Career
Kafka earned his undergraduate degree at Columbia College of Columbia University in 1968 and his M.D. cum laude in 1973 from the Medical College at SUNY Downstate Medical Center. He completed his psychiatric residency at the University of Michigan Medical Center in 1977.
He was Clinical Instructor of Psychiatry at University Hospital in Ann Arbor, Michigan from 1977 to 1983. He has taught at Harvard Medical School since 1983 and is affiliated with McLean Hospital. In 1999 Kafka was elected a full member of the International Academy of Sex Research. He joined the editorial board of Sexual Abuse: A Journal of Research and Treatment in 1999 and Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention in 2001. Kafka was a charter member of the International Association for the Treatment of Sex Offenders (IATSO) in 2000. He has been president of the Massachusetts Chapter of the Association for the Treatment of Sexual Abusers (MATSA) from 2002–2008 and a member of the national ATSA ethics committee from 2004-05. In 2010 he was named a Distinguished Life Fellow of the American Psychiatric Association. In 2008, Kafka was selected to be a member of the American Psychiatric Association's Work Group on Sexual and Gender Identity Disorder for the development of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, due for publication in 2012.
Kafka was the only American in a panel of eight non-Catholic scientists commissioned by the church to prepare a report on Catholic sex abuse cases. His article questioned whether "Catholic clerical education and socialization could be associated with an increased risk of expressing or experimenting with socially immature but aberrant sexual behaviors."
Kafka notes that "we don't know" the causes of atypical sexual behaviors. He cautions that "the research is in infancy," but it appears that physiological factors and environmental factors may both play roles. Though sexual abusers of children are more likely to have been child sexual-abuse victims themselves, "most pedophiles have not been sexually abused." Kafka believes "social skills deficits" can be a factor.
Kafka’s work on hypersexuality bases an evaluation on total sexual outlet. While previous treatments attempted to reduce androgen levels via chemical castration, Kafka uses drugs that regulate monoamines such as dopamine and norepinephrine, but especially serotonin. He states that "sexual deviance is linked to an as-yet-unidentified disregulation affecting the serotonin system." After treating a sex offender among a group of people diagnosed with eating disorders, Kafka connected the two: "I began to see that the sex offenders were just like the bulimics. Both groups were suffering from a disregulation of appetite."
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