation in religious activities ranges from very intensive to none at all and no specific configuration emerges. III. FAMILY BACKGROUND

(A)

PARENTS

(a) Absence of Parents from Home Information on the exhibitionists' relationships with parents was derived in the same way as for the pedophiles. It was available in 45 cases of the 54 for "absence of parents from the home." The criteria for "absence" and for "childhood" were the same as those used in pedophilia and the results were similar. Table LII indicates that one-third of the fathers of exhibitionists were away from the home during the offender's childhood for prolonged periods of time. In contrast to the father, only 4 mothers, all among ExA., were away from home during part of the offender's childhood, 2 by death and 2 by separation. Arieff and Rotman ( 1942) had 14 per cent of cases with broken homes or early death of parents. Henninger ( 1941) had 2 out of 3 cases

EXHIBITIONISM; THE OFFENDER

I

139

TABLE Lil FORENSIC CLINIC STUDY, ABSENCE OF PARENTS FROM HOME Father Total

n Separation Deaths Military service TOTAL

ExA.

Mother

ExC.

45 29 12 (100%) (100%) (100%)

ExAC.

4

Total

ExA.

47 29 (100%) (100%)

ExC.

ExAC.

14

4

6 6

4 3

2 2

0 1

2 2

2 2

0 0

0 0

3 15 (33%)

2 9 (31%)

1 5 (42%)

0 1

0 4 (13%)

0 4 (14%)

0 0

0 0

with experiences of step-parents or foster parents. One of Rickles' ( 1950) cases had a broken home at age 6. The Cambridge study had 16 (27%) out of 60 cases of indecent exposure with incomplete families; the father was absent in 9 cases, mother was absent in 2 cases, and both parents were absent in 5 cases.

( b) Relationship with Parents Relationship to father. It has already been indicated that about a third of the fathers of the offenders had been absent from the home, either temporarily or permanently. In the offenders' descriptions of the relationship with their father, almost half of them said that they felt distant from him, and only a fifth that they had been close to their father ( Table LIii). With regard to the quality of the relationship, TABLE LIII FORENSIC CLINIC STUDY, RELATIONSHIP WITH PARENTS Father

n

Mother

Total

ExA.

ExC.

ExAC.

Total

ExA.

ExC.

ExAC.

n % 43 (100)

27

12

4

n % 37 (100)

25

9

3

10 5 7 9 4

6 4 3 3 2

3 0 0 2 0

3 17 16 7 14

3 11 10 4 11

0 5 5 2 2

0 1 1 1

19 (44) Distant 9 (20) Close Positive 10 (23) Negative 14 (33) Ambivalent 6 (14)

(8) (45) (42) (18) (37)

1

however, only a few more offenders stated a negative relationship to their father than the ones admitting a positive one. In regard to the ExC., negative and positive expressions were equal; in the cases of ExAC. only negative expressions could be found for father.

140 /

PEDOPHILIA AND EXHIBITIONISM

The nature of the relationship is best described in an impressionistic way. Positive relationships seemed to be characterized by statements like: "real pal to me," "liked kids" ( but was unable to put up with mother), "enjoys life," "just like me." These give the impression that positive relationships were seen more as sibling relationships or friend relationships. Never was there any mention of protection or guidance and in some cases it could be seen quite clearly that the father-son relationship was a pact against mother. The negative relationship with the father seemed to be characterized mainly by violence and the most common statements involved beating, shouting, and authoritative, aggressive behaviour, followed by statements of rejection such as "no love for me," "did not bother with me." A number of fathers were reported to be heavy drinkers. One gets the impression generally that fathers were not looked up to as guiding figures in the home but rather were experienced as another sibling or, on the negative side, as having compensated for their weakness by strong authoritative behaviour. One offender expressed a combination of these factors in the following way: "He beat me until I was 14, then I stood up to him and after that he ignored me." Similarly, the ambivalent statements referred mainly to "strictness," "old-fashioned," "bossy," in a negative connotation and to "smart," "nice,'' "mild" in a positive connotation. It was Spitz's opinion ( 1956), from psychological examinations of 20 exhibitionists, that fathers or father-surrogates were poor identification figures . Relationship to mother. In regard to mother, some of the exhibitionists' expressions were of a much more emotional character and usually contained terms of strong love, strong resentment, or both. It is not surprising that, in contrast to father, closeness to mother was so much more prevalent than distance. This could also be assumed to be the case in the general population, and there was no difference when compared with pedophiles. Positive feelings were expressed in two major ways. One was admiration for competence, as : "irreplaceable," "chief cook," "good manager," etc.; the other was regard for general goodness, as : "good,'' "kind,'' "only person ever close to me," "softhearted," and "favoured me," etc. It is interesting to note that expressions relating to competence were almost absent in regard to the father although expressions of general goodness appeared there too. Negative feelings referred mostly to controlling attitudes, such as: "domineering," "nagging," "highstrung," "prudish," "mean," and "pushed me around."

EXHIBITIONISM: THE OFFENDER

/

141

The feeling of having been dominated by mother comes out in a comparatively high percentage of ambivalent statements, which usually start out with positive features and then proceed to the negative ones, such as "good mother, but treated me like a baby," "close to her but resented her domineering," "nice but picked on me." Although entirely negative statements occurred rather seldom in regard to the mother, and were far outweighed by the positive ones, the ambivalent statements seem actually to summarize the general character of the remarks in regard to mother, namely, closeness, dominance, over-protection on the one hand, and real concern and love on the other. Arieff and Rotman ( 1956) reported that 7 of 100 cases were recorded as recalling parents as being over-protective. Spitz ( 1956), in a psychological assessment of 20 exhibitionists, claimed that mothers or mothersurrogates were either over-domineering or over-protective. Sperling ( 1947) had a patient whose mother not only dominated him but also rejected him as his siblings arrived. In a comparison of the relationship with the father and the mother in the Forensic Clinic study, the father was expressly perceived as distant by about half of the patients whereas this was so in only 3 cases with regard to mother. On the other hand, closeness to mother was stated by almost half of the group and only in 9 cases with regard to father. The emotional relationship with mother was also more often seen as ambivalent than that with father. The feelings about mother, whether positive, negative, or ambivalent, were expressed emotionally in much more intensive terms than those concerning father. Paitich ( 1962) reported the results of a parent-child relations questionnaire given to normal individuals and to a sexual deviate group which contained exhibitionists and both bi-sexual and exclusive homosexuals. He came to the conclusion that his sexual deviate group did not differ significantly from normal individuals or from each other in regard to their attitudes toward the mother. In regard to father, on the other hand, normal individuals did show significantly stronger favourable attitudes than exhibitionists or homosexuals in the areas of father's affection, father's general competence, and father's strictness and aggression. The two deviant groups, however, did not differ significantly from each other in attitudes to father. Henninger ( 1941) noted parental relationships in 2 cases. In one the parents were foster parents with the stepmother being labelled neurotic and unstable; in the second case the patient's own father was psychotic and remained in contact with the patient to his seventh year. When the patient was 12, he acquired a stepfather who ignored him.

142 /

PEDOPHILIA AND EXHIBITIONISM

Rickles ( 1950) commented that often the parents had a poor sexual adjustment and provided a prudish, excessively modest, morally strict home atmosphere. The mother seemed to gain her satisfactions from her sons while the father was ignored or kept in the background. Caprio ( 1949) also had a case in which the patient was not only much closer to the mother than to the father, but the mother also dominated the father through her neurotic tendencies, causing frequent marital conflict. Pollock ( 1960) described a family where the mother was domineering towards the patient throughout his development stages and set up the father as an all-powerful being even though he was absent during most of the patient's childhood. Some authors have also made more general statements about relationships between parents and their children. A number of authors (Karpman, 1926; Hirning, 1947; Bejke, 1952; and Rickles, 1942 and 1955) agree that a causative factor in exhibitionism is the excessive attachment of the patient to his mother. Both Karpman ( 1926) and Rickles ( 1942) were convinced of the strong part played by the exhibitionist's narcissistic tendencies which were usually encouraged by the mother. Sperling ( 1947) also mentioned the high degree of narcissism found in her patient and, in addition, placed some emphasis on the frustrations created within the patient by the weaning process. In regard to the family generally, Hirning ( 1947) suggested that there are often puritanical, excessively proper attitudes toward sex. Spitz ( 1956) stated that faulty family environments are found in histories of exhibitionists. Summary

A third of the exhibitionists' fathers were absent from home for prolonged periods of time; almost half of the exhibitionists expressed feelings of distance from father, and only one-fifth feelings of closeness. When the father-son relationship was a positive one, it seemed to be a sibling-type relationship, or a bond against mother, while negative feelings were based on the aggressive, authoritarian behaviour of the father. Only a few of the mothers were absent from the home. As in the other deviations there were more positive feelings toward mother than father; ambivalent feelings toward mother were based on her domination and over-protection. Some authors feel that mothers encourage the exhibitionists' narcissism; and others, that a causative feature of the deviant behaviour is the exhibitionist's excessive attachment to his mother.

EXHIBITIONISM: THE OFFENDER

/

143

Other causal factors given include a morally strict, puritanical environment in the home and the parents' marital maladjustments.

( B)

SIBLINGS

(a) Number of Siblings in Family Information on siblings was available in 51 of the 54 cases of the Forensic Clinic study (Table LIV) . The number of siblings in families of exhibitionists ranged from 1 to 9. The mean number was 3.8, and the median and mode was 3 children. TABLE LIV FORENSIC CLINIC STUDY, DISTRIBUTION OF SIBLINGS Total

n Number of siblings Mean Number of children in family

1 2 3 4 5 6 7 8 9

10 over 10

ExA.

ExC.

ExAC.

51

29

16

6

193 3.8

113 3.9

56 3.5

24 4.0

6 9 12 9 6 2 4 1 1 1 0

2 5 6 7 4 2 2 0 1 0 0

2 3 5 2 2 0 1 1 0 0 0

2 1 1 0 0 0 1 0 0 1 0

Some variations occurred among the exhibitionistic sub-groups. Among ExA., most families had 2 to 5 children with a mode of 4 children. Of the 2 only children, one denied his act and the other one was unlikely to have been an exhibitionist. It seems, therefore, that exhibitionists exposing to adult women are rarely, if ever, only children. Among the ExC. and ExAC., the presence of only children seems to point rather to the pedophilic tendency. As noted previously, the pedophiles have the highest percentage of only children (20%). ( b) Birth Order Attention was given in the Forensic Clinic study to the position of the offender in the birth order of siblings (Table LV) . Nothing of any significance seemed to emerge.

144 /

PEDOPHILIA AND EXHIBITIONISM

TABLE LV FORENSIC CLINIC STUDY, POSITION IN BIRTH ORDER

Total

ExA. n

ExC. n

ExAC. n

51 (100)

29

16

6

2 4 9 6 11 12

2 3 5 4 8 7

2 1 2 0 2 2

n n

6 8 16 10 21 21

Only child Only son Oldest child Youngest child Oldest son Youngest son

%

(12) (16) (31) (20) (41) (41) TABLE LVI

FORENSIC CLINIC STUDY, MALE-FEMALE SIBLING RATIOS

Total

n (Excluding only children) Total number of siblings All male siblings All female siblings Number of brothers Number of sisters Have brothers only Have sisters only

45 187 136 51 91 51 17 8

(73) (27) (64) (36) (38) (18)

ExA.

27 111 83 28 56 28 12 4

(75) (25) (67) (33) (44) (15)

ExC.

14 54 39 15 25 15 5 3

(72) (28) (63) (37) (31) (19)

ExAC.

4 22 14 8 10 8 0 1

(64) (36) (55) (45)

( c) Male and Female Siblings

In enumerating the sexes of siblings ( Table LVI), we were impressed by the predominance of male siblings among exhibitionists, especially among ExA. If the offenders are excluded from the total, the proportion still remains about two-thirds male and one-third female siblings. This gains further interest if one considers that the ratio is 50:50 among pedophiles and somewhat in the opposite direction of 43:57 among homosexuals. The ratio for all the sex offender groups combined in the Forensic Clinic study was 53 brothers to 47 sisters, which corresponds with the normal expectation, since there are usually slightly more males than females among all children born. The predominance of male siblings among exhibitionists is further emphasized by the fact that 38 per cent had brothers only, whereas 18 per cent had sisters only. This is more pronounced in the case of the ExA., where almost half had brothers only, as against 15 per cent with sisters only. Pedophiles ran about equal ( 13%: 15%) and homosexuals showed again the opposite picture ( 18%:47%). The 4 subjects among ExA. who had sisters only comprised one

EXIIlBITIONISM : THE OFFENDER /

145

Indian who was raised wherever there was a place for him, one who was raised with his father's younger brother, one who denied the act, and one who exhibited after a severe onset of multiple sclerosis. One wonders if in a sample of unquestionable exhibitionism male siblings would not be even more prominent. ( d) Relationship with Siblings Information on relationships with siblings is neither full nor consistent in coverage, and we can, therefore, only give some impressions that emerged from the record. It seemed, in general, that the relationship with sisters in childhood was a good one. With brothers some rivalry was obvious but not as much as one would have expected. The older brother was sometimes looked up to as a father substitute, but was more often resented. Younger brothers seemed to be generally better liked. Some patients noted their inability to express resentment or hostility to their siblings, but most gave a rosy picture about their childhood with the other siblings. Hirning ( 1947) cited 2 cases of only children, and a third case where the exhibitionist was the elder of two boys. Sperling's case ( 1947) was the eldest of four children, with one brother two years younger, and two sisters six and eight years younger. His mother expected him to care for the smaller children as they arrived. Caprio's ( 1949) case was the third of four brothers. Pollock's ( 1960) patient had a younger sister. In one of Karpman's ( 1948) articles, he suggested that unresolved sibling rivalry could be one cause of exhibitionism. Summary The siblings of exhibitionists range from 1 to 9 in number with a mean of almost 4 and a median and mode of 3. The offender's position in his sib line does not show any particular trend. However, there does seem to be a predominance of males among the siblings of exhibitionists, with over a third having brothers only and less than a fifth having sisters only. In general, the relationship with sisters is good, whereas with brothers some rivalry appears. ( C)

MARITAL STATUS

Since age is a variable with a bearing on marital status, the patients of the Forensic Clinic study were divided into 20 years of age and younger, and 21 years and over (Table LVII). The first group contained most of the single offenders. The second group of patients 21

146 /

PEDOPHILIA AND EXHIBITIONISM

TABLE LVII FORENSIC CLINIC STUDY, MARITAL STATUS Total

n

Ex.A.

ExC.

31

54

Ex.AC.

17

6 0 6 (100) 3 (50)

-20

12 (lm)

9 (lm)

21 and over Single

42 (100) 9 (21)

22 (100) 3 (14)

3 14 (100) 3 (21)

19 (86)(100)

11 (79) (100)

3

(84) (16)

(73) (17)

3 0

TOTAL (marriedseparated) Married/ common-laws Separated

33

(79) (100)

27 6

(82) (18)

16 3

8 3

years and over were more likely to be married and thus provided a better basis for comparison of marital status among exhibitionists and other deviants in the study. Among the exhibitionists, only one was married in the younger group. Of offenders over the age of 21, more than three-quarters ( 79%) were or had been married and less than one-quarter ( 21%) remained single. ExA. and ExC. showed the same proportion of married to single offenders in this age group. In the "married" category, one offender was living in a common-law union, which had lasted well over a year. None of the separated exhibitionists was divorced. (a) Single Exhibitionists

In the total exhibitionist group, there were 21 ( 39%) single persons. As Table LVII shows, half of them were under age 21. After the age of 25 only 3 offenders remained single. Half of the single exhibitionists in the Clinic study had had no adult sexual relations ( Table L VIII). This group consisted almost entirely TABLE LVIII FORENSIC CLINIC STUDY, ADULT HETEROSEXUAL RELATIONS OF SINGLE EXHIBITIONISTS

n None Sporadic More than sporadic Not known

Total

ExA.

