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Abstract: Who is really in the frame? : Psychoanalytic approaches to understanding and treating users of child pornography

The high conviction rate for the use of illegal images of children in the UK has meant that existing treatment facilities are buckling under the weight of demand for specialised treatments to reduce recidivism. At the Portman Clinic, an outpatient forensic psychotherapy clinic in London which patients attend voluntarily, the number of referrals of users of child pornography, both convicted and unconvicted, has increased dramatically, whilst the number of referred contact offenders has decreased.

This presentation will provide an introduction to the developing psychoanalytic understanding of the underlying factors which underpin the use of child pornography. Using case examples, Dr Williams will describe how this understanding can help to inform treatment. Finally, there will be a discussion of what has been learned in working with the Portman Clinic’s sub-population of voluntary forensic patients : and how this can provide a useful insight into factors which are often not explored within the context of compulsory treatment programmes.


Dr Andrew Williams is a Consultant Psychiatrist in Forensic Psychotherapy at the Portman Clinic, UK, which offers group and individual psychotherapy to treat perversion, violence and criminality. He has run a specialist psychotherapy group for patients suffering with paedophilia and has extensive experience of working with perpetrators of sexual offending. He is also currently involved in a pilot project to evaluate the effectiveness of mentalisation-based treatment (MBT) for men with antisocial personality disorder.