Twenty-one years ago when he was 13 years old, Aaron Harvey became haunted by constant thoughts that he was a pedophile. Visions of naked children followed him everywhere. “Naturally this terrified me, and made me think – well this must be what other pedophiles go through. This led to years of anxiety and fear,” he says in an interview this week.
The sexual visions became more hounding into his twenties, eventually morphing, but always haunting. “When I was older and realized logically I would never touch a child – I’d sooner kill myself than do that – I started to have obsessive thoughts about my sexuality. Though I knew I was straight, I started to think, I must be gay, this must be real, this must be happening,” he says. “It was a real full body anxiety. Though I knew I was straight, for years I struggled with my sexual orientation – why was my mind telling me I was gay?” On the other side of the ocean, Rose Bretécher experienced the same haunting, terrifying thoughts. At 13 she worried: Am I actually a pedophile? In her twenties, visions of her best friends naked, or seeing vaginas everywhere around made her worry: Am I actually gay, and do I not know my true self? She was constantly haunted by sexual visions of vaginas on people’s faces, mentally undressing friends, her mind spinning every image in front of her with a sexual twist.
“Once while having a doctor's consultation I couldn't stop thinking about the middle-aged GP masturbating in his y-fronts,” she recalls in an email interview with The Daily Beast. “Another time I couldn't shake the thought of a Heathrow customs official suckling on one giant air balloon size tit. Though the intrusive thoughts can be amusing or absurd in retrospect, they were never funny at the time - always frightening.”
For both Harvey and Bretécher, the constant, uncontrollable, sexual and often violent images led to severe anxiety, depression, and suicidal thoughts. And both eventually had the soul-shattering realization that all their visions stem not from sexual depravity, but from obsessive compulsive disorder, a condition that affects up to two per cent of the world’s population during their lives, and which the World Health Organization has labeled one of the top ten most damaging conditions in terms of quality of life.
The problem is that when most of us think “OCD”, we think obsessive hand-washing, or refusing to touch door knobs, or ritual straightening of every fork in the cutlery drawer. But for many people, compulsive and uncontrollable feelings exist only in the mind. These can take many forms, such as incessant visions of strangling your wife, or wiping out other drivers on the road, or nightmarish visions of having sex with your sister. But all remain hidden in the head, never manifesting as outward behaviors, but constantly spinning and becoming more ferocious. Perversely, the more sufferers try to suppress the thoughts, the more they leap out from the corners of their minds.
The name for this silent suffering: Pure O. And though the images remain confined in the mind, the impact on people’s lives can be intense, from running away from loving relationships, to avoiding having children due to latent fears of paedophilia. Even for those who can manage their condition well, horrid thoughts can creep in at the worst time possible. “When you are having sex, despite that being a mindful and pleasurable experience, those intrusive thoughts don’t stop – you can suddenly picture yourself with a family member, or a piece of roadkill,” says Harvey. “Your mind can try to ruin every beautiful moment you have in life.”The numbers are hard to pin down, but possibly up to half of all people with OCD experience “Pure O”. Ballpark estimate then: if two per cent of Americans experience OCD, that means there are 6.36 million people living in the US with the condition – and therefore about 3.18 million people living with Pure O. The visions can take many forms, but sex – the emotionally charged, graphic, visceral, and deeply meaningful thing it is – is a very common focus. Being that Pure O is so little heard of in mainstream culture, and how shameful the experience can be, the vast majority of people living with the condition will never realize what they have, that their condition is commonplace, and what the right treatments are.
“It is absolutely tragic, the amount of money, time, pain that goes into finding the appropriate help, says Dr Steven Phillipson, psychologist and Clinical Director of the Center for Cognitive-Behavioral Psychotherapy, creator of OCD Online, and author of Thinking the Unthinkable. He has treated more than 8,000 people with OCD, which is not a condition that any generalist psychologist can treat in his opinion. “Most mental health professionals in the US and around the world still see OCD from the media standpoint – engaging in observable rituals, such as handwashing. I still find myself outraged that people who are not specialists in this field claim they can treat it.”
In many cases, conventional forms of therapy can do more harm than good, he says. “Some can be incredibly damaging,” he says.
The worst experience for Bretécher was psychodynamic therapy. “I had twenty hour-long sessions of this, which encouraged me to talk exhaustively about my past in an attempt to un-lock the meaning of my thoughts,” she sighs, describing how she spent years trying different treatments.
People living with Pure O tell the same story, over and over: even after they realize they have a form of OCD (usually an insight gained from scouring online forums and Wikipedia), they spend years wasting time and money on treatments that do little to help. “I had psychiatrists that had no idea what they were doing, and just put me on a variety of medications, or therapists who tried to unlock the ‘hidden meaning’ to these thoughts – which is not helpful, because they are meaningless and not relevant to your personality,” says Harvey. The one treatment that does seem to work, and that did work for Harvey and Bretécher, is Exposure Response Prevention (ERP), which involves exposing you to the very thoughts, images, or objects that trigger your anxiety. So for a man obsessed with the thought that he wants to stab his wife, this could involve showing him knives next to pictures of his wife - eventually, scaling up to having him hold a knife to her throat (with her as a willing participant). It sounds brutal, but it hits the message home: you don’t want to murder your wife. These images are tricks of the mind.
“Doing things like this repetitively, the brain reacts with less and less distress, and eventually the brain lets go of in terms its sensitivity and reactivity to this topic,” explains Dr Phillipson.
After suffering for ten years, Bretécher found relief in ERP, doing sessions online from the UK in 45 minute sessions for a year, viewing sexual images that were gradually inched upwards in graphic content. “It was the sheer intensity of the exercises that was disturbing - sometimes watching hardcore porn five times a day,” says Bretécher. “That was very wearying.”
But, it worked. And for the first time since puberty, she has moments of mental calm. Harvey too has found unimaginable relief with ERP, which he says combined with mindfulness, meditation and mind-focusing things like music and surfing to be the “magic combo”. Though, he cautions, it’s a condition he manages – not one he has “cured”. He still gets visions on a daily basis. “I can have thousands of images a day in my head – it’s like having VR glasses all the time,” he says. “If I’m walking down Broadway in Manhattan, I might picture everyone’s faces as if they are all in the middle of an orgasm, or just picture everyone having sex in the middle of the street.” It’s still intrusive – but it’s manageable. For their parts, Bretécher has written a memoir about her experience, Pure, and Harvey has just launched a website, Intrusivethoughts.org, both hoping to spare others the years of suffering they endured. Certainly neither of them would have ever discovered Pure O without the Internet. Any cursory glance through countless Youtube testimonials hints at how many people deal with the conditions. Their stories can be harrowing. “But it’s going to require these raw conversations to get the information out there - not sanitised public service announcements,” says Harvey.
Does the future have anything in store? Hopefully more people knowing about the existence of the condition in the first place – and not suffering for years in silence. There are some possible new treatments, such as using the psychedelic drug ketamine or deep brain stimulation to rewire the brain’s misfiring circuitry. But in Dr Phillipson’s mind, these are not likely to do much, and ERP will remain the gold standard.
“It’s not about fancy gadgets or drugs,” he says. “It’s about developing a healthy relationship with the brain.”
Zoe Cormier is the author of Sex, Drugs and Rock n' Roll, published by Da Capo Press.