Dr. Fred S. Berlin, who took the stand yesterday as a defense witness in the insanity trail of serial killer Jeffrey Dahmer, has made a career of working with the deviants that much of society disdains.
As director of Johns Hopkins Hospital's Sexual Disorders Clinic, Dr. Berlin, 50, advocates treatment instead of punishment for pedophiles, exhibitionists, rapists, sadomasochists, voyeurs and obscene phone callers -- a position that angers his detractors and has led to repeated attacks on the Baltimore treatment center.
"You can send someone to prison, but he's eventually going to come out of prison," Dr. Berlin explained in a 1987 interview. "And without therapy, there's a strong likelihood he's going to return to the same behavior."
The clinic, set up in 1980, treats as many as 200 patients each year. In addition to offering sexual offenders individual and group counseling and behavior therapy, Dr. Berlin often prescribes Depo-Provera, a drug that reduces a patient's sex drive by lowering the body's testosterone level.
Throughout his career, Dr. Berlin has treated patients or been an expert witness in highly visible cases, ranging from those of the most notorious child molesters and serial killers to a former university president who pleaded guilty to making obscene telephone calls.
For that, and his vocal defense of the confidentiality of patients' criminal activity, Dr. Berlin has earned the scorn of child advocates, victims' rights groups and prosecutors who point to what they describe as the clinic's "failures." They cite patients and former patients who have returned to deviant, and most often illegal, behavior.
In April 1987, for instance, a man on probation for a Miami rape was charged with accosting or fondling seven women in a sex spree in Baltimore and Baltimore County. At the time, he was a patient at the clinic.
Two months later, a clinic outpatient was charged with sexually molesting a 9-year-old girl.
In March 1988, a rape victim undergoing treatment for depression at Hopkins alleged she had been sexually assaulted by a clinic patient. She filed a civil suit against the hospital and Dr. Berlin, who had frustrated police investigators by refusing to turn over records. After a city grand jury failed to return a criminal indictment, the civil suit was settled out of court.
Two years ago, Dr. Berlin appeared to circumvent a Maryland law requiring that all incidents of child sexual abuse be reported. It prompted an opinion by the state attorney general stating explicitly that the clinic's actions were not permitted.
Dr. Berlin had issued an internal memorandum recommending that child molesters first report incidents to a lawyer, who could refer them to the clinic for evaluation. That way, the memo explained, disclosure of an incident would be protected by the attorney-client privilege of confidentiality.
The attorney general ruled otherwise, however, and Hopkins was forced to change the policy.
"I was looking to see if there was a legal way for people who wanted to seek help to come and get it . . . without being prosecuted," he said at the time.
Dr. Berlin maintains that the threat of criminal prosecution keeps child molesters from seeking help -- an argument that temporarily won him an exemption in the state's child sexual abuse reporting law. At the time it was proposed in 1987, the loophole was known by the Maryland General Assembly as the "pedophile protection bill."
The exemption -- proposed by Dr. Berlin specifically for health careprofessionals treating pedophiles -- allowed child molesters to report an incident of sexual abuse to a therapist without requiring the counselor to turn the offender in to police or child protection workers.
But the change in the law was on the books for only a year, from July 1, 1988 to July 1, 1989. Child advocates were able to convince legislators that the loophole should be closed.
Last year, Dr. Berlin published a study that he maintains shows a significant reduction in the number of pedophiles seeking help through self reporting since the exemption was removed. That has led child advocates to believe the psychiatrist will try again shortly for the reporting exemption for child molesters.