Dr. Lothstein said. I treated priests who had two children. I treated priests who got women pregnant and got them abortions. I said to one of them, Why didnt you just use a condom? And he said, Because birth control is against the law of the church.

Written by Mark Oppenheimer for the New York Times

Leslie Lothstein has seen them all: priests sexually active with adult men, others with adult women, others with adolescents, others with children. By his own count, Dr. Lothstein, a psychologist at the Institute of Living, in Hartford, has treated about 300 Roman Catholic priests, not only those with sexual problems, but also those with alcoholism, depression and other mental illnesses.

He has written widely on the topics of pedophilia and ephebophilia, or sexual interest in adolescents. And, when interviewed in his office last month, he was not at all surprised by the continuing revelations about sexual abuse by priests in the Catholic Church.

I had predicted 15 years ago that this would go up to the Pope, Dr. Lothstein said.

He unwittingly found himself in the news almost 10 years ago, when it was reported that the Catholic Church had sent priests to the Institute of Living for treatment without always telling the doctors the full details of the priests transgressions. (One of those priests was the superpredator John Geoghan, whom Dr. Lothstein treated.) Whats more, the Catholic hierarchy often ignored the institutes recommendations about the priests fitness for service.

I found that they rarely followed our recommendations, Dr. Lothstein told The Hartford Courant in 2002. They would put them back into work where they still had access to vulnerable populations.

Although the institute no longer has a formal relationship with the Catholic Church it had been the only secular hospital to serve as a regular treatment center for priests with psychological problems Dr. Lothstein, who joined the institute in 1986, still treats priests. And given his vast experience, as well as his independence from the church, his insights are disturbing, but also helpful.

It was a surprise for me to see how many psychopaths I met in the priesthood, Dr. Lothstein said. Glib, callous, could say anything to you and be charming.

Still, it was only a small minority who were true pedophiles, he said, adding, You have to distinguish pedophiles, who were interested in children under 13, prepubescent, no pubic hair, small penises, and would lose interest any time the children became pubescent, from people interested in adolescents, 13 to 15 years old, or interested in later adolescents.

The ephebophiles had far more hope of successfully managing their preferences, Dr. Lothstein said. The psychological tests show that if youre heterosexual its normal to be interested in adult and teenage females, he said, or if youre a gay man, then adult and teenage males.

Liaisons with teenagers might still be criminal, of course, or socially unacceptable. And for priests, any sexual relations are a violation of their vows.

But those interested in young children seem to be wired differently. There seemed to be a specific fingerprint, Dr. Lothstein said. They would like blue eyes, or a black child, or a white child, or Hispanic girls. And their predilections were unchangeable. You cant treat heterosexuality, he said. You cant treat homosexuality. You cant treat pedophilia.

So what do you treat? Dr. Lothstein asked, rhetorically. You make them aware of the damage. And if they dont have a conscience, you try to give them a mentalizing function to help them imagine other peoples feelings. The doctor must also, in some cases, help the pedophile understand that a child is not capable of the romantic interest the pedophile, in his or her fantasies, thinks is being reciprocated.

Lets say hes saying, This boy, hes 5 years old, hes seducing me, hes coy, hes making eyes at me. The pedophile must learn that the child doesnt have the libido that I have as a 67-year-old, Dr. Lothstein said. With pedophiles, its not just sex, its romance, he said, adding, Theyre in love with the 5-year-old.

Dr. Lothstein is, relative to some of his peers, a bit of an optimist. He believes that sexual offenders, even pedophiles, can sometimes learn the empathy that will help them control their urges. But the treatment is slow, he said. It draws on a range of techniques, from cognitive behavioral therapy to group work to intensive individual sessions.

The work of healing is no easier for priests. Catholic treatment centers, like Southdown in Aurora, Ontario, have a spiritual component to their residential life, but their psychologists and psychiatrists rely on the same psychodynamic treatments used by secular therapists like Dr. Lothstein.

Describing the treatment at Southdown, which she led from 1993 to 2003, Donna Markham, a psychologist and Dominican nun, said, Its excellent psychotherapy, but its not religiously based.

And as the therapists continue to discover, no therapeutic technique can heal a church of all its pathology. And I treated half a dozen priests who fathered children, Dr. Lothstein said. I treated priests who had two children. I treated priests who got women pregnant and got them abortions.

I said to one of them, Why didnt you just use a condom? And he said, Because birth control is against the law of the church.

Dr. Lothstein is not a Catholic; he is a Conservative Jew. But he said he felt for the priests he had treated, at least the ones he did not consider psychopaths and child rapists. The priests were his patients. And he felt for the Catholic Church. Of priests he knew who had affairs with married women, he said plaintively, They destroyed the sacrament of marriage. Could the pope, who is having a very busy month, have said it any better?