Only Pictures? Therapeutic work with internet sex offenders

Book Review by Steve Lowe

The beginning of Only Pictures?: Therapeutic Work with Internet Sex Offenders identifies the struggles in interpreting internet sexual offending when using the established sex offender research and thinking. It was interesting in particular in recognizing the notion of the fragmentation of sexuality and the extent to which, for an offender, even previously unthought of images of sexual activity can be easily obtained.

This is then linked with the enormous difficulty associated with a response from the legal system, in particular with regard to how we should be dealing with pseudo or computer generated images. Reference is also made to the caution needed in making the assumption that whatever an offender fantasizes about is something that they will act upon. Clearly there has been some concrete thinking in the past about this and the book certainly indicates that this is not necessarily the case. There is also some useful information here for practitioners wanting to get to grips with some of the jargon associated with internet, and the authors recognize the difficulty that practitioners have in keeping up to date with these.

This chapter of the book is a useful walk through of basic understanding of the internet and the way in which it has been misused and is reasonably heavily referenced for those who want to explore further.

Chapter two offers a whistle stop tour through the theories of child sexual abuse, and is again a useful piece of reading for practitioners who want to get a sense of how we have got to where we are today in our thinking about both the antecedents of sexual abuse and what has appeared to be effective in treatment terms so far.

There is an interesting section on the notion of risk assessment and the authors have steered clear of making too bold statements about who is right with regard to assessing risk. Again there is a useful précis of the thinking behind risk assessment, drawing particularly on the work of Marshall, Hanson, Grubin and Laws, although many others are referenced.

My only criticism here would be that I was left still wondering what is the most effective way of assessing risk with regard to internet offenders, although the authors themselves also acknowledge that as yet there are insufficient data to be able to make clear statements on re-offending and risk assessment. I guess I am hoping for something that doesn’t yet exist!

The real meat of this book starts for me at Chapter three where the authors begin to develop a model for their understanding of internet sexual offending and offenders. For me, there is a struggle here, though, in terms of naming the problem. The authors are unhappy about some of the connotations of using terms like addiction and indeed the reality that some users would not fit within this category. In choosing the notion of ‘problematic internet use’, I wonder whether they may be falling into the same trap as addiction workers did with regard to substance misuse, that they fail to acknowledge the high levels of compulsive behaviours associated with internet use, which are reached quite quickly through apparently unlimited supply. 

The authors are meticulous in the way that they have broken down internet offending, and the way that they have linked the non-offending use of the internet as a factor in the problem for offenders. They caution us about thinking too narrowly that internet offenders are only interested in abusive images of children, reminding us that they may also be interested in legal adult pornography and erotica, and that these offer routes into obtaining abusive images.

There are also some useful guidelines on the legal position and sentencing and two exercises that can be completed with clients. As a practitioner I am always interested in any new exercises that I can find.

In Chapter four the authors give us a background to empathy work with sex offenders generally, and then consider it in relation to the specifics of internet offending. They recognize that for the internet offender there is often a gap between them and the victim, and that this may assist in lack of empathy at the time of viewing. The authors are clear that research by Fisher et al indicates that in general sex offenders do not necessarily have less overall empathy, but that they may not be able to apply it to particular victims.

The authors mention emotional states such as anger and loneliness as being possible factors in relinquishing empathic responses, but I wonder whether it may also be that an individual’s level of sexual arousal plays a part here. In my experience internet offenders are often able to recognize that children have been victimized, but even low levels of arousal generated through anticipation appear to militate against any empathy for the children involved.

The authors also tell us that whilst there is little resolution to the empathy debate through research, there is even less information on the effects on victims. They indicate that such studies that exist have not included internet victims as yet, and are predominantly pre-internet. However, I was impressed that the authors had made an attempt to separate out different types of images and to consider the possible effects on children in different circumstances.

At the end of the chapter are a number of useful and practical exercises that could be used directly with internet offenders and the authors have, in my view rightly, suggested that they should be used with caution, as they may have the effect of inducing arousal. This is a perennial problem for practitioners working in this field, but needs to be emphasized whenever exercises on empathy are suggested. 

Chapter five, which focuses on fantasy and escalation, follows the pattern of previous chapters in giving an overview of the problem of sexual fantasy within sexual offending and the implications in particular for internet offenders. It then goes on to discuss some of the difficulties that we have in establishing a link between fantasy and action, and provides some exercises to develop an understanding of a particular offender’s fantasy world. What I found useful here was the way in which research into sexual fantasy, deviant or otherwise, and its links with pornography, were summarised. I also appreciated the emphasis on looking with an individual at the function of fantasy, and its relationship to offending. I think at times we can get lost in the exploration of  the detail of what fantasies an individual offender uses, rather than what they mean and what purpose they serve.

Chapter six introduces the notion of emotional avoidance, recognizing that some offenders will attempt to change their mood states through the use of sexual arousal and sexual behaviour. The authors introduce acceptance and commitment therapy (ACT) as a way of dealing with this problem distinct from the traditional CBT work with offenders. It suggests that offenders need to be able to recognize their emotional states and indeed their fantasy thoughts in relation to these and to be able to live with, rather then necessarily look to change, these.

As a practitioner I have often found that offenders have little capacity to hold on to negative emotional states and that the need to alter and seek some level of gratification in the process is central to their offending pattern. I was interested that this appears to be consistent with Bill Marshall’s presentation to a NOTA conference in 2006, where he identified that the lack of engagement with emotional states is one of the limitations of a strictly CBT-centred approach to sex offender work. I am also interested in this as some of my work with religious offenders has involved talking about the way in meditation allows for an acceptance of intrusive thoughts without the need to make attempts to directly block these.

In chapter seven which looks at social activity and the internet, the authors consider the ways in which online communities are formed. The chapter recognizes that there has been a vast expansion in legitimate online communities and establishes some of the characteristics of these in terms of affirmation etc. The authors then link these with online paedophile communities and examine the way in which they are supportive of particular views and expect a level of trust between participants.

In Chapter eight, which focuses on collecting images, there is a valuable distinction made between accumulation, hoarding, dealing and collecting. Again the authors have defined these within the context of non-offending collecting and then linked it with online collecting. They acknowledge that the process of collecting can be an important component in the arena of internet offending, whilst still recognizing that the content of the collection is also clearly relevant here. I found the way in which the authors had classified the collection of pornography generally and of abuse images was helpful in thinking about working with offenders, and as usual with this book, there are some useful ideas on applying the thinking and theory to active work with offenders.

In the last chapter, which focuses on the more traditional areas of maintaining change and relapse prevention, the links with the ‘good lives model’ and ACT are positive. I think that I would have liked to see more here in terms of practical exercises marking the end of a process of treatment.

One of the things that I most like about this book is the author’s willingness to engage with the reader in the thinking behind each of the subject areas and to then offer possible ways forward, including exercises that they feel could be helpful. This approach I think is particularly helpful for those coming new into the work. There is always a tendency in the early stages of the work to look for certainty, and I am heartened that the authors have not fallen into the trap of trying to provide it. As a practitioner with a number of years’ experience there is much here to challenge some of the traditional thinking, to contemplate, and in practical terms to use, with internet sex offenders.

Quayle E., Erooga M., Wright L., Taylor M. and Harbinson D. (2006) Only Pictures? Therapeutic work with Internet sex offenders Russell House Publishing, Lyme Regis;

ISBN 978-1903855683

£21.95

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