Donna J Markham & Samuel F Mikail. Studies in Gender and Sexuality. Volume 5, Issue 2. 2004.

Sexual abuse of a child by a trusted adult is a horrific and inexcusable act, regardless of the circumstances that may have contributed to the abuser’s actions. The impact of such behavior on victims most certainly can be tragic and long lasting. Indeed, there is a significant body of literature attesting to the noxious impact of sexual abuse on the relational lives of victims (e.g., Briere, 1996). Given the gravity of the consequences for victims, church officials have taken sweeping action to remove all clergy with a history of sexual involvement with a minor from their ministerial roles. This decision, warranted by egregious mismanagement by a minority of church officials, nevertheless makes no room for diagnostic distinctions, the possibility for healing, redemption, or forgiveness; it also disregards the nature of the action, treatment outcome, prognosis, or likelihood of harming anyone again. Unconditional removal from ministry of clergy with a history of sexual involvement with a minor reflects a pervasive axiom of contemporary behavioral science that the best predictor of future behavior is past behavior. Our clinical experience, however, has raised questions about the validity of this axiom.

The clinical significance of attachment style as it relates to psychopathology is well known and documented, especially as it concerns the damage done to victims of sexual abuse in their efforts to establish healthy adult relationships later in life (Briere, 1996). Much less has been written, however, on the attachment styles of abusers. Having worked both with victims of abuse and with abusers, we have become increasingly aware of the impaired attachment behavior of those priests who sexually abuse minors. In an effort to understand what went wrong and to inform efforts to prevent such destructive behavior by future members of the clergy, we have found it helpful to frame our clinical formulations in the context of attachment theory.

Reviewing the cases of clergy who were removed from ministry during the past several months, we are struck by the fact that the majority of the cases involve incidents that occurred between 20 and 30 years ago, and that in many cases incidents of abuse did not recur in the ensuing decades. As clinicians, we have been faced with two histories that are grossly at odds: the time during which the priest was abusive and the long period following when there appears to have been no evidence of abuse. In many of these apparently nonrepetitive cases, the priest received intensive psychotherapy, participated in 12-Step programs, and regularly sought out spiritual direction. It appears-and it is borne out by history-that they have achieved a level of healthy relational and emotional integration and spiritual functioning whereby it would be extremely unlikely that they would harm a child or vulnerable adult. On the other hand, we are also tragically aware that there are priests who engaged in predatory, serial abuse of minors. These men must never again have access to minors and should not hold a fiduciary social role. So which historical decade should clinicians or bishops draw on in their efforts to anticipate future behavior? It is this dilemma that we hope to address by examining priests’ capacity to form healthy relational attachments.

Over the past 36 years, nearly 5000 church professionals have been treated in an accredited residential mental health facility located near Toronto, Ontario. Approximately half the cases were male clergy, 12% presenting with an incident or incidents of sexual abuse of a minor and 3% meeting the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for a diagnosis of pedophilia (American Psychiatric Association, 1994). In our work with clergy who were perpetrators of sexual abuse, it has become clinically evident that there is a wide range of psychodynamic factors that bear on treatment outcome and risk of reoffending. While rigorous empirical analysis remains to be undertaken, some elucidation of the dynamics at work within these persons may shed light on this problem.

Attachment Behavior and Attachment Styles

Attachment theory underscores the primacy of emotional attachment in understanding human adaptation and the role of relationship as a source of security. Bowlby (1988) defined attachment behavior as

any form of behavior that results in a person attaining or maintaining proximity to some other clearly defined individual who is conceived as better able to cope with the world. It is most obvious whenever a person is frightened, fatigued, or sick, and is assuaged by comforting and caregiving [pp. 26-27].

Attachment behavior has been characterized as a means of establishing a state of security when one is faced with heightened stress or threat by seeking out supportive others (Johnson and Whiffen, 1999, p. 372). Research has demonstrated, however, that considerable variability exists among individuals in their willingness to seek out the support of others. It is this variability that has led to the identification of varying attachment styles.

