A Comprehensive Look at Pedophilia OCD
It’s truly fascinating how universally reviled and despised pedophilia is. No matter your walk of life or background, almost everyone can unanimously agree that those who desire (and prey upon) children are amongst the most repulsive people on this planet. Because of this extremely negative – and wholly justified! – classification of pedophilia, it makes the subtype of obsessive-compulsive disorder that much more difficult to diagnose and treat.
Pedophilia OCD, also called P-OCD, is perhaps one of the least understood and recognized types of obsessive-compulsive disorder. Unlike the more commonly recognized types of OCD (such as symmetry or germaphobia), P-OCD is not only very poorly misunderstood, it’s actually often silenced before the sufferer can admit to their struggle. Indeed, the taboo surrounding pedophilia is so pervasive, those who do suffer from P-OCD are often marked as being criminals or creeps. In turn, they are left to struggle in private, never admitting to the darkest fears that lurk in the back of their minds.
It’s important, therefore, to quickly point out that there is a vast difference between pedophilia and P-OCD. While there are many diagnostic criteria that need to be met before a person can be accurately identified as a pedophile, there is one thing that makes those who struggle with P-OCD stand out in stark relief from child molesters and those who feel a sexual urge toward children. Individuals with P-OCD have no sexual inclination or desire toward children, and they are so disgusted by their intrusive thoughts that they go to great lengths to avoid experiencing them.
We cannot stress this fact enough. Unlike those who struggle with pedophilia (which is an entirely different mental disorder in itself), P-OCD is defined by the fear that the sufferer may possibly be a pedophile. Indeed, it’s very important to understand that P-OCD sufferers are marginalized, maligned, and misunderstood…even by highly trained healthcare providers and therapists who should know better. Pedophilia OCD is the absolute opposite of pedophilia, and those who struggle with it:
- Do not have sexual desires toward children
- Are repulsed and embarrassed by their unwelcome thoughts
- Will go to great lengths to avoid these thoughts
- Have ended their own lives due to their disorder
It must be emphatically stressed again that Pedophilia OCD is not a form of pedophilia: it is a form of OCD. Approximately 1 in 40 adults suffer from some form of OCD (and by comparison, less than 1% of adults are presumed to be pedophiles), making it a common, widespread disorder in desperate need of treatment and research. And for those of who may be silently struggling with P-OCD, considerate treatment is vital for this particularly marginalized form of OCD to help them overcome the symptoms and function in society.
Despite there being a stark difference in both prevalence and presentation of symptoms between pedophilia and P-OCD, there is an unfortunately common tendency to misdiagnose people with P-OCD as pedophiles. In turn, healthcare providers may inadvertently seek similar paths of rehabilitation for those with P-OCD. This is not only very ineffective, it can even cause them to avoid seeking out treatment for their disorder. After all, if one grows to believe that they are a “monster” for these thoughts, they may also secretly fear that a healthcare provider may also harbor those negative opinions of them.
And you know what’s absolutely heartbreaking? They’re actually right.
What is Pedophilia OCD?
Obsessive-Compulsive Disorder can manifest in many ways, but at the core of the disorder is an irrational obsession that leads to a compulsion. This can range from the relatively benign (such as a fixation on certain numbers, leading to the compulsion to flick a light switch multiple times until it is done the “right” number of times) to the directly harmful (such as obsessive germaphobia, leading to a person compulsively washing their hands until they are raw and bleeding).
There are unofficially 6 different categories that most specialists commonly use to describe OCD broadly, with multiple subcategories that each have specialized emergent classifications, leading to an almost infinite variety of ways this disorder can present. Of particular relevance to P-OCD is the branch of intrusive thoughts that deal with sexual and deviant paraphilia, in particular the subcategory of taboo thoughts.
Throughout all of known history, there have been documented cases of people being afraid of engaging in taboo behavior even when they otherwise had no predilection to act on that taboo. Oftentimes, the fear was related to exposure. For example, thinking that they were now “contaminated” by someone else breaking this taboo, which thereby made them more likely to also do so themselves.
