Pedophilia obsessive-compulsive disorder (POCD) is characterized by having intrusive sexual thoughts about children, followed by compulsions involving avoiding situations where someone may interact with children. The compulsions briefly alleviate the fear and guilt the sexual thoughts provoke, but the anxiety returns in the long-term. The primary treatment for POCD is exposure and response prevention.
Sexually Intrusive Thoughts Are Often A Sign Of OCD
Many people with sexually intrusive thoughts also struggle with misdiagnosed OCD. The first step to getting help is an accurate clinical assessment and diagnosis. NOCD’s therapists will provide a comprehensive assessment of your experience. If they find that you do not meet the criteria for OCD, they will still help assist you in identifying what you may be experiencing. Get Started With A Free 15 Minute Call
What Is POCD?
POCD, short for pedophile obsessive compulsive disorder, is a subtype of OCD that consists of unwanted sexual thoughts about children, provoking anxiety, guilt, and shame. The thoughts cause obsessive fear in the OCD sufferer that they may be a pedophile and that they may act on their thoughts.This results in compulsive behaviors to avoid interactions with children.
POCD can interfere with romantic and sexual relationships because they often trigger avoidance and create difficulty for the person to remain in any situations involving children.
While there are no exact statistics about the co-occurrence of other OCD subtypes, POCD can often overlap with:
POCD Vs. Real Pedophilia
People with POCD are not pedophiles. POCD involves experiencing disgust and shame for having these obsessions and performing compulsive behaviors to avoid situations with children. The compulsions are an attempt to avoid their OCD being triggered and to ensure that they are not a threat to children. In contrast, actual pedophiles often experience gratification when having sexual thoughts about children, and they deliberately plan their course of action and then carry it out.
POCD Symptoms
POCD symptoms consist of obsessive sexual thoughts about children that provoke anxiety, leading them to perform compulsive rituals intended to reduce anxiety. Obsessive thoughts can include “undoing” thoughts, such as imagining scenarios opposite to pedophilic obsessions. Compulsive rituals can consist of mental rituals, such as repeating “I am a good person,” or behavioral rituals, such as visually checking to make sure the child is unharmed.
POCD Obsessions
Common obsessive thoughts in POCD include:
- What if I sexually harm a child?
- What happens if I sexually abuse a child and am caught?
- What if that nice feeling I had when I saw that child means I want to molest him?
- Having these thoughts must mean I am a bad person.
- I’m afraid of being alone with a child because I’m not sure if I will act on my obsessions.
- What if God punishes me for having these thoughts?
POCD Compulsions
Common compulsions in POCD include:
- Avoiding taking their child to a playground, for fear of harming other children
- Avoiding social and family events to protect children from themselves
- Limiting sexual activity with anyone, including a partner
- Making sure to never be alone with a child
- Avoiding or diverting eye contact when watching shows with children in them
- Praying for forgiveness for having the obsessions
- Confessing the obsessions to clergy
- Mentally reviewing a triggering event to replay each aspect of their behavior
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Pedophilia OCD Triggers
Any environmental reminder of children can trigger someone with POCD. These reminders can be children’s physical presence, imagery or videos, or even conversations regarding children. Environments in which children are typically present, such as a playground or school, can trigger POCD, even if there is no mention of children.
Common triggers of POCD symptoms include:
- Being in the presence of children, even one’s own
- Visiting a public location with many children
- Feeling pleasure when noticing how cute or physically appealing a child is
- Experiencing internal pleasurable feelings watching children play
- Changing babies’ diapers or toddlers’ clothes
- Teaching elementary school-aged children
What Causes POCD?
Possible causes of POCD include a chemical imbalance, genetics, or a traumatic event.
- Studies show that neurotransmitters such as serotonin, dopamine, and glutamate are elevated in people with POCD.3
- Around 65% of people with OCD have a genetic history of the condition in their family.5
- A stressful or traumatic event may cause the onset of POCD.6
How to Know It’s OCD
The only true way to know that the symptoms you’re experiencing are cause by OCD is to receive a thorough evaluation from a mental health professional. They can assess the origin and impact of the symptoms to better understand the situation and then recommend effective treatments.