Bartholomew and Horowitz (1991) distinguished four styles of attachment behavior that they termed “secure,” “dismissive,” “preoccupied,” and “fearful.” Their formulation was based on Bowlby’s (1973) hypothesis that attachment styles stem from two underlying dimensions: anxiety and avoidance. Anxiety reflects one’s sense of self-worth and beliefs about the extent to which the self is accepted or rejected by others: avoidance refers to one’s tolerance of intimacy and interdependence. Bartholomew and Horowitz (1991) suggested that securely attached persons have a positive view of self and their intimate others and are free of anxiety in their efforts to establish intimacy and interdependence.

Preoccupied persons possess a negative view of self and a positive view of intimate partners (Griffin and Bartholomew, 1994). They display a high degree of anxiety and low levels of avoidance. Their anxiety is born of a strong desire for closeness (i.e., low avoidance) coupled with a fear of rejection (i.e., a firm belief that the self is unacceptable). Our clinical experience suggests that priests exhibiting preoccupied attachment tend to be at greater risk for entering relationships in which personal and professional boundaries become blurred. At times of heightened vulnerability, the needs of these men for affirmation, approval, and acceptance can lead them to assume a stance of affable submissiveness that diminishes their authority and denies their power. When a priest assumes such a position in a relationship with a vulnerable minor, who may or may not have a compromised attachment history, the possibility of boundary violation, due to the impact of his fiduciary role, increases significantly.

Dismissive persons have a positive self-image and view others negatively (Griffin and Bartholomew, 1994). Overtly, these people display low levels of attachment-related anxiety and tend to avoid intimacy and interdependence. This pattern of avoidance is built on an expectation that others cannot be relied on. Their positive self-concept is maintained by viewing others as incapable of responding adequately to expressed needs. The strong conviction that the self is worthy and valuable equips these persons with the capacity to be aware of their instrumental needs, though perhaps not their emotional needs.

Priests with dismissive attachment are likely to possess a narcissistic personality organization that may include considerable sociopathic features. Their limited capacity to identify emotional needs makes it likely that they will rely on the use of compartmentalization as a primary defense against emotional pain. These men are often unable to achieve a healthy integration of their sexuality and spirituality. Sexual needs are likely to be experienced as biological drives devoid of emotional connection or intimacy. The narcissistic stance of these men propels them to view others as objects or a means to an end, thus heightening the possibility of their engaging in exploitive abusive behavior toward vulnerable others. Consistent with this position is a profoundly diminished capacity for empathy.

Fearful persons have a negative view of self and intimate others. They exhibit high levels of attachment anxiety and avoidance (Griffin and Bartholomew, 1994). Even though they desire close relationships, their avoidance of intimacy is driven by a fear of rejection and abandonment. Fearful people view themselves as unworthy of caring and concern, and they believe that they have little intrinsic value to others. Similarly, they perceive others as either uninterested and unavailable or as incapable of offering help. This constellation of beliefs contributes to a chronic state of fear and anxiety. Fearful persons experience an ongoing devaluing of themselves that results in an inability to identify and recognize basic needs. Thus, in the face of distress, needs are likely to be undefined and are experienced as unspecified, generalized anxiety. The expectation that others are unavailable and unresponsive further exacerbates this situation. Thus, they are prone to keep silent about what vague needs they may have.

Priests having a fearful attachment style tend to objectify both the self and the other. They view themselves in a mechanistic and almost autistic manner. They believe that they are to “do and serve,” and direct little attention toward their emotional and spiritual life. Their expectation is that others are there to take from them but seldom give. Their relational history is often marked by experiences of abuse and neglect, and these become the templates from which they engage others. They desperately seek nurturance from less powerful others who will not hurt them.

