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News ::
A Pre-emptive Strike in Mental Health (english)
16 Jun 2003
This article is an examination of mental health treatment in the post 9/11 atmosphere of fear and suspicion
Group Health Cooperative of Puget Sound.
A Pre-emptive Strike in Mental Health

By
Dennis Bejin
June 16, 2003

I have received mental health treatment at Group Health Cooperative’s Behavioral Health Center since 1992. For the most part the service has been excellent. In this post 9/11 atmosphere of fear and suspicion, however, where the notion of a pre-emptive strike has become a household concept, mental health treatment is no longer the same.

Previous to this year my membership in NAMBLA (North American Man Boy Love Association) was never a forbidden subject in therapy, nor was the fact that I am sexually attracted to boys. In 1994 a considerable number of sessions were spent reviewing my activism in NAMBLA, and the harassment I received when my name, address and my supervisors phone number at work was posted on the web site of the religious fanatic
who has since died in prison.

In 1995 Group Health’s Behavioral Health Center helped me deal with the stress of hosting the 1995 National Membership Conference for NAMBLA in Seattle. Regrettably, this year when I sought help in dealing with the stress surrounding chronic depression and anxiety, and the crisis of a First Amendment lawsuit there was no welcome sign on the door.


Instead, my therapist immediately diagnosed me as a “pedophile” both because of my attraction to boys and my membership in NAMBLA. He said I needed a specialized evaluation, and treatment for pedophilia. This was surprising since the precipitating problem I presented was unrelated to my attraction to boys, and my attraction to boys had never been singled out for special treatment in the past.

My therapist wrote this note regarding our first session on 3/4/03:

“Mr. Bejin will return in two weeks to complete his assessment. I will present him with my diagnostic conclusions, i.e., that his interest in relations between men and boys is considered a pedophilia, and that his other sexual behavior probably represents a diagnosable fetishism, and that his problems with ongoing anxiety and depression don’t stand a good chance of remediation in the context of these sexual disorders. I will strongly suggest that he seek expert treatment in these matters.”

The case note dated 3/25/03 read as follows:

“Session spent discussing scheduling and treatment agreements. I advise that he get treatment for pedophilla and that it is not appropriate for me to help him feel comfortable with his sexual orientation as it may be leading to his depression and anxiety.”

Regrettably, these are not therapeutic statements on the part of my therapist, rather they are a reflection of the prejudice and bigotry that has led many a boy-lover (adult attracted to boys) to commit suicide. As the “National Mental Health Association” says in its statement on Gay youth and Bullying in Schools:



“Gay and lesbian teens are at high risk because ‘their distress is a direct result of the hatred and prejudice that surround them, not because of their inherently gay or lesbian identity”

I have not doubt that the same is true for men attracted to boys. There is nothing inherently wrong with our attraction to boys. It’s society’s reaction to our attraction that creates the distress.

The actual reason why Group Health wanted me receive to treatment for pedophilia became clear in my psychiatrists case note dated 3/27/03.

The note reads as follows:

“I clarified that [the therapist] was not addressing his [Dennis’] choice of partners who had reached the age of consent. Pt. Accepted frame that concern is state of arousal that could lead to increased risk of potential victimization.”

My psychiatrist than goes on to say, “Pt. recognizes [therapist] has professional, ethical, obligations to address risks.”

The statement that I recognized that my therapist “has a professional, ethical, obligations to address risks” is not true.
It would be true if something I had said or done required reporting under mandatory reporting laws.

The concern that my state of arousal could lead to increased risk of potential victimization.” is a word game. Most “male homosexuals attracted to boys” remain in the closet because of the stigma they face in a hostile culture. There are few if any statistics on boy-lovers (men attracted to boys) who have not come the attention of law enforcement and their risk of potentially victimizing a child.
Further, the risk of so called “victimizing” a child is related to impulse control and not sexual orientation. No where in the case notes was there any mention of poor impulse control.

What my psychiatrist and therapists apparently didn’t know is that only months earlier, when I applied for disability due to chronic “depression and anxiety” a state appointed therapist had also diagnosed me as a “pedophile” because of my attraction to boys. However, there was no mention made of poor impulse control,
or potentially victimizing a child. There was no request for a specialized diagnoses or specialized treatment.

Assuming that I did in fact need specialized assessment and treatment for pedophilia what was the most likely option. We find one answer on the web site, “Male homosexual Attraction to Minors”

http://www.mhamic.org/intro/whatitis.htm

This web site makes it clear that the most common type of treatment is focused on sex offenders. The web site further states that this kind of treatment is adversarial rather than therapeutic

http://www.mhamic.org/intro/treatment.htm

The web site states:

“The most common type of treatment available is sex offender treatment provided by clinics and university departments that work in concert with the criminal justice system. Since most participants are offenders whose attendance is court mandated, the approach is adversarial rather than therapeutic.37 The singular purpose of sex-offender treatment is to prevent re-offending and involves the following components:38 “

Since I was not being mandated by any court to receive treatment, such therapy would clearly be inappropriate. If Group Health’s concern was my depression and anxiety I can assure you that being put in an adversarial situation would have worsened my depression and anxiety, not helped it.

