Biology & Chemistry · History · Psychology · Sociology

Punca Pedofilia Dari Sudut Neurologi

pedophilia_nightowls_lk

Oleh : Dick Swaab

Perkara yang mengejutkan tentang penganiayaan kanak-kanak dalam Gereja Katolik telah menjadi jelas baru-baru ini. Kes pertama timbul di Amerika Syarikat, kemudian di Ireland. Dalam pentadbiran uskup Dublin sahaja, beratus-ratus kanak-kanak dianiaya sekitar 1976 hingga 2004. Kes di Jerman kemudiannya terbongkar selepas beratus-ratus mangsa tampil di Netherland. Pendedahan ini menunjukkan wujudnya tabu yang berkaitan dengan pedofilia. Kita tidak tahu kekerapan penganiayaan telah berlaku yang bukan sahaja di gereja, tetapi pada selainnya.

Pedofilia terjadi disebabkan beberapa punca. Jika seseorang dewasa tiba-tiba mengalami desakan pedofilia, mereka mungkin mengalami tumor otak di korteks prefrontal, korteks temporal atau hipotalamus. Kadangkala disebabkan gejala demensia. Perubahan mengejut pada kecenderungan seksual kepada pedofilia juga disebabkan pembedahan dalam pemulihan epilepsi dengan membuang sebahagian luba temporal anteriror. Pesakit itu mampu terkena sindrom Kluver-Bucy yang menyebabkan kesekatlakuan seks. Di Amerika Syarikat, orang yang mula-mula memuat turun pornografi kanak-kanak dihukum penjara sembilan bulan baru-baru ini selepas pembedahan ini! Pedofilia juga disebabkan jangkitan di otak, Parinson, sklerosis dan trauma otak.

Namun, sebab secara neurologi bagi pedofilia masih pelik. Kebanyakan pedofilia selalu tertarik pada kanak-kanak yang puncanya dapat dikesan pada perkembangan otak janin dan perkembangan awal semasa kelahiran. Sepertimana identiti jantia dan orientasi seksual ditentukan dengan latar belakang genetik dan interaksi antara hormon jantina jantina dan perkembangan otaknya, begitu juga pedofilia yang nampaknya mampu dijelaskan dengan genetik dan faktor lain yang menyebabkan otak berkembang secara abnormal pada peringkat awal yang membawa kepada perbezaan struktur.

Saya pernah ditunjukkan silsilah keluarga yang termasuklah tiga generasi lelaki pedofilia. Perlakuan seksual yang menyimpang (seperti pedofilia) dipaparkan dengan peratus yang tinggi (18 peratus) pada tingkatan kerabat pedofilia yang pertama sebagai penetapan faktor genetik. Tambahan pula, pedofilia berkemungkinan besar berpunca dianiaya secara seksual oleh orang dewasa ketika usia muda. Pada penghujung 2009, rahsia derita keluarga pemimpin parti Northen Irish, iaitu Sinn Fein dan Gerry Adam telah terbongkar bahawa ayahnya telah menganiaya anaknya sendiri, manaakala giliran abangnya pula disyaki mempunyai penganiayaan seks terhadap anak perempuannya. Sama ada kanak-kanak yang dianiaya merupakan faktor penyebab pada perkembangan pedofulia semasa dewasa atau sama ada di sana terdapat faktor genetik seperti keluarga masih memerlukan penelitian.

Daniel Gjdusek (1923-2008), tokoh berbakat luar biasa yang mengkaji fizik, biologi, matematik dan perubatan di Amerika Syarikat menganggap bahawa kanak-kanak yang dianiaya kemungkinan penyebab pedofilia. Dia sendiri dianiaya oleh pakciknya ketika kanak-kanak. Dahulu saya pernah begitu ragu-ragu mempengerusikan syarahan oleh Gajdusek yang hipomania. Rakan kolej saya geli hati terhadap keinginan saya untuk menyekatnya.

Gajdusek telah mengkaji sebab kematian besar-besaran wanita muda dan kanak-kanak disebabkan penyakit kuru di kampung di pedalaman New Guinea pada 1957. Pada waktu itu, kampung itu dalam jajahan Belanda dan dia dapat menemukan jalannya ke sana dengan menggunakan kelengkapan tinjauan peta Belanda yang dia curi dari jabatan endorik Lein yang dipengerusi oleh Dries Querido.

