Reader’s Question

Dr. Carver, Thank you so much for your articles and answers, they’ve been extremely helpful to me and my family. I am a 29-year-old male with a history of depression. I was sexually abused by a babysitter when I was 3-4 years old. I was treated with Paxil for depression 5 years ago and then went off the medication thinking I did not need it anymore. About 8 weeks ago I started having horrible thoughts of my children being sexually abused, and it has progressed into sexual thoughts about everyone and everything. I’ve seen a MD (I’ve been back on Paxil for 9 days) and a therapist. My therapist says that many adults have the intrusive thoughts when their children reach the age at which they were abused. Is this true? Also, I’m very worried that I’ve developed OCD and will never get rid of these thoughts. Please help!

Our Clinical Psychologist’s Reply

Your therapist is correct. Sexual and physical abuse create “Emotional Memory” (see article on this website) — a combination of the details of the traumatic event and the feeling state at the time. Emotional memories (good or bad) can be triggered by similiar events or circumstances. This is why we think of our marriage when we attend a wedding and we think of our personal losses when we attend a funeral for anyone. As your children approach the age of your abuse trauma, those memories will surface.

There’s more to your situation, however. The obsessive nature of your sexual thoughts suggests that your depression has returned. Depression is felt to be related to low levels of the neurotransmitter Serotonin (the neurotransmitter that Paxil elevates!). Low Serotonin is also related to Obsessive-Compulsive Disorder so it’s not uncommon for people becoming depressed also to exhibit OCD symptoms — such as obsessive thoughts, rituals, counting, etc. In all depressive disorders, the brain tortures us with all the emotional trauma it can find in our background — often bringing up our childhood, previous bad relationships, etc. Your brain, in your depression, has found your emotional memory related to abuse. It’s now tormenting you with it.

The bad news: this is a horrible experience to go through. The good news: it’s not actually OCD. Your treatment is on the right track — Paxil will gradually elevate Serotonin and your preoccupation with sexual abuse thoughts will slowly fade away. They will fade more quickly if you use techniques I recommend in my Emotional Memory article. You will also improve more quickly with the guidance of a counselor/therapist. You are doing all the right things…it’s just a slow process. You’ve probably been moving into this depression for many months and several months will be required before you return to normal.

For future reference, each time the brain becomes depressed (Serotonin gets low!), it will find and use the same traumatic memories in our background. You now know the memories that will be used and for that reason, ten years from now if you begin thinking excessively about your childhood abuse, it will be time to return to Paxil or another antidepressant. Rather than dwell on the abuse memories, recognize and use them as a sign that your stress level has increased. It will always be like a “hot engine” light on your emotional dashboard.