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player ready...One after another, Roman Catholic priests accused of sexually molesting children check into a handful of specialized hospitals around the country to confront a destructive disorder that science can control but not cure.
There, the new patients–an estimated 1,400 priests since 1985–begin a treatment regimen of five to seven months, in which doctors mix psychotherapy and medication in the hope of halting patterns of behavior that may originate deep in childhood trauma.
When they leave, many of the priests will not molest again. But some will.
Church leaders have placed their faith in an evolving and imperfect science of treating sexual abuse, but nevertheless are now reeling from waves of clerical sexual abuse scandals.
Research on sexual abuse, indeed, offers some hope, by helping doctors distinguish between abusers who may respond to treatment and those who likely will not. Experts are cautiously hopeful that new screening tests will permit identification of some priests who are dangerously attracted to children.
Yet the same research also is forcing the church to confront how celibacy and the privacy of the priesthood may contribute to abuse. High-profile relapses of priests who have been treated raise questions about the reliability of treatment regimens the church has imposed.
One essential point on which all sides agree–with broad implications for the church’s future handling of abusive priests–is that sexual offenders never can be truly cured.
“Today, just like alcoholism, we know you can’t cure [pedophilia], but you can successfully treat it,” said Dr. Fred Berlin, founder of the Johns Hopkins Sexual Disorders Clinic, who has treated hundreds of priests. “But just like an alcoholic who needs to avoid alcohol, a pedophile should not be put back in a situation where they are around children. That has been the major change in thinking.”
Abusers often were victims
Experts say child molesters often have experienced childhood traumas, such as neglect or physical and sexual abuse. They frequently have been awkward in social situations from a very young age and often abuse alcohol or drugs.
The experience of sex abuse at a young age can lead some victims to associate that kind of contact with sexual excitement throughout their lives, said Dr. Mark Schwartz, medical director of the Masters and Johnson Clinic in St. Louis. Schwartz said he has treated priests who have abused children as a way of re-enacting abuse that they suffered at the hands of another priest many years before.
Treatment of pedophilia among clergy also resembles programs for non-priests. A priest in a typical treatment program undergoes group and one-on-one therapy to come to grips with his disorder and may receive drugs such as anti-depressants or the synthetic hormone Depo-Provera.
Developed as a birth control drug for women, Depo-Provera is sometimes used to reduce the sex drives of male abusers by cutting their levels of testosterone. Yet while the drug can be useful as a stopgap measure, it cannot remove the roots of pedophilia or change an offender’s ingrained behavior patterns, said Schwartz.
5 main treatment centers
Eighty percent of U.S. priests treated for sexual disorders pass through one of five treatment centers: church-run facilities in Maryland, Pennsylvania, Missouri and Ontario, and one secular hospital in Connecticut, according to church figures. Patients at such centers are not usually permitted to leave unsupervised. They must consent to a five-year follow-up plan of counseling and return visits before being discharged, say church sex-abuse experts.
“What we provide is more like a retreat that includes psychological assistance,” said Rev. Peter Lechner, who heads the Servants of the Paraclete, a religious order that operates a treatment center near St. Louis.
Just how much medication and therapy actually prevents further abuse is debatable. A 10-year-old study by Johns Hopkins researchers found that fewer than 3 percent of pedophiles who abided by treatment and follow-up programs committed more abuse; that figure rose to 7 percent for those who dropped out of follow-up programs.
The repeat offense rate among all child molesters, including those who had no treatment at all, can be as high as 50 percent, said David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire. True pedophiles–those with a sexual attraction to pre-pubescent children–typically are more resistant to treatment than those who prey on adolescents, Finkelhor said.
Post-treatment placement
The issue of repeat offenders has deep implications for the church as it weighs what to do with abusive priests after treatment.
Dioceses have increasingly adopted policies that attempt to keep priests away from children after treatment for a sexual disorder.
But psychologist Gary Schoener, who has treated scores of clerical sexual abuse victims at his Walk-In Counseling Center in Minneapolis, said many troubled priests re-emerge in parishes without adequate supervision.
“The likelihood of [church officials] saying, `pull an abusive priest from the pulpit,’ is very low, and then the problem is whether there is anyone locally who is qualified to treat him? So who is going to supervise him?” said Schoener.
As newly disclosed cases in Boston, Michigan and elsewhere show some priests have, in fact, been reassigned to parish ministry after treatment for sexual disorders.
Some experts believe such sexual abuse may be connected in some cases to the psychology of celibacy, which can prevent normal sexual development.
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“If someone is afraid of sexual behavior, celibacy in the priesthood becomes quite attractive,” Schwartz said.
Among the gaps in the science of clerical sexual abuse, no one knows for sure the extent of the problem because the church and government do not track it. Church officials estimated that the 1,400 priests treated since the mid-1980s represent 2 percent of the 60,000 priests who served during that period.
But Richard Sipe, a psychotherapist and former priest, estimates the rate of abuse is up to three times that high.
Rev. Stephen Rossetti, a priest-psychologist who is one of the church’s leading experts on sexual disorders, said recently revealed cases of priests who continued to abuse after treatment should not reflect on the church’s overall approach to rehabilitation.
100% success rate unlikely
“Even with the best treatment, or the best supervision, you are never going to get 100 percent success,” he said. “So if three out of every 100 priests treated go on to relapse–and you meet one of those three–then it is a disaster.”
At least one hospital, however, is reassessing its handling of troubled priests.
For decades, the Institute of Living, a psychiatric hospital in Hartford, Conn., enjoyed a close and unique relationship with the Catholic Church, as the only major secular treatment center for sexually abusive priests.
After reviewing the cases of an undisclosed number of priests treated there, the hospital told the Hartford Courant that it now believes church officials have routinely “misconstrued” the hospital’s clinical findings in order to return abusive priests to ministry posts.
For the future, the church is holding out hope for psychological screening that could potentially weed out pedophiles. Most seminarians in the U.S. undergo inkblot tests of emotional function and church officials have tried other methods as well.
But psychologists agree the tests have limited value. Some disorders do not emerge until later, or unless under stress. And ultimately, they say, no test can reliably determine who will ignore impulses and who will act on them.