Trauma, adverse experiences, and offence-paralleling behaviour in the assessment and management of sexual interest

Lawrence Jones

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This chapter will start by exploring the psychological mechanisms linking different kinds of trauma and risk propensity. The developmental contexts of offence related sexual interests will be explored as a critical factor in understanding the nature of sexual interest linked with offending. Following the proposal by Ricci and Clayton (2016), consideration will then be given to how trauma triggers of different kinds can be linked with sequences of events leading up to offending and/or ‘offence paralleling behaviour’, defined as behaviour in the custodial setting that is driven by psychological mechanisms that were evident at the time of their offending. Offence paralleling behaviour will be examined as one approach to monitoring ongoing offence-related sexual interest.

Shine and Morris (2000) and Shuker and Jones (2007) identify the importance of thinking about the developmental and attachment background of an individual in building a formulation of both offending behaviour and offence paralleling behaviour (OPB). This model acknowledges the importance of adverse or traumatic experiences in the aetiology of much offending behaviour and OPB. Explicating the ways in which adverse early experiences can render an individual vulnerable to being triggered into self-destructive behaviour, or patterns of behaving that parallel those that lead up to their offences, in the custodial context, can offer a useful tool to aid assessment of the individual. Indeed, a richer and more nuanced understanding can emerge out of an iterative process where current crisis or distressed behaviour is used as a model for understanding what may have been going wrong at the time of the offence.

Developmental accounts of offending

A central tenet of cognitive-behavioural formulations of offending is that the individual’s current ways of thinking and feeling are underpinned by early experiences. Recent thinking about how early experiences impact on later life suggest that it is not only beliefs that are impacted but also fundamental ways of orienting to the world that are derived from bodily experiences and altered states of consciousness, as well as beliefs and internal working models (Frewen & Lanius, 2015; Jones, 2019).

Developmental accounts of offending postulate a range of adverse or ultimately harmful cascades of events that culminate in the lifestyle contexts in which offending takes place (Layne, Briggs & Courtois, 2014). Key drivers for these processes can be thought of as deriving from a limited set of evolutionary ‘systems’. Building on the work of evolutionary psychologists (e.g. Gilbert, 2017; Liotti, 2017; Panksepp, 1998), Jones (2016) proposed that adverse experiences impact on each of these systems in such a way that their impact on conscious experience and behaviour is, at least, partly outside of conscious control.

In addition to the three systems most often explored in the context of trauma formulations - Safety, Attachment, and Status or achievement (dominance) - Jones explored the Sexual system and the Hunting (or violence) systems (Kobach & Elbert, 2015) as being significant to making sense of offending behaviour (Table 13.1).

Each one of these systems can be impacted by adverse developmental and later life experiences. Any intense activation of a system - either intensely painful experiences or intensely pleasurable experiences - is associated with a change in the functioning of that system in the future. PTSD is familiar to most practitioners as being linked with experiences of dissociation, flashbacks, and intrusive thinking brought about by an overwhelming experience or experiences that activate the fear system. The same cognitive and affective processes are, however, associated with all the systems described above. They all, when activated, are linked with intrusive thoughts and urges, flashbacks, dissociation, myopia, and, when dysregulated, can be associated with compulsive behaviour (i.e. approach for pleasant experiences and avoidance of painful experiences).

Evolution can be thought of as conferring on the individual a process for interfering with or, in more extreme contexts, overriding conscious control in the interests of survival or consolidating ‘resources’. Contexts in which experiences associated with the systems outlined above are strongly activated (i.e. mating, survival from imminent life-threatening events, attachment, resource acquisition, such as food or status, and substance misuse), which effectively

Table 13.1 Evolved systems impacted by trauma and contributing to sexual offending.

Table 13.1 (continued)

hijack the same systems, are associated with changes in the capacity for day-to-day agency in the interests of quick and survival focussed responses. In order to achieve this shift in the face of survival-relevant situations, a number of processes are set in play.

Mills and Teeson (2019) argue that PTSD and substance misuse have been shown to be associated with changes in the cortico-limbic system; specifically, hyperactivity or hypoactivity of the amygdala, hypo-activity of the prefrontal cortex, and reduced volume of the hippocampus. These structures are involved in the mediation of stress responses, executive functioning, and memory, respectively. Together, dysregulation of these structures can ‘impair an individual’s ability to regulate intrusive trauma-related and craving-related thoughts and inhibit repetitive maladaptive behaviours...’ (p. 183). Prefrontal cortex dysregulation is both brought about by poor or damaging attachment experiences and is involved with a range of‘addictive’ processes, such as gambling addiction and sexual addiction (Katehakis, 2016).