Extensive empirical research has demonstrated that child molesters exhibit a compromised capacity for intimacy and deficits in secure attachment. Seidman et al. (1994) conducted a series of studies in which they found that sex offenders scored lower on measures of intimacy and higher on measures of loneliness than did men in the community or men who had been identified as spousal abusers. Garlick, Marshall, and Thornton (1996) reported similar findings. Bumby and Hansen (1997) found that child molesters expressed a greater fear of intimacy than any other group of sexual offenders. They also exhibited higher levels of emotional and social loneliness relative to several comparison groups. Interestingly, child molesters were reported to externalize blame defensively in situations of interpersonal conflict or tension (Garlick et al., 1996). In an earlier study, Marshall, Barbaree, and Fernandez (1995) reported that child molesters exhibited low self-confidence, social anxiety, and a lack of assertiveness, suggesting significantly compromised social functioning. Our experience with clergy sex abusers certainly highlights such findings. The prevalence of loneliness, the lack of rewarding close adult relationships, and over-identification with the clerical role-thus subordinating a developed positive sense of self-are characteristic of most abusive clergy with whom we have worked.

Attachment Style as a Basis for Predicting Sexual Offenses

Hanson and Bussiére (1998) conducted a metaanalysis of 61 studies that examined predictors of recidivism among sexual offenders. The authors identified several variables that predicted relapse in this population. Two demographic variables found to be useful were age (the younger the offender at the time of first offence, the higher the likelihood of recidivism) and marital status (offenders that were single were more likely to reoffend sexually). If the abuse involved a male victim previously unknown to the perpetrator and the sexual activity occurred in the absence of any type of relationship, the risk of recidivism was highest. This form of sexual expression requires deliberate and planned behavior characterized by objectification of the victim. It is indicative of a limited capacity for establishing and maintaining relational attachment.

Extrafamilial child molesters exhibit limited victim empathy. They often justify their actions by suggesting that they were teaching the victim about sex. Their primary focus is directed toward a gratification of their own needs, be they sexual or a need for dominance and control. We believe these characteristics typify a dismissive attachment style that is likely to become more entrenched over the course of adulthood. Clergy in this group typically meet the criteria for pedophlia. Hanson (2001) noted a reduction in recidivism occurring around age 50. He suggested that this may be a function of decreased impulsivity and diminished sexual drive consistent with aging.

In contrast, studies of incestuous child molesters reveal lower rates of relapse (Hanson and Bussiére, 1998). This group of offenders are most likely to act out during early adulthood, a phase of development marked by a heightened need for nonparental attachment and a desire for greater degrees of sexual expression. It is conceivable that the fear of rejection characteristic of persons exhibiting either a fearful or a preoccupied attachment style, coupled with deviant sexual interest, finds expression in incestuous engagements. Once these men are able to establish age-appropriate relationships, their level of risk decreases significantly. Our experience has shown that the majority of clergy offenders are similar to this group. They exhibit psychosexual developmental arrest; they have abused minors known to them, youngsters who were part of the church “family.”

Indices of Treatment: Responsiveness and Case Studies

While the terrible emotional harm done to victims of sexual abuse cannot in any way be diminished or disputed, clinical evidence suggests that abusers do not reflect a single profile of predatory behavior. Hanson and Bussiére (1998) suggest that a number of factors need to be considered when determining the intransigence of the behavior pattern.

The majority of cases of male clergy who abused minors involved psychosexually immature priests who were in their late 20s and early 30s at the time of abuse and who were ordained in the 1970s at the height of the sexual revolution. Their victims typically were adolescent males who were known to them and who were often experienced by the priests as emotional peers.

We have responded to referrals from religious leaders across the English-speaking world (primarily Roman Catholic and Anglican) and are aware of an emerging consensus over the course of the past 10 years or so concerning the management of allegations of sexual abuse by members of the clergy. Typically, when an incident of abuse comes to light, the bishop or religious superior refers the priest for a comprehensive assessment and extended residential treatment. At the termination of treatment, a discharge plan is formulated that includes, among other things, a summary of the following indices of treatment responsiveness:

• The extent to which he was forthcoming about his abusive behavior: that is, he did not deny his behavior
• His awareness of the seriousness of the violation of his fiduciary role
• The extent to which the priest exhibited remorse and empathy for his victim
• His capacity to engage affectively with peers
• His willingness to adhere to strict ministerial supervision
• His commitment to ongoing outpatient psychotherapy and spiritual direction

The clinical team’s assessment of the priest’s demonstrated resolution of these factors is the basis for determining potential for reoffending.