Even theistic literature is often used to reinforce these fears. Many people who struggle with OCD also find themselves turning to hyperreligiosity (also known as scrupulosity), and blasphemy fears can frequently turn up in those who struggle with OCD. For example, consider this quote from the Bible: “Depart now from the tents of these wicked men, and touch nothing that belongs to them, or you will be swept away in all their sin.” (Numbers 16:26.) The overwhelming fear that mere exposure to evil will cause someone to become evil is not a new or novel concept to those who suffer from OCD.
“Am I a Pedophile?”
At the core of P-OCD is this question. After all, if you think about harming children, you must want to harm children, right? No. Entirely, unarguably, and provably wrong. Just as most people with germophobic OCD don’t ever go around intentionally starting plagues, or how people with intrusive thoughts about harming their loved ones are actually very loving and gentle individuals, there is no tangible connection between P-OCD and sexual attraction or abuse of children.
It’s important to clarify: P-OCD is not defined by expressing a sexual attraction to minors (pedophilia), but only the irrational fear of being sexually attracted to minors. The main keyword here is the term “intrusive,” as in very unwanted and disgusting thoughts that are foreign to normal thought processes. Just as some people with OCD may be afraid of injuring others even in situations where they are literally incapable of causing harm, people with P-OCD are afraid of being a risk to children even though they are not.
But before we can address how P-OCD is completely separate from pedophilia (both in potential and actual harm), it’s important to first take a closer look at the common misconceptions of pedophilia. Pedophilia itself is merely attraction to minors, and it doesn’t necessarily ever lead to sufferers taking action on that attraction. Of the marginally small number of adults who are pedophiles, an even tinier subset makes up the group of child molesters and abusers. In fact, some child rapists aren’t even pedophiles, as mind-boggling as that may initially seem.
Just as sexual attraction to minors doesn’t automatically lead to sexual abuse of minors – and may sometimes not even be an element of the crime – intrusive thoughts about sexual attraction to minors doesn’t equate to ever actually having any actual attraction, nor does it lead to “developing” that sort of taboo. P-OCD is a mental disorder, whereas pedophilia is a sexual disfunction. Neither are directly tied to child abuse. The link from P-OCD to criminal activity is extremely weak and hypothetical, at most. In the overwhelming majority of cases, the connection isn’t there, period.
The Negative Stigma of Pedophilia OCD
While negative stereotypes and judgement from your peer group can understandably be hurtful, receiving harsh criticism from your therapist can be especially devastating. It’s fairly well understood that mental health professionals should know better, and yet misdiagnosis and unfair treatment toward their patients is still quite common. These misdiagnoses and unkind judgment are too common for people presenting this disorder, leading to further trauma for those who seek out treatment.
Sadly, professional treatment for P-OCD sufferers very rarely includes actual treatment for their unique subtype of OCD. Instead, these treatment protocols can range from the useless to the actively harmful. Some therapists try to help P-OCD patients develop skills to avoid acting on pedophilic urges (when they do not have pedophilic urges at all). Others try to force a P-OCD victim to first “accept” that they are latent child rapists who will harm children if they don’t get immediate rehabilitation for their criminal deviancy. This, of course, can make their OCD complex even worse.
Understandably, most people with P-OCD would rather suffer in silence and avoid ever getting diagnosed and treated, rather than risk being “confirmed” as a child abuser. What makes this fear worse is that it is largely a justified fear, giving the current depth of understanding and diagnostics of this disorder. In blunt terms, for a person with any illness to ever have a reason to not to trust healthcare practitioners is thoroughly disgusting and tragic. It’s a blight that stains the reputation of all mental health professionals and calls into judgement their credentials and qualifications.
The current state of awareness, compassion, and humaneness for P-OCD is comparable to the historic mistreatment of LGBT people. In decades past, psychiatrists would routinely diagnose homosexuality as a form of insanity, for which any “cure” was justified. No matter how barbarous, and even for people who weren’t actually gay in the first place. Merely “displaying the symptoms” (like a woman interested in mechanics, or a man interested in fashion) was enough to demand conversion therapy. It wasn’t even until very recent times (in 1973) did this attitude change. How long will it take before the negative stigma surrounding P-OCD eventually subsides?