Jones (2016) proposed that shifts in states of consciousness reflect shifts in cortico-limbic functioning. Amygdala hyperactivity is linked with intrusive thoughts/memories, as well as urges to approach (if it is a rewarding experience, such as sexual activity, substance misuse, or status) or to avoid (if it is a painful experience, such as unsafety or fear inducing situations). Prefrontal dysfunction is linked with experiences of dissociation and myopia. Using Kahneman’s (2011) framework, these experiences undermine System 2’s ability (i.e. deliberative decision-making) to override System 1 (automatic) thinking. Thus, System 1 thinking becomes much more dominant, which impacts on System 2 thinking through: (a) Intrusive thoughts; (b) Intrusive action urges; and (c) dissociative states in which System 2 thinking is much harder. Amygdala hypoactivity can be linked with the offence-related trauma processes such as emotional numbing, lack of interpersonal responsivity, and acquired callousness (Kerig & Becker, 2010).

Shifting states of consciousness have been described in the literature on compulsive sexual behaviour. Walton, Cantor, Bhullar, and Lykins (2017) have proposed a similar process in the context of compulsive sexual behaviour. They write: ‘Hypersexual persons may have difficulty moderating their hypersexuality when in a heightened state of sexual arousal because of what we have termed ‘cognitive abeyance’. Cognitive abeyance describes a state of inactivity, deferment, suspension, or diminution of logical cognitive processing. We suggest that during heightened states of sexual arousal, hypersexual persons frequently misappraise, dismiss, or fail to appropriately consider the risks, rewards, and consequences of their sexual behaviour, either past or present. Indeed, when hypersexual persons are in a state of cognitive abeyance, they are likely to operate from a euphoric or highly excited disposition, and their sexual inhibitions are substantially reduced. As such, some hypersexual persons (when highly sexually aroused) may feel unable to “put the brakes on” to stop their sexual activity and so frequently act on a sexual urge’ (p. 13).

Even when there is no obvious shift in mental state, as for instance in some apparently planned offending, the individual’s beliefs about what is pleasurable and what is aversive are likely to be strongly influenced by past experiences where they have experienced intense pleasure or pain associated with significant shifts in mental state. Planning is then associated with strong feelings of anticipation of reward or relief at avoiding pain.

Conceptualizing the psychological mechanisms at play in the context of offending and OPB requires, then, a formulation of shifting states of consciousness - as well as thoughts and feelings - associated with reminders of experiences associated with each of these systems. More specifically, it requires some consideration of: (a) dissociative states, (b) ways in which the individual’s felt sense of agency has been compromised, albeit, sometimes only for brief periods, (c) hyperreactivity and hypo-reactivity, (d) the unique meanings given by the individual to these experiences (i.e. pleasure and pain beliefs), and (e) the social context(s) of state shifting.

Internal working models

Another significant construct related to the systems identified is the ‘internal working model’. Attachment theory postulates that the individual has an ‘internal working model’ (IWM). This an internal representation of the relationship the individual has had with key attachment figures that has been internalized and shapes how an individual sees themselves and others in a relationship. Insecure attachment is thought to be a state where the model of the attachment figure is inconstant. This ‘model’ is then seen to impact in all social interactions of the individual. Each of the systems can also be seen as having their own IWM.

The sexual IWM is a representation of the individual’s characteristic patterns of sexual relating. The concept of ‘love-maps’ (Money & Pranzarone, 1993) is a similar concept but relates to the individual’s definition of what kinds of sexual activity and people they find attractive. Like the IWM for attachment (where a template based on early experiences of relating is in operation), this is a template for future sexual relationships based on the early sexual experiences that an individual has. Pfaus et al. (2012) also proposes that ‘a critical period exists during an individual’s early sexual experience that creates a “love map” or Gestalt of features, movements, feelings, and interpersonal interactions associated with sexual reward’ (p. 31). Emotional and sexual abuse, alone or together, have been found to be significant developmental antecedents of problematic sexual behaviour (Knight & Sims-Knight, 2011), while emotional abuse from a male caregiver has been found to be a strong predictor of hyper-sexual thoughts and behaviour in adults (Kingston, Graham, & Knight, 2017). The concept of sexual scripts is similar to this also (Ward & Siegert, 2002).

