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Think about your biggest fear. We all have at least one. Some of us are afraid of the dark, others are afraid of death. Loneliness may also make some of us feel uneasy. Losing a loved one is a quite common and understandable anxiety that we all share. For the most part, such fears are acceptable if they don’t preoccupy your thoughts and are not exaggerated to the point where they make you seem disturbed.
There are, however, certain fears that are not out of the ordinary, but we don't often talk about. When such fears take over, they may contribute to difficulty for you and those around you.
Why am I thinking about evil things I don’t want to do?
A severe anxiety disorder, obsessive-compulsive disorder (OCD) causes intrusive anxieties which creates discomfort and distress in a person’s life. There are many different subtypes of OCD and each one is equally capable of making a person’s life a living nightmare, no matter the symptoms or the trigger. One particular type of OCD, which seems to be among the most punishing to sufferers, falls in the category of aggressive or taboo obsessions. Fear of causing impulsive harm or violating one’s morals is what best identifies this category of obsessive thoughts. An example would be the fear of harming your own children. Any normal parent feels protective over their offspring. No matter the age of the child, parents are always concerned over their children’s well-being. When images of injuring, murdering, or sexually abusing their child suddenly preoccupy the parent’s thoughts, it would immediately create fear and pose the question, “Why? Why am I thinking about evil things that I don’t want to do?” It is extremely stressful to have such intrusive thoughts and no ability to make them go away.
Thoughts of committing immoral acts keep coming back.
Consider the following scenario. You are happily married with two beautiful children. You love them with all your heart and you would never forgive yourself if something bad happened to them. However, you repeatedly see yourself sexually molesting them when they are in your vicinity. You feel very uncomfortable taking care of them because each time you help them change clothes or give them a bath, perverse thoughts take over your mind, and you realize there is nothing to prevent you from molesting them. You are feeling mounting distress and discomfort that you try to ignore, but the worry remains. You have doubts about being able to resist an urge the next time you find yourself in that situation, and this just generates repeated attempts for reassurance. In order to avoid the panic and the opportunity to commit an act that clearly violates your morals, you begin avoiding your children and your responsibilities towards them. You try not to think of yourself as a perverted monster so you seek reassurance from others, but the thoughts of you committing immoral acts keep coming back. How would that make you feel?
Afraid of crossing the line.
The story of a 35-year old man tells us how he was missing the joy of being a father due to his obsessive anxieties. He had had contamination-related OCD throughout his life, and had been avoiding trash bins, door knobs, sharing drinks, etc. He had also been avoiding his wife due to fear of transferring germs to her in any way. When she became pregnant, he began having sexual thoughts about the baby, and did not want to hug her because of fear of "crossing the line." He was afraid of having some kind of sexual connection with the baby. When his daughter was born, he was deathly afraid of being near her due to uncertainty about his intentions toward her. He felt that holding her in his lap was inappropriate and sexual, and constantly had to reassure himself by reviewing his thoughts and memory. Eventually, being home alone with his daughter became of the question .
It is a terrible feeling to be afraid of being near your own children. It may be equally terrible to be married to someone who is having frightening thoughts towards your children. Individuals with sexual obsessions in OCD suffer quite a bit, because they see themselves as crazy and dangerous, although they do not want to harm anyone. Ironically, these people are actually the least likely to harm a child, but shame and fear keep people from getting help.
If not treated properly, this sort of OCD can result in dysfunction, depression, and divorce. Patients with sexual obsessions usually remain in treatment longer than patients with other types of OCD, and therefore it is important to begin early treatment (Grant et al., 2006). Exposure and ritual (response) prevention, a form of cognitive-behavior therapy (CBT) is the most effective treatment so far. However more research is needed to better understand how to help families facing this challenge.
by Victoria Dimitrova, B.A., and Monnica Williams, Ph.D.
New Book!
Oxford University Press will soon be releasing Dr. Williams' latest book: Sexual Obsessions in Obsessive-Compulsive Disorder: A Step-by-Step, Definitive Guide to Understanding, Diagnosis, and Treatment. ISBN: 9780190624798. Co authored by Dr. Chad Wetterneck, this is an excellent treatment manual for mental health professionals.
References
Bruce, S. L., Ching, T., & Williams, M. T. (2018). Pedophilia-themed obsessive compulsive disorder: Assessment, differential diagnosis, and treatment with exposure and response prevention. Archives of Sexual Behavior, 47(2), 389-402. doi: 10.1007/s10508-017-1031-4
Grant, J., Pinto, A., Gunnip, M., Mancebo, M., Eisen, J., & Rasmussen, S. (2006). Sexual obsessions and clinical correlates in adults with obsessive-compulsive disorder. Comprehensive Psychiatry, (47), 325-329.
Williams, M.T., Mugno, B., Franklin, M.E., & Faber, S. (2013). Symptom Dimensions in Obsessive-Compulsive Disorder: Phenomenology and Treatment Outcomes with Exposure and Ritual Prevention. Psychopathology. doi: 10.1159/000348582