ExC.

18(100)

10

6

2

11 (61) 4 (22) 3 (17) 3

6 2 2 2

4 1 1 0

1 1 0 1

Ex.AC.

EXHIBITIONISM: THE OFFENDER

/

147

of adolescents. However, most of them expressed a wish for sexual relations and their masturbatory phantasies went in this direction. Besides youth, the main reasons for their not having engaged in closer personal and sexual relations were shyness and inability to establish contact, as well as specific inhibitions with regard to sexual relations. Heterosexual pedophiles in this age group also showed an absence of close personal or sexual relations with adult females. However, their desire for and phantasies about adult relations were not expressed, and we assume that it is less a specific inhibition than general immaturity which prevents the P.het. adolescents from attempting such relations. The exhibitionist expressed his aim rather clearly and it was the inability to satisfy his wishes which seemed to stand out. Promiscuity was rare also in the older and married exhibitionist, in spite of a great deal of phantasy in this direction. Relations with prostitutes were considered unsatisfactory by the few that had experienced them. They wanted a "clean" girl. In addition to the 3 who had more than sporadic experiences and were planning marriage, another 3 were married soon after coming for treatment and were therefore included in the married group. ( b ) Married Exhibitionists Among the exhibitionists in the Forensic Clinic study over the age of 20, three-quarters (74%) were married; among offenders over the age of 25 only 3 remained single, but with two of these symptoms were questionable. It appears that among exhibitionists the motivation for marriage and a normal heterosexual adjustment is high. However, marriage, at least in the first few years, does not remove, as is often anticipated, the urge to expose. Age at Time of Marriage. Most of the Clinic's offenders were married in their early twenties, with a peak at age 22 to 23 (Table LIX). In the TABLE LIX FORENSIC CLINIC STUDY, AGE AT TIME OF MARRIAGE Age

Total

ExA.

ExC.

n

29

19

7

3

-19 20-21 22-23 24-25 26-27 28-29 30

3 6 9 4 3 2 2 5

3 5 5 2 2 0 2

0

0 0

Not known

1

1

3 2 0 1

0 4

ExAC.

1

0

1 1

0 0

148 /

PEDOPHU..IA AND EXHIBITIONISM

analysis of the onset of symptoms reported earlier in this chapter it was found that this period was also given as the second peak of onset. The assumption was made that this peak of onset seems to occur at a time when a strong relationship with a female with sexual (genital) connotations threatens the offender, such as with the mother in the mid-teens and the wife or wife-to-be in the twenties. In contrast to this finding, it is Hirning's ( 1947) opinion that exhibitionists marry at a relatively late age. Length of Marriage. At the time of coming to the Clinic about a third of the offenders had been married less than a year (Table LX). TABLE LX FORENSIC CLINIC STUDY, LENGTH OF MARRIAGE AT TIME OF REFERRAL OR SEPARATION Total

ExC.

Ex.A.

Ex.AC.

Length n

Marr. 24

Sep. 6

Marr. 16

Sep. 3

Marr. 5

Sep. 3

Marr. 3

Sep. 0

-1 yr. 2-3 yrs. ,, 4-5 ,, 6-10 ,, 11-20 21 Not known

8 5 4 4 3 0 4

2 0 1 3 0 0 0

5 3 4 2 2 0 1

0 0 2 0 0 0

1

3 0 0 2 0 0 3

1 0 1 1 0 0 0

0 2 0 0

0 0 0 0 0 0 0

1

0 0

Two other marriages had broken up in the first year. Of the 9 patients who were married from two to five years, only 1 was separated during this time of marriage. Of the marriages that had lasted more than five years, 7 were still intact at the time of referral and in 3 cases there had been separation. A comparison was made with some other studies of the percentages of married, single, and widowed exhibitionists (Table LXI). With the exception of cases reported by Henninger and Arieff et al., the marital status distributions of exhibitionists are similar. But with an adjustment TABLE LXI COMPARISON OF MARITAL STATUS OF EXHIBITIONISTS IN SIX STUDIES Study Source

Sample Size

Married

Single

Widowed

Forensic Clinic Taylor (1947) East (1924) Cambridge (1957) Henninger (1941) Arieff et al. (1947)

54 98 150 429 19 100

63% 61% 60% 58% 42% 41%

37% 39% 38% 40% 58% 59%

2% 1%

EXHIBITIONISM: 1HE OFFENDER

/

149

of age factors, the differences between Henninger and Arieff et al. and the other studies are slightly less. Marital Relationship. The picture of the exhibitionists' wives provided by the Clinic study is incomplete, since a number of offenders obviously had difficulty in talking about their wives. The most common characteristics of the wives that emerged were: (a) nervous, shy, jealous, and restrictive; ( b) dependent yet dominant; ( c) like mother; ( d) afraid of sex and childbirth; and ( e) promiscuous. The general impression was one of strong mutual dependency and ambivalence. It is difficult to decide just how much of a patient's description of his wife was a true statement of reality and how much of it represented his own problem. For instance, wives were again and again described as shy, withdrawn, and unable to establish and retain social contacts. These were also common features among the exhibitionists themselves and we wondered whether the wives' shyness was a projection of the husband's or was complementary to the exhibitionist's own shyness. It would seem, however, from other experiences at the Clinic, that exhibitionists' wives do indeed show personality problems similar or complementary to those of their husbands. The dependency and dominance theme is by far the outstanding one. Wives were either dominant or passive-dependent, or both. For instance, crying and helplessness were used as a means of domineering in a number of cases. The same polar attitudes were apparent in the wives' attitudes to sex. Some of them were described as being afraid of sex and yet the husbands were threatened by the possibility of their promiscuity. In Henninger's ( 1941) report of 19 patients, one-third ( 6) admitted divorce, 1 for the second time, and only 2 claimed to be happily married to their first wives. Eleven ( 58%) were still unmarried, even though their average age was 30. Arieff and Rotman ( 1942) had 38 out of 100 subjects married, 5 remarried, and 2 widowed. Eleven had demonstrated marital maladjustment, and 3 had pregnant wives; 23 had children. The authors suggest that the children represented some sort of marital adjustment but that they still did not act as a preventative against exposing. Fifty-three of Taylor's ( 1947) offenders were married. Fifteen of them were separated from their wives, 18 reported unsatisfactory relations, 5 wives were pregnant with no intercourse possible, and the remaining 15 marriages showed "no obvious disharmony." Sperling's patient ( 1947), a recent medical school graduate, was unmarried; Caprio's ( 1949) was first married at 19 when his bride

150 /

PEDOPHILIA AND EXHIBITIONISM

was 17; after divorcing her, he married one of her friends. Half of Guttman's 6 patients were married, and Pollock's ( 1960) was married immediately after discharge from the air force at the end of the Second World War. From an assessment of 20 exhibitionists, Spitz ( 1956) concludes that psychologically they have difficulties relating to the opposite sex. Henninger ( 1941) feels that an outstanding feature of exhibitionists is their failure to achieve normal heterosexual relationships. Rickles ( 1950), on the other hand, says that exhibitionists may make heterosexual adjustments, but frequently practise coitus interruptus and continue to masturbate throughout life. He adds ( 1955) that many exhibitionists remain unmarried, some fail in normal adult sexual adjustments, and others survive with only marginal adjustment. In his opinion the single exhibitionists are overly modest with all women and their sexual contacts are absent, infrequent, or unsatisfactory. Sexual Relations. As can be expected, there is considerable difficulty in the area of sexual relations between husband and wife. It has been stated above that a number of exhibitionists in the Clinic study blamed their exposing on lack of intercourse, yet some exposed when intercourse was available and even after it occurred. Lack of sexual outlet may partly account for some actual overt exhibitionistic behaviour, but it seems that dissatisfaction and anxiety aroused by sexual relations play a bigger role in breaking down controls. The major reasons given by the Clinic's patients for impaired relations were vaginal defects, lack of interest on the part of the wife, her fear of conception, pregnancy ( five wives were pregnant during the year preceding the charge), and a work schedule which kept the husband away from his home. It seems, however, that the relationship between sexual intercourse and exposing is rather a co-relational than a causal one. The wish to expose, in most cases, precedes experiences in coitus and problems encountered in coitus seem to stem from the same personality problems that underlie the urge to expose. It is significant that masturbation is retained in most cases as a sexual outlet, and its frequency seems to be generally high. The deviant act in many cases does not seem to be a substitute for sexual relations, nor do normal sexual relations seem to lessen the need for the deviant act beyond causing a general decrease in sexual needs. Arieff and Rotman ( 1942) reported sexual histories of 74 offenders with the following results: 21 had had no previous heterosexual experience; 5 had unsatisfactory heterosexual experience; 8 had per-

151

EXHIBITIONISM : THE OFFENDER /

versions including homosexual experiences; 2 had very promiscuous wives; 31 admitted masturbation even though their sexual relations were adequate; 5 expressed no desire for women; 2 admitted impotence. Maclay ( 1952), in discussing compensatory types of exhibitionism, states that man has a polygamous streak which might account for his exhibitionism. Bejke ( 1952) states that from his experience as long as the wife wishes more children, the exhibitionists are able to enjoy coitus uninhibitedly; however, if the wife no longer desires children, the husband loses his sense of release. Exhibitionists have strong compulsive feelings towards their marriage vows and Bejke believes that this compulsive aversion to unfaithfulness may be a common cause of exhibitionism. Summary

Exhibitionists over the age of 21 tend to be married. Under the age of 21 they are unlikely to be married or to have had any adult heterosexual experiences even though their orientation is in that direction. On the whole, marriages tend to be young ones, and are more likely to break up in the first year than at any later time. The most important times in relation to exposing seem to be when the marriage is impending or recent, and the impending or recent birth of a child. The marital relationships are characterized by strong mutual dependency and ambivalence as well as considerable difficulty in the area of sexual adjustment. ( D) CHILDREN Of the 34 married exhibitionists in the Forensic Clinic study, 19 had children ( Table LXII) . It has to be taken into consideration that these TABLE LXII FORENSIC CLINIC STUDY, CHILDREN Total Married patients Patients with children Number of children Mean number of children Married more than one year No children after one year

ExA.

ExC.

ExAC.

34

(100%)

20

(100%)

11

(100%)

3

19

(56%)

13

(65%)

4

(36%)

2

37

23

1. 9

1.8

10

4

2.4

2.0

22

(100%)

14

5

3

5

(23%)

3

1

1

152 /

PEDOPHILIA AND EXHIBITIONISM

marriages were mostly young ones and many had not had sufficient time to create families. If one takes the 22 offenders that had been married for more than one year, only 5 were without children. In these cases, the offenders stated that the wife was the one who did not want children. Arieff and Rotman ( 1942) stated that 23 of 41 married exhibitionists or 56 per cent of marriages had produced children. Caprio's offender ( 1949) had 2 daughters by his first marriage and 1 daughter by his second marriage. In the Cambridge study ( 1957) information was available in 206 cases of indecent exposure: no children, 22.3 per cent; 1 child or wife's first pregnancy, 41.3 per cent; 2 children, 20.4 per cent; 3 or 4 children, 12.1 per cent; 5 or more children, 3.9 per cent. There is little information in the Forensic Clinic study about the relationship of offenders to their children. One has to consider that most of the children of the offenders studied were infants. Some expressed feelings of jealousy, but at the same time there seemed to be a preference for male children. There did not seem to be a strong personal relationship to the children.

Summary Most of the exhibitionists studied had young families which were incomplete, therefore numbers were not too meaningful. If the offenders had been married more than a year and were without children, they usually stated that their wives did not want children. Since most of the children were infants, little of a qualitative nature was known about the child-parent relationship; however, there seemed to be some preference among the fathers for male children.

10. Legal and Criminological Factors

I. CRIMINAL CHARGES AND INCIDENCE

(A)

CHARGES

The greater uniformity of exhibitionism as a clinical symptom, compared with pedophilia, has already been emphasized. Consequently the criminal charges applied to this form of socially unacceptable sexual behaviour also show greater uniformity. These charges represent truly exhibitionistic behaviour to a great extent, with the possible exception of exposure to children. In common law it is a misdemeanor "publicly to exhibit the naked person or do any other act of open and notorious lewdness." In England this offence is tried on indictment but indecent exposure is also covered by the Vagrancy Act and local acts and bylaws, in which case it is tried summarily. The English position is well spelled out in the Cambridge study. Most statutes in common law countries consider exhibitionism a minor offence. In the United States it is generally considered a misdemeanor, as in the New York Penal Law, which reads: "A person, who willfully and lewdly exposes his person or the private parts thereof in any public place, or in any place where others are present ... is guilty of a misdemeanor." A fuller discussion of the American position is given by Ploscowe ( 1951). Under the Canadian Criminal Code, exhibitionism may be prosecuted on three charges ( ss. 158-160), covering indecent exhibition ( s. 160), indecent act ( s. 158), and nudity ( s. 159). However, exhibitionists are usually charged under section 158 which says: "Everyone who wilfully does an indecent act (a) in a public place in the presence of one or more persons, or ( b) in any place, with the intent thereby to insult or offend any person is guilty of an offense punishable on summary conviction." Exhibitionism is thus the only deviated sexual offence which is punishable on summary conviction and not on indictment. The law

154 /

PEDOPHILIA AND EXHIBITIONISM

therefore commonly recognizes that exhibitionism is more of a social nuisance than a danger. ( B)

INCIDENCE

There is overwhelming evidence that indecent exposure consistently comprises about one-third of all sexual offences. East ( 1924) has found that 36 per cent of 291 sex offenders were exhibitionists. In Arieff and Rotman's study ( 1942) the proportion was 35 per cent; Apfelberg et al. ( 1944) found 36 per cent; Taylor ( 1947), 32 per cent; Shashkan ( 1939), 24 per cent; the Cambridge study, 25 per cent, and Ellis and Brancale ( 1956 ), 30 per cent. In Metropolitan Toronto from 1,256 sexual offenders convicted in Magistrates' Court in the years 1957 to 1960, 27 per cent were charged with indecent exposure. Guttman ( 1952) estimates that 25 to 35 per cent of all sexual offences are committed by exhibitionists; Rickles' ( 1942) estimate is one-third of all sexual offences. Differences can be expected in samples taken from various forms of dispositions. The proportion of exhibitionists in institutions will be generally lower with a respective increase among those placed on probation or fined. Glueck ( 1955) did not report any exhibitionists in his studies on the sex offenders in Sing Sing; the Kingston study ( 1961) found no exhibitionists in a survey of a Canadian penitentiary. In the New York City institutions in 1948 the proportion of exhibitionists among sexual offenders was 18 per cent and in the Ontario reform institutions in 1960 it was 12 per cent. The same percentage ( 12%) was given by Frisbie ( 1959) for Atascadero Hospital. In contrast, referrals of sexual offenders to the Forensic Outpatient Clinic, Toronto, during the years 1956 to 1960 show 39 per cent exhibitionists. Among sexual offenders placed on suspended sentence and probation in Metropolitan Toronto during the same period, the proportion of exhibitionists was 34 per cent, increasing from 17 per cent in 1957 to 49 per cent in 1960. Dispositions will be further considered in Chapter 12. Guttmacher ( 1952) states that, after homosexuality, exhibitionism is the most prevalent offence. This view is further shared by Bowman ( 1951) who states that exhibitionism is first in frequency of sexual offences. The order of criminological frequency of an offence not only depends on its occurrence, of course, but also on the relevant legislation and on law enforcement. In regard to sexually deviant behaviour, there can be no doubt, after Kinsey, that homosexuality between adults is the most frequent deviation. Whether exhibitionism is more frequent than pedophilia is difficult to decide because of the wide variety of

