Little over a decade ago, a highly acclaimed British documentary filmmaker, Louis Theroux, stepped into the midst of 500 paedophiles admitted to the psychiatric hospital in Coalinga, California, trying to find out if the complex treatment the convicts had to go through was really working.
During his investigation, however, Theroux discovered an unexpected path which made him wonder if the hospital wasn’t in fact a prison, and the patients he was interviewing weren’t, in effect, sentenced to life in prison, despite serving a criminal sentence. Beyond the affirmative answer, which it gradually argues for, the documentary leaves behind a difficult question, the stakes of which go beyond the borders of the United States.
The documentary, simply titled A Place for Paedophiles, earned Theroux an award from the Royal Television Society in the UK. In fact, the United Kingdom and Australia are the only countries where the documentary was broadcast on TV. In the United States, Theroux’s dialogue with patients would ordinarily have been against the law, namely the Health Insurance Portability and Accountability Act, which prohibits the disclosure of a disease a patient suffers from (including mental illness) without their consent. The patients from Coalinga were there against their will, for an imposed internment, and many of them did not consider themselves to be suffering from a mental disorder.
The 60-minute production was the first interview-based film made in the hospital. Critics have described it as an investigation based on sound observation and as “brilliant, devoid of sensationalism or compassion.” And given the atrocities that some patients described, in clinical language, as being their own actions towards children, compassion would be the last thing anyone could feel about these sexual predators. But as the frame widens, viewers see an even more tragic picture than the title announces.
Why this centre exists
Opened in 2005, the hospital was the first state hospital to be built in California in the last 50 years. According to the its website, the facility’s buildings cover an area of 1.2 million square meters, located on a mountainous stretch of coastline, 640 kilometres from Santa Barbara and near the Pleasant Valley State Prison. The hospital in Coalinga is one of the five state hospital units that, between 2019 and 2020, have shared a budget of 2 billion dollars. When Theroux made the documentary, the mental health institution in Coalinga housed 500 patients, former detainees who had a record for molestation or sexual abuse of minors. Today, the number of patients is almost double , 941 of them being classified as “violent sexual predators.”
Patients admitted to Coalinga are imprisoned by court order and serve their years in prison. However, before releasing them back into society, authorities must be convinced that these people no longer pose any real danger to the social community and are able to reintegrate. State assessors have diagnosed those admitted to Coalinga with “volitional disability” and have categorized them as dangerous, estimating that they could attack again, since they are unable to control the actions they take.
State assessors have diagnosed those admitted to Coalinga with “volitional disability” and have categorized them as dangerous, estimating that they could attack again, since they are unable to control the actions they take.
The evaluation of patients includes psychiatric and even physical examinations, which test their mental and biological responses to stimuli that, at least in their criminal past, they had considered sexually arousing. Consequently, the hospital provides patients with a treatment designed to cure deviant paedophiles. But only a third of those hospitalized participate in the programme. Most of those hospitalized refuse treatment and remain in hospital indefinitely, despite the fact that the unit was created to ensure the transition of former detainees from maximum security prisons back into society.
For now, for life
This is, in fact, the plot of the documentary, which depicts the stalemate in which the authorities find themselves. From a legal standpoint, these people have served their sentences. But simply being deprived of freedom, in itself, does not make paedophiles less prone to attack; it only limits their physical ability to act out their deviance. Therefore, releasing detainees who have served prison sentences for paedophilia could, in some cases, be an act of state irresponsibility. As such, Californian authorities resorted to the creation of an intermediate stage of release, during which former detainees are forcibly interned.
The documentary manages to capture the diversity of those hospitalized at Coalinga and to convey how difficult and misleading the process of treating these people can be. The host, who admits making every effort to discern among the patients who claim to have been healed, those who lie and those who tell the truth, confesses that the approach is full of obstacles, the biggest being having to deal with people who have perfected their ability to relate to others, to disguise themselves and to manipulate, precisely because they needed these skills in order to lure their victims.
