POCD is a type of OCD that can be anything from annoying to devastating for those who have it. Read on to learn about this condition and the recommended treatment for POCD.
Last updated: November 1, 2020
What is POCD?
Pedophilic obsessive-compulsive disorder (POCD) is an informal name for OCD when the primary symptom is pedophilic obsessions. It is a sub-type of obsessive-compulsive disorder (OCD).
POCD is sometimes considered a version of “pure O” OCD or purely obsessive OCD. OCD usually involves obsessions and compulsions. The “pure O” label is used for the rare patients who do not appear to have any compulsions. (Please note: Research shows that someone with obsessions but without visible compulsions is likely to have unobservable or mental compulsions. So, the “pure O” concept is probably a myth.)
POCD often involves compulsions. These can be inward, outward, or both.
What Are Pedophilic Obsessions?
An obsession is a thought, image, or impulse that is usually repeated, unwanted, and/or inappropriate. Obsessions cause significant anxiety when they occur.
Pedophilic obsessions are repeated thoughts, images or impulses related to concerns about being a pedophile. Here are examples of obsessive thoughts, images, and impulses that an adult might encounter if they were worried about being a pedophile:
A pedophilic obsessive thought might be, What if I’m attracted to that twelve-year-old child?
A pedophilic obsessive image might be imagining that you are engaging in a sexual action with a twelve-year-old child.
A pedophilic obsessive impulse might be experiencing an urge to perform an inappropriate or sexual action with a twelve-year-old child.
These obsessions can be about children who are familiar or not; family members, friends, strangers, or even one’s own children may be the foci of POCD obsessions.
As described above, these obsessions occur repeatedly and are unwanted. Typically, they have a terrifying effect on the person with POCD because they suspect that having these thoughts, images, or impulses means they are a pedophile.
How Common Is POCD?
One of the largest and most comprehensive research efforts ever made to measure the prevalence of conditions like OCD was a study called the National Comorbidity Survey Replication. It assessed thousands of people. The study found that over a quarter of Americans have obsessions or compulsions at some point in their lives. They also found that 2.3% of Americans have OCD during their lifetime and, at any given time, about 1.2% of Americans live with OCD. This means that, right now, around four million Americans have OCD!
The study referenced above did not specifically measure how common POCD was because POCD is not an official psychiatric diagnosis. However, the study gives us some helpful clues about how frequently POCD occurs in the American population.
There are several categories of obsessions. These include, but are not limited to, perfectionism, sex and sexuality, religion, contamination, losing control, and harming others. POCD involves a sub-type of sex and sexuality obsessions.
Although research doesn’t give us exact figures, it is reasonable to surmise that less than 10% of people presenting for OCD treatment have POCD.
What’s It Like to Have POCD?
People with POCD often describe their obsessions as demoralizing. They suffer from a lot of shame and doubt, and may feel isolated.
Those who have POCD usually do not confide in loved ones. This is because when they do, they are often met with kind reassurance, such as, “Oh, you’ve got nothing to worry about. I’m sure you’re not one of those people. Please don’t stress about that.”
Sometimes this feels helpful, but only for a short while. Other times, responses like this feel so disconnected from one’s anxiety and concern that they feel impossible to believe. This leaves the POCD sufferer feeling misunderstood and ashamed.
Uncertainty Avoidance
The engine that drives POCD is a deficit in tolerating uncertainty. This experience drives a sequence of events that creates significant anxiety.
Here’s a typical example of how it works for a person living with POCD:
- You see a cute kid on a TV show.
- You think to yourself: Am I sexually attracted to that kid?
- Then — despite the fact that all your previous romantic and sexual relationships have been with age-appropriate partners — you feel terror accompanied by the suspicion, I think maybe I am attracted to that kid!
What comes next is often one of four things, none of which are ultimately helpful.
Unhelpful POCD Coping Efforts
Distraction
Either out of calm strategizing or outright panic, someone with POCD may decide to focus their attention on something totally unrelated to the obsessive thought, image or impulse. They do this in the hopes of being productive with their time — or of just escaping the obsession. This often works in the short term, but not in the long term.
Successful Attainment of Reassurance
Seeking reassurance — which is also a compulsion — is perhaps the most popular strategy to calm the anxiety of those with pedophilic obsessions. POCD sufferers who find themselves obsessing are very tempted to find “proof” that they are not a pedophile. The ways people do this vary widely.
Here are some examples:
- Explicitly asking for a loved one’s opinion (“I’m probably not a pedophile, right?”).
- Laying a reassurance “trap” when talking to a loved one (“I wasn’t being weird at our 6 year old cousin’s birthday party last weekend — was I?”).
