Sunday, November 27, 2016

An Interview With A Sex Expert

Introduction

This blog has long focused on facts over myths, research over media articles, and experts over advocates. Child sexual abuse and its prevention is an extremely emotional topic for most people, and the facts often get lost in the emotional whirlwind of people who just want to make sure children are protected. Because of this, it is essential for policies and plans to be formed based on facts. Our current policies are not, however. We have formed registries, lists, and management techniques to either address problems that do not exist, or we leave the protecting of children to policies that are effective after someone has been victimized rather than before.

Yet here we are, two decades after passing the first sex offender registry laws, and the epidemic continues. Clearly, we are allowing our emotions to lead and we are attempting to form the facts to fit what we believe is best, rather than going the other way and allowing the facts to form what we believe is best. I believe that primary prevention absolutely must be a part of how we respond to the epidemic that is child sexual abuse.

I felt that asking an expert some pointed questions that people no doubt want to know about sexual offending would be extremely valuable. It is one thing to read about facts and studies, and to read news articles that cite those facts and studies. But I think it is quite another to hear those facts directly from an expert. With that said, I would like to welcome Dr. Holly Silva to this blog.


TNF 13 (TNF): So, Dr. Silva, what is your experience with sexual offenses? What do you do, and where did you learn to do it?


Holly Silva (HS): My motto is "No More Sexual Victims," and over the past decade, my work has revolved around doing my best to make that happen. Evaluating and treating adult sexual offenders, as well as providing education regarding dynamics related to sex offenses has been essential in working towards this goal. I received my doctorate from Alliant International University in 2004. I have experience evaluating and treating civilly committed sexually violent predators in New Jersey, as well as sex offenders in Connecticut. I am affiliated with the Connecticut Association for the Treatment of Sexual Offenders, which is an organization that provides effective assessment and treatment information to professionals who treat sexual offenders. I also provide trainings including those to police officers related to investigations and sex offender dynamics. I will soon be expanding my practice to include treating offenders through telehealth services, including video-conferencing, for ease of access.


TNF: So, you work with sexual offenders to prevent more sex crime from happening? And, not only have you treated sexual offenders, you train people who work with them as well? How did you come up with your motto?


HS: "No More Sexual Victims," developed over time, following my experience working in New Jersey with civilly committed Sexually Violent Predators (SVP's) and offenders in Connecticut, following sentencing and typically, release from jail/prison. I've found that evaluating and treating offenders is only one way to decrease sexual offenses from occurring. Getting the public involved and educated regarding multiple aspects of offenses including why such offenses take place, how to prevent such offenses, preventing inappropriate student/teacher relationships, as well learning about non-offending pedophiles are other essential components to prevent offenses.


TNF: How common is it for sexual offenders to commit more sexual crimes? If you treat offenders to prevent more victims, does that mean sex offenders are dangerous?


HS: The research varies but overall, the known re-offense rate for sexual offenses is between 12% and 24%. With that said, many believe that such percentages do not reflect the true re-offense rate, as many offenses are not reported. It is important to note that some offenders are high risk and others are low risk to re-offend. Each offender presents a unique set of dynamics that needs to be taken into to account, which is why it is essential to complete risk assessments on all offenders, regardless of the type of offense. Providing specialized sex offender treatment is an important aspect regarding “No More Victims.” Having said that, offenders must be motivated to gain insight into what brought them to offend and alter their lives accordingly to prevent re-offense, as there is no “cure.”


TNF: Are risk assessments and treatment always required by the courts, or is that something that varies by location?


HS: Every state has a different process regarding managing sexual offenders. Although all states have a sex offender registry, the use and type of risk assessments and treatment for sexual offenders vary.


TNF: What kind of motivations do you see from the offenders you work with?


HS: With regards to motivation, those who sexually offend do so for various reasons. Although it’s not possible to share all motivations, I’ll share some. Some individuals sexually abuse children due to their difficulty communicating and interacting with those their own age. Some of these individuals are cognitively delayed, others struggle with a lack of social skills. As human beings, we all have the desire to be liked, feel accepted and comfortable around those we associate. It feels even better when people look up to us. Although not acceptable, it is understandable that, for example, a 33-year-old cognitively impaired male, who is developmentally 10, would want to associate, which could eventually become sexual, with someone on his level… someone who has similar interests and is viewed as an equal. Of course, this child is not an equal, and education regarding this issue certainly needs to be addressed in treatment.

