Obsessive-compulsive disorder is often misunderstood in our shared culture. Some people think of people with OCD as someone who is risky, potentially dangerous, or someone with extravagant personality traits (i.e., likes to clean, washes hands frequently, is rigid in the arrangement of belongings). These falsehoods and stereotypes are harmful and detrimental to those who suffer from debilitating fears and symptoms. Some lesser-known OCD themes include harm, pedophilia, and sexual obsessions. The presence of shame and stigma is a heavy reality and an obstacle to the treatment of those who suffer from OCD, especially with taboo topics.
Harm, pedophilia, and sexual obsessions need more advocacy and representation to increase public understanding, reduce misdiagnosis, and encourage sufferers to seek support, such as effective treatments such as ACT, ERP, and I-CBT. Obsessions are recurring thoughts, images, sensations and sounds that cause distress. Compulsions are repetitive physical and mental behaviors intended to prevent feared outcomes and/or relieve distress caused by obsessions. Pedophile-OCD (P-OCD) is an obsessive theme that describes the fear of becoming a pedophile, manifesting as disturbing thoughts, images, and body sensations.1. Having an unwanted bodily response, such as arousal or sensation in the groin area, as a result of obsessions, is not evidence of pedophilic disorder.2 Compulsions with P-OCD often include avoidance of anything that might trigger the distressing content, controlling, excessive body scanning, mental rituals, investigation, reflection, calming, safety behaviors, and self-punishment.3 Compulsions and avoidance may seem to the sufferer to be responsible both for others and for oneself.
A person’s values are often the target of OCD. People susceptible to P-OCD are those who care deeply about children, have the desire to be good, are vulnerable to doubting their true identity or self-concept, people who are easily attracted by imagination and can invest too much in remote possibilities.4
An essential difference between P-OCD and pedophilic disorder is that people with OCD fall into the category of egodystonic, meaning that thoughts do not align with values, beliefs, and worldview.5 The fact that the symptoms (thoughts, images, sensations) cause distress, are unwanted, and go against the person’s value system are important factors that make OCD egodystonic.
What makes someone a pedophile is someone who has a sexual desire and preference for prepubescent children and/or someone who has participated in child sexual abuse.6 Someone reading this with OCD might think, “Well, how do I know these thoughts, images, and sensations are unwanted? How can I be sure this is causing me genuine distress? How can I know what my true desires or intentions are? First, know that having thoughts, images, and sensations alone is not evidence of pedophilia. Needing a “sure” answer is also an indicator of anxiety and intolerance of uncertainty. Doubting the diagnosis is a common experience in those who suffer from OCD. The brain will look for ways to continue confirming that its worst fears are correct, because the feared consequence is probably too disturbing to risk, even if it lacks reasonable evidence. The fact that you are worried about it indicates that the desire is not true. If it really were your sexual preference, it would feel like other things you “know” about yourself: like when you know you need to yawn or drink water, or when you know you like a work of art or enjoy a song. True pedophiles do not doubt their sexual desire for children and act accordingly.
Second, the data concepts of “inner sense” and “reality detection” of inference-based CBT emphasize the five senses, including common sense, existing knowledge, observation, intention, and desire, which They can be used to restore confidence in yourself and your true self. self-confidence. I-CBT posits that the process of self-narrative and faulty reasoning reinforces a person’s obsessive doubts and subsequent anxiety and compulsions. Data from the inner senses and perception of reality can help provide clarity about the true self, even when doubts arise. You probably aren’t questioning your desires and intentions in other ways of your life, ways that don’t involve the fear of being a pedophile. Like when you crave a slice of pizza, or have the urge to sneeze, or the instinctive urge to hold the door open for the person behind you, or times when you felt genuine sexual desire in an appropriate way (you liked and you wanted!). . When OCD is not so loud, you are using your senses, trusting your intentions, including desires and preferences, effortlessly. It is personal history and flawed reasoning that confuses your reality and creates distrust. Reality sensing involves using information from the senses to inform you about reality in the present moment and encourages acting based on the knowledge that the feared version of yourself is false (in this case, being a pedophile).7
In P-OCD, overthinking is often one of the main compulsions: also known as rumination. Resisting “finding out” if you are a pedophile is a very challenging practice. Rumination-focused ERP frames the mental work and energy of thinking about worry as a primary source of anxiety.8 This means that you can learn to choose when to respond and engage with thoughts, feelings, and sensations that are worrying. When you stop trying to respond to every thought, feeling, and sensation, you can redirect your energy and time toward more values-based living, which might actually bring you some relief.
Lastly, it is important to know that there is no obsession, thought, feeling, image or sensation that makes you untreatable or unworthy of support. Recovery is possible and there is more hope than ever in the community as there is more than one evidence-based treatment available for those suffering from OCD.
Here are some tips for practicing self-confidence in the presence of obsessions:
- Recognize and label thoughts when they occur, without attachment or judgment.9
- “Give up” trying to answer or solve problems with obsessive content.10
- Identify ways in which you do not doubt or doubt your intentions and desires.eleven
- Reorient yourself to the reality of the “here and now”, search your senses for “evidence” in the present using your senses, resist responding with information to your “imagination”.12
- Talk to yourself and treat yourself with the same care and respect as you would a friend so that you can tolerate the suffering caused by your symptoms.13
- Live your life anyway: If you didn’t care about trusting yourself, what would you be doing? Do that!14
Questions to ask yourself:
- In what ways do I trust myself, outside of the particular worry I have?
- Do my actions or avoidance behaviors bring me closer to my values or the life I want for myself?
- Do my actions, including avoidance, really keep me and others “safe,” or do these behaviors confirm the fear I have about myself?
- Is there an imbalance in the way you live your values due to your obsessions (exaggerating the value of “security” to the detriment of other parts of your life that are important to you, i.e. “health, family, fun, love ”? , adventure, peace”)?
Recommended reading:
Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Overcoming Frightening, Obsessive, or Disturbing Thoughts (Sally M. Winston & Martin N. Seif, 2019)
Resolving OCD: How to Overcome Your Obsessions with the Inference-Based Approach (Frederick Aardema, due 2024)
Sexual Obsessions in OCD: A Definitive Step-by-Step Guide to Understanding Diagnosis and Treatment (Monica T. Williams & Chad T. Wetterneck, 2019)
The Intrusive Thoughts Toolkit: Quick Relief for Obsessive, Unwanted, or Disturbing Thoughts (Hershfield et al., 2022)
The Self-Compassion Workbook for OCD: Lean into Your Fear, Manage Difficult Emotions, and Focus on Recovery (Kimberely Quinlan, 2021)
This publication is brought to you in collaboration with the ADAA OCD and Related Disorders SIG.More information about GIS.
