Intrusive thoughts ocd hierarchy12/27/2023 To the POCD sufferer, the idea of discovering that you are a pedophile means losing it all. It wants total control over who you spend time with, what or who you make contact with, where you go, how you raise your children, what you listen to on the radio, what movies or TV to watch… It wants it all. It’s dirty work, but there’s a lot at stake. Or, more accurately, your CBT therapist wants you to let them come, let them be, and ultimately let them go. You want to stop having thoughts about children that make your stomach churn, and your CBT therapist wants you to have them. Demystifying Cognitive Behavioral Therapy for OCD and POCD: ERPĬBT treatment for POCD is a frightening prospect. You accept these things and learn that responding to these thoughts and fears the way you have been brings you no closer to the things you value and it’s time to identify new behaviors that will. You accept that you care strongly about the kind of moral person you are. You’re accepting that you have thoughts, that you have fears, that you are uncomfortable around uncertainty, that you very strongly wish no harm to come to anyone you love. Sure, anything to get out of this living nightmare, but how am I supposed to accept something that is anathema to my values? Mindfulness work can teach you to make room for that “stuff” and reduce the power it has over you. The stuff that goes through your head is just that – stuff that goes through your head. By accepting the presence of unwanted thoughts, you are not only doing exposure to your fear of not responding the “right” way, but you also lighten the burden of constantly having to punish yourself. You need to be able to see that you are ritualizing, to see the thought approaching and choose a response (often by not responding) instead of just reacting. Mindfulness skills are those which enable you to observe your thoughts, feelings, and sensations as they happen, without engaging them or judging them. Incorporating mindfulness skills is often an important part of the CBT work, especially for POCD and other manifestations of the disorder that are maintained by mental rituals. writing narratives about your pedophile fears potentially being true, reading triggering articles/websites without ritualizing), or any or all of the above. babysitting your niece and resisting rituals), imaginal exposures (e.g. continuing to walk on the same side of the street as a child when you have an urge to avoid), purposely increasing closeness with children (e.g. bathing your children while not engaging in rituals), resisting the urge to do compulsions serendipitously (e.g. This may involve resuming your role in challenging activities at home (e.g. Naturally, this does not involve putting you or any children in risk of any harm, but instead is designed to readjust your responses to the POCD triggers. Behavioral Approaches to POCDīehavioral approaches for OCD emphasize exposure with response prevention (ERP), which involves gradually training yourself to resist compulsions as you methodically confront your fears. You can’t argue with the content of an obsession, but you can challenge the way in which you have formed your conclusions. Modifying distorted ways of thinking in this approach doesn’t involve trying to prove your fears are untrue (you’ve already tried that plenty), but instead works on drawing your attention to a more objective assessment of your experience. This might include addressing things like black-and-white thinking (if I have even one intrusive thought about a child, it means I am a pedophile) and magnifying (I noticed my baby’s cute bottom and that means I was leering at it inappropriately). Cognitive Approaches to POCDĬognitive approaches to the treatment of POCD focus on teaching you how to recognize when you are making assumptions that are problematic, unhelpful, or plain wrong about your pedophile fears. Though there are multiple forms and variations on CBT, the ones that are most likely to help with OCD use a combination of cognitive, behavioral, and mindfulness-based interventions. The most effective treatment for obsessive compulsive disorder is cognitive behavioral therapy (CBT). POCD is not some untreatable separate diagnosis that requires some strange outlying treatment approach. The idea of actually getting treatment for POCD can be terrifying, especially when you think your obsession is unspeakable and untreatable.
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