There are offenders, that, as stated above, lack social skills. These individuals may have been shunned by others for most of their lives, experienced various types of abuse during childhood and/or adulthood, and have developed or have always experienced a lack of self-esteem/self-worth. When a child shows interest in this adult, he feels accepted for the person he is and comfortable around this child. It is also more comfortable for the individual because the child does not have adult-like expectations, and often looks up to him. Cognitive distortions develop, leading to sexual crimes.

With regards to an offense perpetrated against an adult female, the offender may have harbored resentment, anger and possibly hatred towards a significant female in his life, possibly his mother, spouse, etc. Due to the offender feeling as though he was unable to express his anger to this woman, he chose to take this anger out, often in a violent manner, on a female that may have looked like or displayed similar characteristics as that significant woman for whom he was unable to appropriately communicate.

Again, these are only a few examples of motivations of offenders. Entire books have been written regarding typologies of sexual offenders. 


TNF: Is there a particular set of emotions that come up with people who sexually offend?


HS: Emotions that sexual offenders present include those displayed by all humans. Many of the offenders I have evaluated and/or treated have experienced significant trauma in their lives. It can be said that many people experience trauma and don’t go on to offend. That is true. It is also true that most individuals who have been sexually abused, don’t go on to sexually abuse others.

As human beings, some people are more resilient than others, and some have encountered positive figures that have helped them turn their lives around, bringing them to proceed on a healthier path. Still more people have been able to turn their own lives around due to various factors, either earlier or later in life. There are others who were not born with such resiliency, did not have guidance to potentially turn their lives around, and others who rejected such guidance and proceeded to live an unhealthy life.  

Countless offenders have shared with me that they wish they could turn back time and not have offended for many reasons including having hurt their victims and countless others. Many also shared that through treatment, they felt more connected to their family. They felt healthier emotionally, having gained a better understanding of their unhealthy behaviors, as well as non-offending behaviors. They recognize their triggers, what they need to look out for to not behave in a manner that will hurt others, including themselves.

Many offenders realize if they don’t take care of themselves, emotionally, physically, etc. they will not be able to live healthy, productive lives. I am beyond pleased when offenders continue therapy after mandated treatment. I believe therapy is typically helpful for all and essential for many to become or remain positive, healthy, and law-abiding citizens. Who can’t benefit from learning from different perspectives, especially an unbiased therapist? They can provide information that individuals are initially oblivious to.


TNF: So, those horror stories we see on the news, like Sandusky, Savile, or the kidnapper in Ohio... Are these cases common? What sets these high-profile cases apart?


HS: Before I begin, it’s important to emphasize that victimization of any type can be or is a horror story. No one asks to be victimized and abuse of any sort should not occur. With that said, the most horrific stories are put on display by the media, as these disturbing events are financially lucrative for these media sources. That is not to say that these horrifying events don’t occur, because they do; we hear about them day-in and day-out on television, in the newspapers, etc., often played and replayed multiple times before another horrific event catches the media’s attention, and the prior one falls behind the scenes. We are somewhat inundated in that way, as these stories are on repeat. With that said, it is important to draw attention to various issues in the world today, as such attention often significantly assists with solving such problems.

On a side note, this makes me think of a period of many years when I cared for my grandmother. I did my best to limit her exposure to the news, as the most devastating and horrific stories seemed to be “on repeat,” hour after hour… flooding, killings, sexual abuse, etc., many of which she perceived to be new events. Being in her 80’s, it was not healthy for her to see such devastation on repeat. To her it seemed the entire world was coming to end. Flooding after flooding, after flooding, all in one day. The problem was that although a terrible event had occurred, this flooding occurred once, not multiple times in one day. Seeing such devastation, repeatedly, can bring us all to have misconceptions. 

You mentioned Sandusky, Saville, and the kidnapper in Ohio… I have evaluated and/or treated offenders many individuals that have committed horrific crimes and often those who have done so repeatedly. Again, it is important that I don’t minimize any type of abuse, as abuse, in and of itself can have devastating consequences, especially those who repeatedly abuse. With that said, the ones that currently stand-out in my mind are those individuals that are psychopaths and those who are hypersexual.

