Your Complete Guide to Pedophilia OCD (POCD)

Pedophilia OCD (P-OCD) is a subtype of obsessive-compulsive disorder (OCD) characterized by obsessive thoughts, images, and impulses and compulsive behaviors around unwanted sexual thoughts about children. A person with P-OCD may be obsessively concerned with proving to themselves they are not a pedophile. For someone with P-OCD, the idea of potentially harming a child is terrifying, and this fear causes them to engage in compulsive behavior aimed at alleviating this fear (e.g., excessive online research about what makes someone a pedophile).

OCD tends to fixate on what is most important to the individual, and when children’s well-being and safety is one of a person’s core values, OCD will often latch on and cause a person to have obsessions and compulsions centered around this value. The fact that the obsession is centered on something so important to the individual makes the doubting thoughts all the more anxiety-provoking (e.g., “How can I be absolutely sure I won’t hurt a child?”). 

Pedophilia OCD symptoms

People with P-OCD generally experience this disorder in two ways. They are either excessively afraid of acting like a pedophile (“What if I accidently touch this child in an inappropriate way when I’m alone with them?”) or they are concerned that their thoughts will make them a pedophile (“I can’t believe I found a teenager attractive. It must mean I’m a pedophile.”) For people with P-OCD, these concerns and fears feel impossible to let go of. They feel terrifying and all-consuming, and they won’t leave a person’s mind until they have found temporary relief, either internally or externally, to dismiss these concerns.

It is important to emphasize that the intrusive thoughts people with P-OCD experience revolve around being afraid of being a pedophile or doing something that could characterize them as a pedophile, but the experience is entirely separate from actual pedophilia. While a pedophile takes pleasure in their sexual thoughts about children, someone with P-OCD is horrified by them and will spend a huge amount of energy trying to make these thoughts go away. They might stop seeing their family and find themselves isolated and consumed with fear. The shame, guilt, and isolation people with P-OCD experience can make this subtype of OCD particularly difficult to endure.

Examples of pedophilia OCD obsessions

People with P-OCD experience obsessive thoughts focused around fear of being a pedophile. Here are some examples of common themes:

• Is it possible I would hurt this child?
• I just thought this teenager is attractive/beautiful/handsome. Does this make me a pedophile?
• I’m not allowed to find my student attractive. She’s my student, after all! I am a horrible person. I should be fired from my job.
• What could happen if I’m alone with a child? I couldn’t bear the idea of ever hurting a child, but what if I did and it wasn’t in my control?
• I shouldn’t be left alone with children. I can’t be trusted.
• If anyone knew the kind of thoughts I had about children, I would go to jail.
• Just the fact that I’m thinking about a child sexually makes me an evil person. 
• I shouldn’t think someone who is younger than 18 is attractive. That’s disgusting. I must be a pedophile.
• What if I’m manipulating and seducing my child because I’m secretly a pedophile and I just haven’t found out yet?
• Am I being manipulative when I’m affectionate to my child? How can I know for sure?

Examples of pedophilia OCD compulsions 

In response to their obsessive thoughts, a person with P-OCD will engage in compulsive actions as an attempt to alleviate their anxiety. Here are some examples of what that might look like:

• Avoidance: People with P-OCD may avoid certain situations where children may be present. For example, they may decline babysitting jobs because they can’t stand the idea of being in the same room as a child and what they might do. They may stop visiting certain family members, or even their entire family, in order to avoid being in the same room with children. They may even feel compelled to neglect basic childcare responsibilities, such as changing an infant’s diaper or helping a small child bathe.

• Excessive research: A person with P-OCD may spend hours excessively researching articles about pedophiles. Because this subject is so heavily stigmatized, people with P-OCD will often turn to the internet for reassurance, rather than consulting family and loved ones. They may compare themselves to pedophiles in the news in an effort to reassure themselves (“See? Everything’s fine. I’m nothing like her.”) They may try and compare different facts of known pedophiles with their own life. (“This man was shy as a child, and I am a shy person. Maybe this is proof I really am a pedophile.”) A person may post about their experience in chat forums asking for reassurance that they are not going to hurt a child. If a person with P-OCD is already aware of their condition, they may continually seek out information about P-OCD in order to reassure themselves they actually have P-OCD (“I know these thoughts are usually my POCD, but what if they aren’t this time?”)

• Mental review: An individual may excessively engage in mental reviews of past experiences to make sure their behaviors do not make them a pedophile. For example, they might think, “I was very affectionate with my nephew five years ago on his birthday. Was that inappropriate?” That incident may stick in a person’s mind, and they will replay it continually and obsessively for years. Every time they experience intrusive thoughts, they may turn to this memory and replay it to try and gain relief from their fears of being a pedophile. 

Pedophilia OCD ERP therapy

The best course of treatment for P-OCD, like all types of OCD, is exposure and response prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found effective for 80% of patients with OCD. The majority of patients experience results within 12-25 sessions. As part of ERP therapy, you will track your obsessions and compulsions, and make a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective, and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.

The idea behind ERP therapy is that exposure to these thoughts is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety. 

One barrier to treatment for people with P-OCD is reaching out for support. The shame and disgust a person feels about their condition can make it very difficult to seek help. There is research to suggest that P-OCD is actually a fairly common subtype of OCD. Yet, 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. However, it’s worth remembering that mental health professionals who have been trained in dealing with P-OCD are used to hearing these thoughts and will be able to help you treat your condition effectively and without judgment. 

Examples of pedophilia OCD exposures

Rather than trying to make unwanted sexual thoughts, images, and urges about children go away with compulsive behavior, ERP therapy works to help a person become more accepting and tolerant of them. As a patient becomes more familiar with these unwanted thoughts, they will begin to loosen their grip on their mind.

Let’s use a specific example. A person may experience an intrusive and unwanted sexual thought about their friend’s teenage daughter or son. Each time this happens, the guilt and shame they experience about finding someone under 18 attractive is so great that they feel they must leave the room immediately. When working with an ERP-trained therapist, this patient might practice being in the vicinity of teenagers, at a beach for example, and resisting the urge to leave. With a therapist, the person will work to overcome their compulsions. At first, staying at the beach may feel unbearable in the face of the patient’s guilt, shame, and fear. In order to avoid becoming overwhelmed, the patient will work with a therapist to come up with a hierarchy of anxieties and related exposures and gradually work your way through them. 

Instead of leaving the beach or searching online for reassurance, a therapist may have the patient think to themselves, “Maybe these thoughts I have are wrong. Maybe they’re not. It’s impossible to know for sure.” This teaches the brain a new response to the uncertainty, fear, and shame fueling these obsessions and compulsions. Eventually, the patient may find their P-OCD thoughts subside and they are able to be around teenagers without being overwhelmed with fear and guilt.

How to get help

It’s an unfortunate reality that people with P-OCD are often misdiagnosed as potential pedophiles. The condition of P-OCD is terrifying and painful, but fundamentally different from pedophilia: It is driven by a concern to keep children protected rather than a desire to hurt them.

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If you’re interested in learning about P-OCD and how it’s treated with ERP, you can schedule a free call with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment.

Learn more about pedophilia OCD

• Why POCD Arousal is Not A Sign of Real Desire
• POCD: Am I a pedophile? Living with Pedophilia OCD