OCD subtypes
Pedophilic OCD

How Long Does POCD Last?

5 min read
Keara Valentine
By Keara Valentine
All types of OCD include obsessions and compulsions. Obsessions are unwanted and intrusive thoughts, feelings, urges and doubts, while compulsions are repetitive physical or mental actions performed in an attempt to relieve distress and anxiety

Obsessive-compulsive disorder affects 3 to 4% of the population worldwide and millions of people in the United States. There is research to suggest that pedophilia OCD, an OCD subtype characterized by obsessions and compulsions around fear one might be a pedophile, is actually a fairly common subtype of OCD.

It’s difficult to know just how many people live with this condition because many people do not share these thoughts, even with their therapist, for fear of being judged on such a taboo topic. The condition often goes undiagnosed or misdiagnosed.

The good news is that POCD is treatable just like any other subtype of OCD. In this article, we’ll talk about what kind of treatment is available, and some factors that can affect how long treatment will take.

What is POCD and how is it treated?

Pedophilia OCD, or POCD, is characterized by persistent, intrusive and unwanted sexual thoughts about children or thoughts that one might be a pedophile. For example, if someone with POCD finds themselves thinking a student of theirs is attractive, their OCD might take hold of this thought and try to convince the person they are a pedophile. Everyone has intrusive thoughts from time to time, but a person with POCD will assign it meaning about who they are as a person. They might tell themselves, “If I found my student attractive, I must be a pedophile. What other explanation is there? What if I act on my thoughts next time?” 

The difference is, the idea of potentially harming a child is terrifying and causes a sufferer to engage in compulsive behavior meant to alleviate this fear and prevent the feared outcome from occurring (e.g., excessive online research about what makes someone a pedophile, or avoiding children altogether). It is important to emphasize that the intrusive thoughts people with POCD experience center on the fear of being a pedophile, or doing something that could characterize them as a pedophile — and are entirely separate from pedophilia. 

If you have POCD, your fears are entirely separate from pedophilia.

While a pedophile takes pleasure in their sexual thoughts about children, someone with POCD is typically horrified by them and will spend an outsize amount of energy trying to make these thoughts go away. They might stop seeing their family and find themselves isolated and consumed with fear.

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The best treatment option for POCD is the same as all forms of OCD: exposure and response prevention therapy, or ERP. It’s considered the first line of treatment for people with OCD. ERP therapy works to expose you to stimuli that triggers your anxiety without engaging in any compulsive behavior to neutralize the obsession. By doing this, you gradually learn that your anxiety is manageable and that the feared outcome likely does not occur. 

For someone with POCD, ERP therapy might look something like this. Let’s say a person’s POCD has led them to avoid their niece, for fear they’ll behave in such a way that would “make” them a pedophile. The idea of potentially hurting a loved one is so terrifying that the person has avoided all contact with their family. An ERP therapist would work with the person to eventually get to a place where they could spend time with their family again. The patient and therapist will work together on a list of gradual exposures personalized to the obsessions and compulsions the person is experiencing. For example, the idea of speaking with their niece over the phone may still feel scary but more manageable than visiting in person. Eventually, stopping by for a few minutes to drop off a gift may feel doable.

A patient and therapist will choose a plan of personalized gradual exposures, and will work together to process the emotions that come up during the exposures. This process may bring up many of the fears the patient has been trying to alleviate with their compulsions (e.g.: “What if I really am a pedophile and my therapist is wrong? My life will be ruined.”) However, when a person with POCD realizes their worst fears aren’t actualized through their actions, they learn they can tolerate the discomfort or anxiety driving their obsessions and compulsions. It might not happen right away, but the goal is for people to gradually get to a place where POCD no longer has a grip on their actions and lives. 

How long does treatment take for POCD?

Like many issues revolving around mental health, the answer is: It depends. While the duration of treatment will vary from person to person, mental health professionals say to generally expect between 12 and 20 sessions to notice significant change or improvement. This of course depends on how an individual responds to ERP and how severe the condition is to begin with. Some people see positive results within a few sessions. For others, the course of treatment will be much longer. OCD is a condition that can’t necessarily be “cured,” but it can be treated and managed. 

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One barrier to treatment for people with POCD is reaching out for support. The shame and disgust a person feels about their condition can make it very difficult to seek help. However, it’s worth remembering that mental health professionals who have been trained in dealing with POCD are used to hearing these thoughts and will be able to help you treat your condition effectively and without judgment. Unfortunately, we are all too aware that sometimes people encounter several therapists who are not familiar with POCD before finding the right treatment. We commend your bravery for continuing to try and recommend you specifically look for someone trained in OCD and ERP.

One barrier to adequate treatment for POCD is getting an accurate diagnosis.

Another barrier to adequate POCD treatment is getting an accurate diagnosis. POCD symptoms might look different than how the media and others portray OCD. For instance, individuals with POCD might engage in more mental compulsions than behavioral compulsions. A person with POCD might spend hours trying to convince themselves that they would never hurt a child and come up with a list of why this must be the case, but no one can tell this is happening from the outside. 

Once a person is seeking treatment, however, therapists say the length of treatment isn’t affected by the specific subtype of OCD, but mainly the severity of the condition, comorbidities and how willing someone is to engage in the treatment. Some examples of comorbidities that are more common in people with OCD include: generalized anxiety disorder (GAD), depression, panic attacks or panic disorder and social anxiety disorder. 

ERP therapy has been found to be 80% effective, but it can be difficult. It requires willingness on behalf of the patient to feel discomfort and engage in exercises outside of therapy sessions. This can take time to develop, and a trained therapist can help you find the motivation you need to do the work. When someone is fully ready to commit, they’ll be in the best position for their treatment to be effective. Change is hard, but help is available for people struggling with POCD.

If you’re interested in learning more about how ERP therapy can help you, sign up for a free consultation today to speak with the NOCD clinical team. NOCD therapists specialize in OCD and receive specialized training in ERP therapy.

Keara Valentine

Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.

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NOCD Therapists specialize in treating Pedophilic OCD

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Taylor Newendorp

Taylor Newendorp

Licensed Therapist, MA

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Madina Alam

Madina Alam

Licensed Therapist, LCMHC

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Tamara Harrison

Tamara Harrison

Licensed Therapist, MA

I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.

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