Church’s Defense Called Valid--to a Point

In defending themselves against the sex abuse scandal, leaders of the Roman Catholic Church often point fingers of blame at the quality of mental-health advice they have received about reinstating errant priests.

In previous decades, when many of the incidents now in the news occurred, psychiatry and psychology had markedly more optimistic notions about how to handle sex offenders, church leaders say. That, they maintain, sometimes led the church to believe that priests who had sexually abused children were unlikely to re-offend.

Cardinal Roger M. Mahony, meeting with a group of Times reporters and editors Tuesday, repeatedly said it was unfair to impose today’s standards of judgment on bishops who had kept priests in the ministry on the basis of psychological advice of a different era.

“Everyone is taking the matrix of 2002 knowledge and placing that matrix on what happened some time 15, 20, 30 years ago,” he said.

Leading experts in the area of sexual abuse say there is some truth in this line of defense--but only some.

For one thing, they say, it is inaccurate to suggest, as Mahony has on occasion, that there has been a radical change in expectations from therapy as recently as the late 1980s or early ‘90s. The primary sea change in the way psychologists and psychiatrists viewed sex-abuse treatment began in the mid-1970s, when the notion of an easy cure started to melt away.

These specialists say blame also falls on church officials, who sometimes failed to provide sufficient information about priests referred for treatment, and in other cases ignored the advice of medical professionals or interpreted it too optimistically.

It is clear that both professionals and clergy operated with inadequate knowledge about treatment, especially in the 1960s and early 1970s, experts say.

Back then, optimism about cures was greater, psychological damage done to abused children was underappreciated and the therapies in vogue for treating perpetrators were fundamentally flawed. Many of the cases that have recently come to light occurred in the 1970s or ‘80s, but some go back as far as the ‘60s.

Psychology experts fault practitioners even more recently for meting out unrealistic or vague advice to church officials, taking on cases that were outside their area of expertise or insufficiently investigating the true extent of their clients’ problems.

These experts also blame society for failing to take a pragmatic approach toward the unsavory problem of child sexual abuse. The government, they say, inadequately funds research into the roots of sexual abuse and ways to better treat perpetrators. Trained practitioners are lacking, as are teaching hospitals where therapists can gain expertise in this highly specialized area, they say.

‘Polarized Thinking’

There are also few effective, communitywide treatment and prevention programs that coordinate with the criminal justice system so that those serving prison time also get treated.

Progress is sabotaged by “this polarized thinking--that you’re either for the victim or for the offender,” said Dr. Fred Berlin, associate professor of psychiatry at the Johns Hopkins School of Medicine in Baltimore and founder of the Johns Hopkins Sexual Disorders Clinic. “In reality, they’re opposite sides of the same coin.”

The experts stress that such deficiencies cannot justify the repeated reassignment of abusive priests to ministries that put them in contact with children.

They refer to cases such as that of former Boston priest John J. Geoghan, the convicted child molester whom more than 130 people accuse of abusing them while he worked in the archdiocese of Cardinal Bernard Law, or of Father Michael Stephen Baker in the Archdiocese of Los Angeles.

Mahony transferred Baker to several parishes after the priest told Mahony in 1986 that Baker had molested young boys. The cardinal later approved a secret $1.3-million settlement with two men allegedly abused by Baker in the 1990s.

Richard Sipe, a former priest living in La Jolla and a retired psychotherapist who has worked with hundreds of priests and victims, said the shortcomings in the mental health profession pale in comparison with the church’s culture of secrecy.

“When did the bishops discover that sexual abuse of minors was illegal? Was that something that was hidden from them for the last 30 years?” he said.

Still, there are examples that make mental health professionals wince. Gary Schoener, a Minneapolis psychologist and an expert on sexual abuse by priests and other professionals, recalls that, in the late 1980s, he was asked by the then-archbishop of St. Paul and Minneapolis to review 15 years of case assessments involving priests who had sexually abused children or adult parishioners.

The priests, he said, had been sent for assessment or treatment to various places, including facilities specializing in treating clergy with behavioral problems. They returned, were reassigned--then abused again.

The archbishop “said, ‘It’s obvious we’ve been told some of these guys can go back, and it was bad advice,’ ” Schoener said. “He wanted to know what to do.”

After reviewing the cases, Schoener said, he uncovered patterns of problems.