A case of Dismissive Attachment

Fr. A, a 57-year-old priest, was referred following his being reported to his superiors for having allegedly fondled two prepubescent boys over the course of several years. The events had purportedly occurred approximately 18 years earlier, when the priest was in his late 30s. He presented as superficially cooperative, articulate, and bright and clearly minimized the seriousness of the allegations. Of interest was his style of staring directly into the eyes of each clinician who evaluated him. He repeatedly and vehemently denied he had behaved in a sexually exploitative manner. He continually stated that his behavior had been “misinterpreted” by the boys and exaggerated by the parents.

Although his superiors had already decided to remove him from any future ministry, they felt it was in Fr. A’s interest to assist him in addressing the dynamics that had led to his abusive behavior and in developing strategies to contain his behavior, thus increasing safety to the community at large.

The results of psychological testing supported diagnoses of narcissistic personality disorder with antisocial traits and pedophilia. Test data indicated that, at the time of the evaluation, despite the seriousness of the allegations, he was experiencing no acute distress. His difficulties appeared rooted in significant deficits in self-esteem and fears about being caught and consequently shamed. That is, fear of punishment outweighed any apparent moral incongruity with his behavior. Test results further suggested that in an effort to deal with this internal state, he would likely employ a variety of narcissistic and manic defenses. This conclusion was borne out in the clinical setting.

For example, in the context of his therapeutic program, he tended to relate to others in an overly dramatic manner, calling for attention, adulation, and special treatment. When his efforts proved unsuccessful, he resorted to conflictual exchanges permeated with devaluation and open disdain for those whom he perceived he could not readily manipulate. These included most of the therapists who worked with him. Treatment consisted of four months of daily, psychodynamically oriented group therapy; individual psychotherapy; participation in a cognitive behavioral group focusing on sexual acting out behavior; individual spiritual direction; and a variety of psychoeducational groups.

His initial attitude toward the treatment team was overtly compliant. As the intensity of treatment sharpened, however, and he was faced with challenges to his relational style and confronted with the contradiction between his behavior and his public position as a trusted cleric, he became increasingly defiant, argumentative, and devaluing. He was able, nonetheless, to contain any direct expression of rage toward other patients or toward staff members. He preferred, instead, to attempt to manipulate others so as to obtain a positive “report” to his superiors.

As it became evident to the clinical staff that Fr. A was not likely to benefit to any significant extent from further residential treatment, he was discharged with the recommendation that he be prevented from any unsupervised contact with minors. Fr. A was infuriated at the discharge summary and appended a five-page, handwritten letter to the discharge report in which he refuted the treatment team’s recommendations and sarcastically commented on the ineptness of the therapists. Some months later, he attempted to devalue the clinicians and treatment facility as he responded to media requests for interviews concerning his allegations.

From the perspective of attachment style, it is obvious that Fr. A employed a dismissive/avoidant relational style evidenced by his seething rage toward others combined with a need to exert absolute control over those whom he perceived to be inferior to him. Such a long-standing toxic pattern of manipulation and exploitation underlay his ability to present himself to others as competent and affable. Thus he was able to engage vulnerable others in a seductive ploy, enticing them to become entangled in a chokehold of sadistic charm. He exhibited an entrenched pattern of denial of his sexual exploitation and no empathy for his victims. He saw no need for further therapy and discredited the possibility of spiritual direction.