Gadjusek menemukan bahawa kematian itu berpunca daripada kanibalisme yang tidak langsung. Selepas lama otak mereka dimakan yang ditawan musuh, mangsa ditimpa virus yang bergerak perlahan. Salah satu daripadanya ialah demensia. Penyakit itu ternyata disebabkan prion (agen yang berjangkit diperbuat daripada protein) yang sama penyakit lembu gila. Pada 1996, Gajdusek diangerahkan Hadian Nobel dalam perubatan.

Walau bagaimana pun, apabila dia pulang dari New Guinea dan lokasi terpencil yang lain, dia bukan sahaja mengkaji lebih mendalam pada tisu otak, dia juga membawa balik 56 kanak-kanak yang kebanyakan budak lelaki. Dia membawa mereka ke rumahnya dan memberikan mereka pendidikan. Namun, dia juga mencabul mereka sepertimana pendedahan tuduhan yang dibuat oleh seseorang yang tinggal bersama dengannya sebagai kanak-kanak. Dia dipenjara selama setahun dan meninggal pada 2008.

Terdapat juga segala faktor pada perkembangan awal yang mampu mempengaruhi risiko mengembangkan pedofilia. Sangat logik untuk mengkajinya, tetapi tabu pada keadaan ini menghalanginya. Siapa dalam masyarakat kita sanggup mengaku secara terbuka untuk menjadi pedofilia dan menyertai kajian bagi punca kerancuan ini?

Pada tahun baru-baru ini, perbezaan struktur yang pertama telah dikaji antara otak pedofilia dan mereka yang pada kelompok kawalan. Kajian yang melibatkan pengimejan resonan magnet menunjukkan orang itu ada sedikit gray matter (neuron) pada pelbagai kawasan otak seperti hipotalamus, dasar nukleus terminalis stria (yang saiznya juga berbeza dengan transeksual) dan amigdala yang memainkan peranan untuk perlakuan seks, ketakutan dan agresif. Tambahan pula kajian menunjukkan semakin kecil amigdala, semakin tinggi kemungkinan seseorang itu melakukan jenayah pedofilia. Pendedahan kepada gambar orang dewasa erotik dan beremosi menyebabkan sedikit aktiviti di hipotalamus dan koreks prefrontal pada orang pedofilia berbanding orang biasa. Ini menunjukkan bahawa orang pedofilia mempunyai minat seksual yang kurang pada orang dewasa.

Golongan pedofilia mempamerkan lebih banyak aktiviti amigdala berbanding kelompok kawalan dalam memberi respons imej kanak-kanak. Tambahan pula, imbasan fungsian pada otak orang homoseksual, heteroseksual dan pedofilia yang ditunjukkan gambar lelaki dewasa, wanita dewasa, budak wanita dan budak lelaki menunjukkan perbezaan yang nyata di antara kelompok dikelaskan mengikut aktiviti otak. Walau bagaimanapun, kita perlu ingat bahawa kajian pedofulia hanya fokus pada yang kecil dan kelompok pedofilia yang dipilih.Majoriti mampu untuk mengawal desakan mereka, tetapi tidak melakukan jenayah. Hal itu menyebabkan mereka tidak dikaji.

Kerosakan penganiayaan seksual kanak-kanak yang dihukum bukan sahaja kerana reaksi penebus, tetapi juga sebagai pencegahan penganiayaan yang selanjutnya. Bangkangan yang akhir-akhir ini mengutarakan sebuah masalah, iaitu bagaimana anda mengubah kelakuan yang telah diprogramkan di otak pada peringkat awal perkembangan? Pada masa yang lalu, setiap percubaan telah pun dilakukan bagi mengubah orang homoseksual kepada heteroseksual, namun tidak berhasil apa-apa. Perkara yang sama terjadi pada pedofilia. Tidak lama dahulu, mahkamah di Utrecht mendengar kes menteri gereja heteroseksual yang berusia 60 tahun yang dihukum kerana seks pedofilia. Orang itu dijatuhkan hukuman sepuluh bulan di penjara, tetapi selepas melalui perimbangan yang banyak, dia berkemungkinan dihukumi untuk khidmat masyarakat. Betapa hebat perubahan yang berlaku.