- Looking at children or images of children to gauge one’s reaction / attraction toward them.
- Looking at adults or images of adults to gauge one’s reaction / attraction toward them.
- Masturbating while imagining children / adults to gauge one’s level of arousal. (See also our separate page on sexual arousal and POCD.)
- Seeking / having sex with adults to gauge one’s attraction toward them.
- Researching pedophilia on the internet.
Unsuccessful Effort to Attain Reassurance
The strategies listed above may or may not result in achieving reassurance. Looking at an attractive adult of one’s preferred gender may not produce a feeling of attraction. Internet research on pedophilia may not yield comforting information. When this happens, the person with POCD often feels even more distress.
Typically, this leads to more reassurance seeking behaviors. The POCD sufferer might think, Well, I didn’t feel attracted to that woman, but I’ll find another one. This often spirals and leaves them feeling even more despair and shame than ever. Depression often results if this pattern is frequently repeated.
Avoidance Behaviors
In addition to the compulsive ways that people with POCD try to seek reassurance, they may also take steps to ensure that they do not sexually abuse or inappropriately touch children. These are called “avoidance behaviors” and could include measures like the following:
- Ensuring one is never alone in a room with a child, including family members.
- Finding excuses to not attend parties for children, even if they’re marking important milestones.
- Intentionally arriving late — after children are likely to be sleeping — to family gatherings.
- Avoiding normal physical contact with children who are relatives or children of friends (e.g. lap sitting, hand holding, hugging, etc.).
- Crossing the street or maximizing physical distance on the sidewalk to avoid an approaching child.
- Taking a seat unnecessarily far away from a child on a bus or train.
An Addiction — to Reassurance
The reduction of anxiety that POCD sufferers feel when they gain reassurance is powerful. As with most addictions, getting your “fix” only makes you more likely to seek it out again later. (This happens due to a phenomenon called negative reinforcement.) With POCD, this release combines with the abject horror one faces at the idea of being a pedophile and creates a supercharged obsession-compulsion cycle.
For example, if someone has an obsession about being attracted to a child and then achieves reassurance by remembering they recently had enjoyable sex with their adult partner, they feel better. This relief is seductive and causes them to want more; but the only way to get more is to find another obsession. So, then they may think: What if I really am attracted to children, and my relationship with my partner is just a manifestation of my denial?! Thoughts like this are often followed by another effort at attaining reassurance, and the cycle continues.
People often find there are no easy off-ramps from this POCD highway.
“Despairing POCD”
Some people with POCD have been so victimized by the condition that the obsessive thoughts no longer feel like new and startling possibilities — they just feel like the truth. I call this “despairing POCD.”
People with this kind of POCD avoid being around children, not because they’re afraid that they might be a pedophile, but because they’re confident they are one. The last thing they want is to endanger children.
Treatment for “despairing OCD” with exposure and response prevention (described below) can be effective. Despite the hopelessness this condition entails, various forms of cognitive-behavioral therapy can be potent tools to help people with this dispiriting condition.
POCD Treatment
The most effective treatment for POCD is exposure and response prevention therapy (ERP). ERP is a form of cognitive-behavioral therapy typically delivered once a week for several months. During this therapy, patients learn about OCD, how OCD works in general, and how it works for them in particular. Patients learn to identify their obsessions and compulsions and gain critical strategies to handle these symptoms when they happen. Eventually, patients receive training in exposure exercises. Exposures are ways to practice improving tolerance for the unpleasant emotional states that precede a compulsion.
By improving your tolerance for these feelings, you hone your ability to refrain from compulsions. This is true for either observable (behavioral) compulsions or for invisible (mental) compulsions. In so doing, you weaken the OCD gradually over the course of therapy.
What’s the Prognosis for POCD?
As mentioned, ERP is the treatment of choice for POCD. Studies typically show ERP for OCD to produce meaningful improvement in two-thirds of patients who receive it. One in three recovers completely.
The two most commonly used medications to treat OCD are selective serotonin reuptake inhibitors (SSRIs) and clomipramine (Anafranil). Research suggests that although these medications can help people with OCD, neither add benefit beyond ERP alone. At this time, there is no reason to believe that POCD would respond differently to the various forms of OCD treatment.
Advice for Those with POCD
If you suffer from POCD it might seem daunting that only two thirds of people typically respond well to ERP therapy. It is helpful to keep the following points in mind:
- Many of the people who do not benefit from ERP do not complete the homework exercises that are assigned by their therapist as part of their POCD treatment. Others drop out of treatment. If you don’t follow the therapist’s recommendations — or if you stop going to therapy — there is little reason to believe you will improve. So, this part is under your control!