Clinically deemed a treatment failure, Fr. A remained at high risk for continuing his exploitative, abusive behavior. On being dismissed from the treatment facility owing to lack of responsiveness to therapy, he became engaged with the criminal justice system for instances of child abuse that had occurred 15 to 20 years earlier. He was subsequently charged with and sentenced for sexual abuse of minors and remains in prison.

A Case of Preoccupied Attachment

Fr. B is a 60-year-old who turned himself in to the civil authorities 35 years ago after he fondled a teenaged boy while under the influence of alcohol. He was convicted and sentenced to prison. During the time of his two-year incarceration, he became involved in AA and in a sex-offender treatment program. Following his release, he continued in AA, had weekly psychotherapy, and began monthly spiritual direction. After a period of several years, during which time he had no relapses in drinking or in sexual acting out, he was assigned to supervised ministry.

His superiors were aware of his history and were in contact with his therapist. His immediate supervisor in his ministerial setting was also apprised of Fr. B’s history. For 25 years, Fr. B served as a well-liked, effective priest whom people felt was approachable, level headed, and kind. Throughout that time, he continued in AA and met regularly with a psychologist and spiritual director as “insurance” for his continued healthy and honest functioning as a priest. In the throes of the United States bishops’ “zero tolerance” document, however, Fr. B was removed from ministry. He became distraught, reported suicidal ideation, and referred himself for a psychological evaluation and possible residential treatment.

Test results supported a diagnosis of adjustment disorder with mixed anxiety and depressed mood. There was no diagnosis on Axis II. Results of the Abel Assessment of Sexual Interest did not support pedophilic interests. Fr. B’s testing evinced an expressive, affectively available, psychologically minded man who currently was plagued by shame, loneliness, self-blame, and profound sadness. Intrapsychically, he presented as highly selfcritical, prone to ruminate on aspects of himself that he found reprehensible. In contrast to the way he felt about himself, others were likely to experience him as a kind, mature, even-tempered, and flexible person to whom they felt drawn.

Given other circumstances, Fr. B would likely not have met admissions criteria for residential treatment. However, given the circumstances he was facing and the extent of his depression, it was felt that he would benefit from a supportive inpatient setting as he tried to come to terms with the apparent loss of his ministry. During the course of his three months in residential treatment, he maintained a transparent, forthcoming relationship with his therapists and with those in his psychotherapy groups. He felt drawn to prayer and was highly regarded by the other residents as a peer-leader in the community of faith, a man who was able to face his sinfulness and failure without losing his relationship with God, a person who sought forgiveness and who was able to forgive.

Fr. B exhibited a preoccupied attachment style, self-denigrating but drawn positively to others. His warmth was engaging and disarming, and he manifested little need to exert control over others. He presented as passive in his relational style, although a man with significant cognitive and interpersonal strengths. His caring for others and his capacity for veracity suggested that his track record of over 30 years of fidelity to his priestly vocation was not likely to be tarnished. He demonstrated significant remorse; was forthright with his superiors, therapists, and appropriate peers about his history; and was willing to adhere to ministerial supervision. Consequently, the clinical team did not deem him to be at risk for exploitating minors or of anyone else.

A Case of Fearful Attachment

Fr. C, a 42-year-old recently ordained priest, was referred for assessment following a complaint of boundary violations that allegedly occurred 17 years earlier. The incident took place while Fr. C was an adult volunteer leader in a youth program. Fr. C was accused of having invited a youth to his office, where he showed him pornographic materials. Other complaints noted that, during the same time period, Fr. C had tried to push youths into friendship and in one instance wrote to one of the boys several letters that had the tone of love letters. Fr. C denied the allegations and stated that they had been motivated by anger.

When Fr. C was a child, both parents physically abused him. His father was a violent man who beat him frequently while intoxicated. His mother disciplined him by locking him in a closet. Fr. C also reported that an older brother had abused him sexually. He described his childhood as bereft of affection or signs of caring. He and his siblings were fearful of the parents and distant from each other.

Prior to ordination, Fr. C’s work history was highly varied. His adulthood was characterized by a pattern of wandering from place to place in search of a home and a source of approval. Eventually, he applied to the seminary and was admitted.