Ada suatu ketika berlakunya ketegangan yang bercampur aduk kesamarannya bagi berhadapan dengan eugenik, hukuman, perlindungan masyarakat dan tekanan terhadap homoseksual sehingga membawa kepada pengembirian pedoseksual di Netherland. Sekitar 1938 dan 1968, sekurang-kurangnya empat ratus pesalah laku seks “merelakan diri” untuk dikembiri. Praktik ini tidak ditetapkan oleh undang-undang. Pesalah laku seks ini ditahan bawah perintah hospital yang diberi pilihan sama ada penjara seumur atau pengembirian. Mereka telah menghantar surat rasmi kepada kementerian kehakiman yang dalam teks itu menyebut, “Bolehkah saya meminta dengan rendah diri kepada Tuan Yang Terutama bagi membenarkan diri tuan dikembiri?”. Selepas 1950, 80 peratus orang yang dikembiri ialah pedofilia. Dalam masa yang sama berlaku situasi rumit dalam penentuan cukup umur untuk seksual di sisi undang-undang. Di Jerman, hipotalamus pedofilia dilukakan secara pembedahan dengan harapan agar ini mampu mengubah orientasi seksual mereka. Kaedah ini tidak pernah didokumenkan secara saintifik.

Insiden pengembirian secara kimia terhadap pesalah laku yang ditahan bawah arahan hospital sedang bertambah sekarang ini. Ini melibatkan penyekatan libido dengan bahan-bahan kimia yang mengurangkan kesan testosteron. Ini mampu melegakan ketagihan seksual ketika dibebaskan. Walau bagaimanapun, perkara ini membimbangkan sebahagian individu ini dikembiri secara kimia. Pihak berkuasa cuma akan berlepas diri atas kesan perbuatan mereka. Bahan-bahan kimia ini tidak sesuai untuk setiap pesalah laku seks dan kesan sampingan baginya termasuklah perkembangan buah dada, obesiti dan osteoporosis yang merupakan sesuatu yang bahaya.

Menteri pedofilia dari Utrecht boleh memanjatkan kesyukuran kepada nasib tuahnya kerana perkara itu berubah sejak hari permintaan pengembirian yang formal. Hakim yang mempengerusi siasatan kesnya begitu bimbang terhadap perlakuan semula dan itulah yang sebetulnya. Namun, dia fikir bahawa enam bulan tahanan prapembicaraan mampu memberi kesan hukuman dan gabungan antara hukuman bersyarat yang lama dan komuniti order lebih efektif berbanding pemenjaraan yang lama. Sama ada dia benar, kita masih tidak tahu kerana sistem kehakiman tidak ada tradisi untuk mengkaji kefektifan hukumannya. Begitu juga dunia perubatan. Alahai! Itu pun tiada tradisi bagi mengkaji faktor perkembangan awal yang menyebabkan pedofilia. Menyahkan tabu daripada kajian itu mampu memberi pencerahan kepada faktor ini dan merupakan kaedah terbaik bagi memeriksa impuls pedofil serta menghentikan orang lain daripada. Ini mampu menghilangkan kesengsaraan besar yang sangat dibimbangi.

Perkara yang sama teraplikasi pada wanita pedofilia. Tanggapan tentang wanita tidak disabitkan melakukan kesalahan bagi seksual pedofilnya cumalah mitos sahaja. Penganiayaan seksual kanak-kanak oleh wanita selalunya dilakukan oleh ibunya sendiri. Pada kebanyakan bahagian, mangsa ialah wanita dan purata umur kira-kira enam tahun. Ibu itu disebabkan kemiskinan, tidak berpendidikan dan selalu mempunyai masalah kesihatan mental seperti kerosakan kognitif, psiko dan ketagihan.

Inisiatif di Kanada telah menunjukkan bahawa inisiatif itu mampu mengatasi isu ini dengan cara yang begitu mudah. Di sana, pedofilia dibantu oleh kumpulan sukarela selepas penahanannya.  Hasil rangkaian sosial ini telah mencegah perlakuan semula dengan kadar yang berpatutan. Ini lebih baik daripada situasi di Netherland. Pada akhir 2009, seorang pedofilia mula-mula dilarang dari memasui ke bandar Eindhoven oleh datuk bandar, kemudian dihalang dari memasuki taman negara di wilayah Utrecht. Sekarang orang itu tinggal di keretanya dan merantau dari lot letak kereta ke lot letak kereta. Itu sememangnya mencari masalah. Namun, Netherland sedang mencuba inisiatif Kanada.