EXHIBITIONISM: LEGAL AND CRIMINOLOGICAL FACTORS

/

155

legal and other classifications into which pedophilia falls. The best estimate at this time would be that they are about equal and cover together about two-thirds of all sexual offences. II. CRIMINAL RECORDS AND RECIDIVISM

General considerations about criminal records and recidivism were given in the corresponding chapter on pedophilia. There it was found that the general recidivism rate for all sexual offences ranges from 13.6 per cent to 16.8 per cent in various studies in different countries, involving a fairly random court population. Studies based on prison populations usually show a higher rate, because of a greater proportion of repeaters therein. It was also stated that exhibitionists consistently show the highest rate of recidivism, followed by homosexual pedophiles. East ( 1924) found that of his group of 107 exhibitionists, 24 per cent had a previous record for a similar offence. Almost the same proportion of 23.5 per cent was found by Taylor (1947). The Cambridge study reported 21 per cent as having previous records of sexual offences and the Forensic Clinic study showed 20 per cent. Studies on institutional populations again reported a higher rate of previous records, such as the New Jersey study by Ellis and Brancale ( 1956), which showed that 34 per cent of offenders had previous arrests on sexual offences. In regard to non-sexual offences, the Cambridge study showed that 22 per cent of the exhibitionists had previous non-sexual convictions; Taylor's proportion was 19 per cent, and the Forensic Clinic study showed 17 per cent. Ellis and Brancale's (1956) group showed 23 per cent with previous non-sexual convictions. The evidence indicates that of the exhibitionists coming to court, about 20 to 25 per cent have a record of previous conviction on a sexual offence. Another 20 per cent (approximately) will also have previous non-sexual offences on their record. Since both offences are overlapping, offenders with some kind of previous record will constitute about 30 to 40 per cent of the indecent exposure group. This means that 80 to 85 per cent of the exhibitionists appearing in court will be first offenders in terms of previous sexual convictions. The rate of recidivism, measured by previous conviction on sexual offences, although the highest among sexual offenders, is still relatively low. Follow-up data are available only from the Cambridge study and the Forensic Clinic study. In the Cambridge study over a four-year period,

156 /

PEDOPHILIA AND EXHIBillONlSM

18.6 per cent of the offenders in the indecent exposure class repeated a sexual offence. This was the case for 20 per cent of the Forensic Clinic group, over a mean period of three years. The latter study also indicated that exhibitionists exposing to children are more likely to become repeaters than those who expose to adults. (A)

PREVIOUS RECORD AND RECIDIVISM

It has been shown in considering pedophilia that a great difference exists between the re-conviction rate of first offenders and previous repeaters in all sexual offences. The general rate was about 10 per cent for first offenders, 33 per cent for those with a previous conviction for a sexual offence, and about 50 per cent for those with previous sexual and non-sexual offences. The same is true for exhibitionists, with even greater differences. The Forensic Clinic study shows a re-conviction rate of 9 per cent for exhibitionist first offenders, 57 per cent for those with more than one previous sexual offence, and 71 per cent for those with previous sexual and non-sexual offences. Stiirup ( 1961) shows 12 per cent for first offenders and 31 per cent for those with a previous conviction ( sexual or non-sexual unspecified) . It is therefore apparent that expectations or predictions for any exhibitionist must be strongly influenced by his previous record. This will be further explored in the discussion on judicial disposition in Chapter 12. Another factor to be considered is the time-lapse of recidivism. As one can expect from the compulsive nature of the exhibitionistic act, the exhibitionistic recidivist is likely to repeat his offence much sooner than are other sexual offenders, especially the next highest recidivating group, the homosexual pedophiles. Of the recidivists that were treated at the Forensic Clinic, the majority repeated the offence while under treatment and only 3 ( 8%) repeated after termination of treatment. Summary

Indecent exposure is considered a minor offence in most jurisdictions. The majority of those charged with this offence are exhibitionists, and this permits a better comparison of data than was possible with pedophilia. The incidence is about one-third of all sexual offences. The proportion of exhibitionists in prison populations is lower since exhibitionists are less likely to be imprisoned than other sexual offenders. Of all cases of exposure coming to court, 20 to 25 per cent of those

EXHIBITIONISM: LEGAL AND CRIMINOLOGICAL FACTORS

/

157

involved have a previous conviction for a sexual offence. The follow-up rate of recidivism for the general group is between 17 and 22 per cent. Exhibitionism has consistently the highest rate of recidivism among sexual offences. About 20 per cent of exhibitionists also have a non-sexual offence on their record. The chances of recidivism increase with previous convictions. Differences are likely to be greater than for sexual offences in general, which show an increase from 10 per cent for first offenders, to 33 per cent for those with a previous sexual offence, to about 50 per cent for those with previous sexual and non-sexual offences. Because of the compulsive nature of the deviation, the offence, if repeated, is likely to be repeated sooner than in other deviations.

11. Clinical and Correctional Factors

The major difference between exhibitionism and most sexually deviated offences in terms of correctional policy is the less serious threat which exhibitionism represents to society. This has been established in the discussions on the nature of the offence and the criminal charges, and will receive further emphasis in the consideration of judicial dispositions. In most cases exhibitionism is considered a minor offence. Despite this, symptoms of exhibitionism and the resultant behaviour tend to persist because of the compulsive nature of the act. The lives of many exhibitionists who have otherwise made an acceptable social adjustment are interrupted by court appearances, fines, and finally impositions of short sentences. These will tend to disrupt the social adjustment of the offender and increase the social isolation to which his personality often tends anyway. In pedophilia the protection of society and the potential victim must be a primary consideration; in exhibitionism society can be more lenient and concern itself primarily with the fate of the offender. In considering clinical and correctional factors, it is therefore important to differentiate between the truly psychotic, organic and mentally deficient exhibitionist, with whom exposure is only one of various symptoms of personality disorganization, and the exhibitionist with whom exposure is the major clinical symptom. In discussing definitions of exhibitionism, we have previously pointed out that, as in most other sexual deviations, the tendency in older investigations was to stress organic and functional mental disease or deficiency. This approach still persists in some studies and an objective assessment is made difficult because of a wide variety in the use of diagnostic categories. I. AETIOLOGY The difficulties in determining aetiological factors in sexual deviation have been discussed in regard to pedophilia. A survey of the definitions of exhibitionism has shown ( Chapter 7, above) the organic bias of

11. Clinical and Correctional Factors

The major difference between exhibitionism and most sexually deviated offences in terms of correctional policy is the less serious threat which exhibitionism represents to society. This has been established in the discussions on the nature of the offence and the criminal charges, and will receive further emphasis in the consideration of judicial dispositions. In most cases exhibitionism is considered a minor offence. Despite this, symptoms of exhibitionism and the resultant behaviour tend to persist because of the compulsive nature of the act. The lives of many exhibitionists who have otherwise made an acceptable social adjustment are interrupted by court appearances, fines, and finally impositions of short sentences. These will tend to disrupt the social adjustment of the offender and increase the social isolation to which his personality often tends anyway. In pedophilia the protection of society and the potential victim must be a primary consideration; in exhibitionism society can be more lenient and concern itself primarily with the fate of the offender. In considering clinical and correctional factors, it is therefore important to differentiate between the truly psychotic, organic and mentally deficient exhibitionist, with whom exposure is only one of various symptoms of personality disorganization, and the exhibitionist with whom exposure is the major clinical symptom. In discussing definitions of exhibitionism, we have previously pointed out that, as in most other sexual deviations, the tendency in older investigations was to stress organic and functional mental disease or deficiency. This approach still persists in some studies and an objective assessment is made difficult because of a wide variety in the use of diagnostic categories. I. AETIOLOGY The difficulties in determining aetiological factors in sexual deviation have been discussed in regard to pedophilia. A survey of the definitions of exhibitionism has shown ( Chapter 7, above) the organic bias of

EXHIBITIONISM: CLINICAL AND CORRECTIONAL FACTORS

/

159

the older authors. One factor that has persisted, although more as a precipitating factor than a casual one, is alcoholism. East ( 1924) and Karpman ( 1926) felt that alcohol was a contributing factor to exposing. In Shaskan's study ( 1939), 50 per cent of the 24 exhibitionists had an accompanying diagnosis of alcoholism. In Henninger's ( 1941) sample of 19 offenders, 5 had been drinking at the time of the arrest, but this was true for only 5 of 98 offenders in Taylor's ( 1947) study. The Forensic Clinic study similarly found that alcohol is rarely a factor in true exhibitionism. It can be seen clearly that, as studies moved from special groups of pre-selected offenders to more general groups, the factor of alcohol became less significant. Bejke ( 1952) also stated that emphasis could no longer be placed on factors such as alcoholism. In his opinion, causes should be seen in the family life and the exhibitionist's total environment. Among psychoanalytic authors, castration anxiety, weaning frustration, and conflict over masturbation appear most often ( Sperling, 1947; Riming, 1947). Anxiety, tension, and restlessness have been generally observed to precede the act of exposure. A number of aetiological considerations should arise out of data given in Chapter 9, such as the onset of symptoms, relationship to the mother, and the exhibitionist's response to a meaningful heterosexual relationship. The elaboration of psychodynamic or behavioural theories is, however, outside the scope of this study. II. PSYCHIATRIC DIAGNOSIS

Exhibitionism, as a sexual deviation, is included under disorders of character, behaviour, and intelligence in the International Statistical Classification of Diseases. Every exhibitionist is therefore prima facie psychiatrically ill and would be classified as such. Of greater interest is the incidence in exhibitionists of other identifiable mental disorders, especially those of a psychotic character. (A)

PSYCHOSIS

In the Forensic Clinic study, none of the exhibitionistic patients were found to suffer from a psychotic illness. This study, however, was conducted in an outpatient clinic and it can be assumed that psychotic patients were referred to a mental hospital. The same is true for Apfelberg et al. ( 1944), who excluded psychotic offenders from their study. · East ( 1924) found that 7 ( 6.5%) of his 107 subjects suffered from a

160 /

PEDOPHILIA AND EXHIBITIONISM

psychosis. Another 7 were classified as "undeveloped psychosis." Henninger ( 1941) among his 51 subjects found 8 ( 16%) suffering from psychosis, 4 of whom were schizophrenic. Arieff and associates ( 1942) found 12 ( 12%) psychotics, half of whom were schizophrenics. Taylor (1947), using East's classification system, shows 3 (3%) of his subjects as suffering from a psychosis and another 4 as suffering from an "undeveloped psychosis." The evidence, with a range between 3 per cent and 16 per cent of psychotic illnesses among cases of exposure, would indicate that the incidence of such illnesses is about the same as in studies of offenders in general. In these cases, exhibitionism would be a secondary diagnosis and the treatment and disposition of such patients would focus primarily on their psychotic illness and not on their exhibitionism. ( B)

NEUROSIS

The term neurosis has become so flexible that its statistical usefulness is highly questionable. The neurotic basis of exhibitionism has been stressed by psychoanalytic authors and indeed there is unquestionably a compulsive component to the act of exposing in many cases. This factor must have lead Arieff et al. ( 1942) to classify 26 per cent of their subjects as compulsive neurotics. The evidence of the other larger-scale studies is that psychoneurosis is rare. East's ( 1924) group contained 5 per cent psychoneurotics; Henninger ( 1941) showed 4 per cent; Taylor ( 1947), 4 per cent and Apfelberg ( 1944) gave 3 per cent with neurotic traits. In the Forensic Clinic study, only 1 out of 15 additional diagnoses was psychoneurosis.

( C)

MENTAL DEFICIENCY

Figures on the clinical diagnosis of mental deficiency vary greatly in the different studies. This is exemplified by Taylor's ( 1947) duplica-

tion of East's study. East (1924) found 22 per cent of his subjects to be mentally defective, whereas Taylor found only 2 per cent. If one includes subnormals, then East's proportion is 33 per cent and Taylor's 13 per cent. Among Arieff's 100 cases ( 1942 ), 13 offenders were classified as being mentally defective, and another 31 as being of dullnormal or borderline intelligence, which means that almost half of his subjects were considered to be below average in intelligence. It has been shown in the section on intelligence ( Chapter 9) that, where objective tests are used, the results usually show a normal distribution. We would suspect that the inhibitions and lack of social skills of many exhibitionists, together with generally low scholastic achievements,

EXHIBITIONISM: CLINICAL AND CORRECTIONAL FACTORS

/

161

would contribute to a clinical impression of lower intelligence than is actually the case. ( D) CHARACTER AND BEHAVIOUR DISORDERS

It has been indicated before that exhibitionism is classified as a disorder of character and behaviour. However, the diagnosis of psychopathic personality in addition to the sexual deviation appears in only a small percentage of cases. Henninger ( 1941) found 3 per cent, Taylor ( 1947) 4 per cent, and Apfel berg ( 1944) 6 per cent of their cases in this diagnostic group. Arieff et al. ( 1942) classified 13 per cent of their cases as non-institutional constitutional psychopaths; however, we have to consider that all of their 100 patients received a psychiatric diagnosis, which would result in over-diagnosis and could account for differences from other studies. In the Forensic Clinic study, in which 15 diagnoses in addition to exhibitionism were found, 9 ( 19%) referred to disorders of behaviour and character, but none to antisocial or asocial personality ( which would include the old classification of psychopathic personality). These additional diagnoses referred to immature personality ( 5), inadequate personality ( 2), cyclothymic personality, and acute situational maladjustment. The categories simply underline the concept of the exhibitionist as a person suffering from feelings of inadequacy and showing signs of immaturity in social relations. ( E) ExmBITIONISM AND VOYEURISM

The only relationship to other sexual deviations that has been frequently mentioned in the literature concerns voyeurism or scoptophilia. Karpman ( 1926) describes an association of the two deviations in mythology and poetry. Henninger ( 1941) excluded 3 persons out of 83 charged with exhibitionism because they were actually voyeurs masturbating when apprehended. Caprio ( 1949) published a case history to show the interrelationship between scoptophilia and exhibitionism. Bowman ( 1951), Guttman ( 1953), and Rickles ( 1955) all observed that voyeuristic tendencies often accompanied exhibitionism. From the Forensic Clinic study, the same observation emerged although true voyeurism, the compulsive looking for sexual stimuli which one is not supposed to see, occurred in only a few cases, where it tended to alternate with exhibitionism. Mild forms of voyeurism, however, are too common to permit any special inference. Other deviations are rare among exhibitionists and occur in cases which tend towards a polymorphous sexuality.

