The majority of pedophiliac individuals are sexually attracted to and involved with adult sexual partners. Only 6.6% of these persons report no adult sexual attraction or interest (Abel and Osborn, in press). Even with the reduction of pedophiliac interests, however, it is difficult for these individuals to interact sexually with an adult partner when they have no sexual attraction to adults. It is fortunate that only a small percentage of pedophiliac individuals experience no adult sexual arousal, because treatments to develop this component are less developed than other components of treatment for pedophiliac patients.

Fading

Fading is a treatment designed to gradually shape the pedophiliac patient’s attraction to children into an attraction to adults. A child stimulus (i.e., photographic slide) to which the patient is strongly attracted is projected on a screen while his erection is concurrently recorded. If the pedophiliac patient responds with a significant erection response, the child stimulus slide is decreased in light intensity as an adult stimulus slide that has been superimposed on the child’s image is gradually increased in light intensity. If the patient has a significant erection response to this new blended stimulus, the pedophiliac slide is further decreased in intensity as the adult nonpedophiliac slide superimposed on it is increased in intensity. This procedure is continued, on multiple occasions, until the pedophiliac patient is successfully able to respond to the stimulus containing only adult characteristics as a result of the gradual fading procedure.

The downside to this training is that it is labor-intensive and requires ongoing objective measurement of the pedophiliac patient’s genital response. For more details on this procedure, the reader is referred to Barlow et al. (1975).

Exposure

Some pedophiles lacking in adult sexual arousal find it difficult to respond sexually to adults. This is, in part, attributable to their lack of sexual experiences with adults. Because of their poor social skills or as a result of their pedophiliac involvement, pedophiliac individuals often avoid sexual encounters with adults that might provide them with adult fantasies to use during autoerotic behaviors (as opposed to using pedophiliac fantasies). Exposure involves frequent viewing of erotic adult-adult sexual videotapes or movies to provide pedophiliac patients with explicit fantasy material of a nondeviant nature that can be used during autoerotic activities or during sexual encounters with adults. Care is taken to select videotapes or movies that are most easily tolerated by pedophiliac individuals. Double-X-rated movies, for example, are avoided because the scenes they portray are frequently very disparate from these patients’ actual life experiences. Instead, erotic films and videos are shown that are prone to capture components of adult-adult sexual encounters that are most commensurate with the pedophiliac patient’s comfort level.

Some of the advantages of this treatment component are that it is cost-effective, the erotic material is easily obtainable, and the viewing of the material can be controlled by the patient. During the treatment, patients keep notes on the components of adult-adult interaction that they find erotic. Pedophiliac patients are also asked to take notes on their real-world experiences when they see and interact with a variety of individuals who have some attributes that are erotic to them. These attributes are then incorporated when patients practice the recall of such erotic material during autoerotic activities or sexual interactions with adults. Readers are referred to Barlow et al. (1975) for further details regarding this component.

Masturbatory Conditioning

A variety of masturbatory conditioning procedures have been recommended to help pedophiliac individuals acquire adult sexual arousal (Abel and Blanchard 1974). A few of these methods allow the patient to use pedophiliac fantasies to become sexually aroused during masturbation and then gradually shift the sexual fantasy material to include adult-adult sexual interactions (Conrad and Wincze 1976). Some shifting methods involve a gradual qualitative or quantitative change in the fantasy material, whereas other methods involve abrupt shifts from the use of deviant fantasy material to only the use of nondeviant fantasies during masturbation.

To augment such masturbatory conditioning, pedophiliac patients are asked to collect various adult-adult pictures depicting sexual interactions that are most erotic (or least repulsive) to them and to fantasize about such material when shifting to the use of adult-adult sexual fantasies. As with most therapies, the therapist reminds patients to incorporate adult fantasies involving individuals in their natural environment into their sexual fantasy material during masturbatory conditioning. This is a cost-effective procedure that is consistent with theoretical understanding of the evolution of sexual fantasy and, most importantly, affords pedophiliac individuals the opportunity to incorporate real-life experiences into the treatment process so that the resultant fantasies potentially can be reinforced by actual interactions with individuals in the real world. For further information, the reader is referred to Abel and Blanchard (1974) and Laws and Marshall (1991).