Examples of POCD
People will POCD may show symptoms in subtle or very clear ways including:
- Staying at home constantly to avoid being around children
- Never allowing themselves to be alone with a child
- Having no access to the internet to avoid looking at children online
- Moving to a secluded or isolated area
- Excessively praying or attending religious events to manage the distressing thoughts
How Is POCD Diagnosed?
Receiving an OCD diagnosis can be complicated, because people with POCD may feel shame to disclose their obsessive fears. They may fear being reported to law enforcement or child social services. Instead of seeking professional help, those with POCD may confess their thoughts to clergy, not realizing that there is a clinical reason for the thoughts and that they are not choosing to sin.
Two different questionnaires, the Y-BOCS and the DOCS, are the measures that are used to assess for and diagnose POCD symptoms.
If you suspect you may have POCD, here are some questions you could ask your doctor or therapist:
- Where can I find specialized POCD treatment?
- How do you treat POCD?
- What does a typical treatment plan look like?
- How do you know whether these thoughts are true?
- Do you know how to conduct exposure and response therapy?
What is the best treatment for Pedophilia OCD?
Exposure And Response Prevention Therapy (ERP) – Do live video sessions with a therapist specialized in ERP, the gold standard treatment for OCD. Treatment from NOCD is covered by many insurance plans. Start With A Free 15 Minute Call
POCD Treatment Options
POCD treatment options are the same as all other types of OCD treatment, which is mainly a combination of exposure and response prevention therapy (ERP) and medication. Some ERP practitioners will also incorporate mindfulness practices, and for some, group therapy may also be helpful.
Exposure and Response Prevention (ERP)
ERP helps people face their fear without compulsively attempting to reduce or avoid anxiety. It is considered the gold standard OCD treatment as it recalibrates the brain and helps people learn to accept uncertainty caused by obsessive fears.
Examples of Exposures for POCD
Exposures for POCD will focus on situations that are safe and reasonable for the individual as well as any children involved.
Exposures for treating POCD could include:
- Looking at pictures of children while emphasizing the nonsexual nature of the POCD intrusive thoughts
- Watching nonsexualized videos of children
- Going to a park where children are playing
- Attending a movie with children in the same theater
- Being in the same room with a child
Other Therapy Options for POCD
Other potential therapy options could include:
- Group therapy: Group therapy can help reduce shame and stigma by meeting and talking with people with the same symptoms.
- Acceptance and commitment therapy (ACT): ACT helps people accept their current reality and commit to changing dysfunctional thought and behavior patterns.
- Self-Compassion (SC): SC is an approach that teaches people to be mindful of their negative or judgmental self-talk and instead talk to themselves as they would a good friend who is struggling.
Medications for OCD
The most commonly prescribed medications for OCD include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). If these medications are not sufficiently effective, atypical antipsychotics may also be prescribed to enhance the effects of SSRIs or SNRIs.6
The Importance of Mindfulness for OCD Treatment
Mindfulness and meditation for OCD can be a great addition to any OCD treatment. With patience, thoughtfulness, and attending to one’s surroundings, they can gain a better understanding of their obsessions and compulsions and be better prepared to respond to obsessions appropriately.
How to Find a POCD Therapist
It may be a challenge to find the right therapist for POCD since it involves specialized skills. Be sure to find someone who specializes in ERP therapy for the treatment of OCD, and who specializes specifically in POCD. Begin by checking an online therapist directory or asking your doctor for a referral.
How to Cope With POCD
It is incredibly challenging to live with POCD, but there are healthy coping mechanisms for OCD that can help a person to accept obsessive doubt and still live a life according to their values and goals. Treatment can help reduce self-stigmatization so you do not base your worth or identity on obsessive thoughts.
Helpful coping strategies for POCD include:
- Recognize the obsessions: Recognize and label the cognitive distortions in your head and reframe the thoughts to a more realistic view of what is happening.
- Practice opposite actions: Opposite action is a dialectical behavioral therapy (DBT) skill that emphasizes the importance of doing the opposite action that a person’s compulsions suggest. This reinforces to the brain that the feared behaviors are not as scary as the POCD tells them.
- Develop mindfulness skills: Mindfulness helps a person with POCD by staying focused in the present moment over which you have control. It enables you to shift your focus from thinking about the past or future to being more objective and less emotional about the obsessions.
In My Experience
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