162 /

PEDOPlllLIA AND EXHIBITIONISM

Summary The incidence of a psychotic illness appears to be no higher in exhibitionism than among other offender groups. The diagnosis of psychoneurosis has been rarely applied in general, although the compulsive nature of the deviation has led investigators to see it as a compulsive neurosis. Mental deficiency can no longer be seen as having a special relationship to exhibitionism, since the distribution of intelligence among offenders is a normal one. Although the exhibitionist is not generally antisocial or psychopathic, behaviour disorders of immaturity and inadequacy are found in a good number of cases. In regard to other deviations, voyeurism has been assumed to be strongly associated with exhibitionism. III. PSYCHOLOGICAL ASSESSMENT

A general discussion of psychological assessments appeared in Chapter 5. With exhibitionism, while some authors have discussed personality characteristics, reports of these were not always accompanied by data from psychological assessments. Karpman ( 1926, 1948) was of the opinion that the exhibitionist's personality was as variable as that of a neurotic. Guttman ( 1953) gave a descriptive summary of the personality of an exhibitionist as a "show-off of decency, diligent church-goer, religious, shy, timid, with feelings of inadequacy and a minimum expression of aggression." He felt that the exhibitionist is filled with anxiety, tensions, and restlessness, and struggles hopelessly with his compulsions. Apparently, this assessment of personality was made by the author but did not involve the use of a formal psychological examination. Henninger ( 1941) reported that diagnoses of cases referred from the Allegheny Court were made on the basis of psychological, psychiatric, and social examinations. Rickles' ( 1950) book contains one chapter on the psychological testing of exhibitionists. He concluded that the tests confirmed the clinical observations that exhibitionists were of compulsive make-up with rigid control over emotions. The exhibitionists were tense, anxious, and exceedingly concerned with sexual matters. In general, the Rorschach protocols showed a weakening of neurotic defences, and the possibility of eventual precipitation into a schizophrenic reaction. Rubin ( 1960) made a preliminary survey of characteristics of 13 exhibitionists by using Cattell's Personality Factor Questionnaire.

EXHIBITIONISM: CLINICAL AND CORRECTIONAL FACTORS /

163

From the "E Scale," Submission-Dominance was taken as a cardinal factor and two groups of exhibitionists were formed. The other traits were then compared and the author concluded that the dominant exhibitionists were closer to normality and less psychologically deviant than the submissive exhibitionists. The latter seemed to have more extreme deviant scores in the direction indicating greater mental illness. A further division was suggested: submissive exhibitionists seemed to separate into those with "Low Ego Strength" versus "Average Ego Strength," and the dominant exhibitionists into "Average Paranoid Suspiciousness" versus "High Paranoid Suspiciousness." Moreover it appeared that the "Dominant Paranoid Exhibitionists" differed in type from the "Dominant Non-Paranoid" group. Paitich ( 1957) investigated the extent to which the results of clinical observations of genital exhibitionists were reflected in psychological test findings. The clinical group for study included 10 genital exhibitionists, 10 homosexuals, and 10 control cases ( non-sexual offenders). Hypotheses developed from clinical observations of exhibitionists were that they ( 1) had very strong feelings of inferiority, and ( 2) made vigorous efforts to overcome a sense of inferiority and to achieve mastery. Information from a test battery which included WAIS, Rorschach, Picture-Preference, and Blacky was utilized to test the hypotheses. Hypotheses and predictions were re-stated in operational terms and the results presented. Further hypotheses were added from the discussion, and tested statistically for significant differences. The findings were summarized as follows. When compared with homosexuals, exhibitionists appeared to be characterized both by strong feelings of inferiority and by a prominent aggressive striving ( reflected in the choice of occupation). A relatively lower degree of feminine passivity seemed to be present, although the importance of these tendencies could be assessed only by comparison with normal controls. The factor of "fear of genital injury" also required validation by control groups. Spitz ( 1956) prepared a clinical investigation of personality characteristics of 20 male exhibitionists. The problem the author set was an examination and evaluation of personality characteristics which might be common to a group of exhibitionists but which distinguished them from another offender group. The subjects for the study were 20 institutionalized exhibitionists ranging in age from 20 to 40 years, and a control group of sexual assaultists close in age to the exhibitionists. Using the social histories provided by the institution's files and a personal interview, background material for the assessment of

164 /

PEDOPHILIA AND EXHIBITIONISM

roles and identities was obtained. The psychological battery included Form II WBIS, Rorschach, TAT, HTP, and an autobiography. Spitz's results showed the exhibitionists to be severely inhibited emotionally and to differ from the sexual assaultists. The exhibitionists also showed passivity, immaturity, shyness, and dependency, but not with a significant difference from the controls. The intelligence test results varied as with the normal population. The main findings of the assessment suggested that exhibitionists came from faulty family environments with mothers or mother-surrogates who were over-dominating and/ or over-protective. Fathers or father-surrogates were usually poor identification figures. The exhibitionists seemed to have an inordinate need to please or to be appreciated by significant figures in their early lives. They had difficulty relating to the opposite sex, and often gave indications of covert hostility against females .

Summary Personality assessments of exhibitionists provide interesting data but little comparative material has been made available. The quality of the information remains uneven and difficult to assess. General statements about the personality characteristics of the exhibitionists include terms such as passivity, shyness, dependency, and inhibited behaviour. IV. SOCIAL FACTORS (SUMMARY)

In Chapter 9, the distribution of a number of social factors was given. From the data showing onset of symptoms and precipitating factors, various events can be isolated which are specific stress periods for exhibitionists. The first peak of onset of symptoms falls at the height of puberty and an examination of the circumstances usually reveals a struggle with the mother. In the case of the adolescent exhibitionist, it is therefore important to clarify the patient's relationship with his mother and if possible to involve the mother in the treatment programme. The next stress periods arise when the patient becomes involved in a serious libidinal relationship, when he marries, and when his wife becomes pregnant. It has been shown that in spite of a good deal of phantasy, promiscuous behaviour is rare among exhibitionists. Their feelings of inadequacy, sexual and otherwise, are easily evoked by negative occurrences in the social environment, particularly on the part of the patient's wife. An assessment of the wife's contribution to the release of the urge to expose is important.

EXHIBITIONISM: CLINICAL AND CORRECTIONAL FACTORS

/

165

In addition to these stresses, any other social stress, often precipitated by the patient's personality, can result in the urge to expose. A social assessment must therefore examine the stresses impinging on the patient in his work situation, his home, and other life situations, for these would give clues to a reality-oriented treatment programme. Since part of the symptom seems to be a general inhibition in terms of human relationships, the amount of social isolation of the patient should be examined together with the possibilities of broadening the life space of the patient. Group therapy may be one of the means by which this can be achieved.

V. TREATMENT In the absence of a specific aetiology, the knowledge and experience of psychiatric and social treatment in general have to be applied to the problem of exhibitionism. This is a wide area with many variations and we have selected only those aspects about which some knowledge is available. Inferences regarding treatment should also be drawn from the data provided in previous chapters. (A)

MOTIVATION FOR TREATMENT

There is no indication that exhibitionists are less motivated for treatment than any other patient group. In the Forensic Clinic study, of 54 cases, 36 ( 67%) patients entered into treatment, which was slightly more than with pedophiles and homosexuals. Of the remaining 18 seen on a pre-sentence level of investigation, 12 were subsequently placed on probation without treatment, I was certified to a mental hospital, 1 was fined, 1 was incarcerated, and in one case the charge was dismissed. In 2 cases the subsequent disposition was unknown. The average length of treatment was slightly more than a year ( 12.6 months), and twice as long for those exposing to adults ( 15.4 months) as for those exposing to children ( 7.3 months). This is at least partly explained by the fact that more of the adult group participated in group treatment, which, as we have shown before, tends to involve patients longer than individual treatment. It is a common experience that offenders referred by the courts are defensive in the initial stage. In many cases of exhibitionism, patients also reported that they were glad to be caught and referred to a clinic, a step they may have considered before but never had the courage to take. One initial experience, which seems to be helpful to first offenders, is the discovery that they are not the only ones who suffer

166 /

PEDOPHILIA AND EXHIBITIONISM

from this bizarre symptom, and that it is not necessarily a sign of severe mental disorder. Later in the course of treatment, it has been the experience, especially of the analytically oriented therapist, that the exhibitionists' narcissism tends to interfere with progress. Ellis ( 1933) stated that the exhibitionist is often simply a narcissist of a pronounced type. Christoffel ( 1936) found that effective psychotherapeutic contacts were difficult, even .if the exhibitionist desired treatment, because of his narcissism. This was further experienced by Sperling ( 1947) and Thomson ( 1957). ( B)

FORMS OF TREATMENT AND RESULTS

It was pointed out in regard to pedophilia that most of the literature deals with the treatment of sexual deviation in general. The account here will only include reports which deal specifically with exhibitionism. (a) Individual Therapy Psychoanalytic treatment of exhibitionists is reported by Peck ( 1924), Sperling ( 1947), Karpman ( 1948), Caprio ( 1949), Bejke ( 1952), and Thomson ( 1957). Peck saw his patient only for a short time, whereas Sperling's was seen 5 times weekly for 2½ years. Sperling states that the major problem was to overcome the patient's narcissism, after which he was treated as a case of neurosis. The patient married and made a good social adjustment. The other authors deal with the dynamics of the cases but do not state the eventual outcome. Conn ( 1949) reports the use of "brief psychotherapy" with 4 patients, 3 of whom were treated effectively; with one there was failure. Rickles ( 1955) reports one successful treatment and relapse in one other case after an initial improvement. Bond and Hutchinson ( 1960) applied Wolpe's reconditioning techniques to a case of exhibitionism and good results are reported.

( b) Group Psychotherapy General references to group psychotherapy with sexual offenders have been given before ( Chapter 5). There are no specific references, except for the work carried on at the Forensic Clinic, Toronto. Turner ( 1961) reports on an exhibitionist-voyeur group which had been in operation for four years. During that time 10 patients were discharged as relieved of their symptoms and as having achieved sufficient modification of their underlying psychopathology to be regarded

EXHIBITIONISM: CLINICAL AND CORRECTIONAL FACTORS

/

167

as "cured." Seven patients left the group of their own accord; 2 committed further offences, 1 sexual and 1 non-sexual; 1 patient left the city and 2 other patients were transferred to individual therapy. Eight group members were still receiving treatment at the time of the report. At the same clinic, a complementary group for patients' wives was formed after it was found that a wife's attitude played a vital role in the treatment process. This group is described by Paitich ( 1960) who reports on 84 sessions. The experiences of these two groups led to the formation of a group of married exhibitionists and their wives. VI. FOLLOW-UP

Problems related to the assessment of psychotherapeutic treatment have been discussed previously ( Chapter 6). We have also given an account of follow-up in terms of criminal records and recidivism, from which base expectancies of reconvictions can be drawn. Results of the Forensic Clinic follow-up study show that, in terms of criminal records, patients who received some form of treatment do not differ significantly in terms of recidivism from those that did not. It has to be considered, however, that the treated group consisted of the more difficult cases, the likely repeaters, and therefore such a comparison is not valid. Differences within the treated group emerge between patients who exposed to adult women and patients who exposed to children. Of the 20 patients treated in the first group, only 3 ( 15%) repeated with a sexual offence during a period of almost three years. All 3 repeated while in treatment and none after the completion of treatment. On the other hand, of those patients who had exposed to children, 4 ( 36%) of the 11 treated committed another sexual offence, 2 while in treatment, 1 after treatment had ended, and 1 while in treatment and afterwards. Exhibitionists exposing to children in this sample show a reconviction rate which is more than twice as high as those exposing to adult women. Of the 5 offenders that had exposed to both adult women and children, 2 out of 5 committed another sexual offence. In the personal follow-up, 14 of the 22 offenders were interviewed. Twelve of the 14 patients still experienced impulses to expose and only 2 were impulse-free. However, only 3 were acting out, which would indicate that improvements were due to an ability for increased control and not the eradication of the impulses themselves. This is further borne out by the fact that of the 8 married patients followed up, 7 reported improvements in the sexual relationship with their

168 /

PEDOPHILIA AND EXHIBITIONISM

wives. On other social and personality factors, the follow-up group showed generally marked increases in stability and greater social and family adjustment. For an adequate assessment of the impact of treatment on the rate of recidivism, first offenders would have to be excluded, since their base expectancy is only around 10 per cent. From a criminological and social point of view, it is doubtful whether this group warrants treatment, with the exception of selected offenders and those that feel a need for treatment, since in 90 per cent of the cases no repetition of a sexual offence is expected and exposure, being a minor offence, does not involve too great a risk. It is different with the repeater; almost one-third can be expected to commit further offences and even more than that, if the offender has been involved in non-sexual offences too. This is the group which often shows long conviction records and alternates between prison and freedom.

12. Sentence and Disposition

Exhibitionism is important because of the frequency of its occurrence but is of minor concern in regard to the nature of the act. The consequences, although shocking to many victims, are in general not dangerous to them. This is well recognized by the law. East ( 1924) considered imprisonment a deterrence but stated later ( 1946) that imprisonment is unjustified for minor offences such as exhibitionism. I. MODE OF DISPOSITION A review of judicial dispositions shows that extensive use is made of fines. In Metropolitan Toronto during 1957 to 1960, 68 per cent of the persons convicted for indecent exposure were fined. The Cambridge study shows 39 per cent. Suspended sentence and probation were used in 19 per cent of the cases in both instances and the proportion of those receiving short-term prison sentences was 20 per cent for Toronto and 23 per cent for the Cambridge study (1957). The Cambridge study also shows that more than half ( 57%) received a sentence of 2 months or less and only in one case was the sentence longer than 6 months. On the other hand, of those sent to prison, 81 per cent were first offenders. From the study of the criminological and correctional factors, it would seem that fines could be used for first offenders with a recommendation that the offender seek help at a clinic if he should find himself unable to control his impulses. To insist on clinical examination of all these offenders would seem to be a misuse of limited clinical resources. Measures such as presentence reports, clinical investigations, probation, and treatment should be instituted for a second offence, which would involve a substantially lower number of persons. In this way more attention can be given to the offender who by his persistence in this behaviour shows a real need for such measures. The imposition of prison sentences, which, as East ( 1946) points out, cannot be justifiably long enough for treatment purposes, serves

170 /

PEDOPHILIA AND EXHIBITIONISM

only to disrupt any social adjustment the offender has made. As a result he is liable to experience greater stress, which makes him more prone to exposing. In most cases it seems that imprisonment is used as a routine gesture to dispose of the problem. For the persistent offender who is unable to sustain himself with outpatient treatment, institutionalization may have to be considered, but this would involve only a small group which should be accommodated in a psychiatric setting. In regard to exhibitionists exposing to children the court may not be able on the evidence to decide whether it is dealing with an exhibitionist or a pedophile, and closer clinical scrutiny would be indicated in many cases. This group also seems to be more persistent in their symptoms than are offenders exposing to adult women. II. SPECIAL LEGISLATION

Since exhibitionism is not a progressively dangerous sexual offence, legislation involving preventive detention cannot be justified. The relatively high recidivism rate compared with other sexual offences can lead to the inclusion of exhibitionists under broad "sexual psychopath" legislation, with periods of detention which are by no means justified by the offence. The exhibitionistic recidivist poses the problem, reflected in common judicial practice, that short prison sentences are ineffective if not detrimental. Society, on the other hand, cannot be expected to tolerate persistent unacceptable behaviour without limits, even if this behaviour represents a minor infraction. The persistent offenders, who fortunately are only a moderate proportion of exhibitionists, are likely to have a number of other psychological and social problems, including other forms of antisocial behaviour. Their correctional needs and treatment would therefore not differ essentially from those of other offenders who have persistent difficulties in controlling their unacceptable impulses. Because sexual offences evoke an emotional reaction, not only in the general public, but also in those dealing with the offender, it is especially important that judicial and correctional procedures be based on what the problem is, and not on what it is feared to be.

