What is Pedophilia OCD (POCD), and how long does it last?

Obsessive-compulsive disorder affects 3 to 4% of the population worldwide and millions of people in the United States, which works out to 1 in 40 people. 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 or even reported 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 Pedophilia OCD (POCD)?

Pedophilia OCD, or POCD, is characterized by persistent, intrusive and unwanted sexual thoughts about children and/or teens (under 18) and the resulting fear or worry that one might be a pedophile. For example, if someone with POCD finds themselves thinking a student of theirs is handsome, 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 that the idea of potentially harming a child is often completely terrifying to people 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. 

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

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?
• Could I become a child predator some day in the future? How can I know for sure?

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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”), 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”), or 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. 

How can POCD be treated?

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 their worries could be proven true. 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 person with POCD 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.

Together with their therapist, they 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. 

One barrier to treatment for people with POCD is reaching out for support. The deep 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.

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 minor 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 effective for around two thirds of people with OCD, 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 care team. NOCD therapists specialize in OCD and receive specialized training in ERP therapy. You can also access personalized self-management tools built by people who have been through OCD and successfully recovered.

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