Over the past few years, there has been increased awareness and understanding of OCD within the general public. The simplest definition of OCD is the frequent experience of intrusive thoughts and associated behaviors engaged in to decrease discomfort associated with these thoughts.
One category of OCD which we frequently see at our treatment center that is less understood and sadly can be associated with tremendous emotional pain and suffering is Harm OCD. Harm OCD is no different from other forms of OCD in that one experiences frequent, uncomfortable intrusive thoughts and associated behaviors to decrease emotional discomfort and attempt to gain control over the thoughts. But what is unique (and so devastating ) about Harm OCD is that it strikes where it hurts most. Harm OCD goes after one's values and sense of identity and injects thoughts that conflict with everything one holds most true and life enhancing about themselves.
Webinar Q&A
Q: I was wondering whether or not I could get some ideas or suggestions for hierarchy items-exposure for fear of molesting their child-pedophile OCD. My clients fears are only related to her own children. Any suggestions would be appreciated.
A: Sample exposure hierarchy items for individuals struggling with pedophile OCD.
Sample hierarchy items:
- repeatedly saying out loud and writing “I am a pedophile” or “I am attracted to me child”
- imaginal exposure of sexually molesting her child
- imaginal exposure of sexually molesting child with all details leading to feared consequences (harming child, being ostracized and isolated and alone, not being able to live with guilt, etc) (downward arrow can help identify specific feared consequences for patient)
- looking at pictures of child (or other children) and saying or thinking “I am attracted to child”
- if client engages in compulsion of body scanning to see if showing physical sensations of arousal, combining exposure to images of child with thought “I am feeling sensations of being sexually attracted such as tingling or increased wetness” (whatever clients feared sensations)
- you can go with client to a park and stare at children and practice having the thought “I am a pervert and depraved and attracted to children”
And of course you will need to customize a bit for clients specific feats.