APPENDIXES

FORENSIC CLINIC STUDY Comparative Data on Pedophilia, Exhibitionism, and Homosexuality

Appendix A

STUDY POPULATION AND FOLLOW-UP

I. 2. 3. 4. 5. 6. 7. 8.

Classification of Study Population. Disposition of Cases Assessed but not Treated at the Clinic. Total Intake, Court Referrals and Study Group. Residence at Time of Referral. Residence within Metropolitan Toronto. Charges at Time of Referral. Time Span between Offence at Referral and Follow-up. Criminal Records before, during and after Contact with the ClinicTotal Group. 9. Criminal Records before, during and after Contact with the ClinicTreatment Group. 10. Length of Treatment. 11. Therapy Sessions.

Al. CLASSIFICATION OF STUDY POPULATION

April 1956 to July 1959

Total no. of cases

Appear twice*

Total

n Referred by court Treated Assessment only Treatment ended before August 1959

123 (100%) 77 (63%) 46 (37%) 55 (45%)

9 8 1 5

132 (100%) 85 (64%) 47 (36%) 60 (46%)

Exhibitionists A.

C.

AC.

31

17

6

20

11

5

11

6

1

13

11

2

Total n 54 (100%) 36 (67%) 18 (33%) 26 (48%)

Pedophiles

Het.

Ho.

Und.

27

23

5

17

15

2

10

8

3

15

8

2

Total n 55 (100%) 34 (62%) 21 (38%) 25 (45%)

Homosexuals

--n

23 (100%) 15 (65%) 8 (35%) 9 (39%)

LEGEND----Exhibitionists: A, Exhibiting to adults; C, Exhibiting to children; AC, Exhibiting to adults and children. Pedophiles: Het., Heterosexual pedophile; Ho., Homosexual pedophile; Und., Undifferentiated. *These cases appear in two of the three groups, e.g. Exhibitionists and Pedophiles.

I 175

APPENDIX A

A2. DISPOSITION OF CASES ASSESSED BUT NOT TREATED AT THE CLINIC Exhibitionists Disposition Total cases Probation Certified to Ontario Hospital Incarcerated Fine Charge dismissed Not known

Homosexuals

Pedophiles

AC. Total Het. Ho. Und. Total

Total

A.

C.

47 28

11 8

6 4

1 0

18 12

10 5

8 5

3 2

21 12

8 4

5 4 3 1 6

1 0 1 0 1

0 0 0 1 1

0 1 0 0 0

1 1 1 1 2

1 1 0 0 3

0 2 1 0 0

1 0 0 0 0

2 3 1 0 3

2 0 1 0 1

A3. TOTAL INTAKE, COURT REFERRALS, AND STUDY GROUP; YEAR OF INTAKE Total intake

Court referrals

Year

No. of months

Total

Mean per month

Total 1956 1957 1958 1959

40 9 12 12 7

645 121 191 179 154

16.1 13.4 15.9 14 .9 22.0

Study group

No.

%

Mean per month

371 86 106 102

(58) (71) (56) (57) (50)

9.3 9.6 8.7 8.5 11.0

77

No.

%

Mean per month

123 20 47 41 15

(33) (23) (44) (40) (20)

3.1 2.2 3.9 3 .4 2.1

A4. RESIDENCE AT TIME OF REFERRAL

Exhibitionists Residence Total City of Toronto Suburbs Metro Toronto Outside Metro Toronto

(64) (60) (76) (68) (44)

Homosexuals

n

% treated

n

% treated

n

% treated

54 (100%) 21 (39) 27 (50) 48 (89) 6 (11)

67

55 (100%) 26 (47) 20 (37) 46

62

65

9 (16)

33

23 (100%) 13 (57) 7 (30) 20 (87) 3 (13)

Total Treated n % 132 (100%) 60 (45) 54 (41) 114 (86) 18 (14)

Pedophiles

61 74 69 50

(84)

58 80 65

62 71 65 67

176 /

PEDOPHILIA AND EXIIlBITIONISM

AS. RESIDENCE WITHIN METROPOLITAN TORONTO Population (in thousands) n % Total 1441 City of Toronto 653 Centre East West North Suburbs 788 York Township 123 East York 67 Leaside 16 Scarborough 186 North York 228 Etobicoke 135 15 Mimico Weston 9 Swansea 9

100 45

55

n

Total

%

114 60 23 12 12 13 54 4 4 1 20 14 2

100 53

Exhibitionists Pedophiles Homosexuals n % n % n % 48 21 6

100 44

27

56

46 26

9

100 65

44

7 0 1 I 2 I 0

35

6

3 1 0

20 1

2 0 7 5 1 1 2 1

11

8

1 2

4 3 2

20 13

7 4

5 6 4

47

100 56

1 0

8 0 2 3

1 0

1

A6. CHARGES AT TIME OF REFERRAL Charge

n

Total

Total 132 Indecent exposure36 Indecent act 9 Indecent assault 27 Gross indecency 12 Contributing to juv. delinquency 45 Other 3

%

(100) (27) (7) (20) (10) (34) (2)

Treated

%

(64) (61)

(71)

(59) (67) (71)

(33)

Exhibitionists Pedophiles Homosexuals n n n 54 31 7 2 0

55 2 I 21 1

23 3 1 4 11

13 1

29 1

3 1

A7. TIME SPAN BETWEEN OFFENCE AT REFERRAL AND FOLLOW-UP

Total Number Mean years Range

132 2.8 1.2-5.2

Exhibitionists Pedophiles Homosexuals Treatment group Total Treated Total Treated Total Treated 85 2 .7 1.1-5 . 2

54 36 2.7 2.7 1.1- 1.14 . 2 4.1

55 2 .8 1.25.2

34 2 .8 1.85 .2

23 3 .0 1.34 .0

15 2.7 1.24.0

AS. CRIMINAL RECORDS BEFORE, DURING AND AFTER CONTACT WITH THE CLINIC (TOTAL GROUP) Actual total Sex. off. ch. p.

Total

Exhibitionists

0th. off. Sex. off. 0th. off. Sex. off. 0th. off. ch. p. ch. p. ch. p. ch. p. ch. p.

Pedophiles Sex. off. 0th. off. p. ch. p. ch .

clinic 2. More than one offence previous to clinic 3. TOTAL

5. 6. 7.

Sex. off. p. ch.

19 40 40 0 0 0 0 37 37 0 0 96 90 90 0 0 96 (83%) (73%) (69%) (73%) (73%) 4 15 32 (6) 11 17 80 (9) 32 36 124 (18) 64 33 110 (16) 42 (17%) (27%) (21%) (27%) (27%) 23 72 (6) 11 55 123 200 (16) 42 132 220 (18) 64 54 117 (9) 32 (100%) (100%) (100%) (100%) (100%) 1 2 0 0 2 19 0 0 7 24 0 0 10 20 0 0 8 Offences during contact (4%) (4%) (13%) (8%) (7%) 0 10 (2) 2 6 5 18 (10) 15 8 (5) 9 10 16 (10) 15 11 Offences after contact (11%) (9%) (8%) (8%) 12 (2) 2 1 7 27 (5) 9 11 19 42 (10) 15 17 36 (10) 15 TOTAL* (4%) (13%) (20%) (14%) (14%) p. p. 8 (15%) p.14 (26%) p. 26 (20%) p. 24 (20%) Combined offences during ch. ch.14 ch. 36 ch.57 ch. 51 and after contact

1. One offence previous to

4.

Homosexuals

*NOTE: In some cases a patient is included in both items 4 and 5 but only counted once in the total, item 6.

19

0th. off. p. ch. 0

0

12

(3) 21

31

(3) 21

3

0

0

0

(3)

4

3

(3)

4

4 (17%) 7

A9. CRIMINAL RECORDS BEFORE, DURING AND AFTER CONTACT WITH THE CLINIC (TREATMENT GROUP) Actual total Sex. off. p. 1. One offence previous to clinic 2. More than one offence previous to clinic 3. TOTAL 4. 5. 6. 7.

ch.

Total

0th. off. Sex. off. p.

ch.

p.

ch.

Exhibitionists

0th. off. p.

ch.

Sex. off. p.

ch.

0th. off. p.

ch.

Pedophiles Sex. off. p.

ch.

Homosexuals

0th. off. p.

ch.

53 53 22 0 22 0 58 58 24 0 0 0 24 0 0 (69%) (68%) (61%) (71%) 24 94 (11) 36 27 108 (13) 59 14 10 22 (4) 75 (7) 30 (31%) (32%) (39%) (29%) 147 (11) 36 77 85 166 (13) 59 36 97 (7) 30 34 46 (4) (100%) (100%) (100%) (100%) Offences during contact 8 20 0 0 10 24 0 0 7 2 19 0 0 2 0 (10%) (12%) (19%) (6%) Offences after contact (5) (5) 5 9 4 (3) 6 8 6 11 8 3 3 7 (1) (6%) (7%) (8%) (9%) TOTAL* (5) 12 (5) 29 14 35 23 (3) 6 8 4 8 9 9 (1) (14%) (25%) 16(%) (12%) Combined offences during p. 16 (21%) p.18 (21%) p. 11 (31 %) p.11 (31%) and after contact ch.37 ch.43 ch.29 ch. 10

Sex. off. p.

0th. off.

ch.

p.

ch.

12 12 (80%) 3 11 9 (20%) 15 23 9 (100%) 0 1 3 (7%) 1 0 0

0

0

0

1

*NOTE: In some cases a patient is included in both items 4 and 5 but only counted once in the total, item 6.

(2) 20 (2) 20 0

0

(1)

1

1 3 (1) 1 (7%) p. 2 (13%) ch. 4

APPENDIX A

/

179

AlO. LENGTH OF TREATMENT

Total Number of cases 85 Mean length in months 12. 2 O. 5-50. 3 Range

Exhibitionists

Pedophiles

Homosexuals

36 12 . 6 1.4-50.3

34 13 . 0 0.5-47.7

15 11.3 0.8-37.5

Pedophiles

Homosexuals

All. THERAPY SESSIONS Total

Sessions with patient Physician Social worker Psychologist TOTAL individual sessions Group Collateral sessions Physician Social worker Psychologist TOTAL Group All sessions combined

Exhibitionists

n

Mean no. of sessions

12.3 2.3 1.5 15.2

36 31 34 (36)

27

36.4

14 19 1 (85) 5 (85)

2.2 6 .4 1.0 1.8 54.1 31.9

n

Mean no. of sessions

85 66 69 (85)

n

Mean no. of sessions

n

Mean no. of sessions

10.9 1.8 1.5 13.9

34 20 20 (34)

12.4 3.9 1. 7 15.6

15 15 15 (15)

15.2 1.1 1.3 17.6

14

41.2

7

34.6

6

27.5

6 9 1 (36) 4 (36)

2.3 7.7 1.0 2.4 54.7 38.4

8 10 0 (34) 0 (34)

2.1 5 .2 0 2.0 0 24 . 7

0 0 0 (15) 1 (15)

0 0 0 0 58 32.5

Appendix B

PERSONAL AND SOCIAL DATA

1. Comparison of Age of Patients at Intake. (a) Study Population. ( b) Non-Court Referrals (Control). 2. Comparison of I.Q.s of Patients 3. Comparison of Educational Achievements. (a) Final Grades. ( b) Final Grades and I.Q.s. 4. Comparison of Occupations and Judgment of Work Record. (a) Occupations. ( b) Percentage Distribution of Occupational Groups. ( c) Judgment of Work Records. 5. Comparison of Interests of Patients.

APPENDIX B /

Bl (a)

181

COMPARISON OF AGE OF PATIENTS AT INTAKE : STUDY POPULATION

.,.

- - Exhibitionists •·········· Pedophiles

35

- - - - Homosexuals

30 25 20

..-····•.... r--, ' '

15

.....,,,-----,,,-/·,.....·--..

10 5

.... .._/

... ··- ....... •··~~~-:.·_ -, -.,_ '• .. ~,,.~

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69

Fig, 10.

n

Mean Median Range -19 20-29 30-39 40-49 50-59 60-69 70 plus

Total

Exhibitionists

Pedophiles

132(100%) 32.1 28

54(100%) 27.2 25

55(100%) 36.4 35

23(100%) 33.6 29

n %

n %

n %

n %

19 54 25 17 11 4 2

(14) (41) (19) (13) (8) (3) (2)

7 33 8 4 1 1 0

(13) (61) (15) (7) (2) (2)

10 11 14 7 8 3 2

(18) (20) (25) (13) (14) (6) (4)

Homosexuals

2 10 3 6 2 0

(9) (43) (13) (26) (9)

182 /

PEDOPHILIA AND EXIDBITIONISM

Bl ( b)

COMPARISON OF AGE OF PATIENTS AT INTAKE: NoN-CouRT REFERRALS ( CONTROL)

%

- - Exhibitionists

35

··· · ····· Pedophiles

30

-- -- Homosexuals

25 20 15 10

'

--·' ,...' -- ___,;;-:-..· --

5

15-19 20-24 25-29 30~4 35-3940-4445-49 5),64 55-59 60-64 65-69

Fig. 11

Total Range -19 20-29 30-39 40-49 50-59 60-69

Total n %

Exhibitionists n %

Pedophiles n %

Homosexuals n %

138 (100)

31 (100)

22 (100)

85 (100)

5 (16) 16 (52) 8 (26) (6) 2 0 0

4 (18) 1 (55) (5) 11 4 (18) (5) 1 1 (5)

9 (11) 38 (45) 31 (37) (7) 6 (1) 1 0

18 55 50 12 2 1

(13) (40) (37) (10) (2) (1)

APPENDIX B /

B2.

COMPARISON OF

1.Q.s. OF

183

PATIENTS

- - Exhibitionists ········· Pedophilts(lunder I.Q.60) ---- Homosexuals

-- --,\ \ \

\

\

\ \

I.Q. 60-69

70-79

\

''

''

'

80-89 90-109 110-119 120-129 130-139 140-149 150-plus

Fig. 12. The comparison is based on a percentage distribution, range 90-109 adjusted to one-half of its actual percentage.

Total n Mean Verbal Performance Full Scale Range -69 70-89 90-109 110-129 130 plus

113

47

103.2 102.7 103.2

n 1 20 55 30 7

Exhibitionists Pedophiles Homosexuals

% (1)

(18) (4!)) (26) (6)

47

103.2 103 .5 103.6

n 0 6 25 13 3

% (0) (13) (53) (29) (6)

19

99.0 97.4 98.4

n 1 13 22 11 0

% (2) (28) (47) (23) (0)

112.7 113 .5 113. 7

n 0 1 8 6 4

% (0) (5) (42) (32) (21)

Norm 2.2 22.8 50.0 22 .8 2 .2

184 /

PEDOPHILIA AND EXIIlBITIONISM

B3. COMPARISON OF EDUCATIONAL ACHIEVEMENTS (a) Final Grades

Total

Exhibitionists

Pedophiles

Homosexuals

129

54

53

22

8.9

8.7

8.6

10.5

n Mean final grade Final grade -7 8-10 11 plus

n 35 64 30

(b) Final Grades and l.Q.s Final grade -7 8-10 11 plus

n 15 31 8

%

(27) (50) (23) Total

n 15 28

%

(28) (57) (15)

10

Exhibitionists

I.Q. range

Grade

I.Q.

