Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Paternity fears

6 min read
George Polke, LCPC

By George Polke, LCPC

Oct 13, 2022

Possibly related to:

Obsessive Compulsive Disorder (OCD) is often referred to as the “doubting disorder.” People with OCD often find themselves constantly reflecting upon intrusive and unwanted thoughts that cause distress and uncomfortable feelings, trying to find absolute certainty about a worry or fear. In the case of Paternity OCD, any parent can feel distress from invasive doubt related to the paternity of their child. They may understand “rationally” that they have no reason to question the child’s paternity, but even an unrealistic shred of doubt can cause intrusive thoughts and distress to persist.

People with paternity themes in OCD feel compelled to engage in various compulsions to mitigate their anxiety. Unfortunately, engaging in compulsions like reassurance-seeking or avoidance offers only a temporary reduction in one’s discomfort. By attempting to remove doubt or anxiety in the short term, more doubt persists over time and one’s distress rises again and again in response to fears and intrusive thoughts. This creates a repetitive cycle of anxiety followed by a desire to engage in compulsions and find certainty, ultimately leading to interference in many areas of life as obsessions and compulsions become excessive and time consuming.

  • What if my partner is not my baby’s father?
  • What if I am not the biological father of this baby?
  • What if the baby doesn’t look like my partner?
  • I feel like my baby doesn’t look like me. What if I’m not the father?
  • Could I have accidentally gotten pregnant in some random or unlikely manner, and my partner isn’t the father of my child?”
  • I’m having difficulty connecting with my child. Does that mean I’m not the father?”

These obsessions all involve some form of uncertainty that creates anxiety and leads people who suffer from Paternity OCD to seek absolute certainty or reassurance in order to experience a sense of relief. By seeking reassurance, one may experience temporary relief from the anxiety that comes from their obsessions, but this only reinforces the OCD cycle and causes intrusive thoughts and worries to persist over time.

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Common triggers

Individuals with Paternity themes in OCD may be triggered by pregnancy as it progresses, by spending time with their child, by conversations about previous sexual partners, or by media relating to issues of paternity. For example, obsessions may be sparked by a movie or article about parenthood, or by overhearing a related conversation or discussion on social media. Any cue related to one’s obsessions—no matter the source—has the potential to start the cycle of uncertainty and distress. 

These triggers may also lead to further doubt and evaluation about whether one is dealing with Paternity OCD and not just anxiety, cautiousness, or stress.  This theme of OCD, like all subtypes, is relentless in creating doubt in the mind, causing anxiety even about one’s symptoms and thoughts themselves.

How can I tell if it’s ROCD centered on abandonment issues, and not anxiety? 

While it is common to experience some form of anxiety before the birth of a child or while raising a child, OCD will likely be distinct. For one, anxiety during these periods would likely attach to any number of important topics, beyond just paternity: financial matters, health concerns, fitness as a parent, and so on. While OCD can also target any or all of these other themes, if your doubts, anxieties, and intrusive thoughts are centered on paternity specifically, OCD may be more likely.

Identifying the cyclical nature of OCD is also helpful in determining what you’re dealing with. If you feel an urgent need to resolve doubt or eliminate anxiety and uncertainty through things like researching, seeking reassurance, or distracting yourself from thoughts on a regular basis, that may be a sign that you’re struggling with OCD. 

Common compulsions

When individuals with Paternity OCD experience intrusive thoughts, images, or urges that cause distress, they may engage in various compulsions to escape their discomfort. Compulsions in OCD go beyond basic evaluation, stressors, or any rationally applied process. You may feel an element of urgency to figure doubts and anxieties out with 100% certainty through either mental or physical behaviors.

Compulsions performed mentally or physically by people with Paternity OCD fears include:

  • Analyzing or trying to figure out paternity
  • Controlling or attempting to stop doubts and anxiety
  • Distraction
  • Prayer
  • Going over events or memories in the past to feel certain about paternity
  • Rumination on worst-case scenarios
  • Researching online about ways to determine paternity
  • Avoiding one’s partner or child so thoughts and doubts aren’t triggered

These are all done in an attempt to eliminate uncertainty and doubt. Sufferers can spend a significant amount of effort seeking reassurance overtly or in a subtle way from a partner, friend, or family member. With Paternity themes in OCD, seeking a paternity test may sound like an effective way to address the issue, but with OCD, any answer often leads to more doubt and therefore creates additional questions. One may continue to worry “What if the lab made a mistake or mixed up the samples?” or “What if I just got lucky and the baby could have had a different father?”

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NOCD Therapists have used ERP therapy to help thousands of people regain their lives from OCD. I encourage you to learn about accessing ERP therapy with NOCD.

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How to treat OCD paternity fears

Paternity OCD, as with all OCD subtypes, can be debilitating but is highly treatable with the right form of therapy. Exposure and Response Prevention (ERP) therapy is widely regarded as the most effective treatment for OCD, backed by decades of clinical research. ERP uses exposures in which you gradually learn to face your fears without resorting to compulsions that only reinforce the cycle of OCD.

ERP methods can be challenging and uncomfortable. IIn the short term, you will be trading one discomfort for another. However, ERP opens the door for long-term relief from your distress, while compulsions only make OCD worse over time. Through exposure exercises, the fear you feel in response to your worries gradually reduces over time and your brain learns that it can tolerate uncertainty and doubt. This process is referred to as habituation: ERP teaches you to respond to fear and uncertainty in a new way by accepting them, allowing you to feel less distress and anxiety over time.

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.

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