You Are Not a Monster - An Example of Pedophilia OCD

Hello Everyone,

I hope you’re all staying safe as the pandemic continues to plague us all, and with the vaccine being available later this year hopefully we will soon be past most of the danger. In this post I return to a topic that needs more attention because it is so frequently misunderstood. Since the post is fairly long, I’ll keep my comments brief and let you get to my client’s story below.

One of the versions of OCD that is most frequently misunderstood, even by some fellow professionals, is what has been called “Pure O”, or more recently, and more specifically, Pedophilia OCD (POCD) or Harm OCD (HOCD).  The term “Pure O” stands for Pure Obsessional because initially it was thought that there were just obsessions and no compulsions with this kind of OCD, but now we realize that there are indeed compulsions, it’s just that the majority of them are mental and so they can’t be observed by anybody else.  Luckily it does seem that in recent years more and more people are becoming aware of POCD and HOCD thanks in large part to efforts from people such as Stuart Ralph from the OCD Stories Podcast , Chrissie Hodges , Jon Hershfield , Sally Winston and Martin Seif (these last two are Amazon affiliate links and if you purchase their books I receive a small portion of the purchase price), but we still have a ways to go. While every version of OCD can be  quite challenging, this particular version of OCD has a twist that makes it especially painful. People who have POCD or HOCD often believe that they are not just flawed human beings, but that they really are “monsters” and fear they’re capable of doing some of the most despicable things imaginable and usually to the people they love the most. I’ve had the privilege of working with quite a number of people with this kind of OCD and have been consistently impressed with just what fine human beings these individuals are and would feel comfortable having any of them babysit my children.

One of the reasons that this kind of OCD is so hidden from view is that the sufferers are so very ashamed and embarrassed by their thoughts and what they think those thoughts mean, that they may go years without telling anybody about them. They suffer in silence. As you’ll see in the following blog post, these individuals are often even uncomfortable sharing their thoughts with their therapist and often fear that once the therapist hears what they are thinking about, they will call the police and have them hauled off to jail. 

In an effort to further awareness and understanding about this type of OCD, I asked one of my clients if she would be willing to share her story dealing with POCD.  I asked her to think in terms of what would’ve been helpful to her to know early in her battle with OCD and/or what she might tell somebody else she had just met who was suffering from POCD.  Luckily, she agreed to write her story and you can read it below.  There is much to learn from her story, but in the interests of keeping this blog post to a reasonable length, I will save any additional comments for future blog posts.

Note: If you also struggle with this type of OCD, some of what is written below may be triggering for you. Please be careful as you read the following post. You might consider incorporating reading this post into your treatment program for your OCD.

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You Are Not a Monster

I first learned about OCD on an episode of Girls where Lena Dunham's character meticulously and repetitively locked the deadbolt on her apartment door until she'd completed the exact number of clicks that allowed her to move on. I had also heard about compulsive hand washing, however didn't think much of that because I'm a fan of clean hands. Into my thirties, these examples alone were what I associated with OCD-related conditions.

I have endured a lifetime of intrusive, uncomfortable and repetitive thoughts, however they never kept me from living a mostly carefree life. These thoughts were more of a general lurking in the background -- questions I refused to entertain and truths I was afraid of. One example of this stems from an experience I had in elementary school playing doctor with a friend. The game basically consisted of us going into their room and laying on top of each other while we explored various sensations. My memory of this time doesn't serve me well but what I do remember is that it felt both intriguing and wrong. While I don't know who initially suggested this game, (nor is it necessarily an important detail) my anxious mind has convinced me over the course of twenty years that it was me. Therefore, the recurring thoughts that I've endured over this time are that I'm a sexually-flawed pervert who took advantage of a childhood friend.

When my child was born, these thoughts of sexual perversion got louder and more frequent, but I continued to stuff them down and ignore them. The newborn period was difficult for all the newborn-esque reasons, but also because I was unknowingly suffering from an anxiety disorder. But I got through it, and if I'm being honest with myself, I knew that I never wanted to experience the newborn stage and those lurking background thoughts again. When I became pregnant the second time, I was terrified that all these thoughts were going to come flooding back. I decided to take action into my own hands and do everything I could to prevent these issues the next time around. My first step in this process was to find a therapist, in hopes that voicing some of these repressed thoughts might help me start feeling normal again.