Psychopaths, in general, do whatever, whenever they want. Robert Hare, a world-renowned expert in psychopathy, revealed that psychopaths consist of approximately 1% or 1 in 100 people, of the general population. These individuals are ego-centric, narcissistic, disregard social norms, have poor impulse control and lack empathy and guilt, which all typically become evident at a young age. In my experience, when working with psychopaths, who were on probation, their locations were often monitored electronically. Due to their disregard for rules, behaving as though they are above the law, they typically violate their probation quickly.

As stated above, based on their general disregard for social norms, their crimes tend to be diverse. For example, a psychopath, while in the process of committing a burglary, observes a vulnerable individual, and impulsively fulfills his sexual desires, potentially leading to a conviction of sexual assault. Additionally, psychopaths tend to be hypersexual in nature, and combined with their antisocial personality traits, many commit sexual assaults. Psychopaths tend to be resistant to treatment, and often become better criminals when taking part in treatment. As a result, electronic location monitoring is extremely helpful with such clients. 

Other concerning sexual offenders are those that are have extreme difficulty controlling their sexual impulses, especially those who are resistant to obtaining assistance with treating such impulses. Unless difficulty controlling one’s sexual impulses is noted in previous evaluations, appears clear based on offense history, or the offender voluntarily shares such information, such information often comes to light when an offender completes a sexual history booklet or polygraph. In many states, polygraphs are a part of treatment.

Prior to taking such polygraphs, offenders are provided with booklets to complete which the offenders provide extensive information regarding their sexual history, beginning during childhood. These booklets provide the offender the opportunity to share deviant and/or concerning behavior, the treatment provider to become aware of such concerns and the opportunity for such concerns to be treated. Many of the individuals who have trouble controlling sexual impulses, especially those who experienced hypersexual behaviors at an early age, reported sexual interactions with animals during childhood. This behavior is certainly concerning, but is predictable, considering a hypersexual 8 or 9-year-old, has limited access to others that would be interested in participating in sexual behaviors.

Another concerning behavior amongst individuals having trouble controlling sexual impulses is the amount of times they masturbate each day. Such individuals have shared that they masturbate 6-8 times a day. I empathized with those individuals that shared such information, as, to me, that sounds like a part-time job, not to mention exhausting. Due to such behavior being a significant coping mechanism for stress, these individuals were resistant to being medicated to decrease their libido. At times, these individuals were mandated to comply, as their lack of impulse control contributed to their offending behavior and therefore, was a significant component to their treatment. All individuals that I’ve treated, after taking the medication, were quite pleased with the results. One individual ended up working 20 more hours a week when he was medicated and not consumed with thoughts of sexual activity. 

Another type of type of horror story that comes to mind is preferential offenders, offenders whose primary attraction is towards children. They desperately attempted to hide and contain their sexual desires towards children, but ended up repeatedly abusing them. Many of these individuals had convinced themselves that they were helping children by teaching them about sex, as who better to do so than someone who loves them. Because of various cognitive distortions, many reported hundreds of victims. After learning of such problematic thinking, these offenders typically welcomed various forms of chemical castration, as they realized they were unable to contain their sexual impulses. 

Another type of concerning sexual offender are those that are aroused by significant violence, including stabbing their victims. Changing one’s arousal, depending on how deviant, can be exceptionally difficult and may be impossible. Long ago, I taught a group called arousal reconditioning. While facilitating these groups, I learned that many offenders were not aware of what healthy relationships consist of and how to go about having a healthy intimate relationship. 

Lastly, there are some individuals that, due to their being ostracized during childhood by both family and peers, resorted to sexual behaviors with animals during adolescence and continued such behaviors through adulthood. These individuals, typically mentally limited, shared that these animals were the only living things that treated them well. Much thought needs to be put into treating this specific population of offenders, as helping someone who is developmentally 8 or 9, develop social skills, could potentially bring them to develop sexual attraction to those they identify with most, children at their developmental age rather than their chronological age. 


TNF: Many of my most popular pages are the pages that center around practical advice. What practical advice can you give to people about sexual offending, so that they know how to prevent it before it happens, or respond better to it when it does happen?