Fr. C exhibited marked disdain for himself and a fear of others. He typically approached relationships by anticipating rejection or abuse. Yet he always held out the hope of being loved and embraced. The slightest sign of disapproval evoked a self-protective “might makes right” stance. When feeling threatened, he displayed an interpersonal brutality that bordered on cruelty. In more hopeful moments, he assumed a stance of dependent self-absorption. His early life experience was characterized by a persistent invalidation of his needs and emotions, particularly his feelings of fear and terror. These experiences led Fr. C to mistrust his own appraisal of his emotions.

His attraction to adolescent boys and young men was understood as being rooted in a desire for affection and admiration in relationships in which he was unlikely to be viciously dominated as he had been by members of his family. Fr. C exhibited a fearful attachment style.

When the allegation came to light nine years ago, Fr. C was referred for intensive psychotherapeutic residential treatment extending for six months. Throughout that time Fr. C struggled to regulate his experience of others and self. During the initial weeks of treatment, he fluctuated between intimate engagement, sullen withdrawal, hostility, and a desire to keep others at a distance. His self-perception vacillated between apparent competence and hopelessness. Stress often paralyzed him. For a period of time, Fr. C assumed a stance of extreme dependence, demanding that others give him direction and assurance as to how to live and behave. During this phase of treatment, he alternated between narrow self-focus and reckless self-neglect.

These patterns were confronted repeatedly by the use of empathie reflection and resulted in an expanded capacity for self-soothing and a heightened sense of worth. Gradually, as Fr. C became more self-aware, he recognized his interpersonal impact and the ways in which it recapitulated his early experiences of abuse and neglect. Fr. C did not satisfy diagnostic criteria for pedophilia. His attraction to adolescent males had been motivated by a deep need for affection and affirmation superimposed on a profound fear of abuse and humiliation.

While Fr. C demonstrated remorse for the adolescents he had abused, had a profound awareness of the breach of his fiduciary role as a priest, and did not withhold the extent of his acting-out behavior from the clinical staff, he nonetheless was deemed to be at moderate risk for relapse. This determination was based upon the fact that his capacity for healthy peer attachment remained fragile and his self-esteem, while significantly improved, was still compromised. It was recommended that he continue in ongoing therapy and that any ministry be circumscribed and directly supervised. Fr. C was assigned as a chaplain in a prison under the mentorship of a senior priest and was not permitted any ministerial activity in the presence of minors. When Fr. C was removed from ministry as a result of the American bishops’ zero tolerance policy, he had completed eight years of chaplaincy without any evidence of relapse.

Conclusion

Our experience makes it clear that clergy sex offenders are not a homogeneous group. While the result of the abusive behavior is the same for the victim, the path that leads a priest to engage in this criminal activity varies considerably, depending on

attachment history and personality organization. This suggests the need for careful consideration of the potential for rehabilitation and subsequent risk to the community. Clergy with a dismissive attachment style and narcissistic or sociopathic personality organization, should have no opportunity for ministry. Given these situations, no role of power should be considered.

An attachment style characterized by the capacity for mature peer-relationships, however, affords greater latitude. Risk of relapse is significantly diminished when there has been a fundamental shift in the priest’s sense of self. That is, he demonstrates responsiveness to therapy evidenced by a shift from self-loathing and devaluation to heightened self-esteem accompanied by a trust of and empathy toward others. In such cases, it may be possible for the priest to serve in supervised ministry successfully and without risk to the community.

It should be noted that these reflections are based on a growing body of research from the public forensic population (see Anderson, 2002, for an overview), as well as on our clinical experience with hundreds of clergy who have had an incident of abuse of a minor. There is a compelling need for comprehensive longitudinal research that focuses specifically on this population in order to refine these indices of treatment responsiveness. Until such work is completed, there remains the sad reality of applying the same punishment, regardless of remorse and the capacity for healing and redemption, to each person who has sinned.