- If you don’t improve from ERP, you can try medication treatment.
- Whether or not you take medication, you can always try ERP again in the future. It is possible that, even if you do not benefit from the therapy initially, you may benefit from it later on.
POCD is a treatable disorder, just as OCD is. If you suffer from POCD and are looking for help, please contact us using the blue “schedule an appointment” button below. We are happy to work with you or help you find someone local who can help.
Frequently asked Questions about POCD
Now It’s Your Turn
Let us know about your experience in the comments below. If you have questions this page did not address, please mention them and we will try to address them as the page gets updated over time.
Please contact us if we can help you in your efforts to find therapy for POCD here in New York. Our CBT therapists are doctoral-level psychologists. We also have student therapists who offer reduced-fee services. Our offices are in midtown Manhattan, but we offer teletherapy services to people elsewhere in New York State, New Jersey, and Florida. If you’re looking for therapy for POCD in another part of the country or world, please contact us — we are happy to help!
Lrw says
Oh man. These comments are exactly how I’ve been feeling. On my heart I know I’m not one but in my mind it’s like it’s trying to convince me I am one? (So just a quick backstory before I start. I was raped multiple times as a kid by someone I trusted, I was also molested by multiple different family members)
One day I was sitting on the couch with my husband and we were watching Private Practice (spinoff of Grey’s anatomy). There was an episode that was about this guy who had court mandated therapy for a risk evaluation about pedophilia. In his therapy session he said “all I want to do is talk to her hang out with her” the therapist then said “is that what the man who hurt you said” in that moment it was like a switch flipped, an overwhelming sensation came over me and I went through a complete mental break down. Wondering if because I was raped because I was molested does that mean I’m going to become one. I stayed up for a week couldn’t sleep wouldn’t eat drink or do anything. I literally could not function. I stayed in the bath tub and even called my mom waking her up in the middle of the night to come sit with me in the bathroom because if she didn’t I was scared I might hurt myself. It’s been 3 weeks since that happened and for a minute I started to get better, but then another episode about pedophiles came onto tv and it sent me back through the spiral. I’m telling my husband I hate him and he’s a cheater and all sorts of things. Trying to place blame I guess. I feel like there’s another person trying to fight their way out of me. I wanted to have kids more than anything, I wanted to be a mother more than anything. Teach my kids how to treat others, teach them no means no, teach them that even tho the world is scary it’s worth fighting the demons, I wanted all of these things for me and my husband and our future together. Now I am so terrified about ever becoming a pedo that Im scared to have kids and move on with my life. I’m stuck in this loop that I can’t pull myself out of and I’m dragging others down with me. I’m only 21. I feel that I deserve better then what I’m being delt right now. I know that sounds selfish but my mind is conflicting with my heart so much that I have ended up hurting myself. I feel alone. Like no one is ever going to understand and that I just look like a pedophile or I seem crazy because I worry I am one. After everything I’ve said I’ve had to put in I’m not one tho just to reassure. I know I’m not one I shouldn’t have to reassure myself. Why is this happening? Why would I even think I am one ? That must make me one? Why am I so worried about it? That kid touched my leg and I didn’t like it it made me feel weird does that make me one?
These are constant questions I ask myself and more, then I come to the realization that if I was one I wouldn’t be so worked up over it. If I was one I would’ve known the second I started having sexual feelings towards anyone. If I was one I wouldn’t want to hurt myself. If I was one….
It just keeps going an endless loop. I don’t want this to stop me from living my life. I don’t want this to ruin relationships. I don’t want this to be a problem anymore. I want my thoughts gone. I want to know I’m not alone. I want to know I’m not one and I never will be one. I don’t want to avoid children I don’t want to feel isolated. Before any of this happened I could be around a child without a second thought. Most of my friends have children and they absolutely love their auntie but this past month I don’t even want to have the kids around me I avoid kids on Facebook and tik tok I avoid being outside when the kids go to school or come home from school. It hurts thinking that I could ever be that way because I am great with kids. I know I’ll make a great mother. I know I’ll hurt myself or anyone else before that child gets hurt you know. And once again typing those thing my mind went straight to what if people think I’m a pedophile? This form of mental disability is suffocating. You don’t know who to tell who to trust or who’s just going to spread things about you if you tell them. I feel broken and lost. I have no sexual desires about children but the fear of it is crushing me and making it very difficult to get out of bed in the morning. I’m becoming an adult now, it’s time to grow up.
