OCD subtypes

Why POCD Arousal Is Not a Sign of Real Desire

4 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

Note: This post contains discussions of pedophilia and a form of OCD that causes people to fear that they may be a pedophile. We recognize that these topics are very difficult for many to discuss — this post is simply intended to educate and inform those with concerns that may relate to pedophilia OCD. 

Intrusive thoughts happen to nearly everyone. Every once in a while, most of us find our minds wandering off very suddenly into uncomfortable territory. These intrusive thoughts can even make us question ourselves. That discomfort is no stranger to those with obsessive-compulsive disorder (OCD). For those with OCD, intrusive thoughts are frequently recurring and cause substantial distress, leading to compulsions in an effort to try to quell the discomfort. 

These thoughts can be particularly unsettling for people with various subtypes of OCD. Pedophilia OCD, or POCD, is no exception to this. In fact, it can be one of the most uncomfortable subtypes of OCD to discuss. Research suggests that although POCD is fairly common among people with OCD, it goes largely unnoticed and misdiagnosed in most patients because the shame surrounding POCD thoughts is so strong, they don’t want to tell even a therapist. 

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However, POCD is a fairly common form of OCD, and having POCD does not make someone a pedophile. The concern around the intrusive thoughts that POCD can bring is completely understandable, but it’s important to remember that while POCD may have worrisome mental and even physical symptoms, they are just that: symptoms of OCD — and nothing more. 

What is POCD?

While pedophilia itself is defined as sexual attraction to children, pedophilia OCD or POCD is a subtype of OCD that causes fears or worries that one might be a pedophile. It often involves intrusive, sexual thoughts around prepubescent children. The important distinction between pedophilia and POCD is that sexual thoughts of this nature are, by definition, enjoyable to pedophiles, while those with POCD find these thoughts extremely uncomfortable. 

Occasionally with POCD, these intrusive thoughts can cause physical arousal, also known as ‘groinal response’, and this can be incredibly unsettling for those dealing with POCD. Research has shown that arousal comes in all shapes and forms and, in most cases, physical arousal is not at all linked to our values and beliefs but simply triggered by sexual relevance. Often times the groinal response is linked to anxiety. 

POCD arousal: a biological response

Sudden physical arousal can happen to anyone as a result of intrusive thoughts — not just those with POCD or OCD. Simply experiencing a thought that is sexual in nature can cause physical arousal. When humans sense or imagine something that is generally sexual, the brain sometimes signals the body to experience arousal. Typically, the brain sends these messages before true values and preferences can be taken into consideration. 

The physical arousal those with POCD may experience as a result of their intrusive thoughts is no exception. If someone with POCD has an intrusive sexual thought about a child, they can experience sexual arousal as a result. However, this arousal is not a result of specifically thinking about children — it’s a result of experiencing a sexual thought in general.

Often when someone with POCD experiences physical arousal as a result of these thoughts, they may be further disturbed by their obsession, and their mind goes around and around: “How could I think this?” or “Would I ever act on this?” or “Does this mean I really am a pedophile?” The physical response to such thoughts is purely biological and can happen to anyone. 

How is POCD treated? 

Like other forms of obsessive-compulsive disorder, POCD can be successfully treated with exposure and response prevention (ERP) therapy. A form of cognitive behavioral therapy (CBT), ERP has been proven in studies to be incredibly effective in treating OCD, making it the first and best choice for anyone living with OCD or POCD. ERP works in a very simple way by exposing those with OCD to potentially triggering thoughts or situations to work on preventing compulsive responses to their obsessions in a safe and controlled environment. Through ERP, one works on tolerating uncertainty and reducing compulsions such as reassurance seeking. Over time and with repeated practice, ERP can help those with OCD end the obsessive-compulsive cycle and regain freedom over their thoughts and actions. 

If you or a loved one is struggling with POCD, you may fear seeking treatment because of the stigma surrounding pedophilia. Remember that having POCD, and experience POCD related groinal arousal, does not mean you are a pedophile, and a good therapist that specializes in OCD will never judge you for your intrusive thoughts.

If you’re ready to seek treatment for POCD, we recommend looking for an ERP-certified therapist. It’s also easy to find POCD treatment virtually through services like NOCD. In fact, online therapy provided through NOCD is one of the most affordable and accessible options for ERP therapy available. 

With a nationwide network (as well as the UK and Australia), the NOCD clinical team guarantees to find members of a licensed ERP therapist in your state. Therapy is conducted via one-on-one calls or video sessions, and you can be sure that all NOCD therapists have experience treating various forms of OCD with ERP therapy. Schedule a free call to get started finding the right care provider for you.

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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Adriana Delgado

Adriana Delgado

Licensed Therapist, LMHC

My journey as a therapist has brought me in front of more and more cases of OCD, which has led to specialization in OCD treatment. My experience working at intensive in-home services for children & families, and intensive outpatient programs, has prepared me for even the biggest challenges. During sessions, I use Exposure and Response Prevention (ERP) therapy because it’s one of the most effective treatments for OCD, and works for any OCD subtype.

Alyse Eldred

Alyse Eldred

Licensed Therapist, LMFT

I’ve been a licensed therapist since 2017, and as an OCD specialist, I only use Exposure and Response Prevention (ERP) therapy. Research shows that ERP is the most effective OCD treatment available. I truly enjoy helping people understand themselves through ERP and I’m grateful to be part of a process that helps people gain control of their lives.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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