-89 90-109 llOplus

27 50 23

18 49 32

n

%

(28) (53) (19)

5 5

12

Pedophiles

Percentage distribution Grade 1.Q. Grade 1.Q. 28 57 15

13 53 34

28 53 19

30 47 23

%

(23) (23) (54)

Homosexuals Grade 23 23

54

I.Q. 5

42 51

I

APPENDIXB

185

B4. COMPARISON OF OCCUPATIONS AND JUDGMENT OF WORK RECORDS (a) Occupations

Occupations Student TOTAL Professions TOTAL TOTAL Business Managerial, owner Accounting, book-keeping Clerical Sales Storekeeper, clerk Trades TOTAL Engineering, mechanics, plumbing, etc. Printing, painting, dyeing Building trades Upholsterer, furrier Barber Photographer Semi-skitied occupations TOTAL Assembly, shipping, store-keeping Commercial driving Construction Gardening Unskilled Labour TOTAL Labourer, farmhand, etc. Service TOTAL Maintenance, cook, waiter, orderly, etc. Armed Forces TOTAL

Total

Exhibitionists

Pedophiles

Homosexuals

Dominant Other

Dominant Other

Dominant Other

Dominant Other

10 6 28 5

2 22 8 2 3 4 5

5 0 9

11

5

5 2 9 2

0 6 3

4 10 2

2 5 0

2 0 2 2 6

2 2 0 3 10

0 1 1 1 4

2 5 1 0 3

0 2 1 2

0

1

5 7 6 5 36

11

1 0 5 2 23

20

4

11

2

7

2

2

0

7 2 3 3

1

6 1 0 0 0

6 2 3 1 0

4 0 0 0 0

1 0 0 1

1

2 0 0 0 0

0 0 0 1 0

0 1 0 0 0

23

22

9

5

11

15

3

2

11

11

6 3 0 0

3 2 0 0

4 2 2 3

7 6 1

1

1 1 0 0

7 2 3

9 1 1

12

4

6

8

11

17

7

2 2

2 6

(b) Percentage Distribution of Occupational Groups Total Exhibitionists Occupational Groups % % Student Professions Business Trades Semi-skilled occupations Unskilled labour Service occupations Armed forces TOTAL

1

1

2 0 0

1

3 8

3 9

3 2

1 1

Pedophiles %

Homosexuals %

8 5 21 27

9 0 17 43

9 4 16 18

0 17 43 13

17 9 5 8 132= 100%

17 7 4 4 54= 100%

20 13 5 15 55= 100%

13 4 4 4 23= 100% (continued)

186 /

PEDOPHILIA AND EXIIlBITIONISM

B4. (Continued)

(c) Judgment of Work Records Total n Judgment % Good Undetermined Poor TOTAL

72 34 26 132

(54) (26) (19) (100)

Exhibitionists n % 33 11

10 54

(61) (20) (19) (100)

Pedophiles n % 27 18 10 55

(49) (33) (18) (100)

Homosexuals n % 12 5 6 23

(52) (22) (26) (100)

B5. COMPARISON OF INTERESTS OF PATIENTS Interests

Sports TOTAL Unspecified Cars, boats, 'planes Boxing, Judo, weightlifting Swimming Fishing, hunting out of doors Cycling, skating, skiing Team-sports, soccer, baseball, etc. House and TOTAL Garden Gardening, farming Do-it-yourself Cooking Hobbies and Games Games (chess, cards, etc) Collections (stamps, coins) Photography Model building Artistic and Intellectual TOTAL Books, writing Music Painting Social Interests TOTAL Youth work Church work Adult clubs No interests *n

Total n* %t 54 10 11

(50)

Exhibitionists n % 28 3 4

(65)

Pedophiles n % 17 4 6

(40)

Homosexuals n %

9 8

6 7

0

1

2 1

6

3

3

0

6

3

2

1

4

2

1

1

20 11

(19)

1

(14)

12 8 4 0

(28)

2 2 0 0

(10)

(5)

4

(9)

5

(24)

4 1

8 1

11

6

(11)

2

4

0

1

3

3 3 1

0 2 0

2 0

1 1 0

33 15 13 5 17 9 4 4 19

(31)

(16)

(18)

= number of times item stated

t% = percentage of informants

11

3 7 1 2 0 2 0 8

(43)

9 3 1

1

(25)

(15)

(19)

9 4 3 2 13 8 2 3 9

(21)

13 8 3

(30)

2 1 0 1 2

(21)

(62) 2 (10)

(10)

Appendix C

BACKGROUND DATA

1. (a) ( b) 2. (a) ( b) ( c) 3. (a)

4. 5. 6.

7. 8.

Comparison of Absence of Parents from Home. Comparison of Relationships with Parents. Comparison of Siblings. Comparison of Birth Order. Comparison of Male/ Female Sibling Ratios. Comparison of Marital Status. ( b) Comparison of Adult Heterosexual Relations of Single Patients. ( c) Comparison of Age at Time of Marriage. ( d) Comparison of Length of Marriage at Time of Referral or Separation. Comparison of Number of Children in Families. Comparison of Country of Birth. (a) Comparison of Religious Affiliations. ( b) Comparison of Participation in Church. Comparison of History of Physical Conditions as Stated by Patients. Psychiatric Diagnosis. ( Other than Sexual Deviation.)

188 /

PEDOPHILIA AND EXIDBITIONISM

Cl(a) COMPARISON OF ABSENCE OF PARENTS FROM HOME

n

Fathers n

Separations Death Military service TOTAL

Mothers n

Separations Death Military service TOTAL

Total

%

Exhibitionists

n

%

118 10 17 6 33

(100) (8) (15) (5) (28)

45 6 6 3 15

(100)

120 4 8 0 12

(100) (3) (7) (0) (10)

47 2 2 0 4

(100)

(33)

(9)

Pedophiles

n

%

51 4 8 3 15

(100)

51 2 3 0 5

(100)

(29)

(10)

Homosexuals

n

%

22 0 3 0 3

(100)

22 0 3 0 3

(100)

(14)

(14)

(b) COMPARISON OF RELATIONSHIPS WITH PARENTS

n

Fathers n

Distant Close Positive Negative Ambivalent

Mothers n

Distant Close Positive Negative Ambivalent

Total

%

Exhibitionists

n

%

Pedophiles

n

%

Homosexuals

n

%

110 46 17

(100) (41) (15)

43 19 9

(100) (44) (20)

45 11 5

(100) (24) (9)

22 16 3

(100) (73) (14)

26 34 12

(23) (30) (11)

10 14 6

(23) (33) (94)

10 14 3

(22) (31) (7)

6 6 3

(27) (27) (14)

106 16 48

(100) (15) (45)

37 3 17

(100) (8) (45)

47 8 21

(100) (17) (45)

22 5 10

(100) (23) (45)

46 14 29

(43) (13) (27)

16 7 14

(42) (18) (37)

16 7 12

(34) (15) (26)

14 0 3

(64) 0 (14)

APPENDIXC /

189

C2 (a) COMPARISON OF SIBLINGS

Total number of siblings Mean Number of children in family 1 2 3 4 5 6 7 8 9 10 Over 10

Total n 120

Exhibitionists n 51

Pedophiles n 49

Homosexuals n 20

488 4

193 3.8

207 4.2

88 4.4

19 24 22 14 16 5 6 3 3 5 3

6 9 12 9 6 2 4 1 1 1 0

10 8 7 5 7 2 2 2 1 3 2

3 7 3 0 3 1 0 0 1 1 1

(b) COMPARISON OF BIRTH ORDER

n 120 Only child Only son Both n excluding only children Oldest child Youngest child Oldest son Youngest son

Total

%

(100)

Exhibitionists n % (100) 51

Pedophiles n % (100) 49

Homosexuals n % 20 (100)

19 22 41

(16) (18) (34)

6 8 14

(12) (16) (28)

10 6 16

(20) (13) (33)

3 8 11

(15) (40) (55)

101 34 22 48 47

(100) (34) (22) (48) (47)

45 16 10 21 21

(100) (31) (20) (41) (41)

39 12 8 16 16

(100) (31) (21) (41) (41)

17 6 4 11 10

(100) (35) (24) (65) (59)

(c) COMPARISON OF MALE-FEMALE SIBLING RATIOS

n n (excluding only children) Total number of siblings All male siblings All female siblings Number of brothers Number of sisters Have brothers only Have sisters only Have brother and sister

Total

%

101

Exhibitionists n % 45

Pedophiles n %

Homosexuals n %

39

17

469 300 169 199 169 25 22

(64) (36) (54) (46) (25) (22)

187 136 51 91 51 17 8

(73) (27) (64) (36) (38) (18)

197 118 79 79 79 5 6

(60) {40) (50) (50) (13) (15)

85 46 39 29 39 3 8

(54) (46) (43) (57) (18) (47)

54

(53)

20

(44)

28

(72)

6

(35)

190 /

PEDOPHILIA AND EXIDBITIONISM

C3 (a) COMPARISON OF MARITAL STATUS Exhibitionists n %

Total

n

%

132 n -20 25 21 and over 107 Single 32 Total (married and separated) 75

54

55 11 44 12

12 42 9

(Im) (100) (21)

(70) (100) (72)

33

32

27

(79) (100) (82)

(28)

6

(18)

(100) (30)

Married common law 54 Separated, divorced, widowed 21

Pedophiles n %

Homosexuals n % 23 2 21 11

(100) (27)

(52)

10

22

(73) (100) (69)

5

(48) (100) (50)

10

(31)

5

(50)

(b) COMPARISON OF ADULT HETEROSEXUAL RELATIONS OF SINGLE PATIENTS

Total

n n None Sporadic More than sporadic Not known

Exhibitionists n %

%

(100) (58) (32) (10)

50 29 16 5 7

Pedophiles n %

(100) (61) (22) (17)

18 11 4 3 3

19 12 5 2 4

Homosexuals n %

(100) (63) (26) (11)

13 6 7 0 0

(100) (46) (54) (0)

(c) COMPARISON OF AGE AT TIME OF MARRIAGE

Total

n n Age -19 20-21 22-23 24-25 26-27 28-29 30+ Not known

%

Exhibitionists n

Pedophiles n

Homosexuals n

66

(100)

29

29

8

6 9 17 8 9 5 12 10

(9) (14) (26) (12) (14) (8) (18)

3 6 9 4 3 2 2 5

2 3 4 3 6 3 8 3

1 0 4 1 0 0 2 2

(d) COMPARISON OF LENGTH OF MARRIAGE AT TIME OF REFERRAL OR SEPARATION Total Sep. Marr.

n Length - 1 yr. 2- 3 " 4- 5 " 6-10 " 10-20 " 21+ Not known

.

Exhibitionists Sep. Marr.

Pedophiles Marr. Sep.

Homosexuals Marr. Sep.

48

20

24

6

19

10

5

4

8 8 7 11 7 7 7

5 5 2 5 1 2

8 5 4 4 3 0 4

2 0 1 3 0 0 0

0 2 3 4 3 7 3

1 3 1 2

0 1 0 3

2 0

0 0

2 2 0 0 0 0

1

1

1

1

APPENDIX

c /

191

C4. COMPARISON OF NUMBER OF CHILDREN IN FAMILIES n

Married patients 76 Patients with children 46 Number of children 105 Mean no. of children 2 .3

Total % (100) (61)

Exhibitionists n % 34 19 37 1.9

(100) (56)

Pedohphiles n % 32 22 58 1.8

(100) (68)

Homosexuals n % 10 5

10

(100) (50)

1.0

C5. COMPARISON OF COUNTRY OF BIRTH Total %

n n Canada Great Britain Ireland South Africa U.S.A. Holland Denmark Switzerland Germany Italy Malta Macedonia Latvia Ukraine

126 89 17 4 2 2 2 l l l

3 1 1 1 1

(100)

(71)

(13) (3)

Exhibitionists n % 50 32 5

l l l l 1 l

0 3 1 1 1 1

(100) (64)

Pedophiles n % 53 39 9 3 0 0 l

0 0 1 0 0 0 0 0

(100)

(73)

Homosexuals n % 23 18 3 0

(100) (78)

l l

0 0 0 0 0 0 0 0 0

1951 Census, City of Toronto: Males born in Canada 67%; United Kingdom 15%.

192

I

PEDOPHILIA AND EXIDBITIONISM

C6 (a) COMPARISON OF RELIGIOUS AFFILIATIONS General population

n Roman Catholic Anglican United Church Presbyterian Baptist Lutheran Salvation Army Pentecostal Gospel Hall Jehovah's Witness Church of Christ Christian Science Greek Orthodox Hebrew Protestant

Total

%

n

(100) (20) (25) (23) (10) (4) (2)

117 25 25 17 10 8 3 8 3 2 1 1 1 1 2 10

%

(100) (21) (21) (15) (9) (7) (3) (7) (3)

(9)

Exhibitionists Pedophiles Homosexuals n n n % % % 47 12 11

7 2 2 3 1 3 0 1 1 0 1 0 3

(100) (25) (23) (15) (4) (4) (6)

50 10 10 6 7 5 0 5 0 2 0 0 1 0 1 3

(100) (20) (20) (12) (16) (10)

20 3 4 4 1 1 0 2 0 0 0 0 0 0 1 4

(100) (15) (20) (20)

(b) COMPARISON OF PARTICIPATION IN CHURCH

n n Practising Non-practising Not known

93 56 37 24

Total

%

(100) (65) (35)

Exhibitionists n % 33 19 14 14

(100) (58) (42)

Pedophiles n % 42 27 15 8

(100) (64) (36)

Homosexuals n % 18 10 8 2

(100) (56) (44)

I 193

APPENDIXC

C7. COMPARISON OF HISTORY OF PHYSICAL CONDITIONS AS STATED BY PATIENTS

n n Never ill Had condition Total of conditions Headache Nervous tension Dizzy spells Seizures Other neurological conditions TOTAL V.D. Other genital conditions Enuresis TOTAL Gastro-intestintal Respiratory Accidents Other

cs.

