I have images of sexually assaulting my child and others

It may be OCD

If you’re worried about having images of sexually assaulting your child and others, it may be a sign that you have a subtype of OCD known as Pedophilia OCD, or “POCD”. Pedophilia is a difficult topic for many, however it is important to understand the difference between pedophilia and the OCD subtype of POCD.

Pedophilia vs POCD

In pedophilia, an individual has sexual images, thoughts and urges about children which they find enjoyable. They may feel ashamed about their thoughts and scared about what will happen because of them; however, they do not feel any urgency to disrupt or change these thoughts, images or urges due to the limited distress that they cause. 

Many individuals who are not pedophiles will experience intrusive thoughts, images and urges about committing any sort of inappropriate sexual act with children. With POCD, these thoughts are perceived as being intrusive by the individual, which means they are unwanted, distressing and can be impairing to their day to day life. These individuals will likely try to get rid or attempt to prevent these intrusive images through compulsive behaviors such as (but not limited to) avoidance, seeking reassurance, checking, testing, or mentally reviewing or replaying the thought or image. 

For example, if you’re having intrusive images of sexually assaulting your child, you may find more distress when you’re with your child during bath time, changing their clothes/diapers, or being alone with them in general. In response to these anxiety triggering situations, you may find yourself avoiding, being hyper-vigilant or cautious, or replaying situations in your head to ensure nothing inappropriate happened. You may rationally know nothing inappropriate has happened and still experience anxiety around the possibility.

Individuals with POCD find intrusive thoughts and images distressing in part due to uncertainty and doubt: “What if I do something inappropriate?” or “What if I lose control and do this someday?” Uncertainty caused by the doubts leads individuals with OCD to engage in compulsions for short term relief; however, it often leads to more challenges in the long run, as 100% certainty can never be achieved.

Am I a bad person? What if my fear is legitimate?

People often characterize their intrusive thoughts from OCD as “bizarre,” or share that they “don’t make sense.” That’s because these thoughts are ego-dystonic, meaning that they don’t align with a person’s identity, values, or actual intentions. Experiencing intrusive thoughts that oppose values that are especially important can be disorienting, confusing, and highly distressful.

People will often reassure themselves by saying things like “I would never hurt my baby in that way,” or “I have never hurt a child or wanted to hurt a child.” Even when they believe that these things are true, the reassurance they feel never provides 100% certainty or stops the thoughts from occurring. They continue to engage in rumination, mental reviewing, self-reassurance and seeking reassurance from others.

How to treat POCD fear of child sexual assault

Pedophilic OCD and Postpartum OCD can be debilitating, but they are highly treatable. By doing exposure and response prevention (ERP) therapy with a trained, licensed professional who specializes in treatment of OCD, you can get on the path to recovery.    ERP therapy is the gold standard for the treatment of OCD and related disorders. Working closely with a trained ERP specialist, individuals will identify the things or situations that trigger their obsessive thoughts, and the fears that come as a result. An ERP specialist will also help identify compulsive behaviors that individuals may not have recognized on their own. Then together, they will create a hierarchy of triggers and intrusive thoughts ranked by relative distress, and prepare exposures, or situations/activities intended to trigger obsessive thoughts and anxiety in a safe and controlled environment. Some of these exposures will be practiced during therapy sessions, and then members will be expected to practice them on a daily basis until habituation occurs. Habituation is defined as the reduction of physiological or emotional response as a result of repeated exposure to a stimulus. By frequently, carefully exposing themselves to triggers, an individual will be able to experience less and less distress over time, allowing them to have a better quality of life. This can lead to being more present at work, when socializing, when alone, and when spending time with family and friends. One of the goals of ERP is to become more comfortable with feeling uncomfortable.

If you’re struggling with OCD, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

We look forward to working with you.