Cara lain untuk mencegah penganiayaan kanak-kanak mungkin menghasilkan rekaan pintar pornografi kanak-kanak tiruan yang tidak melibatkan penganiayaan kanak-kanak sebenar. Milton Diamond, terkenal dengan ahli seksologi di Hawaii telah mendapati bukti yang banyak untuk mencadangkan bahawa cara ini berkesan. Meskipun begitu, ini tidak diragui lagi betapa sukarnya untuk meyakinkan pihak berkuasa untuk pertimbangkan idea pembaharuan iu itu.

Nukilan dan terjemahan daripada We Are Our Brains, Dick Swaab, m/s 72-77, terbitan Penguin Group, 2014.

Teks asal :

The shocking scale of child abuse within the Catholic Church has come to light in recent years. The first cases emerged in the United States, then in the Ireland, where, within the bishopric of Dublin alone, hundreds of children were abused between 1976 and 20014. Cases in Germany were subsequently exposed, after which hundred of victims came foward in the Netherlands. These revelations show that, as a result of the taboo surrounding pedophilia, we have no idea how frequently such abuse actually occurs–not just in the church but in general.

Pedophilia can have different causes. If an adult suddenly experiences pedophilic urges, they may have a brain tumor in the prefrontal cortex, temporal cortex or hypothalamus. Sometimes it is a symptom of dementia. A sudden switch in sexual inclination to pedophilia has also been caused by operations to cure epilepsy by removing part of the anterior temporal lobe. Such patients can go on to develop Kluver-Bucy syndrome, which involves the loss of sexual inhibition. In the United States, a man who started to download child pornography after an operation of this kind was recently sentenced to ninteen months of imprisonment! Pedophilia can also be caused by infection of the brain, Parkinson’s, multiple sclerosis and brain trauma.

But a neurological cause for pedophilia is rare. Most pedophiles have always been attracted to children, and the cause can be traced to fetal brain development and early development after birth. Just as gender identity and sexual orientation are determined by genetic background and the interaction between a fetus’s sex hormones and its developing brain, so too pedophilia can apparently be explained by genetic and other factors causing the brain to develop abnormally at an early stage, leading to structural differences. I was once shown a family tree that included three generations of pedophile men. Deviant sexual behavior (like pedophilia) is displayed by a high percentage (18 percent) of first-degree relatives of pedophiles, pointing to genetic factor. In addition, pedophiles are more likely to have been sexually abused by adults as young children. At the end of 2009, the leader of the Northern Irish party Sinn Fein, Gerry Adams, went public with the painful family secret that his father had abused his own children, while his brother was in turn suspected of having sexually abused his daughter. Whether abuse as a children causal factor in the development of pedophilia in adulthood or whether there’s a genetic factor in such families, still needs to be investigated.

Daniel Gajdusek (1923-2008), a man of remarkable talent who studied physics, biology, mathematics and medicine in the United States, thought that abuse as a child could cause pedophilia. He had himself been abused by an uncle as a child. I once had the dubious honor of chairing a lecture by the hypomanic Gajdusek; my colleagues were amused by my vain attempts to keep him in check. Gajdusek had been researching the cause of mass deaths of young women and children from the disease kuru in the villages in the interior of New Guinea in 1957. At the time, it was still a Dutch colony, and he was able to find his way there by using Dutch ordnance survey maps that he’d stolen from the Leiden endocrinology department headed by Dries Querido. Gajdusek discovered that the deaths were indirectly caused by cannibalism. Long after they had eaten the brain of conquered enemies, the victims were struck down by a slow-acting virus, one of whose symptoms was dementia. The disease turned out to be caused by prions (infectious agents mad of protein) just like mad cow disease. In 1996 Gajdusek was awarded the Novel Prize for Medicine. However, when he returned from New Guinea and other remote locations it wasn’t just with brain tissue for further research; he also brought back fifty-six children, mostly little boys. We always thought that this was very odd. He took them into his home and gave them an education, but as an accusation made by a man who had lived with him as a child later revealed, also molested them. He was imprisoned for a year and died in 2009.

There are all kinds of factors in early development that could influence the risk of developing pedophilia. It would seem logical to study them, but the taboo on this condition stands in the way. Who in our society would dare openly admit to being pedophile and take part in research into the causes of this disorder?