And this has so far only addressed how harmful the medical professional community’s stigmatism of the topic is, which is supposed to be the most compassionate and objective of fields that intersect with the mentally ill. How then do you think people with P-OCD fare when they seek help from relatives and friends? Assuming that they are brave enough to risk permanently destroying their personal and familial relationships – and make no mistake, that’s what is at stake. At best they can hope to get a co-conspirator in hiding their disorder from others, including the very professionals who might understand it. It is a depressing state of affairs for people in need of assistance and support.
When you can’t trust doctors, friends, or even family, who can you turn to for help with your disorder?
The Fear of Losing Control
So far, we have mostly addressed this topic abstractly. It is important to also acknowledge that like other mental illnesses, successful remediation cannot be done from afar. It is needed to not merely understand, but to empathize with sufferers of this unique form of Obsessive-Compulsive Disorder. This starts with knowing what may be going on inside of their head, that drives them to have irrational fears and behaviors.
Intrusive thoughts in other forms of OCD are well understood to be typically completely harmless – to others. They are alarming, irritating, and potentially harmful to the wellbeing of the victim suffering from it. Similar to how watching scary movies can convince children that there are monsters in the closet, being exposed to harmful stimuli can convince people that they themselves are monsters. The most persistently negative stimuli are “intrusive thoughts”, which are so vile and terrible that they can feel “planted”, as though somebody evil put them into your head against your will.
All of us will experience intrusive thoughts in some form throughout our lives. It’s estimated that some 6 million people struggle with these unwelcome and anxiety-inducing thoughts on a daily basis. The scope of these thoughts can vary from person to person, ranging in from the mildly bothersome to entirely overwhelming. Trying to rank these thoughts on a scale of severity may still fall short when defining the emotional distress that they can cause. Nevertheless, it’s reasonable to state that they can be very troublesome for those who struggle with them. However, for someone with P-OCD, these thoughts can be debilitating. Having unwanted intrusive thoughts that revolve around sexual abuse, violation, and rape of the frailest and most defenseless members of society is horrifying beyond description.
That, in a nutshell, is P-OCD.
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Types of Intrusive Thoughts in P-OCD
The irrational fears that drive obsession in those who struggle with P-OCD always leads inexorably to compensatory compulsions. Whether it’s avoiding jobs that require working with children, or refusing to go to gatherings that may have children present, the sufferers of P-OCD are no different in this regard. Many aspects of normal life are blocked off to people with pedophilia OCD, from going to church or school gatherings to starting a family of their own, because of that intrusive fear that if they “get access” to children, they will somehow start developing pedophilic tendencies. This can be aggravated if they responsibly try to seek help for overcoming their fears, only to have the fears reinforced by misguided professionals.
Similar to pedophobia, the irrational fear of children in general, people with P-OCD will oftentimes go out of their way to avoid interactions with minors, to great personal detriment. It can even color their existing healthy or otherwise normal interactions, leading to them feeling as though they must constantly question all of their actions. Many sufferers devote an inordinate amount of time obsessing, looking for hidden meanings like:
- “Was I looking at that screaming child in the mall weird? Are people going to remember this and start suspecting?”
- “Was having a girlfriend in middle school a hint that I was a latent pedophile? It can’t be normal to be attracted to minors, all my friends were into adult celebrities.”
- “Even if I can control these dangerous thoughts ‘for now,’ how do I guarantee I’ll never give in to them and hurt a child?”
- “Does letting my child sleep with me put them at risk? Should I refuse to comfort them for their own safety?”
- “It’s not like I ask for ID before viewing, so isn’t it possible I’ve enjoyed child pornography before?”