Links between trauma and offending

Following Ricci and Clayton (2016), if we look at the Pathways Model of sexual offending developed by Ward and Siegert (2002), we can see the way in which each pathway has trauma origins. Thus, each of the specified causal mechanisms can be seen as deriving from these trauma origins

Intimacy deficits

Ward and Siegert (2002, p. 336) argue that those with a

preoccupied attachment style were characterised by emotional neediness and profound doubts about their ability to elicit love and support from partners. Alternatively, the fearful-dismissively attached offenders tended to emotionally distance themselves in relationships because of their fear of rejection. Both groups of child molesters experience problems with intimacy and may turn to sex with children if their adult relationships are compromised or unsatisfactory... their (normal) needs for sex and closeness will be transferred to children, because of their perceived acceptance of the offender.

In this pathway, the impact of trauma on the attachment system is postulated as the central mechanism.

Deviant sexual scripts

The core causal mechanism in this pathway is a ‘distorted’ sexual script, Ward and Siegert (2002) write: ‘These individuals may have experienced sexual abuse as children and as a consequence become prematurely sexualised’ (p. 336). In this pathway, the impact of trauma on the sexual system is postulated as the central mechanism. Attachment or connection (see Needs, 2018) crises are, however, seen as setting events for triggering the enactment of the problematic sexual scripts. They write: ‘The onset of sexual offending is expected to typically start in adulthood and be episodic in nature; associated with periods of rejection, disappointment or extreme loneliness’ (p. 337).

Emotional dysregulation

Ward and Siegert (2002, p. 337) argue that

individuals following this pathway offend if unable to effectively manage negative emotions and either become disinhibited or else use sex as a soothing strategy. Thus, the primary dysfunctional mechanisms might reside in defects in emotional and behavioural control or relate to the inappropriate utilisation of sex as a coping strategy.

Also, ‘their base level of masturbation may be high and typically occurs in response to periods of emotional dysphoria’ (p. 338). Formulation of what underpins emotional regulation difficulties typically link it with a combination of: a) poor attachment experiences leading to a lack of opportunity to learn how to regulate affect (Fonagy, Target, Gergely, Allen, & Bateman, 2003); and b) people with chronic trauma histories being repeatedly triggered by a range of trauma reminders. Thus, the attachment system, as well as fear system trauma, are postulated as drivers. Biologically determined emotional dysregulation can be seen as traumatic in so far as it can create the conditions for traumatic events impacting on all the systems described above.

Antisocial cognitions

For this pathway, Ward and Siegert (2002, p. 339) write

The major type of mechanisms for this group resides in their antisocial attitudes and beliefs. These cognitive distortions (for want of a better term), in conjunction with sexual desire and opportunity, will result in the sexual abuse of a child. Such individuals disregard social norms forbidding sex with children and are expected to exploit any opportunity for self-gratification if it presents itself.

Hackett and Smith (2018) argue that there is a developmental path from ‘their prior experience of physical neglect and domestic violence to general aggression and the development of antisocial thinking into sexual aggression and violence’ (p. 19). This pathway is largely linked with dysregulation of the attachment system (lack of parental protection) and the dominance system. Hilburn-Cobb (2004) argues that, in the absence of secure attachment experiences providing a secure base and a sense of safety, the individual turns to one of the other systems, dominance primarily, to meet safety and contact needs.

Offence paralleling behaviour, trauma and the self-regulation model

Four pathways to offending were outlined by Yates and Ward (2008); namely, avoidant passive, avoidant active, approach automatic, and approach explicit. Each one is potentially linked with different kinds of OPB and different ways in which trauma-derived processes impact on the individual. All the pathways are seen as being triggered by a ‘life event’ that precipitates an underlying developmentally determined psychological process. Custodial ‘life events’ are, thus, ideal opportunities for assessing and formulating what it is that is being triggered in an individual’s offending process. Yates and Ward (2008, p. 7) write:

For some individuals, the occurrence of a life event.. ..triggers a progression to sexual offending, whereas for other individuals, the same event will not trigger such a progression. The difference between these individuals lies in differences in their developmental and learning histories, and psychological, social, biological, and other factors. For example, individuals for whom a life event triggers the offence progression may have experienced histories of sexual or other abuse, modelling of violence and abuse during development, insecure attachment during development, or may be biologically predisposed to respond to the event in a sexual manner.

