Research and Treatment Sexual Abuse

Sexual Abuse: A Journal of Research and Treatment http://sax.sagepub.com A Brief History of Behavioral and Cognitive Behavioral Approaches to Sexual Offenders: Part 1. Early Developments D.R. Laws and W.L. Marshall Sex Abuse 2003; 15; 75 DOI: 10.1177/107906320301500201 The online version of this article can be found at: http://sax.sagepub.com/cgi/content/abstract/15/2/75 Published by: http://www.sagepublications.com On behalf of: Association for the Treatment of Sexual Abusers Additional services and information for Sexual Abuse: A Journal of Research and Treatment can be found at: Email Alerts: http://sax.sagepub.com/cgi/alerts Subscriptions: http://sax.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Citations (this article cites 71 articles hosted on the SAGE Journals Online and HighWire Press platforms): http://sax.sagepub.com/cgi/content/refs/15/2/75 Downloaded from http://sax.sagepub.com at ATSA on June 17, 2008 © 2003 Association for the Treatment of Sexual Abusers. All rights reserved. Not for commercial use or unauthorized distribution. A Brief History of Behavioral and Cognitive Behavioral Approaches to Sexual Offenders: Part 1. Early Developments D. R. Laws1,3 and W. L. Marshall2 This is the first of two papers which briefly outline the development of behavioral and cognitive behavioral treatment of sexual offenders from the mid-1800s to 1969. We first consider the historic role of Sigmund Freud and note that a broad scientific interest in deviant sexual behavior was well established by 1900. In the early to mid- 20th century, two psychologies were prominent in the development of behavioral approaches, those of John B. Watson and Alfred Kinsey. Behavior therapy for a variety of problems emerged in the 1950s and soon found application to deviant sexuality. The development of penile plethysmography helped to focus interest on deviant sexual preference and behavior. While nonbehavioral approaches to sexual offenders paralleled these developments, a combination of behavioral and cognitive behavioral treatments began to emerge in the late 1960s which ultimately developed into the approaches more commonly seen today. KEY WORDS: sex offender treatment; historical antecedents; Watson’s behaviorism; Kinsey’s sexology; behavior therapy. PRELIMINARY REMARKS So much has been written and discussed at conferences over the past 30 years that it is impossible to do justice to the contributions of everyone in two history papers. We apologize to those whose names we have omitted. It has been especially difficult for us to see our own work in an objective way but we have tried not to be too immodest. We decided not to describe the emergence and subsequent growth 1 South Island Consulting, Victoria, British Columbia, Canada. 2Rockwood Psychological Services, Kingston, Ontario, Canada. 3To whom correspondence should be addressed at South Island Consulting, PO Box 23036, #4-313 Cook Street, Victoria, British Columbia, Canada V8V 4Z8; email: [email protected]. 75 Downloaded from http://sax.sagepub.com at ATSA on June 17, 2008 © 2003 Association for the Treatment of Sexual Abusers. All rights reserved. Not for commercial use or unauthorized distribution. 76 of organizations devoted to assessing and treating sexual offenders. Organizations such as ATSA, NOTA, and IATSO and their conferences have played a very signif- icant role in promoting work and disseminating knowledge but including a history of these organizations would make our already extensive papers far too long. The discussions have been separated into two papers: one covering the history up to the end of 1969, and the second outlining developments over the subsequent three decades and in the two years of the new century. It is hoped that these two papers will provide readers with something of an understanding of how work with sexual offenders emerged, developed, and became widespread by the end of the 1990s. BACKGROUND , In 1896, Sigmund Freud addressed the Vienna Society for Psychiatry and Neurology where he announced his seduction theory of childhood sexuality. It was not well received. The chair, the eminent sex researcher Richard von Krafft- Ebing said to Freud, &dquo;It sounds like a scientific fairy tale&dquo; (Hunt, 1993, p. 181). Freud eventually abandoned the theory replacing it with an account of reported childhood sexual abuse that suggested it was a product of the imagination of the alleged victims. In 1899, while The Interpretation of Dreams (Freud, 1957a) was in press, he remarked to his colleague Wilhelm Fleiss that &dquo;A theory of sexuality may become the successor to the dream book&dquo; (Gay, 1988, p. 142). And quite a successor it was. Freud’s Three Essays on the Theory of Sexuality (Freud, 1957b) originally