And here is where I tell you that my first extreme intrusive thought was that I'm a pedophile. If I am this sexually flawed pervert, what will I do with a child? Despite this, I decided to see a therapist anyway, even if it meant that sharing these thoughts would land me in jail. I decided that if I was a pedophile I shouldn't be a mother anyway, and if my therapist thought I was a pedophile and I should be in jail, then that's where I belonged. So I told her. Everything. Shaking and crying to a woman I literally just met. I shared with her my deepest darkest secret, willfully presenting her with my wrists so that she could cuff them. After my confession I came back to myself and looked her straight in the eye. She seemed unmoved. Unconcerned. Not even surprised. She told me I was normal and that being a new mother is scary. She told me all kids play doctor. She told me I was going to be ok and that I didn't belong in jail. This blew my mind. I had hidden this part of me my entire life, assuming the worst. We set up a plan to combat what she deemed anxiety and I started seeing her weekly so we could get me feeling as comfortable as possible with baby number two.

And then I had a miscarriage. The absence of my future with another child was both incredibly sad and a psychological relief because of my fears. I had been feeling much better from an anxiety standpoint and working on moving on and making room for all my feelings. Shortly thereafter, I was tucking my child into bed. As I traced a line over my child's eyebrows and down their chin, while singing them to sleep, a sudden and horrific image flashed through my mind where I was taking advantage of them in that moment - sexually. It stopped me in my tracks. I immediately withdrew and moved away, fearful that it meant they were in danger of me. That I had desires I was unaware of that might come out that I was not in control of. There was no other reasonable explanation for why I would have imagined that scene. From that day on I behaved in ways that would keep them safe from me. If they slept in my bed, I put a pillow between us because I was afraid of getting accidentally aroused. When I held them I made sure my hands weren't touching anything inappropriate. I was overly cautious with changing their diapers and avoided it whenever possible, leaving the task to my husband. I looked away when they were bathing. I monitored my arousal when I was around them - constantly checking to see if I felt anything when I accidentally saw them naked. I re-thought my thoughts to find inconsistencies in them or challenge them. I hid out in the bathroom to review any new thought that just entered to see if I needed to take it seriously or not. I repeatedly tried to rationalize all the reasons I wasn't a pedophile, in hopes to convince myself once and for all. My therapist was on vacation.

Without a therapist, I turned to google. The thoughts and images continued to get worse and take up more mental space, and in turn I doubled down on my efforts to protect my child from me. In the span of a few weeks I started noticing a sense of arousal on a regular basis and assumed it was because of what I feared I was becoming. I was unable to lay next to my child. I wanted my husband around all the time to watch us. I confessed to him what was going on and after comforting me he got up and went to work, leaving me alone with our child, (which to this day remains the biggest vote of confidence I've ever received). But those bouts of reassurance only lasted a few minutes before I started poking holes in their theories. I typed in 'does anxiety cause arousal' into the search bar and it pre-filled what would be the first step in my journey to recovery -- 'OCD'.

There wasn't a lot out there regarding this kind of OCD (Pedophilia OCD, or POCD), but there was one article about something called the "groinal response" that someone had written for her friend. It contained the words "YOU ARE NOT A MONSTER" and detailed what happens when you have this type of OCD, including the physical sensations that can accompany it. She talked about the Vagus nerve and how one can perceive a physical reaction that isn't actually there. I couldn't believe that someone had written about it, and I couldn't believe it was real. Mostly I couldn't believe that what I have might actually be OCD, not pedophilia.

When I was able to reconnect with my therapist I told her everything once again. I told her that I think I might have OCD and she thought that sounded right, although she didn't seem convinced. We started with Exposure and Response Prevention (ERP) therapy which she knew about but wasn't specialized in. During this time I heard a story on the news of an incredibly sad event in which a mother shot her child and then herself. I started worrying that if that could happen to her, it could happen to me. I started acting in ways that would prevent me from physically hurting my child, and monitoring my mood for depression. These became my new compulsions. My therapist suggested I supplement my ERP with medication. I was incredibly uncomfortable with that because I had read that some people react to medication with thoughts of suicide or depression. To me that meant a straight line to my newfound fear, so I vehemently declined. It seemed like things weren't getting better and I was starting to lose confidence in the process. It was my husband who suggested I get a second opinion and see a specialist.

