The psychological profiling of rapists in Pakistan is important to design interventions to prevent sex offences. At the moment, we do not have any data and limited capacity to undertake such assessments. Following is a model (MTC:R3) based on motivating dimension (why rape?):
1) Opportunistic rapist: Offence is unplanned, impulsive, for sexual gratification, with force used as necessary. Driven largely by immediate antecedent events (situational factors) rather than personal psychopathology, eg late night, isolation, alone woman, no witnesses etc.
2) Anger rapist: His offence is driven by extreme aggression, severe violence, can lead to serious physical injury to the victim. There is usually a history of other anti-social offences as well.
3) Sexual rapist: He is driven by preoccupation with sexual fantasies and urges, best described by a clinical diagnosis of a type of Paraphillic disorder.
4) Sexually non-sadistic rapist: He is also driven by sexual fantasies and urges, but the sexual arousal is inappropriate in nature (e.g., fetish- where gratification is linked to an object/activity, body part). This is associated with feelings of inadequacy re masculinity/sex.
5) Sexually sadistic rapist: His motivation is not sexual but driven by fantasies of degradation and humiliation of the victim with primary gain of power and control (diagnosis is sexual sadism).
6) Vindictive rapist: He is driven by anger, but his anger and aggression is focussed exclusively on women (unlike the angry rapist). His behaviour is intended to humiliate and degrade victims with little/no evidence of eroticised aggression and low levels of impulsivity.

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More from @AsmaHumayun

11 Jun
After a month of navigating through the struggle of online clinical work as a psychiatrist, here is a summary thread based on my experience:
1) There is no doubt that the option is essential for following-up severely ill and for emergency consultations during the lockdown eg a doctor with pre-existing mental disorder on COVID duty had a breakdown, and I was able to manage her care online.
2) For psychotherapy requiring high level of conversational nuance and emotional intimacy in real space, both myself and patients remain discontent.
3) For new assessments, there is a serious disadvantage of missing much of no-verbal cues and limited instinctual perception.
Read 9 tweets
22 Apr
‘Health’ is a provincial matter in Pakistan. To initiate a #mentalhealth response to #Covid_19, mental health professionals must organise themselves at provincial levels. They need to come together and use their powerhouses to put up a strong case through sustained advocacy.
Setting up helplines and webinars can only be helpful if there is an effective mental healthcare system in place. There is none. Nobody owns mental health at the provincial level and nobody will present the opportunity for #MHPSS, mental health professionals must create one.
When will these titles and positions deliver?
Read 7 tweets

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