Many of my clients with harm obsessive-compulsive disorder (HOCD) or pedophilia obsessive-compulsive disorder (POCB) have asked me “Why do I have all of these terrible thoughts? And why are these thoughts always about something awful happening to my loved ones?” Virtually all of my clients with these types of OCD interpret having these thoughts as possibly meaning that they want to do the things that they think about. They fear that having these thoughts mean that they want to harm their loved ones and/or engage in inappropriate sex. Until recently, I had at times struggled to give my clients a satisfactory answer to these questions. Luckily, I had a recent experience which gave me a way to answer my clients questions more satisfactorily.
Upon leaving my gym after a recent workout and as I was walking towards the parking structure with my car keys in my hand I suddenly had a clear mental image of dropping my car keys through a metal grate in front of me. As I approach the parking structure, and since I live in Oregon where it rains a lot, there is a large metal grate designed to capture and drain the water from any rainstorms. This grate is quite large and measures about 2 feet on each side. The grate is a series of metal bars each of which is about a half-inch wide separated by a space of about an inch or so and as I was walking towards this grate the thought suddenly occurred to me that if I wasn’t careful I could drop my keys through that grate and lose them forever. I had a distinct and clear visual image of holding the keys in my left hand, walking over the grate and then the keys slipping out of my hand through the grate into the pipes below. This brief episode has given me a way to explain to my clients why they have their “terrible” thoughts. Did my having that image of dropping my keys into the grate mean I “wanted” to drop my keys in the grate – of course not. Rather, I saw this image as a “warning sign” of what could happen if I wasn’t careful. So, in precisely the same way, my clients HOCD and POCD thoughts and images do not mean that they want to do these things, but rather, quite the opposite, they do NOT want these things to happen.
Another similar example that I’ve often used involves a grandfather walking his granddaughter to the park. Between the grandfather’s house and the park there is a rather busy street and so this grandfather always holds his granddaughter’s hand as they approach the street to be careful that she doesn’t dart out into traffic. If, under these conditions, the grandfather has the image of his granddaughter rushing out into traffic and being harmed does this mean he wants this to happen or is it, once again, another example of an image meant to warn him of what could happen if he isn’t careful. So just as in my example of the keys above, the thoughts and/or images this grandfather has are indications of what he does NOT want to happen rather than what he does want to happen. And just as my image of my keys falling into the grate lead me to hold onto my keys all the more tightly, in this case the image of his granddaughter being harmed leads this grandfather to be all the more careful with his granddaughter and hold her hand that much tighter.