Among the very different patients—some difficult to figure out, some aggressive in communication, others completely in denial of the horrible acts they committed—Theroux finds an individual who, according to the evaluations of specialists, could be socially reintegrated. He is a man who has resorted to chemical and then physical castration to end his deviant tendencies. However, his situation showed how difficult it is even for a person who is no longer physically able to commit any sexual abuse to re-enter the community. None of the 1,100 homeowners the state had reached out to for him could guarantee him access to a home for rent. Some of them claimed that all potential neighbours threatened to reject the former detainee from their community.
The human factor
The people working with former detainees are also very diverse. One of the social workers who acts as a patient facilitator in group therapy says that he does not consider people to be a sum of past actions, and that he tries to see what other aspects reflect the identity of the patients. “No one wakes up at the age of 5 wanting to become a rapist or a paedophile,” said the social worker, arguing that, from his point of view, paedophilia is not a choice, but a mental illness, a deviant pull the patient cannot resist. Another psychologist, a young woman with extremely controlled language, shows slight signs of verbal aggression towards some patients, who, consequently, reject her, accusing her of “hypocrisy”. However, the psychologist has the last word every time, and defends her position by warning patients that in society they will not be surrounded by people they like and that rejecting her sends a message of aggression that will cost them in their evaluation.
These two approaches actually reflect two opposing premises regarding the fundamental nature of man, both found under the umbrella of the same institution.
These two approaches actually reflect two opposing premises regarding the fundamental nature of man, both found under the umbrella of the same institution. The social worker started from the premise that the paedophiles he works with can, in turn, be victims of their own nature, while the psychologist treated them as completely free and completely aggressive agents. Both apply protocols already established by the state, but these protocols cannot prevent the interference of subjectivity.
This is clear from a tense dialogue in which a patient, disturbed by the awkward questions posed by the psychologist in front of the camera, asks her in what capacity she is involved in the BBC documentary. It is a question which is, after all, legitimate: the patient had agreed to a filmed discussion with the reporter, not with the psychologist. Although the patient confesses that he has nothing against the psychologist attending the interview, he nevertheless states that he would like her presence to be more discreet, for her to attend from the shadows. The psychologist replies that, “in her perception”, this requirement of the patient is aggressive and is an alarm signal that a wider aggression is possible in the presence of a stimulus, such as those that abound in real society. Paradoxically, what clarifies this dialogue is the existence of a diffuse palette of values. The man is hospitalized there for horrible sexual deviance. The authorities undertook the task of trying to eliminate it.
However, the psychologist speaks as if she were trying to completely rewrite the personality and affinities of the individual, imposing a narrative that goes beyond the sphere of paedophilia and enters the general area of morality.
However, the psychologist speaks as if she were trying to completely rewrite the personality and affinities of the individual, imposing a narrative that goes beyond the sphere of paedophilia and enters the general area of morality. Here is where compassion uninvitedly enters the stage, because the viewer realizes that, were he to compare himself to the psychological profile that the professional seemed to want to impose on patients, he would have been found lacking. The viewer too would have been annoyed in the dialogue with the psychologist. Perhaps many would not have even addressed her as eloquently as that patient.
Thus, as he realizes that most patients will never leave the institution, the viewer also begins to wonder if it is not, in fact, the subjective perspective of the institution’s employees that contributes to prolonged incarceration; if it is not the human factor, instead of a commonly agreed set of objective values, that is decisive in deciding the destinies of patients admitted to Coalinga.
The film ends without a definitive answer to this hypothesis. But the picture it builds is that of a tormented society, in which the freedom of deviant people is at the discretion of the freedom of the facility’s staff to act according to a mixture of protocol and subjectivism, which ultimately turns out to be bankrupt, both literally and figuratively.
Bankruptcy of a well-intentioned institution
The system fails to “cure” paedophiles of their deviance and, over time, accumulates more and more patients. The decade since the completion of the documentary has not led to an improvement in the situation. On the contrary, the number of inmates continues to grow. And patients already hospitalized have continued to age. Many of them have difficulty moving, some are bedridden, others are connected to life support devices. And the cost of maintaining these “permanent patients” is borne by taxpayers, who, despite their need for protection, have not unanimously agreed to financially support the lifelong detention of the paedophiles who were incarcerated there.