For the avoidant pathways, there is a ‘turning point’ at the moment of lapsing (Stage 6) in the lead up to the offence, which requires some kind of regulation. Trauma-derived processes contribute significantly to both the initial response to the life event and to the absence of or misapplied self-regulation strategies. Lapsing can be linked with a significant shift in state of consciousness involving a reduced capacity to self-monitor and experience potentially pro-social emotions, such as empathy and shame. For the approach pathways, the absence of an aversive emotional reaction to the offending and the absence of self-regulation is often linked with longstanding trauma derived dysregula-tion of the sexual, dominance, and attachment systems that do not require a significant shift in state in order for the offending process to proceed.

Trauma triggers

If we use a broad definition of trauma as outlined above, including exposure to intense experiences that are illegal, such as early sexual experiences or substance misuse (in effect a form of/consequence of neglect), then we can outline a set of trigger types that may be relevant to working with people who have offended sexually. Triggers are experiences that evoke a trauma

Figure 13.1 Exacerbating and inhibiting processes to trauma derived risk mechanisms.

memory-based reaction ranging from simply remembering, unintentionally thinking about, reliving or vividly recalling, feeling urges or cravings to acting in manner driven by the trauma - either approach or avoidance depending on the kind of experience.

Trauma triggers impact on behaviour in different ways. On one hand, they can directly elicit a state that the individual wants to get rid of, such as feelings of rejection or abandonment pain following real or imagined rejection or abandonment. On the other hand, they can have a more indirect impact by, for instance, triggering a state of consciousness in which - much in the same way as drink and substance misuse can increase impulsivity - the capacity to reflect is impaired or in which the propensity to be impulsive is increased. The impact of this kind of trigger is non-specific in that it is not specific to sexual offending but it is a background factor that increases the likelihood of any kind of offending or relapse to substance misuse.

Another related non-specific process is the notion of‘post traumatic riskseeking’ (e.g. Kerig, 2019)

posttraumatic risk-seeking can be defined as the emergence in the aftermath of trauma of the active pursuit of experiences that serve the function of imparting danger to the self or others. These behaviors are construed as intentionally motivated in that they serve distinctly posttraumatic functions, whether those involve striving for mastery, turning passive into active, masking vulnerability with fear defiance, escaping from intolerable emotions, or activation of reward centers of the brain following from surviving threat, but they do not necessarily require conscious recognition of their intention. Further, unlike more globally ascribed characteristics such as recklessness or sensation-seeking, which can be viewed as characterological in nature or related to other psychopathologies such as conduct disorder, posttraumatic risk-seeking refers specifically to the emergence of these behaviors following exposure to trauma.

Whilst Kerig is here referring to a general increase in risk-seeking following PTSD, clinical observation suggests that this phenomenon becomes more salient amongst traumatized people who have offended after further experiences of trauma or trauma reminders.

Trigger chaining also needs to be considered, Briere (2019); this is a process whereby one reaction, (e.g. shame) triggered by a current event then triggers a memory of another response (e.g. shame from an abusive experience) and this then triggers another response (e.g. memories of self-harm), which triggers a further reaction (e.g. panicky thoughts about having selfharmed). This is important as the triggers might not be directly related to the eventual reaction(s).

Sexual triggers

If we see sexual preoccupation as deriving from sexual system imprinting experiences, such as: (a) early childhood exposure to sexual experiences as a consequence of either sexual abuse or neglect linked with sexual acting out amongst peer group or exposure to pornography; and (b) exposure later in life to offence-oriented or offending pornography or information about offending that has a strong impact, then inevitably triggers for sexualized behaviour will include exposure to individuals or images that fit the individual’s sexual script or ‘love-map’.

Andrew

This fictional vignette illustrates a process of trauma triggering an increase in an already existent risk-seeking problem.

Andrew had been through a series of repeating and serious traumatic experiences in his childhood and adolescence (Layne et al., 2014 describe this as a cascade or risk factor caravan of traumatic experiences highlighting the complexity of multiple traumatic experiences - rather than traditional PTSD based single event conceptualizations of trauma). He was placed into care due to his mothers neglect, physical abuse and his father’s sexual abuse. In care he was exposed to repeated experiences of loss and abandonment as he was moved from one foster family to another. He was also sexually abused and violently abused by peers and staff in the context of care. He reacted to this by becoming increasingly hostile and engaging in risk-seeking behaviour, such as stealing and abusive behaviour with peers and teachers. This resulted in him being moved within care, which further exacerbated the adverse impact. When he reached adolescence, he assaulted another child and was sentenced to a period in a young offenders’ institution. Whilst there, he was assaulted sexually by older boys and violently assaulted also.

