Does having a bad thought about a child make me a bad person?

This is a question I hear time and time again from my clients, which is the reason I feel the need to write about this topic on a regular basis. My clients wonder if, because they have experienced an unpleasant thought in relation to a child (sometimes in the company of children) they are guilty of wrongdoing.

This can apply equally to having an image, emotional feeling, bodily sensation or urge related to children. Often clients think of these experiences as confirmation that they are a criminal and that they would be viewed as such if they told someone else about it. They also fear that this could lead to them being arrested, imprisoned and put on a sex offenders' register.

When I ask my clients what harm they have actually caused to children so far, they tell me 'none'. However, the feeling that they are somehow inherently bad stays strong. Quite regularly, I also hear clients voice fears around losing control one day and harming a child or doing something inappropriate to them, despite there being no evidence so far that this has happened.

Another aspect of this theme is that clients often feel unworthy in this situation of leading a normal life, of having fun with friends and family, and feeling relaxed and happy. It's as though a black cloud appears out of nowhere on these occasions reminding them of how bad they are and how they would be ostracised if people knew about their 'secret'.

This theme is called 'Paedophile OCD' and just like other OCD themes this stems from a very high anxiety and a strong focus on a certain topic. As with other OCD themes, the feelings are experienced as incredibly real and as though they belong to the sufferer, rather than being a manifestation of a mental health condition.

POCD can feel especially difficult to deal with, since apart from the stress and exhaustion presented by the obsessions and compulsions themselves, there is a taboo sense about this theme which makes it very difficult to talk about. It's open to the possibility of misunderstanding and judgement from others.

There is often a huge sense of shame for these clients in experiencing their thoughts. This can create a situation where they refuse to spend time with children, in case they have an intrusive thought, image, feeling or bodily sensation at the time, or because they fear losing control and end up harming the child. This can happen even when the person loves children and generally enjoys being around them. Sometimes the client also works with children, which presents its own difficulties.

Other times people with this OCD theme find it extremely difficult to interact with their own children. This may lead to a complete avoidance of them or to excessive rumination around their interactions with them. It usually takes the shape of questions like 'was it inappropriate of me to hug my child in that way, did I do it because I felt aroused by it?' or 'I must not give my child a bath or change their nappy in case I think the wrong thought or do something bad to them'.

This theme can sometimes lead to excessive ruminations around past events and whether we have acted inappropriately many years ago. Often we then seek to turn every stone and retrieve every last detail, in order to "prove' to ourselves that we didn't do anything bad. The reality is that not only is this impossible to achieve, but in our efforts to find clarity we only succeed in creating more doubts.

Another aspect of POCD is that sometimes clients' obsessions relate to adolescents rather than children. This can take many different forms and often presents as a concern around exactly what age a particular young person is. It feels crucial for the client to know with absolute certainty if the person they looked at is above or below the age of consent. There is a sense that if they don't find out, it may be that the person was below the right age, in which case the OCD sufferer, in their own mind, becomes a bad person.

The reality is that we have absolutely no control over the random thoughts, images, feelings, sensations or urges we experience. They happen to every human on the planet. Usually this doesn't feel in any way troublesome to them and they can easily leave the thought behind. However, when a person with OCD has the same experience, they begin questioning why they had the thought, what it says about them, what other people would think if they knew and if it's possible they could cause harm as a result. It's this reaction which enables the condition of OCD to develop and to be maintained over time.

In my experience, people with OCD are extremely sensitive, caring and compassionate humans with high levels of anxiety. Because we are so harm averse, we are far less likely than the average person to cause harm. However, despite this, we are far more likely to worry about creating harm.

If you would like help with managing your issues with OCD, please find an OCD specialist experienced in working with Exposure and Response Prevention. It's also worth reaching out to the UK charity OCD Action for support and information.