While a lot of consideration has been given to intrusive thoughts, it is important to note that another manifestation of OCD that pertains to P-OCD is “rumination,” or the habit of excessive thinking and overthinking on topics. While typical people might spend an unreasonably long thinking about the plot of their favorite movie, people with ruminative P-OCD may spend hours awake at night thinking over every child they’ve ever met, trying to pick apart the moments in their memory and see if there was any evidence of pedophilia in their reactions.
“I asked that kid if he was fine after he fell off his bike. Was that me unconsciously trying to groom him? Should I have asked if he were okay, was that a Freudian slip? Should I have just ignored him entirely? Maybe even noticing he fell off the bike is proof that I pay too much attention to children. And what about when his mother and kid sister came running out to check on him? Wait, why did I even notice he had a little sister? Was I trying to ‘seduce’ his sister by being so nice to her brother?” and other excessively drawn-out thoughts on the topic can possess people with this OCD, leading to prolonged mental and physical health tolls.
Compulsive Behaviors with P-OCD
As mentioned before, compulsions are an inherent part of OCD. In the sense of “cause and effect,” obsession leads directly to compulsion. This can lead to differences in behavior that are irrational or unreasonable. And yes, these actions are undoubtedly potentially harmful. But the harm isn’t directed toward the the target of the fixated obsession, but to the person experiencing these unwanted obsessive thoughts. People with P-OCD will dramatically go out of their way to avoid interactions that they think might prove harmful to children, even when there is no risk of harm.
The sheer lengths of avoidance could permanently and irreparably harm the presenter. Tragic examples of these compulsions can include dropping out of school because they don’t feel that younger students are safe around them, or no longer going out to public places that are accessible to children because of the risk they believe they pose. These are just a handful of examples of the types of compulsions that a person with P-OCD may experience. Taken to the extreme, they may even choose not to have children at all, out of a fear that they would be inviting a future victim of abuse into the world.
They can also form compulsions of comprehension, which ties in closely with the “ruminative” aspect of this type of OCD. Examples of this include staying up all night worrying over previous interactions they had with children, looking for the “link” that proves they were pedophiles all along. They could invest time in reading as much literature on the topic as possible, becoming a sort of “pedophilia expert.” Yet they will form false confirmation biases whenever they discover any evidence that even marginally suggests their imagined disorder is true, and conversely, they’ll discard all other evidence that demonstrates that they are blameless.
Not only does that not help anybody (not even hypothetical victims), but it feeds into the anxiety that surrounds P-OCD, exacerbating and worsening the irrational fear. If their hand slips while helping a relative down off of a dangerous wall, they’ve now got “evidence” in their minds of molesting-based tendencies instead of rescue tendencies. If they read an article about how pedophiles constantly think inappropriate thoughts about children and form sexual fantasies from those thoughts, they will glaze right over the “sexual fantasies” portion and only read “inappropriate thoughts,” confirming that their OCD is somehow pedophilia. It becomes a dangerous echo chamber where the sufferer tears down their psychological wellbeing trying to cure a disorder they don’t even suffer from.
Is Someone with P-OCD Dangerous?
The person at greatest risk of harm or injury from P-OCD is the presenter themselves. People with this uniquely taboo form of OCD are more likely to engage in self-harming “corrective” behavior while trying to fix the pedophilia they believe they have. There’s also the risk of misdiagnosis and malpractice from healthcare professionals who also perceive P-OCD as actual pedophilia. This not only puts the sufferer at greater risk of trauma, but feeds into their irrational fears and makes them worse.
The societal taboos also make them potential victims of misplaced violence. It is an “open secret” that even in prison (where respect for the law is at a minimum), pedophiles and deviants are “permitted” victims of targeted violence. But even if they never end up in that sort of extreme environment, they will likely face severe mistreatment and judgment from their peers and family should any of them discover this unusual, secretive OCD. Important personal relationships can be wrongfully destroyed by OCD, at no fault whatsoever to the sufferer.