When he was released, he committed a series of three rape offences and was imprisoned again for a long sentence. In custody, he was involved in a dispute over a drug debt and was assaulted seriously by a group of five inmates. Following this, he began to self-harm and became extremely assaultive. It took little provocation to trigger him into strong reactions. He described enjoying the violence, saying that it made him excited. Occasionally he reported becoming sexually aroused when he was violent. He said that he had developed a survival strategy that involved ‘getting in there first’ if he felt threatened in terms of his ‘status’ or reputation.

This kind of risk-seeking can take on the form of a behavioural addiction that serves the function of regulating trauma-related affective dysregulation, particularly in the context of the absence of healthy attachment-based regulation and learning experiences (Katehakis, 2016).

The complexity of trauma accumulation as a causal process

Most practitioners think of PTSD when the concept of trauma is raised. However, more recent thinking in this area has highlighted the complexity of trauma and its cumulative impact across the life course. Layne et al. (2014) talk about ‘risk factor caravans’ for trauma having an impact:

Risk factor caravans consist of constellations of causal risk factors that: a) occur, co-occur, and statistically covary; b) ‘travel’ with their host over time; c) each serve as a risk marker for the occurrence (whether temporally prior, concurrent, or subsequent) and adverse effects of one another; d) intersect with, and exacerbate, the adverse effects of one another in potentially complex ways; e) tend to increase their host’s risk for subsequent exposure to, and vulnerability to the adverse effects of, additional risk factors; and f) accumulate in number, accrue, and ‘cascade forward’ in their cumulative adverse effects across development. In contrast, elements making up risk factor caravans do not necessarily: g) emanate from the same causal origin, h) occur, co-occur, or recur at the same point in time or during the same developmental periods, i) relate in similar ways to other variables, j) carry the same risks, k) exert similar causal effects, 1) operate through the same pathways of influence, m) eventuate in the same causal consequences or sequelae, or n) respond in similar ways to the same intervention components ...

Jones (submitted) argues that this causal modelling framework can also usefully be used for thinking about risk factors for offending. What is clear, from clinical experience, is that there is a complex cascade of causal processes in the lives of people who offend. See Figure 13.2 for illustration of a characteristic trauma history of an individual who has offended seriously. Both the trauma impact on offending and the trauma impact on mental health is not a

Figure 13.2 Developmental pathway frequently experienced by people who have offended repeatedly.

simple process. The Bentall et al. (2014) empirical programme attempting to identify specific kinds of psychological sequalae linked with specific kinds of trauma misses the importance of the complex interactions between multiply traumatic background factors that aggregate over time both in complexity and in their adverse impact (e.g. Farrell & Zimmerman, 2017).

Trauma triggers and OPB linked to sexual interest risk domains

Akerman and Beech (2013) identified a range of OPBs linked with empirically supported risk domains identified by Mann, Hanson, and Thornton (2010). In the following section, the sexual interest-related domains are explored in terms of the potential trauma triggers linked with each.

Sexual preoccupation

Attachment and trauma process

Sexualization developed in the context of sexual abuse is well documented in the literature on the impacts of child sexual abuse. One of the most common impacts of sexual abuse is sexualization and precocious sexual activity. Inevitably in childhood, when acted out with peers, this is offending behaviour. The impact of a poor attachment experience on this kind of acting out is not described or explored in the literature. However, seeking sexual contact as a way of meeting attachment needs has been previously hypothesized. For example, Liotti (2000) argued that, for people with traumatic attachment experiences resulting in a disorganized attachment style, there can be a propensity to avoid experiences where their attachment system is triggered. This is because the experiences that trigger the attachment system are associated with feelings of unsafety and distress. For this group of individuals, inhibiting the activation of the attachment system can be achieved in a number of ways; one of which is sexualizing attachment needs. Liotti (2000, p. 245) writes:

inhibiting the activation of the attachment system implies a shift of the meaning attributed to the wish for bodily contact with another human being. Since both the attachment system (whose goal is protective proximity and comforting hug) and the sexual system imply a wish for physical closeness, borderline patients may misinterpret as sexual, both in themselves and in other people, wishes that are instead related to attachment needs. It is because of the confusion between sexual and attachment wishes that borderline patients may appear improperly seductive within the therapeutic relationship and may get trapped into promiscuous or dangerous sexual affairs within other social relationships.