A says
So i remember once i had found something called loli when i was 12,and didn’t know literal what it was,i found it odd and i had thought it was like some adult stuff.i had just found out what masterbation was and had tried it out and nothing happened,pretty sure it was just like some random groinal response.forgot about it then a year later i found that again and had a stronger response and i started panicking since i got an intrusive thought saying “hey are you a pedo? hey are those kids” and i was like no? like these are grown adults right? i didn’t even know what it was i google and it had said there *falsely* that they were grown women so i had thought it was ok.ended up masterbating to prove to my intrusive thoughts i was not a pedo,then i saw comments saying that it was loli meaning kids,and instantly started panicking thinking “oh my lord my intrusive thought was right i was pedo this whole time oh my goodness what am i doing” i couldnt do anything well that day of all the panicking.and i can’t get therapy since i’m still a minor and my parents don’t think anything’s wrong with me.
Jesse says
So my situation is different. Long story short I had a normal sexual dream with a friend my age. Right at the end of the dream I look down it’s my dog and immediately throw her off (in the dream) and was like WTF. Waking up and remembering this dream was absolutely terrifying. For some odd reason my mind said that was pedofilish which is far from that. Ever since the P word has been in my head and won’t leave.
I don’t have thoughts like most POCD people really at all. But this word has been nagging at my mind for two weeks straight Daily. Now to the point
As soon as a see I kid I go into reassurance mode. My thoughts go something like this. See you are fine. You’re NOT attracted to kids but then the other side is like hey but what if you are.
This is debilitating. As stated I haven’t had thoughts about children at all. But that P word won’t leave and is a vicious cycle.
I’m so lost and scared
Josh says
I’ve been dealing with this for nearly 2 years and It’s caused me to break up a relationship I had because I was so obsessed with it that I couldn’t be in a relationship. I have weeks where I’m fine and then weeks I’m not. Even tho I know I’m not one and my thoughts aren’t real It still makes me feel terrible and ruins my life. Being excited for something or even just hanging out with friends. The thoughts pop up and I instantly get anxiety. I’m 20 years old and I haven’t told anyone for 2 whole years. I’m learning to live with it but I’m so fed up of having this condition I just want it gone. I’m scared that if I tell someone they will think I am one, and I don’t know what to do….
H. S says
Hi, m.c . I can completely relate to how you are feeling. I am a 20 year old who has had OCD for 4 years. I started out with religious OCD but then it included contamination OCD and the religious OCD stopped when I became agnostic and then for the last year and a half or so I’ve had POCD.
I don’t think I’ve seen anyone my age and gender with this type of OCD yet so if you’d like to talk to me then I would be more than happy to just for some kind of support or to share what you’re experiencing because I know it is incredibly difficult.
Dr Greene, I’m not sure if she will see this but could you potentially offer her my email address if that’s not breeching any kind of rules and if she would be interested in that?
Paul Greene, Ph.D. says
Thank you, m.c., for your comment. It’s true, thoughts like these can certainly make life feel hellish. But you’re not alone. We will reach out to you separately to make sure you’re ok.
m. c. says
So this just started completely random for me. Im 18 and ive just finished a show where the characters were younger than I thought they were. I was attracted to on and then I saw someone saying he was 14. My brain automatically went “Thats disturbing.. maybe i can make your life a living hell with this.” And BOOM. Intrusive POCD thoughts bloomed. I didn’t know what to do.. i still dont know what to do. Cause now im I’m looking at people I would find attractive searching for proof that my thoughts are wrong and i would look at babies and kids trying to see if i felt anything. All i felt was disturbed really. It’s so annoying because I was just making a pact with my friend two weeks ago to have babies at the same time and just last month I was expressing to my mom how excited i was to be a young mom… and now i just feel like my entire life is falling apart. Im not a stranger to intrusive thoughts, I’ve had religious ones for a year and a half now so I know what this is but… I’ve never actually contemplated dying before until this. Like i dont wanna die but I dont wanna live with these thoughts either.. children don’t deserve anything that my thoughts are conjuring up. I will kill myself before i ever do something like this.
Im gonna try and talk to my mom about seeing my doctor and then I’m gonna talk to her about OCD and intrusive thoughts and see if she can help me out with therapy or some medicine to fix this.
The comment section has really helped me see that im not a completely horrible person even though i feel like i am for something i have no control over. Hopefully I get the help I need and I can kiss these thoughts goodbye.