And of course, there are the elements in between, strangers who might discover a person has P-OCD. According to the National Institute of Health, sufferers of OCD are ten times more likely in general to be victims of crime, and only 3-5% of violent criminals targeting them have established histories of mental illness. The numbers grow with “worse” obsessions, and inarguably P-OCD is very far down on that list. Phrased another way, not only are they far more likely to be targeted for their disorder, it frequently isn’t even criminals and sociopaths targeting them. It is the “normal” members of society who fear their disorder enough to enact violence.
And if living with the irrational and unfounded fear of being a pedophile weren’t enough, victims also have to be mindful not to let others form irrational and unfounded fears of them being pedophiles, driving this disorder deep underground where treatment cannot reach it. All in all, P-OCD is one of the more tragic and devastating forms of this disorder, making it a burden that can almost seem too much to bear at times. Nevertheless, those who struggle with it continue on relentlessly, suffering in silence in order to protect those around them.
Treatment of Pedophilia Type OCD
Fortunately, despite the many misgivings and clarifications we’ve highlighted, there is treatment readily available. Many follow the typical patterns of assistance for people presenting with less taboo forms of OCD. The most core among them is compassionate care, having a professional you trust to disclose the issue to, and seek help with controlling the disorder through tested and proven means. There are ways to control and minimize the impact of OCD so that sufferers can lead healthy, normal lifestyles.
One major treatment method for P-OCD is controlled exposure and response cognitive behavioral therapy, which has had great success in treating most forms of OCD (and is particularly effective against P-OCD). The practice involves escalating exposure to the source of your obsession, with coaching and assistance in developing healthy responses that are not compulsive in nature. People with obsessive fears of heights may be exposed to pictures of cliffs and sudden drop-offs, and encouraged to respond naturally to them. Knowing that their source of fear is not actually present helps to overcome panicked reactions to it.
While yes, “exposing yourself to children” sounds like a terrible idea, P-OCD’s should be encouraged to interact normally with children. Starting from just seeing children present without becoming disturbed, and later having normal interactions and conversations with them. A skilled therapist will help cope with the trauma this causes, and let you know when your responses are or aren’t healthy.
There is also pharmaceutical treatment available, with a limited number of anti-OCD and anti-anxiety medications available on the market that might help with the intrusive thoughts and ruminative patterns. This can also help with OCD paraphilia disorders, as well, including depression, anxiety, and panic attacks (many of which are almost always linked to, if not causative, of OCD). Regulators to fix chemical imbalances in the brain may lessen or remove the symptoms that cause P-OCD, especially when paired with more holistic methods of treatment like therapy or exposure.
Self-care can be great for treatment of P-OCD, but it must be stressed that like all other OCD, it is far more effective as part of a routine of care, not as a standalone solution. Things like changing up your diet, exercise and proper hygiene, and even certain self-medications (with approval) can help reduce the impact of obsessiveness on your behavior. As always, people seeking home remedies to augment their remediation should speak with a doctor before starting new medications or changing dosage of existing medications, but with approval they might find that their range of options dramatically expands.
In Summary of P-OCD
Pedophilia Obsessive-Compulsive Disorder is a subset of a very routine, treatable mental illness that many people suffer from. It is not pedophilia or criminal deviancy to have invasive thoughts and fears about sexual attraction to minors, and people with those fears are overwhelmingly never any threat to children. Treatment is possible with many options available, from pharmaceutical to cognitive behavior therapy. While a history of misdiagnosis does exist, there are new trends and discoveries in the mental health community now. To the field’s credit, psychiatry has expanded in scope to allow for comprehension of this distinct form of OCD. This allows it to be focused on, rather than just lumping it in with pedophilia and other sexual disorders.
If you or someone you know suffers from P-OCD, it is important to recognize that you are not a monster or latent abuser in wait. Instead, you’re someone who struggles with a fairly common, controllable mental disorder. It cannot be emphasized enough that pedophilia is not – in any meaningful way – the same as the pedophobia that accompanies this OCD. It is important for you and others around you to understand this, and help guide you to seek out treatment with compassion and fairness. By acting with respect and reason, only then can those of you who suffer from P-OCD eventually develop the tools to learn how to conquer the irrational fears that drive you to compulsively act upon suppressing them.