Briere (2019) also describes compulsive sexual behaviour as a response to trauma derived confusion between a need for attachment experiences and sex when an individual is experiencing distress. He construes sexual compulsiv-ity as one of a set of Distress Reduction Behaviours (DRBs) used to manage trauma sequelae.

Associated with this is are the links between attachment trauma, sexual trauma, and sexual compulsivity highlighted by Katehakis (2016), essentially elaborating on the sex as coping model of the Ward and Siegert’s (2002) emotional dysregulation pathway.

Trauma process triggers

The trauma related process here is relapse - often precipitated by an interpersonal crisis or loss resulting in negative affect - to, or reiteration of, sexually preoccupied behaviour originating in abuse related sexualization experiences. Sexual triggers such as pornography, images in magazines and television, listening to accounts of sexual offending from peers eliciting ‘euphoric recall’ -sometimes consciously or unwittingly inciting self or others to engage in this kind of discussion because of the ‘euphoric recall’. In the absence of the possibility of having relationships individuals may increasingly take recourse to fantasy as a way of meeting sexual needs. Current interpersonal triggers such as loss or abandonment might be associated with fantasies that are about undoing this loss in some way (e.g. trapping or imprisoning somebody so that they can’t get away). These fantasies can then parallel what was happening at the time of the offence.

Offence paralleling behaviour

OPB is behaviour in the current setting that is driven by the same or similar psychological mechanisms and process/processes as those that were evident in the lead up to and during the offence. Understanding the trauma origins of an individual’s presentation can assist in identifying the kinds of precipitating factors for relapses.

Akerman and Beech (2013, p. 11) describes the following kinds of OPB linked with sexual preoccupation:

Excessive discussion of sex, Sexualising female staff, stalking staff, Producing drawings of offence related images, Brushing against a female visitor, Excessive masturbation, Described having three to four sexual fantasies in a half-hour period, Sexualising non-sexual situations, Use of pornography, Seeking sex in prison.

Sexual preference for prepubescent or pubescent children

Attachment and trauma process linked with this preference

For some individuals, abuse has involved sexual contact with other children, for others abuse was modelled by perpetrators, which resulted in them believing it did no harm them (and consequently they don’t believe it harms their victims). For some individuals, adults are associated with a range of abusive experiences and feelings of unsafety such as flashbacks to violent sexual or physical abuse. If, at the time of the abuse, they sought solace and support from other children then they may develop beliefs and attachment styles whereby they only feel a sense of attachment and intimacy with children; this can be associated with a sense that they themselves - as adults - are children. Alternatively, they may replay grooming experiences, developed in the context of their own abuse, whereby they feel that they are protecting or rescuing vulnerable children but then go on to abuse them. They describe seeing their victims as being like they were when they were vulnerable and abused. This may be influenced by their attachment needs for safety and security having been met by somebody who went on to abuse them. Identification with (social learning) perpetrators can develop out of this.

Trauma triggers

Being exposed to images of children, hearing, seeing or reading about vulnerable children. This triggers protective and ‘rescuing’ thoughts and feelings, and misinterpreting vulnerability as indicating sexual need - in a way that might parallel their own abuse. Experiences of violent abuse as an adult in the custodial context, or witnessing this in others, can trigger a return to seeking safety from children or others that they see as vulnerable.

Offence paralleling behaviour

Akerman and Beech (2013) describe the following kinds of OPB linked with sexual preference for prepubescent or pubescent children: ‘Seeking images of children, Seeking sex change to a girl’ to enable abuse, Watching children’s’ television. Seeking out collusive relationships with people in the custodial setting who are clearly very dependant, vulnerable and also identify with children in a similar manner can be evidence of a version of this pattern’ (p. 11).

Sexualized violence

Attachment and trauma process

Some individuals who go on to develop a propensity to sexualized violence have had abusive and violent experiences from attachment figures in the past. The violence may be a generalized form of violence or may be more specifically focussed on female attachment figures. Residual feelings of anger and rage at experiences of shame or humiliation and rage linked with early violent and emotional abuse is a common theme. This is then played out in fantasy and offending. Shame can be conceptualized as loss of status, while the individual’s reactions are attempts to ‘turn the tables’ and feel better by taking on a position of power in relation to them.

Trauma triggers

Triggers might be experiences where they are left feeling ashamed as a result of interaction with somebody that is similar to or reminds them of the early experiences of shame or humiliation. It is important to recognize that the reaction isn’t just to the person now who has triggered a shame reaction, it is often a shame reaction deriving from a traumatic early experience - perhaps from a significant attachment figure - involving shame.