In recent years, the first structural differences have been reported between the brains of pedophiles and those of remote control groups. A study involving magnetic resonance imaging (MRI) showed that the former have less gray matter (neurons) in the various area of the brain, like the hypothalamus, the bend nucleus of the stria terminalis (whose size also differs in the transsexuals), and the amygdala, which play a role in sex, fear and aggressive behavior. It moreover emerged that the smaller the amygdala, the more like an individual was to commit pedophilic crimes. Exposure to emotional and erotic images of adult sparks less activity in the hypothalamus and prefrontal cortex of pedophile men than in control men, which ties in with the fact that pedophiles are less sexually interested in adults. Convicted pedophiles display greater amygdala activity than control men in response to image of children. Functional scans of the brain of homosexual, heterosexual and pedophile men shown pictures of men, women, girls and boys moreover show a clear difference between these group in terms of brain activity. However, we must bear in mind that research into pedophilia focuses solely on a small, selected group of pedophiles. The majority are able to control their urges, don’t commit crimes, and therefore aren’t studied.

Sexual abuse damages children and is punished, not only for reasons of atonement but also to prevent further abuse. The latter objective poses a problem, though because how do you change behavior that has been programmed in the brain at an early stage of development? In the past, every conceivable effort has been made to change homosexual men into heterosexuals, without any success whatsoever. The same applies to pedophiles. Not so long ago, a court in Utrecht heard the case of sixty-year-old heterosexual church minister charged with pedosexuality. The prosecution called for a sentence of ten months in prison, but after a great deal deliberation he was eventually given a community sentence. How things have changed.

There was a time when an obscure mix of arguments bearing on eugenics, punishment, the protection of society, and the repression of homosexuality led to the castration of pedosexuals in Netherlands. Between 1938 to 1968, at least four hundred sex offenders were “voluntarily” castrated. This practice wasn’t laid down by law. These were offenders detained under a hospital order who were given the choice of his life imprisonment or castration. They had to submit a standard letter to minister of justice, the text of which ran, “May i humbly crave Your Excellency’s permission to be castrated?”. Up to 1950, 80 percent of the castrated men were pedosexual, a situation complicated by the high legal age of sexual consent (sixteen). In Germany, the hypothalami of pedophiles were surgically lesioned in the hope that this would change their sexual orientation. These brain operations were never scientifically documented.

The incidence of chemical castrations among offenders detained under a hospital order is currently increasing. This involves suppressing the libido with a substance that diminishes the effect of testosterone. It can provide relief at being freed from sexual obsession. However, it’s worrying that some of the individuals are being chemically castrated because the authorities would otherwise deny that applications for leave. These substance certainly aren’t suitable for every sex offender, and the side effects, including the development of breasts, obesity and osteoporosis are serious.

The pedosexual minister from Utrecht can thank his lucky stars that things have changed since the days of formal castration requests. The judge who presided over his case was worried about reoffending, and rightly so. Nevertheless, he thought that the six-week pretiral detention would have a deterrent effect and that the combination of a long conditional sentence and a community order would be more effective than lenghty imprisonment. Whether he was right we’ll never know, because the judicial system has no tradition of researching the effectiveness of its punishments. And the medical world, alas, has no tradition of researching the factors in early development that cause pedophilia. Doing away with the taboo on such research could shed light on these factors and on the best methods of checking pedophile impulses and stopping people from reoffending. This would prevent a great deal of misery for all concerned.

The same applies to female pedophiles. The idea that women can’t be guilty of pedosexuality has been found to be a myth. Sexual abuse of children by women is usually perpetrated by mothers on their own offspring. For the most part, the victims are girls with and average age of around six. The mothers tend to be poor and uneducated and often have mental health problem like cognitive impairment, psychoses, or addictions.

An initiative in Canada has shown that it’s possible to tackle this issue by quite simple means. There, pedosexuals are helped by group of volunteers after their detention. The resulting social network has been shown to cut reoffending rates quite considerably. This is much better than the situation in the Netherlands, where in late 2009, a pedophile was first banned from the city of Eindhoven by its mayor, then prohibited from entering a national park in the province of Utrecht. The man now lives in his car and travels from parking lot to parking lot. That’s asking for trouble. But the Netherlands is trying out the Canadian initiative. Another way of preventing child abuse might to be issue smart form of fake child pornography that don’t involve the abuse of real children. Milton Diamond, a renowned sexologist in Hawaii, has found considerable evidence to suggest that his works. However, it will no doubt prove difficult to convince the authorities to consider such an innovative idea.

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