HS: I could write a book about practical prevention, so I’ll choose a few topics. Bear in mind that Stop It Now is an excellent organization that provides a great deal of information regarding how to handle various situations, from how to talk to a child about sexuality to steps to take when a child has disclosed abuse.

With regards to primary prevention, I recently wrote a short article, 5 Tips to Teach Children About Consent. This article focuses on primary prevention, with the goal of educating children about consent within relationships and the importance of respecting “NO MEANS NO,” beginning at a young age.

It is important to note that the research indicates that approximately 1 in 5 girls and 1 in 7 boys are sexually assaulted prior to reaching adulthood. It is also important to know that over 90% of children are abused by someone they know, such as a family member, including siblings, or neighbor. Approximately 7% of such abuse is perpetrated by a stranger. There is no typical profile of a sex offender, as they can be male or female, any age- young or old, from any ethnic, religious, or educational background, of any marital status, and can be of any relationship to the victim.

It is essential to be aware of inappropriate behavior between adults and children. I’ve worked with many individuals who have stated something like, “I knew something was not right.” Often the individual reported keeping quiet for fear of upsetting the individual or family dynamics. Very often, incest takes place for multiple generations because of the above concerns. Although one would think otherwise, it is not uncommon for individuals to think that the family member has “changed” and, although the family member molested them as children, they would not do so to their child. The same thought process often takes place with other types of abusers, not only sexual abuse.

Awareness is important, as is open communication with children. Speaking with children about various, difficult to discuss topics such as sexuality, using appropriate names of body parts, the difference between appropriate and inappropriate touch, that it’s okay to say “no” if they feel uncomfortable, regardless of who is touching them, is important. Informing children about sexual abuse in an age-appropriate manner and allowing them to ask questions brings children to feel more comfortable and willing to share such concerns, if such concerns arise in the future.

If a child informs an adult about inappropriate sexual behavior, it is essential that the adult remain calm, listen to and believe the child, as false accusations are rare, thank them for telling you and let them know that you care about them. It is also essential that the child is told, often repeatedly, that they are not to blame, that the abuser is wrong and needs help so that he does not hurt others. Planning with other trusted adults to keep the child safe is of utmost importance. Safety includes ensuring that the child is not alone with the abuser. If the abuser is an adult that is responsible for the child’s care, child protection services should be contacted. If the adult is not a caregiver to the child or any other child, the police should be contacted. Another option is contacting a child advocacy center. 


TNF: What would you say are the biggest myths about sex offenders that most people believe, but are not true from your experience?


HS: 1. Most sexual assaults are committed by strangers.
Research indicates that approximately 27% of all sexual offenses are perpetrated by strangers. Most sexual offenses are committed by someone known to the victim such as a family member, friend, neighbor, intimate partner, or acquaintance
2. Most people who have been sexual abused, sexually abuse others.
Although it is true that some victims of sexual abuse go on to sexually abuse others, this is not typically the case. Most victims of sexual abuse do not sexually offend others.
3.  Alcohol causes people to sexually offend.
Alcohol does not bring one to sexually offend. Alcohol is a drink that may assist one to do what they really want to do. Although certainly an inappropriate term, alcohol, at times has been referred to as “liquid courage.”
4. Sexual offenses are typically impulsive.
Sexual offenses are most often planned. Although sexual offenders often initially state that they just “did it,” through treatment they later realize that they were either in denial or unaware of the amount of planning involved. Perpetrators who offend impulsively, with very little forethought, are often quite dangerous, as they have minimal time to prevent an offense.


TNF: You said that sexual offenses are usually planned. Why would someone sexually abuse a child, and how are they planned? Are there any examples that come to mind?


HS: As stated above sexual offenses are most often planned. This is important to know, as this indicates that offenses don’t “just happen.” There are several “road blocks” that an offender must get through in order to offend. Dr. Finkelhor developed the Four Preconditions Model (1984) that reveals preconditions that must exist for a sex offense against a child to occur. Such conditions consist of the motivation to abuse, followed by overcoming internal inhibitions, external inhibitions, and victim resistance. The following will provide some information regarding each precondition:

1. MOTIVATION: The first precondition consists of the desire to sexually offend. This desire may be the result of a need to feel powerful, inability to get one’s sexual needs met due to inept social skills, sexual attraction to children, etc.
Finkelhor noted several ways which motivation can develop related to emotional needs, sexual arousal and blockage. The following concepts will be explained further below:

Emotional Needs can consist of a desire for power and control or a desire to relate better with children, due to not feeling comfortable being social with peers. Some feelings may consist of loneliness, insecurities, anger and/or fear of rejection.  

