Handle With Care

Sex offender David Rivera was willing to do almost anything to stay out of jail. Except masturbate.

"How could this sick, dirty exercise make you better?" Rivera recalls asking Strain about that goal. "I do the will of God and live by the Word. We don't yield our members to unrighteousness."

The satiation technique, first mentioned in professional journals in 1982, is in use in clinics throughout the world. It requires the subject first to masturbate while thinking about an appropriate sexual fantasy. After the climax, the individual must continue masturbating for the rest of an hour while fantasizing about the aberrant image on which he is fixated.

"That's usually at least 50 minutes, so the deviant image becomes tedious and boring," Strain says. "It sounds like it would be counterproductive, but it is not." He monitors compliance by making his subjects tape-record the sessions, which are done at home. They must speak out about their thoughts as they go about their business. With the ammonia technique, the subject is made to masturbate while breaking an ampul of the pungent chemical and breathing it. This, says Strain, also lessens arousal and deadens the pleasure.

Strain and other sex therapists handling probationers in Dallas and Tarrant counties defend the techniques as effective because follow-up trips to the plethysmograph show the offenders' reactions are indeed changed.

Hardly--say critics of the method--who point to recent research that questions the entire concept of satiation therapy. A 1992 study by a researcher working with child molesters in a New Zealand prison, for instance, found that "support for these clinically popular procedures remains weak." The study concluded the method actually decreased male offenders' responses to "appropriate stimuli," meaning naked women. Another review, published in 1991 by a behavioral researcher in Alberta, Canada, concluded: "There is some hope that satiation may be effective. More careful, larger-scale studies are required."

Mike Cox, a psychologist and director of the sexual-abuse treatment program at Baylor College of Medicine in Houston, says satiation can backfire. "It's reintroducing inappropriate ideas, and I don't think that's necessary," says Cox, who runs one of the oldest and largest sex-offender programs in the state, with a staff of 20 professionals. "This is using a punishment paradigm, which isn't in the spirit of treatment."

Cox says an emphasis on empathy with victims and the development of appropriate fantasies are more useful in long-term treatment. Even if satiation shows results on follow-up tests, he says the benefits will likely be short-lived.

As for what he derisively terms "that ammonia stuff," Cox says, "That's old, tired methodology. It's tied back to the days when they used electric shock on homosexuals."

In Tarrant County, several practitioners besides Strain say they use both of these techniques. At Psychotherapy Services and Yokefellows, P.C., a south Fort Worth clinic attended by about 300 probationers, about 30 percent are prescribed masturbation satiation, says therapist Brian Bilyeu. In Dallas County, probation officials familiar with the more than two dozen sex-offender treatment clinics working with court-ordered patients say it is not in widespread use.

All clinics that perform such work are required to be registered with the state Council on Sex Offender Treatment. The council issues broad guidelines on treatment, but takes no stand on the use or effectiveness of specific techniques such as satiation.

"Even in the past five years, we're seeing drastic changes in these treatments," says Maria Molett, director of the Counseling Institute of Texas, a Garland clinic. Molett says she has found satiation to be effective in breaking down offenders' "patterns of deviant arousal," but only when they are willing. "In some cases you really have to have this behavioral approach," she says.

Of course, she adds, treatment works only on some sex offenders; there are those who just can't be cured.

Rivera was talking about salvation, not science, when he began mounting his own attack on the treatment. Masturbation-satiation therapy went against his idea that a cure would come when God cleansed him from all unrighteousness. "I live by the Word," he says. "God can do the miraculous."

Last June, about six months into his sex-offender treatment program, Rivera and Angela were married before Justice of the Peace Barbara Ferrell in a wood-lined, century-old chamber in the Tarrant County Courthouse. She wore a print dress, he a mustard-colored suit. Her two kids, ages 2 and 8, were the only family present.

Around the time of the wedding, Esmeralda Molina, Rivera's ex-wife, lodged a complaint with child-welfare workers that he had beaten their children. It led to Rivera signing an agreement with Child Protective Services, dated June 14, 1995, which prohibited him from being around Molina's kids at all. He was allowed to see Angela's children only with an approved chaperone.

And although Angela attended eight classes during the summer to become a recognized chaperone--twice the required number--she could not pass. "They said I didn't get it," she says. "I don't know why. I had those materials memorized."

Meanwhile, Rivera lashed out at Strain's treatment. At one group session, he began preaching, offering to lay hands on a former minister to help heal him spiritually. "If you are sick, you can have hands laid on you to recover," Rivera told him. "There is nothing impossible for the Lord to do."

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