The tragedy of the situation reveals the limitations of the law, which, by applying coercion, can only punish, not transform. But it also shows how vulnerable systems tailored for human transformation are, given that the scientific community has not reached a consensus on the causes of the phenomenon it is trying to address.
Since the 2000s, various studies have correlated paedophilia with brain dysfunction or altered brain structure. But they could not accurately establish causality. Studies of this kind have taken into account the existence of neurological characteristics at birth that predispose individuals to paedophilia. Others have done IQ assessments or quantitative assessments of grey matter. Other studies have looked at the incidence of childhood abuse, personality disorders, or substance abuse. And their results, although inconclusive, have shown how varied the interaction of factors that could contribute to triggering this violent deviation is, and how sensitive the decision-making process is that any society wanting to protect itself must undergo, while at the same time giving the offender a chance to rehabilitate themselves.
Solutions, when there is no treatment
Unfortunately, there is no scientific evidence that paedophilia can be cured (“changed” is the word used by some specialists). The interventions are meant “to increase voluntary control over sexual arousal, reduce sex drive, or teach self-management skills to individuals who are motivated to avoid acting upon their sexual interests,” as Canadian Professor Michael Seto explained in a paper published in the Annual Review of Clinical Psychology.
In other words, at least apparently, paedophilia cannot be eliminated. But paedophiles can be helped to control their behaviour, and one of the recent goals of researchers on this subject is to devise methods of prevention.
Some are simply not interested. Take Tom O’Carroll, a 73-year-old Briton who has been sentenced to prison twice for crimes related to paedophilia, who advocates for its normalization. He argues that the ethics of virtue has failed to provide a convincing justification for rejecting sexual intercourse between adults and children. He even says that, in an ideal world, virtue would be understood in such a way as to include such practices and even to appreciate them.
Editorialist Justin Lee makes an extensive comment, denouncing the sophistry by which O’Carroll tries to impose his ideas and states that O’Carroll is “a testament to the degraded standards of interdisciplinary scholarship” after a scientific journal that publishes evaluated materials agreed to include in its pages material titled, “Childhood ‘Innocence’ is Not Ideal: Virtue Ethics and Child-Adult Sex.”
But there are also paedophiles who are convinced that the sexual abuse of minors is a reprehensible act and who oppose discourses like the one promoted by O’Carroll. The members of the Virtuous Paedophiles support group claim that “We do not choose to be attracted to children, and we cannot make that attraction go away. But we can resist the temptation to abuse children sexually, and many of us present no danger to children whatsoever.” “My sexuality has never been the central part of my life,” confessed one of the members of the group in an interview for the magazine Salon. “It kind of remains in a box inside my head but never controls me, and I go about my life.”
Institutions such as the Coalinga Psychiatric Hospital want to build programmes that would help paedophiles transition from mindsets of those like O’Carroll to mindsets of those like the paedophile man interviewed by Salon. Are there other ways in which civil society can contribute, are there less risky investments than financing a system whose efficacy no one can guarantee?
Under the title “Pessimism About Paedophilia”, the Harvard Medical School concludes that “There is no cure, so the focus is on protecting children.” So specialists draw parents’ attention to the fact that, in the vast majority of cases of abuse, the attacker is not a stranger, but a person known to the child. Therefore, cultivating an open, communicative relationship, in which the child feels that nothing will make the parent despise him, is also a way for little ones to be protected from manipulative individuals who might urge them to keep the abuse secret or make them fear that telling would supposedly have terrible consequences for the child.
We can educate our children in a way that is as adapted as possible to their age, but also adapted to the dangers we want to protect them from. Children need to be taught what alarm signals to look out for in order to recognize when someone is behaving dangerously towards them, and whether or not that person is in a position of authority or trust, Joan Smith said in an opinion piece published in The Guardian.
We can then oppose the sexualization of children in media productions that reach us today with greater ease than ever before. We can be actively involved in the fight to protect children from the scourge of pornography. Last but not least, we can contribute to a healthy climate around this issue by educating ourselves in a healthy way about our sexuality. At a time when disparate voices in the public sphere seem more confused than ever on this subject, it is vital to make sure that we can rely on our moral compass.