Sometimes, the psychiatrists, though highly qualified, simply didn’t have enough expertise in this area. “They might be good at depression, they might know a lot about priests, but the sexuality area was not their bag,” he said.

Even specialized centers would sometimes fail to secure enough details about their cases, relying on what the sexual offender or the church told them. Offenders are often less than candid. So, at times, was the church.

This is important, specialists say, because without full details, such as the number of victims, it’s hard to assess the offender, his risk for re-offending and the best treatment.

Unrealistic Advice

Reports to the church in the St. Paul-Minneapolis cases also recommended measures that Schoener views as unrealistic, such as close supervision or follow-up therapy that wasn’t available locally because of a dearth of specialists trained in treating sex offenders.

“They would almost never say to put the guy out of the church,” he said. The church, in turn, tended not to query the priests further, he said.

Repeated telephone calls to the St. Luke Institute, a Catholic psychiatric hospital in Silver Spring, Md., that treats priests who have sexually abused children, were not returned.

The Institute of Living, a center in Hartford, Conn., that also specializes in such treatments, will not comment on the current crisis, a spokesman said. But in an interview with the Hartford Courant, officials there denied church accusations that the institute had provided misleading advice.

Dr. Harold I. Schwartz, the institute’s chief of psychiatry, told the Courant that the church had withheld details about the priests it referred and had “misconstrued” institute advice.

Medical experts said they do not see huge treatment differences between centers that specialize in treating priests and those that do not. However, ex-priest Sipe said that, in the past, Catholic centers were more likely to approach sexual offenses as spiritual transgressions. They were less inclined to focus on sexual problems--priests, after all, are not supposed to have sex--but would tackle other issues, like drinking, drugs or depression, and hope that curbing these would in turn curb the sexual offenses. Schoener said some therapists’ judgment in Catholic treatment centers had been clouded by sympathy toward their patients.

Might Be Treatable

In the first part of the 20th century, behavioral problems such as pedophilia and alcoholism were blamed on moral weakness. After World War II, there was a growing realization that such disorders might be treatable mental disturbances.

Then came a period stretching into the 1970s--the heyday of so-called “psychodynamic” and “psychoanalytic” therapies. The belief was that many mental disorders, including pedophilia, were rooted in childhood and that, once the roots were unearthed, the problem could be solved. These were times of awful advice, said Philip Jenkins, professor of history and religious studies at Pennsylvania State University and the author of several books, including “Moral Panic: Changing Concepts of the Child Molester in Modern America.”

Jenkins says he has read statements from psychologists and sex experts spanning what he dubs the “liberal era” that “make you want to tear your hair out” because of the way they exaggerated the effect of therapy, downplayed the harm that sexual abuse can do and blamed the victim.

What research there is suggests that treatments in that era did not work well. Yet psychologists and psychiatrists were optimistic. Berlin said he has seen documents from the 1960s in which--after therapy--the church was reassured that a priest had been cured.

“And, of course, if you’re ‘cured,’ that means you’re safe,” Berlin said.

As the years passed, concern about child sexual abuse increased and the mental health profession underwent a gradual but profound change: It came to realize that simply talking about one’s childhood was no cure for serious behaviors such as alcoholism, drug abuse and sex offending.

Thus--though problems do persist--church statements about being misled wear thinner the later in time that abuses came to light.

Specialists now know that people who sexually abuse children are a mixed bag--some bona fide pedophiles drawn to prepubescent children, others drawn to adolescents, some with more general proclivities.

Some offenders are especially hard to treat because they lack consciences and empathy for their victims. And experts now believe that, although some offenders may develop patterns of abusing children because they themselves were abused, others--because of heredity or brain damage--may be biologically wired to find youngsters attractive.

Studies suggest that modern treatments have effects. Modeled on risk management for alcoholism, they include various therapies and groups aimed at altering behavior and self-serving thinking and increasing empathy for victims. They also include emergency plans, should a perpetrator be tempted to backslide. Drugs to quash libido and impulsiveness are also sometimes used.

Close supervision--even electronic monitoring and lie detector tests--can be used to help keep an offender straight.

And it has been clear for many years--long before this year’s eruption of scandal in the church--that offenders should not be kept in jobs that give them easy access to children.

“An alcoholic,” said Berlin, “should not be working in a bar.”