Psychiatry, pedophilia, and mental health

The American Psychiatric Association (APA) is the current name of an organization that originated in 1844 with the name Association of Medical Superintendents of American Institutions for the Insane.

Treatment of the insane presumably would be a worthy objective.  As stated on the website of APA, "Psychiatry Online":

American Psychiatric Association practice guidelines provide evidence-based recommendations for the assessment and treatment of psychiatric disorders.

Treatment of the insane, therefore, does still appear to be on the APA's agenda, 175 years after its founding.  In order to treat the insane, those suffering from psychiatric disorders, any given patient or class of patients must be accurately assessed, to formulate an effective course of treatment.  There's the rub.

To accurately assess the psychiatric disorder of a patient or class of patients, it might be intuited to be desirable for those doing the assessment to possess some appreciable degree of mental health.  That is to say, it would seem convenient, in order to arrive at a reliable assessment of the psychiatric disorder of some patient, if the psychiatrist conducting the assessment were...well, not insane.  That seems a reasonable requirement.

That being the case, taking into consideration the range of behaviors psychiatrists display, as well as the range of behaviors they are willing to classify as alternative orientations, rather than as psychiatric disorders, one might hesitate to readily accept many psychiatrists as sufficiently mentally healthy to conduct valid assessments of the psychiatric disorders of others.

Take, for example, an editorial published by The Journal of the American Academy of Psychiatry and the Law on pedophilia.  Perhaps the reader could stomach a review of the statements found in the editorial titled "Pedophilia and DSM-5: The Importance of Clearly Defining the Nature of a Pedophilic Disorder," but perhaps not:

In the face of significant criticism of its inclusion in the DSM-5, the American Psychiatric Association (APA) has stated its intention to remove the term Pedophilic Sexual Orientation from the diagnostic manual. Removing that term in response to public criticism would be a mistake. Experiencing ongoing sexual attractions to prepubescent children is, in essence, a form of sexual orientation, and acknowledging that reality can help to distinguish the mental makeup that is inherent to Pedophilia, from acts of child sexual abuse.

Essentially, the broader statement in the editorial differentiates between the individuals who merely lust after children, indulging in fantasies based on that lust through use of child pornography, and those who actually rape them.  The distinction may mean to assuage the repulsion of those who are repulsed, but the implication that "just" indulging in fantasies of child rape is somehow not quite as reprehensible as child rape seems like a qualifier of insanity.  Recall that the editorial was written by Frederick S. Berlin, an American psychiatrist and sexologist specializing in sex offenses.  And consider that it contains many other statements.

The APA had altered its assessment of pedophilia, which it previously had classified as a psychiatric disorder, but later reclassified as an alternative sexual orientation, as Dr. Berlin pointed out.  Due to controversy that arose over that questionable decision, some backpedaling occurred, and the APA decided to remove the term "Pedophilic Sexual Orientation" from the manual altogether.  So that makes everything all better, right?  Hardly.

Read the manual, if you have the time, a handy supply of aspirins, and a strong streak of self-loathing.  The reflections and observations found therein may be found by psychiatrists to be rational.  That fact is what others might classify as evidence.

Add to all this the fact that psychiatrists commit suicide at a rate at least five times that of the general public, and the image produced of psychiatrists is that of a group whose mental health is unquestionably lacking.

And yet these highly esteemed mental health professionals are those on whom America depends to assess the mental health and stability or psychiatric disorders of others.