98 28 70 92 9

Total

%

(100) (29) (71) (100)

11

5 4

8 37 4

6 3 13 6 4 15 17

(40)

(14)

Exhibitionists n % 34 13 21 28 3 3 0 1 2 9 2 1 1 4

(100) (38) (62) (100)

49 6 43 57 6 8 5 2 5 26 2

(32)

5 2 9 4 3 6 9

(14)

1

1 7 6

(100) (22) (88) (100)

Homosexuals n % (100) (60) (40) (100)

15 9 6 7 0 0 0

1

1 2 0

(46)

(29)

0 0 0 1 0 2 2

(15)

(0)

PSYCHIATRIC DIAGNOSIS (OTHER THAN SEXUAL DEVIATION) Total n %

n

132 14 n 118 (100) Diagnosed other than sexual deviation 42 (33) International list Diagnosis 46 (100) 000.0 Organic changes 2 300.0 Simple schizophrenia 1 Latent schizophrenia 1 300.5 314 Neurotic depression 1 318.5 1 Psychoneurosis 320.2 Cyclothymic personality 2 (87) 320.3 Inadequate personality 5 320.4 Antisocial personality 1 321.0 Emotional instability 4 321.1 Immature personality 14 322.2 Alcoholism 2 324.2 Conduct disturbance 2 325.2 Mental deficiency moron 3 325.3 Mental deficiency borderline 4 326.3 Acute situation maladjustment 2 326.5 Adjustment reaction to late life 1 No diagnosis

Pedophiles n %

Exhibitionists n %

HomoPedophiles sexuals n % n %

55 7 47 (100) 15 (32)

54 6 49 (100) 20 (41)

23 1 22 (100) 7 (32)

16 (100)

23 (100) 0 0

1

7 (100) 1 1 0 0 0 0 (71) 1 0 1 2 0 0 0 0

1

0

1

0

1

0

1

0 0 0

1

1

1 2 0 0 5 0 1 1 3

(88)

1 0 1 2

1

3 7 2 1 2

(91)

Bibliography

A. STUDIES FREQUENTLY CITED IN TEXT THE FORENSIC CLINIC STUDY (short form) MOHR, J. W. A Follow-up of Sexual Offenders referred to the Forensic Out-Patient Clinic. Part I, Documentary Follow-up, September, 1960. Part II, Analysis of Case Records : First Section, February, 1961; Second Section, November, 1961. Unpublished manuscript. Toronto Psychiatric Hospital, Forensic Clinic. BALL, J. R. B. Personal Follow-up Study. Unpublished manuscript. Toronto Psychiatric Hospital, Forensic Clinic, October, 1961. THE KINGSTON STUDY MOHR, J. W. A Short Survey of Sexual Offenders in Kingston Penitentiary. Unpublished manuscript. Toronto Psychiatric Hospital, Forensic Clinic, March, 1961. THE MILLBROOK STUDY MOHR, J. W. A Short Survey of Sexual Offenders in the Ontario Reform Institution, Millbrook. Unpublished manuscript. Toronto Psychiatric Hospital, Forensic Clinic, May, 1961. THE CALIFORNIA STUDY STATE OF CALIFORNIA, Department of Mental Hygiene, California sexual deviation research, January, 1953. STATE OF CALIFORNIA, Department of Mental Hygiene, California sexual deviation research, March, 1954. THE CAMBRIDGE STUDY RADZINOWICZ, L. Sexual offences. London : Macmillan, 1957. B. REFERENCES: PEDOPHILIA K. The experiencing of sexual traumas as a form of sexual activity ( 1907). In Selected papers of .. . London: Hogarth Press, 1949. ABRAHAMSON, D. Study of 102 sex offenders at Sing Sing. Fed. Probat. 14: 26--32 ( 1950) . ALLEN, C. The sexual perversions and abnormalities. 2nd ed.; London: Oxford, 1949. - - A textbook of psychosexual disorders. London: Oxford, 1962. APFELBERG, B.; C. SUGAR; and A. Z. PFEFFER. A psychiatric study of 250 sex offenders. Amer. J. Psychiat. 100: 762-69 (1944) . BENDER, LAURETTA and A. BLAU. The reaction of children to sexual relations with adults. Amer. J. Orthopsychiat. 7: 500-518 ( 1937). ABRAHAM,

196 /

PEDOPHILIA AND EXHIBITIONISM

BENDER, LAURETTA and S. PASTER. Homosexual trends in children. Amer. /. Orthopsychiat. 11: 730-43 ( 1941). BENDER, LAURETTA and A. A. GRUGETT. A follow-up report on children who had a typical sexual experience. Amer. /. Orthopsychiat. 22: 825-37 (1952). BowMAN, K. M. The problem of the sex offender. Amer. J. Psychiat. 108: 250-57 (1951) . BowMAN, K. M. and BERNICE ENGLE. Review of scientific literature on sexual deviation. California sexual deviation research, California State Department of Mental Hygiene (January, 1953). BREMNER, J. Asexualization. New York: Macmillan, 1959. CALDER, W. The sexual offender. Brit. / . Delinqu. 6 : 26-40 ( 1955). CASSITY, J. H . Psychological considerations of pedophilia. Psychoanal. Rev. 14: 189-99 (1927) . CONN, J. H. Brief psychotherapy of the sex offender. ]. clin. Psychopath. 10: 347-72 (1949). CORMIER, B. M.; M. KENNEDY; and J. SANGOw1cz. Psychodynamics of father daughter incest. Can. Psychiat. Ass. J. 7 : 203-17 ( 1962). CORSINI, R. J. Psychodynamic treatment of a pedophile: The case of Manuel. Group Psychother. 4: 166-71 (1951). CuRVANT, B.; M. MELTZEN; and F. TARTAGLINO. An institutional program for committed sex deviants. Amer. J. Psychiat. 107: 190-94 (1950). CusHING, J. G. N. Psychopathology of sexual delinquency. J. din. Psychopath. 11 : 49-56 ( 1950) . CUTTER, F. Sexual psychopathy and psychological differences. Psychol. News Letter 9: 41-46 ( 1957). - - Psychological changes in sexual psychopaths. Psychol. News Letter 10: 322-29 (1959). - - Sexual psychopathy, an MMPI survey. Unpublished manuscript. Atascadero State Hospital Report. - - Sexual outlet and psychotherapy. Unpublished manuscript. Atascadero State Hospital Report. DAVIS, J. C. The child molestor-Fact and Fiction. Unpublished manuscript. Psychology Department, Florida State Hospital, Chattahoochee, Fla. ( 1962). DEWEY, GovERNOR T. E. Report on study of 102 sex offenders at Sing Sing Prison. Utica, N.Y.: State Hospitals Press, 1950. EARLANSON, 0. The scene of a sex offence as related to the residence of the offender. J. crim. Law & Criminal. 31: 339-42 ( 1940:-41). EAST, W. N. Sexual offenders. J. nerv. & ment. Dis. 103: 626-66 (1946). ELLIS, A. and R. BRANCALE. The psychology of sex offenders. Springfield, Ill.: Charles C. Thomas, 1956. ELLIS, H. Psychology of sex. London: Wm. Heinemann, 1933. FENICHEL, 0. The psychoanalytic theory of neurosis. New York: W. W. Norton, 1945. FREUD, S. An outline of psychoanalysis. New York: W.W. Norton, 1949. - - Three essays on the theory of sexuality. Transl. J. Strachey. London: Imago Public. Co., 1949. FRIEDMAN, P. Sexual deviations. In S. Arieti (ed.), American handbook of psychiatry, Vol. I. New York: Basic Books, 1959.

BIBLIOGRAPHY /

197

FRISBIE, LouISE. Treated sex offenders and what they did. Ment. Hygiene 43: 263-67 (1959) . FROSCH, J. and W. BROMBERG. The sex offender-A psychiatric study. Amer. J. Orthopsychiat. 9: 761-77 (1939) . GLOVER, B. Control of the sexual deviate. Fed. Probat. 24: 38-45 ( 1960). GLUECK, B. D., JR. Final report: Research pro;ect for the study and treatment of persons convicted of crimes involving sexual aberrations. New York: Department of Mental Hygiene, 1955. GRAY, K. G.; M. D. TucHTIE; J. D. ATCHESON; and R. E. TURNER. A symposium on the sex offender. Crim. Law Quart. 3: 443-72 ( 1961). GREGORY, I. Psychiatry biological and social. Philadelphia: W. B. Saunders, 1961. GRuNHUT, M.; R. SrnvERTS; and J. M . VAN BEMMELEN. Sexual crime today. The Hague: Martinus Nijhoff, 1960. GuTTMACHER, M. S. Sex offences, the problem, causes and prevention. New York: Norton, 1951. GuTTMACHER, M. S. and H. WEIHOFEN. Psychiatry and the law. New York: Norton, 1952. HADLEY, E. Comments on pedophilia. Med. Rec. 124: 157-66 (1926) . HAMMER, E. F. A comparison of H-T-P of rapists and pedophiles. J. prof. Tech . 18: 346-54 (1954). - - A comparison of H-T-P of rapists and pedophiles. III. J. clinc. Psycho[. 2: 67-69 ( 1955). - - A psychoanalytic hypothesis concerning sexual offenders. J. clin. exp. Psychopathol.18: 177-84 (1957). HARTMAN, V. Some observations of group psychotherapy with pedophiles. Canad. J. Correct. 3: 485-99 (1961) . HARTWELL, S. W. A citizen's handbook of sexual abnormalities. State of Michigan, 1950. HENDERSON, S. D. and R. D. GILLESPIE. A textbook of psychiatry, 9th ed., London: Oxford Medical Press, 1962. HENNINGER, J. M. The senile sex offender. Ment. Hygiene 23: 436-44 (1939). HIRSCHFELD, M. Sexual anomalies and perversions. London: Francis Alder, 1948. HOPPEL, CLARA. From the analysis of a case of pederastry. Internat. Zeitschr. f. Psychoanalyse ( 1925). KARPMAN, B. A case of pedophilia (legally rape) cured by Psychoanalysis. Psychoanal. Rev. 37: 235-76 (1950). --The sexual offender and his offences. New York: Julian Press, 1954. KINSEY, A. C.; W. B. POMEROY; and C. S. MARTIN. Sexual behaviour in the human male. Philadelphia: W . B. Saunders, 1948. KINSEY, A. C.; W. B. POMEROY; C. E. MARTIN; and P.H. GEBHART. Sexual behaviour in the human female. Philadelphia: W . B. Saunders, 1953. KIVISTO, P. Treatment of sex offenders in California. Ment. Hygiene 42 : 78-80 (1958) . KoPP, S. B. The character structure of sex offenders. Amer. J. Psychother. 16: 64-70 (1962) . KORZYBSKI, A. Science and sanity. 3rd ed., Lakeville, Conn.: International Non-Aristotelian Library Pub. Co. , 1948.

198 /

PEDOPHILIA AND EXHIBITIONISM

KRAFFT-EBING, R. VON. Psychopathia Sexualis. 12th ed., New York: Rebman, 1912. KuRLAND, M. L. Pedophilia erotica. J. nerv. & ment. Dis. 131 : 394-403 (1960) . LAFON, R. ; J. TRIVAS; J. L. FAURE; and R. PouGET. Victimology and criminology of debauchery of youth. Ann. Med. leg. 41: 97-106 (1960). LEPPMAN, F . Essential differences between sex offenders. J. crim. Law & C riminol. 32 : 366-80 ( 1941) . LINDMAN, F. T. and D. M. McINTYRE, JR. (ed.) The mentally disabled and the law. Chicago : University of Chicago Press, 1961. McRuER, J. C. Royal commission on the criminal law relating to criminal sexual psychopaths. Ottawa: The Queen's Printer and Controller of Stationery, 1958. MANGUS, A. H. Society and sexual deviation. California sexual deviation research, California State Department of Mental Hygiene (March, 1954). MAYER-GROSS, W.; W. SLATER; and M. ROTH. Clinical psychiatry. 2nd ed.; London: Cassell, 1960. MEWETT, A. W. Sexual offences in Canada. Crim. Law Quart. 2 : 21-36 (1959) . MILLIKEN, RHODA J. The sex offender's victim. Fed. Probat. 14: 22 (1950). MOHR, J. W. The contribution of research to the selection of appropriate alternatives for sexual offenders. Crim. Law Quart. 4: 317-28 (1962) . - - The pedophilias: Their clinical, social and legal implications. Canad. Psychiat. Assoc. 7: 255-60 (1962) . - - Phases in group treatment of immature adolescent offenders. Reporting Day Fall, 13-22 (1962). - - Terminology and nosology: A central problem in research of criminal phenomena. Can. J. Correct. 5: 229-35 (1963). - - A short survey of sexual offenders in the Ontario Reformatory Millbrook. Can. J. Correct. 5: 229-35 ( 1963) . MOHR, J. W.; R. E. TURNER; and R. B. BALL. Exhibitionism and pedophilia. Correct. Psychiat., and J. soc. Ther. 8: 172-86 ( 1962). NOYES, A. P. and L. C. KoLB. Modern clinical psychiatry. Philadelphia : W. B. Saunders, 1958. PLoscowE, M . Sex and the law. New York: Prentice-Hall, 1951. RADZINOWICZ, L. Sexual offences. London : Macmillan, 1957. RASMUSSEN, A. Die bedeutung, sexueller Attentate au£ Kinder unter vierzehn Jahren fuer die Entwicklung von Geisteskrankheiten und Character Anomalien. Acta Psych. et Neuro 3: 351 ( 1934) . REIFEN, D. Protection of children involved in sexual offences : A new method of investigation in Israel. J. crim. Law, Criminal. & police Sci. 49: 223-29 (1958). REVITCH, E. and ROSALEE WEISS. The pedophiliac offender. Dis. nerv. Syst. 23 : 73-78 (1962). RocHE, P. Q. Sexual deviation. Fed. Probat. 14: 2-11 (1950). RODGERS, R. S. Sex and the law in Canada. Ottawa: Policy Press, 1962. HusKIN, S. H. An analysis of sexual offenders among male psychiatric patients. Amer. J. Psychiat. 97: 955-68 ( 1941) .

BIBLIOGRAPHY

/

199

ScHURTZ, W. G. Interviewing the sex offenders' victims. J. crim. Law & Criminol. 50 : 448-52 (1960). SELLING, L. S. Endocrine glands and sex. Med. Records 147: 441-48 (1938). SHASKAN, D. One hundred sex offenders. Amer. J. Orthopsychiat. 9: 565-69 (1939). SocARIDES, C. W. Meaning and content of pedophiliac perversion. J. Amer. Psychoanal. Assoc. 7: 84-94 ( 1959). SPLANE, R. B. Helping the child who is a victim of sexual offences. Canad. Welfare 36: 272-73 (1960). STATE OF CALIFORNIA, Department of Mental Hygiene, California sexual deviation research (January, 1953). STATE OF CALIFORNIA, Department of Mental Hygiene, California sexual deviation research (March, 1954). STEVENSON, I. and J. WOLPE. Recovery from sexual deviations through over-coming non-sexual neurotic responses. Amer. J. Psychiat. 116: 737-42 (1960). STOKES, R. E. A review of Pedophilia. Part I and Part II. Unpublished manuscript, Toronto Psychiatric Hospital, Forensic Clinic Seminar ( October, 1961). SriiRUP, G. K. The management and treatment of psychopaths in a special institution in Denmark. Proceed. Roy. Soc. Med. 41: 765-68 (1948) . - - Sexual offenders and their treatment in Denmark and the other Scandinavian countries. Internat. Rev. Crim. Policy 1 ( 1953). - - Sex offences: The Scandinavian Experience. Law and contemporary problems. Duke University School of Law ( Spring, 1960). - - Correctional treatment and the criminal sexual offender. Canada . J. Correct. 3: 250-65 (1961). SUTHERLAND, E. H. The sexual psychopath laws. J. crim. Law 40: 543-54 (I 950) . TAPPAN, P. Sentences for sex criminals. J. crim. Law & Criminol. 42 : 332-37 (1951). - - Treatment of the sex offender in Denmark. Amer. J. Psychiat. 108: 241-49 (1951) . THOMSON, P. G. Sexual deviation. Can. Med. Ass. J. 80: 381-89 (1959). ToOBERT, S.; K. F. BARTELEME; and E. S. JoNES. Some factors related to pedophilia. Int. J. soc. Psychiat. 4: 272-79 ( 1959). TucHTIE, M. A review of pedophilia. Unpublished manuscript. Toronto Psychiatric Hospital, Forensic Clinic Seminar (October, 1957). TURNER, R. E. The Forensic Clinic, Toronto. Crim. Law Quart. 2: 437-47 (1960). WOLFGANG, M. E. Patterns in criminal homicide. Philadelphia: University of Pennsylvania Press, 1958. C. REFERENCES: EXHIBITIONISM ALLEN, C. The sexual perversions and abnormalities. 2nd ed.; London: Oxford Med. Pub., 1949. - - A textbook of psychosexual disorders. London: Oxford University Press, 1962.