Offence paralleling behaviour

Akerman and Beech (2013) describe the following OPB linked to sexualized violence: ‘exposing genitals to female members of staff, describing masturbating about female staff knowing it is non-consensual, describing films involving sexually violent scenes’ (p. 11).

Paraphilic interest

Attachment and trauma process

Sexual behaviour influenced by unusual early sexual experiences, which in turn shape an individual’s sexual script or ‘love-map’, can result in a range of paraphilic interests. Some of these interests can be specifically linked with offending behaviour. For example, sadistic interests can derive from experiences of being punished or abused in a violent manner (Longpre, Guay, & Knight, 2018; MacCulloch, Gray, & Watt, 2000). Also, paraphilias are often derived from early sexual experiences that are linked with the paraphilia (Pfaus et al., 2012). For example, being exposed to sexual abuse from an elderly woman may be linked to a later sexual interest in elderly women

Paraphilic interests and fantasies can also serve the functions attributed to fear-derived, trauma linked, risk seeking, as proposed by Kerig (2019). These can include ‘striving for mastery, turning passive into active, masking vulnerability with fear defiance, escaping from intolerable emotions, or activation of reward centres of the brain following from surviving threat’.

Paraphilic interest does not, however, have to come out of interpersonal traumatic experiences. It can also derive from chance pairings of sexual arousal with some particular stimuli, such as experiencing arousal when rubbing against a particular object. For example, an individual who formed an attraction to stuffed animals reported:

I’ve felt this way since I was 10 when I’d go to sleep cuddling a bear named Kerry.

I used to rub myself against her, in quite an innocent way at first, and eventually I’d look forwards going to bed just so I could hold her. As I grew up, I tried to understand what was happening to me. I panicked that I’d developed feelings towards real animals, but after finding an online community of other plushop-hiles I realised these fears were unfounded.

(Anonymous contributor to The Guardian's ‘My life in sex’ column, 2019, p. 69)

Trauma triggers

Experiences that map onto sexual scripts are the obvious triggers for paraphilias. Reminders of abuse or of the paraphilia that evolved in the context of the abuse - for example, trauma compensation coping that involves taking on a perpetrator role - trigger the paraphilic response repertoire. Buschman and van Beek (2003) describe the development of fantasy interests in people who have offended sexually and who have personality disorder diagnoses developing out of traumatic childhood experiences being triggered by current events.

Offence paralleling behaviour

The kinds of OPB linked with paraphilia include: masturbating to an image of an animal, interest in particular (non-sexual) parts of a females anatomy’ (Akerman & Beech, 2013, p. 11).

Illustrative fictional case example – Chris

Attachment events

As we have seen, attachment events can trigger offence-related behaviours in the treatment setting. In the following fictional vignette, the trigger is the therapist being away for a protracted period of time. This is associated with a reaction involving a return to older ways of managing the attachment-related beliefs derived from early experiences of abandonment and neglect.

When Chris was 10 years old, his father left his mother and the family home. His father had frequently assaulted his mother and Chris witnessed this often. He sometimes tried to intervene to defend his mother, but this only served to provoke his father into assaulting him. Sadly, his father did not maintain contact with Chris. This left Chris feeling relieved - as the violence stopped - but also unloved and betrayed. He had an ongoing preoccupation with thoughts about previous traumatic events he had experienced or had witnessed in the family home. He had also learned an abusive version of what it meant ‘to be a man from these experiences and, later in his life, he acted in ways that were similar to what he had seen his father doing. He was violent both in relationships and in his offending.

Chris had also had significant experiences of separation from his mother on at least two occasions in his childhood. At the age of five, his mother was in a car accident and was seriously injured, spending six months in hospital. He was reported to have been strongly affected by his mothers absence, becoming aggressive and withdrawn at school. Soon after his father left the family home, his mother had a mental health crisis and was taken into psychiatric care. Chris was left with his maternal grandmother, eventually re-joining his mother when she was released from psychiatric care a year and a half later.

Chris’s offending history was characterized by repeated episodes of violence, mainly where he experienced challenges to his status (e.g. he was in pub fights that started by perceived challenges to his status) or fears about his partner leaving him. He was more prone to violence when he had been working long hours, when he had little contact with his family, and after his partner had been away without him, when he would become increasingly preoccupied with thoughts of her being unfaithful to him, and he would withdraw and drink. His offence of rape had been committed following a row with his partner where he had left the house and had followed a woman and attacked her angrily and proceeded to rape her.