published in 1905 was a bombshell. The first essay dealt frankly with sexual deviations, the second with infantile sexuality, and the third with sexuality in puberty. Freud was denounced as a pornographer and a pervert in both Europe and North America but the book was widely discussed in professional circles (Hunt, 1993, p. 191). After years of professional disappointment, Freud began to receive the acclaim that he had always felt he deserved. Even today, at the onset of the twenty-first century, many clinicians and researchers consider Freud to be the father of the study of human sexuality, both deviant and conventional. This is far from accurate. Gay (1988, pp. 143-144, passim) has noted that in the latter half of the nineteenth century many scientists and clinicians were talking and writing about the vagaries of human sexuality. In 1845, a German physician, Adolf Patze, observed a strong sexual drive in children 3-6 years of age. In 1867 the British psychiatrist Henry Maudsley also spoke of infantile sexuality. The word &dquo;homosexuality&dquo; was introduced in 1869 by Karoly Maria Benkert; a similar phrase, &dquo;contrary sexual feeling,&dquo; was coined in the same year by Carl Friedrich Otto Westphal to describe this orientation. In the latter part of the nineteenth century Richard von Krafft-Ebing (1886) published Psychopathia Sexualis, which remains one of the most complete descriptions of unconventional sexual behavior ever published. However, to avoid upsetting Victorian sensibilities, Kraff-Ebing rendered the most erotic passages in Latin. This was followed by Albert Moll’s Perversions of the Genital Instinct (Moll, 1893). This type of writing Downloaded from http://sax.sagepub.com at ATSA on June 17, 2008 © 2003 Association for the Treatment of Sexual Abusers. All rights reserved. Not for commercial use or unauthorized distribution. 77 carried on well in the early twentieth century, notably in the writings of Havelock Ellis (1915) and Magnus Hirschfeld (1920). Even in such a brief and incomplete account as the preceding, it is clear that what is today referred to as &dquo;sexology&dquo; was quite well established by the time Freud published Three Essays. Attempts to deal with unconventional sexual behavior therapeutically is not a new idea either. The earliest published account of an attempt to treat homosexuality by what today would be called masturbatory reconditioning was reported by Charcot and Magnan ( 1882) and Schrenk-Notzing (1895). Moll (1911), through a series of successive approximations, was able to shift sexual interest in boys to interest in young women. Just over 60 years later, this technique would be formal- ized as a shaping procedure called fading (Barlow & Agras, 1973). Even aversive procedures are not new. The Roman scholar, Pliny the Elder (23-79 A.D.) advocated the use of these procedures to treat alcoholism and this approach persisted well into the twentieth century (Rachman & Teasdale, 1969). Variations of aversive techniques were adapted in the 1960s to eliminate unacceptable sexual interest (e.g., Thorpe, Schmidt, & Castell, 1964). In this early period, contrary to the writings of Freud and other psychody- namicists, there was also a behavioral theoretical stream that attempted to account for the development of deviant sexuality. In the early 1900s, Alfred Binet (now best known for developing intelligence tests for children) theorized that sexual deviations were learned responses. He believed that this learning occurred as ac- cidental experiences with sexually deviant behavior. Norman (1892) believed that deviant sexual interest was developed by repeated masturbation to sexual fantasies of specific deviant behaviors. Both Binet’s and Norman’s accounts are remarkably similar to the explanation that would be advanced by McGuire, Carlisle, and Young (1965) over 70 years later. By the mid-twentieth century it was generally acknowl- edged that the specific expressions of sexual behavior were learned phenomena (Ford & Beach, 1952; Kinsey, Pomeroy, & Martin, 1948). Contemporary approaches to sexual deviance owe little to classical psycho- analytical or psychodynamic theory or practice. Rather they are the result of the Watson confluence of two psychologies: the radical behaviorism of John B. ( 1913,9 1919, 1924) and the descriptive taxonomic approach of Alfred Kinsey and his asso- ciates (Kinsey et al., 1948; Kinsey, Pomeroy, Martin, & Gebhard, 1953). However, nonbehavioral research and treatment programs with sexual offenders exerted some influence on the development of behavioral treatment for these offenders as well. WATSON’S BEHAVIORISM As Marshall, Anderson, and Fernandez (1999) have observed, the predomi- nant

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