200 /

PEDOPHILIA AND EXHIBITIONISM

APFELBERG, B.; C. SuGAR; and A. Z. PFEFFER. A psychiatric study of 250 sex offenders. Amer. ]. Psychiat. 100 : 762-69 (1944) . ARIEFF, A. J. and D. B. ROTMAN. One hundred cases of indecent exposure. ]. nerv. & ment. Dis. 96 : 523-29 (1942) . BEJKE, R. A. A contribution to the theory of exhibitionism. Acta Psychiat. et Neural. Scandinavia 80 : 233-43 (1952). BOND, I. C. and H . C. HUTCHISON. Application of reciprocal inhibition therapy to exhibitionism. Canad. Med. Assoc.]. 83 : 23-25 (1960). BOWLING, R. W. The sex offender and law enforcement. Fed. Probat. 14: 11 (1950). BowMAN, K. M. The problem of the sex offender. Amer. ]. Psychiat. 108: 250-57 (1951) . CAPRIO, F . S. Case report on scoptophilia and exhibitionism. J. clin. Psychopath. 10: 50-72 ( 1949). CHRISTOFFEL, H. Exhibitionism and exhibitionists. lnt. ]. Psychoar.11l. 17: 321-45 (1936). - - Male genital exhibitionism. In S. Lorand (ed.), Perversions: Psychodynamics and therapy. New York : Random House, 1956. CONN, J. H. Brief psychotherapy of the sex offender. ]. clin. Psychopath. 10: 347-72 (1949). CuRVANT, B. ; M. MELTZEN; and F . TARTAGLINO. An institutional programme for committed sex deviants. Amer. ]. Psychiat. 107: 190-94 ( 1950). EAST, W. N. Observations on exhibitionism. Lancet 23 : 370-75 ( 1924). - - Sexual offenders-a British view. Yale Law]. 55: 527-57 (1946). - - Sexual offenedrs. ]. nerv. & ment. Dis. 103: 626-66 (1946). ELLIS, A. and R. BRANCALE. The psychology of sex offenders. Springfield, Ill. : Charles C. Thomas, 1956. ELLIS, H . Psychology of sex. London : Wm. Heinemann, 1933. FLOCH, M. Treatment of a chronic case of exhibitionism. J. crim. Law & Criminal. 4 : 316-17 (1946). FRIEDMAN, P. Sexual deviation. In S. Arieti (ed.), American handbook of psychiatry, Vol. I. New York : Basic Books, 1959. FRISBIE, LouISE. Treated sex offenders and what they did. Ment. Hygiene 43: 263-67 ( 1959) . GRAY, K. G.; M. D. TuCHTIE; J. B. ATCHESON; and R. E. TURNER. A symposium on the sex offender. Crim. Law Quart. 3: 443-72 (1961). GuTTMACHER, M. S. and H. WEIHOFEN. Psychiatry and the law. New York: Norton, 1952. GUTTMANN, 0 . Exhibitionism: A contribution to sexual psychopathology on twelve cases of exhibitionism. J. clin. exp. Psychopath. 14: 13-51 (1953) . HENNINGER, J. M. Exhibitionism. J. crim. Psychopath. 2: 357-66 ( 1941). HrnNING, L. C. Indecent exposure and other sex offences. ]. clin. Psychopath. 7: 105-14 (1945) . - - Genital exhibitionism, an interpretive study. J. clin. Psychopath. 8: 557-64 ( 1947) . HIRSCHFELD, M. Sexual anomalies and perversions. London: Francis Alder, 1948. HousToN, E. P. Exhibitionism. Unpublished manuscript. Toronto Psychiatric Hospital, Forensic Clinic Seminar (December, 1960).

BIBLIOGRAPHY

/

201

B. The psychopathology of exhibitionism. Psychoanal. Rev. 13: 64-97 (1926) . - - The psychopathology of exhibitionism. J. clin. Psychopath. 9: 179-225 ( 1948). --The sexual offender and his offences. New York: Julian Press, 1954. KINSEY, A. C.; W. B. PoMEROY; and C. E. MARTIN. Sexual behaviour in the human male. Philadelphia: W. B. Saunders, 1948. KINSEY, A. C.; W. B. POMEROY; C. E. MARTIN; and P.H. GEBHART. Sexual behaviour in the human female . Philadelphia: W. B. Saunders, 1953. KOPP, S. B. The character structure of sex offenders. Amer. J. Psychother. 16: 64-70 ( 1962). KRAFFT-EBING, R. VON. Psychopathia sexualis. 12th ed.; New York : Rebman, 1912. LASEGUE, C. Les exhibitionistes. Paris, L'Union medicale 23: 703 (1877) . LEPPMANN, F. Essential differences between sex offenders. J. crim. Law & Criminal. 32: 336-80 ( 1941). MACLAY, D. T. The diagnosis and treatment of compensatory types of indecent exposure. Brit. ]. Delinqu. 3: 34-45 (1952). MoHR, J. W. The contribution of research to the selection of appropriate alternatives for sexual offenders. Crim. Law Quart. 4: 317-28 (1962). MOHR, J. W.; R. E. TURNER; and R. B. BALL. Exhibitionism and pedophilia. Correct. Psychiat., and]. soc. Ther. 8: 172-86 (1962). PAITICH, D. Exhibitionism: A comparative study. Unpublished manuscript. Toronto Psychiatric Hospital Journal Club ( March, 1957). - - Group psychotherapy with the wives of exhibitionists. Unpublished manuscript. Toronto Psychiatric Hospital, Forensic Clinic Seminar ( April, 1960) . - - Parent-child relations and sexual deviation. Paper read at Third Research Conference on Criminology and Delinquency (November, 1962). PECK, M. Report of a case of exhibitionism. Psychoanal. Rev. 11: 156-85 (1924). PLoscowE, M. Sex and the law. New York: Prentice-Hall, 1951. POLLOCK, C. B. R. A case of neurotic exhibitionism. Brit. J. Criminal. 1: 37-49 (1960). RADZINOWICZ, L. Sexual offences. London: Macmillan, 1957. RICKLES, N. K. Exhibitionism. J. nerv. & ment. Dis. 95: 11-17 (1942). - - Exhibitionism. Philadelphia : Lippencott, 1950. - - Exhibitionism. J. soc. Ther. 1: 168-81 ( 1955). RuBIN, J. Some preliminary observations of types of exhibitionists. Unpublished manuscript. Toronto Psychiatric Hospital Journal Club ( April, 1960). SHASKAN, D. One hundred sex offenders. Amer. J. Orthopsychiat. 9 : 565-69 (1939). SMITH, D. and E. GUTHRIE. Exhibitionism. J. abnorm. Psychol. 17: 206-09 (1922). SPERLING, MELITTA. The analysis of an exhibitionist. Int. J. Psychoanal. 28: 32-45 (1947). SPITZ, H. H. A clinical investigation of certain personality characteristics of twenty male exhibitionists. Disserta. Abstr. 16: 381-82 ( 1956). KARPMAN,

202 /

PEDOPHILIA AND EXHIBITIONISM

STURUP, G. K. Correctional treatment and the criminal sexual offender. Canad. J. Correct. 3: 250-65 (1961). TAYLOR, F. H. Observations on some cases of exhibitionism. J. Ment. Sci. 93: 631-38 (1947). THOMSON, P. G. Some observations on exhibitionism. Unpublished manuscript. Toronto Psychiatric Hospital Journal Club (March, 1957). - - Sexual deviation. Canad. Med. Assoc. J. 80: 381-89 (1959). TURNER, R. E. The group treatment of sexual deviations. Canad. J. Correct. 3 : 485-91 (1961) .

Index of Names

Abraham, K., 34 Abrahamson, D., 13 Allen, C., 7, 13, 120, 121 Apfelberg, B., 15, 41, 47, 89, 90, 120, 124, 129, 131, 154, 159-61 passim Arieff, A. J., 117, 119, 120, 124, 131, 136, 138, 141, 148, 149, 150, 152, 154, 160, 161 Atascadero Hospital, 24, 40, 41, 106; see also Fxisbie, L. Barteleme, K. F., see Toobert, S. Bejke, R. A., 129, 134, 142, 151, 159, 166 Bellevue Hospital, 15, 81; see also Apfelberg, B., Shaskan, D. Bemmelen, J. M. van, see Gri.inhut, M. Bender, L., 22, 34-36 Bond, I. C., 166 Bowling, R. W., 129 Bowman, K. M., 13, 36, 120, 154, 161 Brancale, R., 15, 46, 88-90 passim, 104, 128,154,155 Bremner, J., 98 Brixton Prison, 114; see also East, N. Bromberg, W., 13, 15, 41, 47, 55-57 passim, 88-90 passim Calder, W., 96 California Study, 15, 22, 24, 26, 27, 29, 32, 34, 46, 75, 78, 79, 81, 93 Cambridge Study, 29, 31, 33, 75, 77, 79, 81-83 passim, 104-106 passim, 117-19 passim, 123, 124, 129, 131, 133, 139, 152-55 passim, 169 Caprio, F. S., 124, 126, 129, 142, 145, 149,152,161,166 Cassity, J. H., 12, 13, 25, 47, 62, 66, 69, 73,96 Christoffel, H., 113, 119, 120, 126, 166 Conn,J.H.,41,97, 124,166 Cormier, B. M., 178 Curvant, B., 106, 124, 129 Cushing, J. G. N., 13, 106 Cutter, F., 92

Darwin, M., 78 Davis, J. C., 22, 30, 31, 36, 46, 48 Dewey, Governor T. E., 46, 77 Dutton, 93 East, W. N., 13, 106, 113-14, 118, 120, 124, 154, 155, 159, 160, 169 Ellis, A., 15, 46, 88-90 passim, 104, 118,154,155 Ellis, H., 4, 13, 112, 119, 120, 166 Engle, B., 13 Fenichel, 0., 13 Floch, M., 120, 126, 129 Freud, S., 12, 13, 121 Friedman, P., 14, 17 Frisbie, L., 15, 40, 81, 83, 106, 154 Frosch, J., 13, 15, 41, 47, 55-57 passim, 82, 88, 89, 90 Gebhart, P.H., see Kinsey, A. Gillespie, R. D., 14 Glover, B., 97 Glueck, B. 0., Jr., 14, 15, 17, 25, 48, 49, 51, 52, 54-62 passim, 64-66 passim, 10, 71, 73, 76-79 passim, 82, 88, 89, 91, 92, 98, 154 Grassland Hospital, 133; see also Hirning, L. C. Gray, K. G., 179 Gregory, I., 14, 90 Gri.inhut, M., 104-106 passim Guttmacher, M. S., 3, 9, 13, 75, 82, 90, 154 Guttman, 0 ., 113, 120, 124, 150, 154, 161, 162 Hadley, E., 12, 47, 66, 96 Hammer, E. F., 13, 15, 46, 47, 63, 81, 82,91 Hartman, V., 96, 97 Henderson, S. D., 14 Henninger, J. M., 124, 129, 131, 133, 138, 141, 148-50 passim, 159-62 passim

204 /

INDEX

Herstedvester Institutions, 106; see also Stiirup, G. K. Himing, L. C., 120, 124, 129, 133, 137-38, 142,145,148,159 Hirschfeld, M., 4, 13, 76, 112, 120 Hoppel, C., 13 Hutchison, H. C., 166 Jacks, I., 91 Jones, E. S., see Toobert, S. Karpman, B., 13, 14, 25, 62, 66, 69, 73, 96, 97, 112, 119, 120, 125, 126, 129, 142, 145, 159, 161, 162, 166 Kingston Study, 6, 80, 154 Kinsey, A. C., 3, 18, 26, 154 Kolb, L. C., 14 Kopp,S.B.,97, 120 Krafft-Ebing, R. von, 4, 12, 111-12 Kurland, M. L., 13, 47, 51, 62, 63, 66,

98

Lasegue, C., 111, 114, 117 Leppman, F., 13 Lindman, F. T., 101, 107 Maclay, D. T., 113, 151 Mangus, A. R., 77 Martin, C. S., see Kinsey, A. C. Mayer-Gross, W., 14 McIntyre, D. M., 101, 107 McRuer, J. C., 82, 107 Meltzen, M., see Currant, B. Mewett, A. W., 75 Millbrook Study, 7, 24, 40, 69, 80-82 passim New Jersey State Diagnostic Center, 15, 78, 105; see also Brancale, R., Ellis, A., and Revitch, E. Noyes, A. P., 14 Paitich, D., 141, 163, 167 Peck, M., 120, 125, 129, 134, 166 Pfeffer, A. Z., see Apfelberg, B. Piotrowski, Z. A., 91 Ploscowe, M., 75, 153 Pomeroy, W. B., see Kinsey, A. Pollock, C. B. R., 129, 142, 145, 150

Radzinowicz, L., see Cambridge Study Rais, Gilles de, 76 Rasmussen, A., 22, 35 Reifen, D., 37 Revitch, E., 15, 27, 30, 78, 88 Rickles, N. K., vii, 7, 111, 113, 120, 124, 126, 129, 134, 138, 139, 142, 150, 154, 161, 162, 166 Roche, P. Q., 13 Rodgers, R. S., 75 Roth, M., 14 Rotman, D. B., see Arieff, A. J. Rubin, J., 162 Ruskin, S. H., 88 San Quentin, 15, 40, 69, 70, 92; see also Toobert, S. Selling, L. S., 13 Shaskan, D., 15, 81, 154, 159 Sieverts, R., see Griinhut, M. Sing Sing Prison, 15, 47, 70, 73, 91; see also Abrahamson, D., Glueck, B. C., Dewey, Governor T. E. Slater, W., 14 Socarides, C. W., 13, 25, 47, 66, 96, 97 Sperling, M., 120, 124, 129, 134, 141, 142,145,149,159,166 Spitz, H. H., 113, 124, 129, 140-42 passim, 150,163,164 Stevenson, I., 14, 97 Stiirup, G. K., 83, 98, 106, 156 Sugar, C., see Apfelberg, B. Sutherland, E. H ., 76 Tappan, P., 75, 82, 98 Tartaglino, F., see Curvant, B. Taylor, F. H., 114, 117, 124, 148, 149, 154, 155, 159-61 passim Thomson, P. G., 166 Toobert, S., 15, 40, 48, 59, 70, 92-93 Weihofen, H., 3; see also Guttmacher, M.S. Weiss, R., 15, 27, 30, 78, 88 Wolfgang, M. E., 76 Wolpe, J., 14, 97