from Clinical/Therapeutic Issues
by Linda Ames NicolosiThe very fact that APA admits to holding a moral viewpoint on a psychological issue ought to have opened up a broad new challenge to psychology's authority as our culture's secular priesthood.
For many years now, psychology has been locked into a philosophical quandary. Exactly what is a "psychiatric disorder"? Many critics despair of ever devising a catalogue of mental illnesses which can be considered to represent science.
Exactly how puzzling this quandary actually is, will be illustrated in an upcoming issue of the Archives of Sexual Behavior.
The Archives is the official publication of the International Academy of Sex Research. That journal will feature a symposium with at least one prominent psychiatrist arguing that pedophilia is in fact (at least in some contexts) a disorder--while another prominent clinician says that it is not.
But if pedophilia isn't a mental disorder, then just what is? If any man who violates the innocence and integrity of a child can be judged to "have nothing psychologically wrong with him"...then has the public in fact broadly misunderstood psychology's scope and explanatory power?
History of the Diagnosis. In the DSM-III, the American Psychiatric Association contended that merely acting upon one's urges toward children was considered sufficient to generate a diagnosis of pedophilia. But then a few years later, in the DSM-IV, the APA changed its criteria so that a person who molested children was considered to have a psychiatric disorder only if his actions "caused clinically significant distress or impairment in social, occupational or other important areas of functioning." In other words, a man who molested children without remorse, and without experiencing significant impairment in his social and work relationships, could be diagnosed by a clinician as a "psychologically normal" type of pedophile.
Challenged by NARTH to defend the change, the APAstated categorically that it had, in fact, no intention of normalizing pedophilia. However, "man-boy love" advocates cheered that DSM shift as good news.
As a result of the provocative Rind study's appearance in an APA journal, the American Psychological Association was struck with an embarrassing wave of criticism--what it called "the political storm of the century." That public-relations nightmare hit "with gale-force winds raging from the media, congressional leaders, state legislatures, and conservative grassroots organizations," according to the Association's journal, The American Psychologist.
The APA apologized for the study --- following later with another statement which sounded like backpedaling (with the Association insisting that researchers have a right to scientific freedom). Then it issued a new and quite surprising official statement.
APA said that no matter what the research showed about the psychological effects of pedophile relationships-- pedophilia remained, in its opinion, "morally" wrong.
The very fact that APA admitted to holding a moral viewpoint on a psychological issue ought to have opened up a broad new challenge to psychology's authority and its presumptions as our culture's arbiter of practically every social and moral issue now under debate.
Indeed, the time was then ripe for layman to issue a fruitful challenge to the entire concept of psychological health--its inherent limitations, its value-laden nature, and its meaninglessness without dependence on an underlying social-moral philosophy.
Most of all, the discussion could have addressed psychology's inability to scientifically answer the essential, basic questions upon which any meaningful psychology must be based...foundational questions such as, "What is good?" And, "What is the meaning and purpose of sexuality?" Or, "How does one define 'self-actualization'?" "What exactly is our distinctively human nature? How does our nature require that we live?"
In an age when even our culture's moral leaders feel obligated to look to science to defend their positions, such a discussion could clarify to the public what psychologists already know but tend to be loathe to publicly admit--that science alone has a limited capacity to either define or resolve our social-moral problems.
In fact, the Association has just quietly instituted a change in its most recent diagnostic manual--the Text Revision of the DSM-IV--regarding the definition of pedophilia. In a return to its previous standard, now, merely acting upon one's pedophilic urges is sufficient for a diagnosis of disorder.
NARTH Scientific Advisory Board member Russell Hilliard, along with psychiatrist Robert Spitzer, have just published a letter in the American Journal of Psychiatry which points out that in contrast to the DSM's statement that "no substantive changes" had been made in the latest DSM-IV Text Revision, "in fact, DSM-IV-TR has made a substantive change" in its criteria for pedophilia.
"Would it not have been better," Hilliard and Spitzer note about the APA's obvious silence, "for the DSM-IV-TR editors to have acknowledged that there were a few substantive changes in the criteria, and that for the Paraphilias they were correcting a mistake made in DSM-IV?"
Many religious traditions recognize pedophilia as an inherent affront to the integrity of the person--but such a characterological and spiritual concept may be difficult to conceptualize, and even more difficult to assess, in narrowly psychological terms.
Perhaps the harm done by pedophilia will be difficult to measure because it is subtle and values-laden. Maybe the molested boy will grow up to routinely sexualize his samesex relationships. Maybe he'll have difficulty with marriage and mature intimacy. Maybe he'll not only have a distorted concept of gender differences, but a distorted understanding of generational distinctions as well--which could lead to the sexualizing of his own mentoring relationships with children.
The man whom these psychological studies trumpet as being "unharmed" by their childhood molestation may, therefore, have been the most harmed by the experience--and he may be the person most likely to reenact it on another child.
Perhaps, indeed, many of the deepest harms to the child, and to the perpetrator, are largely outside of scientific psychology's understanding. So, in a curious twist, maybe the APA--in throwing up its hands and saying pedophilia was "morally wrong"--was right.
Psychologist Gerard van den Aardweg has observed that the Rind study didn't find significant harm to all molested children because Rind was " looking through the wrong glasses." Perhaps the pedophilia debate will challenge psychology to begin to openly incorporate the missing moral dimension-- recognizing our human nature in all its intertwined psychological, moral and spiritual complexity.