Compulsion to repeat, self-exchange and paedophilia

In the current debate on the aetiology of paedophilia, biological, especially neuroscientifically based factors, are being strongly promoted. Paedophilia is constructed as a sexual orientation that should be accepted within the framework of cognitive-behavioral therapies, which are considered as evidence-based in the field. The socially accepted goal of a therapy is to avoid sexual abuse of children through self-control. An understanding and working through of the underlying dynamics and a post-maturation or even a change of paedophile interests through therapy is not a goal or at most of secondary importance. When it comes to the significance of possible real traumatic experiences, the publications mention sexual abuse that pedophilic men have experienced themselves, but question or controversially discuss the significance for the aetiology of paedophilic symptoms. This article examines paedophilic sexual interest and paedosexual actions on the basis of the concept of compulsion to repeat and on the background of traumatic experiences of paedophilic men. It is important to point out that it should not be assumed at the same time that the experience of sexual abuse increases the risk of becoming an abuser or of developing a paedophilic disorder. Theoretical considerations are illustrated with clinical case material and their significance for therapy is presented.