The individual who would hold my hand through this process for the next 2 years called me back after the first call. His voice was certain and unshakeable over the phone. He was quick in his response and didn't waver or doubt. He answered pointed questions before I could ask them, knowing they were on my mind. He provided examples that I was already suffering through, relating and understanding the entire time. For 35 years he had been treating what I was experiencing. He was booked for 3 weeks but suggested some reading material to get me started. I read Overcoming Unwanted Intrusive Thoughts by Martin Seif and Sally Winston. Every page was an explanation in print of what was happening to me and what to do about it. I saw myself in every chapter, understanding for the first time how my brain was currently functioning. I saw how I was contributing to my own anxiety. I learned there were things I could do to get better.

My first assignment with my new therapist (who ultimately ended up being one of the most influential people in my life to date), was to remove the pillow I used at night between my child and I. I told him that was crazy. He told me that if I wanted to get better I needed to take the risk. I trusted him. He listened to me when I told him I didn't want to take medication. He respected that and said there's a lot we can do without it, maybe even all of it, but I had to do the work. So I agreed. He also recommended group therapy, which he led later that night (a mere two hours after my first Official OCD therapy session in which I Officially learned I Officially had OCD). You get to this point that is commonly referred to as desperation, but I see it as openness. And sure, that's preempted by a lack of any other option, but sometimes that's what openness looks like. I was very open, so I took a walk between sessions and came back to reveal to a group of strangers that I was working through some sort of false pedophile fear. I cried the entire time that I told my story (which was exposure therapy in and of itself). As people introduced themselves and their OCD themes, I could relate to each and every one of them. While none of them were suffering from my particular theme, we understood each other anyway. They didn't judge me or fear me. They asked me questions about my child - questions you would ask a mother, not a criminal. They smiled and nodded and empathized. They cheered me on. I kept going back like this -- first one-on-one therapy, then group-- for months. Then I switched to just group therapy because it was my favorite and I was making friends. We laughed together about how ridiculous this all is. We cried together over how hard it was. New people started joining and I took on a new role of 'not the newest person' which had a side effect of confidence and experience. I shared every bump in the road, every thought, every fear, every setback, every triumph. I did all my homework because I thought about my friends throughout the week. If they were doing it, I could too. This was hands down the hardest thing I've ever done, however, in writing about it now, I have a huge smile on my face because it's the most amazing thing I've ever done, too.

My intent here is to give back by sharing my personal experience, in hopes that it will offer some sense of normalcy for other people out there who are also struggling. I want you to know that your thoughts and feelings are not facts. That you are not the author of your thoughts, you are the reader. That people without OCD have the same thoughts as you, you just stick to them and have a hard time disconnecting from them. Having OCD (yes, even this kind of OCD) is common and treatable. If I could, I would put every OCD thought I've ever had on various billboards across America, just so you knew how normal this was. You are not a monster.

And if you skipped the triggering details of my story and went straight to this paragraph in hopes for reassurance, I see you and I know that trick. But I'll tell you anyway. What recovery looks like for me is a willingness to experience discomfort. It's intrusive thoughts that happen but don't stick. It's an awareness of the way my brain works and how to accept it without trying to change it. It's a surrender to imperfection. It's an affectionate, healthy and full relationship with my child. It's a deep and knowing trust in myself. It's a new self-care practice of meditation and exercise which benefits all parts of me, not just the difficult parts. It's a full life driven by me, not my OCD.  

You can read more about POCD at: https://iocdf.org/expert-opinions/am-i-a-monster-an-overview-of-common-features-typical-course-shame-and-treatment-of-pedophilia-ocd-pocd/

https://www.madeofmillions.com/ocd/pedophilia-ocd

As always I welcome your feedback,

Best,

Dr Bob