Tuesday, May 23, 2006

Treatment of Sex Offenders - Important Side Issue

Team treatment of sexual offenders has advantages. Contrary to popular opinion, they are not all the same. While the various attempts to categorize them are not always in accord, it doesn’t take long in the field to learn that Charlie and Sam, accused of the same crime, are wildly different.

The threads of evasiveness, dishonesty, and reframing are quite consistent, however. It may be difficult to tease out whether the offender is lying to himself; there may not even be a clear answer to that. But however it is spun, the web of ambiguity will be there, like the plot of a spy novel with its red herrings, double-checks, and reversals. The first obstacle is getting clear, verifiable information. Rumors spring up and will not die. The victim was a fifteen and a half year old prostitute who accused him to get herself out of trouble. He intimidated little boys so effectively that none would testify. He was stalking his ex-wife. He has fantasies of torturing and killing people. He’s not dangerous, he just steals women’s underwear and it creeps them out. The offender is often a walking Rorschach test, a screen that the staff can use to display their general opinions.

Tangent: For those who enjoy a good paranoid fantasy, this is fertile ground. To be wrongly accused of a sexual crime would be an enormous Catch-22: the more harmless and normal you tried to appear, the more frightening you would become. Imagining yourself in any of the supporting roles of therapist, attorney, or family are other scripts that can be written in a variety of entertaining ways.

Back on topic: No matter how experienced and self-examining the individual clinician is, the need to irrationally believe, or irrationally disbelieve the occasional patient is very strong. If the patient has an Axis II disorder, the various rescuings and punishings of him by others complicates this further. A man who shows more-than-average contempt for women will be perceved as more dangerous (not without reason). A female offender will elicit intensified reaction for both rescue and punishment. The most cynical, I-think-they’re-all-lying-scum psych nurses* will inexplicably choose some one patient who they believe is being railroaded and misjudged. We are all susceptible to this, and I suspect some underlying need among human beings that prevents us from disbelieving everyone. There is a skepticism fatigue which lies in wait for us all.

*Not to pick on them in particular, though it may not be accidental that I imagined a psych nurse in that slot. I am also notoriously skeptical, but broaden it to the whole cast of characters. I don’t believe the husband, I don’t believe the wife; I don’t believe the victim, I don’t believe the accused. Nor do I disbelieve them. Yet even I get sucked in.

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