Sexual Arousal towards children can be a result of multiple factors including issues that have not been resolved due to having been molested as a child, early sexual experiences that were arousing, including viewing of pornography, etc. Although Finkelhor did not mention the following, some research indicates it is very possible that some individuals are born with a sexual preference towards children.

Blockage occurs when a person has sexual urges but various factors prevent the individual from expressing such urges in a socially appropriate manner. Such factors may consist of difficulty developing socially appropriate relationships due to not having been taught good hygiene, not having good social skills, feeling uncomfortable in social relationships, or having been taught it’s morally wrong to masturbate.

2. INTERNAL BARRIERS: This preconditions follows motivation, the belief that one should commit a sexual offense. Internal barriers that need to be overcome in order to commit a sexual offense include the following:

          1. Overcoming the fear of getting caught          
                                                 
2. Determining that the victim’s feeling don’t matter or are not as important as one’s own desires

          3. Disregarding the fact that such behavior is wrong.

Such barriers can be overcome due to poor impulse control, using alcohol and/or drugs, etc. Ultimately, one’s desire to offend needs to be stronger than their conscience telling them not to commit the offense.

3. EXTERNAL BARRIERS: This condition comes into place after the offender wanted to offend (motivation) and decided to do it (internal barriers). This precondition requires the offender to feel confident that he will be alone with child. Such access can occur when babysitting, asking permission to spend time with the potential victim, such as going on a hike, etc.

4. VICTIM RESISTANCE: Following feeling confident that a situation exits where an offense can occur (external barriers), an offender needs to overcome the victim’s resistance in order to offend. This can consist of taking advantage of a trusting relationship, manipulating, and bribing potential victims. Typically, offenders choose children whose resistance is easy to overcome, including those that are less likely to report an offense.

It is important to note that the above preconditions model is used to assist perpetrators in becoming aware of the barriers to prevent re-offense. If one barrier is crossed, there is still time to stop an offense because there are many barriers that need to be crossed for an offense to occur.

The following consists of a few examples based on my experience of those ultimately going through the four conditions described above in order to sexually offend:

Joe, a 40-year-old man, who is developmentally 12, desires a sexual relationship. He does not interact well or feel comfortable associating with adults, as he thinks and acts like a child. It is understandable that Joe, who thinks and acts like a 12-year-old, would desire a relationship with someone who thinks and acts similarly. Based on Joe’s chronological age of 40, sexual interactions with whom he feels comfortable interacting sexually, is not acceptable.

John is a 30-year-old man who has worked on family farm, ever since he can remember. He had always been a social outcast based on facial disfigurement and lack of social skills. During childhood, he was severely ridiculed and after many years of maltreatment, dropped out of school and retreated to the farm where he felt most comfortable. He felt accepted by the animals of whom he took good care. Throughout his year of working on the farm, he viewed the farm animals as friends. These animals showed him unconditional love and he felt these animals were the only living things that did not view him differently, based on his disfigurement. After breaking his leg, he was unable to work on the farm and was given the responsibility of caring for his young nieces and nephews. John found that these young children did not judge him and even seemed to look up to him. John felt comfortable around other humans for the first time in his life. He felt loved. When looking after his nieces and nephews, he would play “tickle” games and “wrestle around.” After a period, John began developing cognitive distortions/thinking errors when the children would laugh while accidently touching his genital area while playing. He began to think his nieces and nephews were intentionally touching him in his genital area. Over time, John convinced himself that his young nieces and nephews wanted to have sexual contact.

The above are just two examples of many that provide some information regarding reasons child sexual abuse occurs.

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Dr. Holly Silva is a member of the Connecticut Association for the Treatment of Sexual Offenders (CATSO). She has a private practice in CT where she provides therapy and education to various populations both in-person and through video-conferencing. Dr. Silva can be contacted through email at drhollysilva@gmail.com. She can also be found on Twitter and LinkedIn.

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