Emma says
I‘m dealing with this thoughts since august and I’m always hoping that it’s „only“ POCD and that I’m not a pedo. I‘m 17 and it feels like my whole life is breaking apart I always wanted children and be in a happy relationship but I could never achieve this. 3 Weeks ago it started that I got the same thoughts about our dog and it makes me so sad I want my life back but in my area are 2 therapist and I can’t go there bc I’m a minor. I hope we will be better soon stay safe !
Anon says
Seeing this article and reading these comments have really helped me. I suffer with this, and it SUCKS! I go days feeling so down on myself, even though I know they are just thoughts. But getting rid of the thoughts is the hardest part. I haven’t talked to anybody about it yet (a doctor or therapist) only a few of my family members because sitting around and letting it linger is the worst feeling. Reading this article and seeing the comments have helped me in realizing that I need to get help with this, I need to speak up to someone and get the help I need. I’m not the only one. I’ve never been the only one. We are good people that OCD had decided to visit, and the visit has been too long! Thank you all for helping me for even though it wasn’t your intention!
KEni says
So I can definitely relate to many of the things said on this article and reading through it I have found something’s that I used to do and don’t do anymore like the reassurance from people. I guess you could say I’ve had experiences with ocd since I was a child but being in a Hispanic household I was always just known as the weird kid that took things too seriously and was very emotional. I have a special needs baby who when I found out about his condition I fell into extreme depression and anxiety. I also started having obsessive thoughts about hurting him, and hurting myself. I didn’t want to ever do any of those things but the images would just pop all of the sudden. Then out of know where it turned to pocd related thoughts as well as throwing him our beating him. It scared the shit out of me so I stayed quiet for a full year and didn’t get help for my postpartum nor intrusive thoughts. Then I all of the sudden started obsessing over having breast cancer when it had only been a few months of me having stopped breast feeding, meaning I was obviously gonna have lumps and stuff but my mind wouldn’t let it go so I checked every five minutes. Back to the pocd I now know I’m not a pedo and would never actually want to do harm on my baby and or any child. But the fact that it keeps you self doubting is just what makes it worse. I have never climaxed in the thought of it or anything like that. Hell no. I guess that’s what keeps me firm. My fight isn’t over but I am not giving up!!! And neither should you if you’re reading this. I literally rather die or turn myself in than to hurt any child PERIOD. We can do this.
Carlos says
I’ve been dealing with a lot of stress and anxiety recently and heard a joke from a comedian relating to pedophilia. I suddenly felt uncomfortable with the joke and asked myself the question, “wait is it because I am one as well?” and have been suffering since. It creates panic that is debilitating.
Anon says
This article definitely helped validate a lot of what I’ve been dealing with. I’ve been wondering if it’s maybe the trauma I went through that’s caused it, but now I think it’s probably pocd. I was diagnosed at 14 with OCD, so it would make sense it could manifest in this way. The way it manifested also may have to do with the trauma, but there’s not really a way to know for sure.
It’ll be really hard to find a therapist knowledgeable on trauma, dissociative disorders, and OCD. But at least I have a reference on what to look for. I might actually bring it up with my current therapist.
Anyway, this article was really helpful. I definitely relate to it a lot, and I hope I can get it figured out. Thank you
S. T. says
Great article, very specific and very relative.
My first OCD encounter was as a 7 year old kid and was health related. Other than some counting and symmetry of touch ‘quirks’ in the following years, I was relatively free of OCD and anxiety.
Then, BOOM, when I was 18 it came back with some clout. I didn’t know it then, but I was in the grips of pOCD and, legitimately, thought I was a danger to children. The rumination, mental review and physical checking for arousal was constant. And then I definitely reached the ‘despairing OCD’ stage and, essentially, had consigned myself to a life of shame, isolation and despair.
I confided in no-one and was too scared to even consult the internet for fear of what I’d find out about myself.
This lasted about 6-8 months and, gradually, went away of its own accord.
15 years on and here I am again! Now, after seeing a therapist and reading some Jeffrey Schwarz, I was tooled up with knowledge and was able to deal with it – for a while!
And then, as feelings of isolation and depression set in due to Covid Lockdown ‘culture’, it all got a bit worse.
Now, about 6 weeks into ‘pOCD Mk.2’, I’m just beginning to start ERP with a CBT Therapist – scared and unsure, but will give it my all.
I want to use this time to really smash this condition to a point where I have accepted and embraced the situation and have developed new and long lasting coping mechanisms via ERP.
Remember folks, avoidance is great, but only in the short term!
This article was great at contextualising pOCD and for educating me on the benefits of ERP – thank you!
ST
Mark says
Thank you, I suffer from this and have found the past years impossible to manage. This article, found quite by chance, has clarified much of my thinking on the matter.