The web site “Homosexual Men Attracted to Minors” goes on to make the following observation regarding the knowledge available on homosexual men attracted to boys who are not sexual with boys:

“Researchers agree that the state of understanding of sexual attraction to minors is poor.
• Cultural, political, and legal obstacles prevent the study of minor-attracted men who have not been convicted of a crime. Thus, most studies are based on criminal samples of convicted offenders who are not representative of the general population.44
• Several researchers have written that the development of a knowledge base is hampered by narrow conceptual perspectives, poor methodology, and imprecise or inconsistent definitions.45

Scientists have also noted that conclusions often result from biased methodology based on moral beliefs rather than scientific principles.46”

If Group Health Cooperative was truly concerned about my attraction to boys and its relationship to my depression and anxiety there are a number of other ways to address that concern without recommending specialized treatment for pedophilia.

Mainly, Group Health could have explored the socially imposed stigma surrounding my sexual orientation. This approached would not conflict with fact that Group Health does not treat sexual disorders. However, the problems that could be addressed are not inherent to my sexual orientation (homosexual pedophile) which under the DSM – 4 is viewed as a sexual disorder. Rather, the issues being confronted are the result of society’s misinformed and hostile response to my sexual orientation.

The web site “Age Taboo.” is mainly a web site for gay youth, and adolescents attracted to younger boys. However many of the problem facing homosexual men attracted to minors are similar.

http://www.agetaboo.org/


All of the items discussed on the above web site also relate to society’s attitude toward men attracted to boys. The first step in addressing any problem is becoming aware of what the problem is. The web site states the following:

“Stigma is society's labeling and viewing of certain people as deviant, unnatural, and intolerable. It involves societal perceptions of the stigmatized individuals as defective, unhappy, lacking family connections, and incapable of maintaining relationships with others. Stigmatized people typically face societal attitudes such as hatred, fear, prejudice, and/or pity, and resulting discrimination, harassment, and verbal or physical abuse.”
The article goes on to say:
“Many of the health and mental health concerns of youth with minority sexualities are associated with how they are perceived in the social environment. Stigma has a powerful impact on self-perception, behavior, and health outcomes. However, the negative effects of stigma can me mediated by sensitive, informed, and nonjudgmental assistance. This does not require special skills or extensive training, but rather awareness that not all youth are straight, sensitivity in talking with them, and understanding the stressors in their lives.”

This information comes from the work of Goffman and Allport who have extensively studied stigmatized groups. Adapted from Caitlin Ryan & Donna Futterman, Lesbian and Gay Youth: Care & Counseling, New York: Columbia University Press, 1998.



Other areas the could have been explored as being problem areas by either my psychiatrist or therapist include the following and are taken for the Age Taboo web site:

Social and emotional isolation: This isolation is due to fear of discovery and feelings of rejection. Such youth feel separated affectionally and emotionally from others. Such isolation exacerbates mental health problems and leads to maladaptive coping behavior. Isolation is a principle cause of suicide. Isolation from others with a similar sexuality prevents them from learning about, understanding, and accepting their sexuality, which is necessary for development of a consolidated positive identity.

The severe stress that results from having a stigmatized sexuality also threatens mental health. Typical stressors for sexual minority youth include coming out or being discovered, strained relationships with family, being ridiculed, experiencing harassment, sensing others' negative attitudes, and feeling powerful pressure to conform to the norm. These stressors increase the potential for depression, risky behaviors, and suicidal ideation.

A lack of information about their sexuality leaves sexual minority youth vulnerable to accepting society's stereotypes and false information about themselves, intensifying the effects of stigma. This lack prevents them from understanding and accepting their sexuality, and developing a positive integrated self-concept. A similar lack of knowledge on the part of care providers leads to refusal to provide care, an attitude of rejection toward sexual minority youth, or inappropriate, inadequate, or unethical treatment which can cause severe psychological damage. Such treatment also causes sexual minority youth to distrust mental health professionals and avoid or delay getting help when they need it.

A lack of role models also interferes with proper development. Most straight youth see many role models around them: men and women who are emotionally healthy and who express their sexuality in responsible ways. They have people they can talk to for advice or to listen to their difficulties. Such role models are more difficult to find for gay youth, and virtually impossible for those who are attracted to boys younger than themselves.


In conclusion I must add the following. My concern is not simply that I am being targeted for special and determental treatment because of what I could “potentially” do because of my attraction to boys, but also because once a person enters a special treatment program for pedophilia the danger of being permanently incarcerated is one step closer to reality.

For those unfamiliar with this concept I refer them to the case of Kansas v. Crane.

http://www.cnn.com/2002/LAW/01/columns/fl.colb.incarceration.01.30/

The case involves a man who was involuntarily committed through civil procedures after he had been convicted of a sex crime and served time in prison for that crime. However, the precedent is also established to involuntarily commit an adult who has never committed a crime, but is deemed as a possible threat because of their fantasies and desires.

In this post 9/11 hysteria over hidden terrorists, and when hundreds of innocent people are being held secretly because of there supposed terrorist affiliations, my concern is not unfounded.

In conclusion, I am entitled to acceptance and compassion from the mental health providers who see me. This means I have the right to live free from stigma and inaccurate negative assumptions based on my sexual orientation. Apparently The Central Behavioral Health Center at Group Health Cooperative of Puget Sound is not familiar with this concept. I wonder what it is doing to other people in similar situations ?
Sincerely,
Dennis Bejin


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