Model of offending

Reduced contact with his partner resulted in attachment fears associated with becoming withdrawn, ruminating about possible abandonment or infidelity, and a vulnerability to feeling threatened by others, or feeling that his status was being challenged. This was then triggered by arguments where these anxieties were played out and he felt a loss of control and used violence to try and force people into behaving in a manner that restored his sense of being in control. His rape offence was an instance of a range of situations where this same dynamic was played out and he used violence to offset feelings of shame and loss of power, safety or intimacy - real or imagined.

It was hypothesized that Chris would play out this kind of pattern of behaviour whilst in therapy - that if he felt insecure in relationships with staff, therapists or peers, this could trigger controlling behaviour including, but not exclusively, violence.

Offence paralleling behaviours

Chris was engaging well in his therapy attending sessions regularly and attempting to complete homework tasks and actively engaging in the therapy process. He had formed a good therapeutic relationship with his therapist. His therapist had to be away from work for a prolonged period and during this period he began to withdraw. He stopped spending time outside of his room, preferring to be alone for as much time as he could. When he explored this time after the event, he described spending a lot of time thinking about his therapist and thinking that he had been a fool to trust her and that she preferred working with other patients. He began to believe that she had gone away from work because she didn’t want to work with him and that he had been too difficult for her. During this period, he was involved with an argument with another inmate and attempted to assault him violently. He was stopped by a member of staff who took him away from the situation and talked him down. He was described by staff as being preoccupied and distant at this time. When this was fed back to him, he reflected that he had been ‘in a world of his own’ or a ‘paranoid bubble’. He reported that at this time he was having lots of intrusive thoughts about being abandoned and not being in control.

He also identified, after the event in therapy sessions exploring what had happened, having had - during this period - fantasies about being controlling and domineering and at times thinking about raping women. From an assessment perspective, it is important to use information about how the individual manages attachment ruptures in the present as a way of thinking about scenario planning for future possible relapses. In this pattern of behaviour, there is evidence of both attachment and status issues being triggered, which then link in with sexual thinking and fantasies.

There is also evidence of shifts in his social orientation to staff and state of consciousness; he reported a state of dissociation - the ‘paranoid bubble’ -and his preoccupation consisted of intrusive thoughts, all suggestive of a state in which his capacity to self-regulate was at least partially compromised by trauma-related state shifts. For generalist offenders, for whom sexual offending can be one of many forms of coercive behaviour that is triggered by status, attachment and safety crises, real or imagined, paralleling behaviour does not need to be sexual. It simply needs to be a pattern of behaviour that repeats the same kind of disturbed response to attachment based concerns deriving from early attachment traumas.

Conclusion

In this chapter, the critical role of psychological processes linked with early traumatic experiences impacting on the attachment system, the sexual system, the dominance system, the violence system, and substance misuse have been foregrounded as significant with regards to making sense of offending and assessing offending through working with OPB. Foregrounding trauma (see also Hasley, 2018) in this way helps the practitioner to think about a range of psychological processes that need to be actively evaluated in developing a formulation that can be used for both risk assessment and psychological intervention. Seeing psychological phenomena, such as sexual preoccupation, as being part of a complex constellation of responses to adverse developmental experiences (which includes significant shifts in states of consciousness, capacity and willingness to think, felt agency and bodily experiences) can facilitate the identification of new and more focussed interventions. Practitioners can use responses to custodial life events as a rich source of information about the kinds of response to life events at the time of the offence that lead to the sequence of events that, in turn, lead up to the offence.

Much work is required to further explore the role of trauma-derived psychological mechanisms in creating the context for the choices that people make in their offending. In this chapter, experiences of social oppression such as social stigmatization and othering’, bullying, homophobia, racism, sexism, ageism and poverty have not been directly addressed. Future work needs to take these kinds of traumatic experience into account as a significant factor in the development of offending and explore how they interact with other kinds of trauma.

The framework developed by Becker-Blease and Kerig (2016) for exploring the developmental sequelae of trauma at different stages of the life course is a useful model to explore the range of relevant trauma processes. This highlights differential impact of trauma in infancy/toddlerhood, pre-school age, school age, early adolescence and late adolescence/adulthood on stage salient issues, cognitive development, attachment development, self-development, emotional development, moral development, social development, family relations, memory for trauma, risk outcomes, PTSD symptoms and trauma processing.

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