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How to Treat POCD: You Are Not Your Intrusive Thoughts

How to Treat POCD: Intrusive thoughts don’t make you a Pedophile

Thinking about young children and teens can be unnerving, primarily because having sexual thoughts about underage people is unnatural and unhealthy. The fear of behaving inappropriately towards young people can cause you to avoid them at all costs. And, while this is one way to deal with unwanted, intrusive thoughts – this is no way to live. More specifically, this is no way to live a good life. Not only are these disturbing thoughts extremely frightening and concerning, but also debilitating.

In other words, these thoughts can cause you to question everything you know about yourself. The good news is that just because you have sexually-inappropriate thoughts towards young children and teens, it does not automatically mean you will act upon them – unless you are a pedophile. However, people with OCD, who have these terrorizing thoughts are unlikely to act them out and are more likely to do whatever they can to avoid or prevent anything from actually happening.

You can take control of your thoughts and behaviors by seeking OCD treatment. OCD professionals can help you get a grip on the unwanted, intrusive thoughts, so you can spend quality time with your children, young relatives, and other children and teens without thinking about them in sexually-inappropriate ways!

So, no, having sexually-inappropriate thoughts or urges towards underage people does not automatically mean you are a pedophile. The deciding factor? Whether or not you act upon these thoughts.


What is Pedophilia OCD?

Pedophilia OCD (POCD) is a subtype of OCD. This type of OCD involves pedophilia-related unwanted, intrusive thoughts, images, beliefs, and/or urges (obsessions) that are triggered by extreme anger and stress. An obsession can lead to the “need” to perform certain rituals and routines (compulsions) for relief.

People, who suffer from POCD, feel an undeniable and unrelenting urge to perform certain actions or engage in certain behaviors to feel “safe,” avoid emotional pain, ease stress and anxiety, eliminate intrusive, inappropriate, and/or upsetting thoughts, and/or prevent something bad from happening.

Thus, a person, who suffers from pedophilia OCD may be extremely afraid that he or she is either a pedophile or is at risk of becoming one. POCD can negatively impact your life in several areas, such as work, sex, relationships, self-esteem and self-confidence, school, etc. POCD is sometimes referred to as a form of “pure O” OCD (only obsessions). The “pure O” label is used to describe people with OCD, who do not feel compelled to perform ritualistic behaviors (compulsions).

However, some experts suggest that people, who struggle with obsessions – without the need to perform certain actions or engage in specific behavior, are likely to experience “invisible” mental compulsions, such as counting and re-counting, reassuring oneself, making mental lists, “wishing” and/or repeating mantras, words, or phases. So, the idea of “pure O” OCD may be inaccurate. Thus, POCD is usually linked to compulsions, however, it is possible to have both obsessions and compulsions. These compulsions can be inward (i.e., counting, mantras, etc.).

An example of POCD is a father, who experiences unnatural and disturbing sexually-explicit thoughts about his little girl (obsession) and therefore, avoids interacting with her (compulsion) because he fears that he will sexually abuse her if left alone with her.

Note: People with POCD do not experience joy, happiness, or euphoria at the thought of having sex with underage people (young children and teens). So, just because these individuals have inappropriate sexual thoughts towards young children and teens, it does not mean they enjoy and want to have these thoughts and feelings, because they do not.

What Causes POCD?

Although the exact of POCD varies from person to person, studies indicate that both genetic and biological factors may contribute to the development and continuation of OCD and POCD (a subtype of OCD). Researchers have also determined that certain areas of the brain are involved in OCD and POCD. Studies suggest that people with OCD or POCD tend to have “overactive” brains – as compared to people without OCD or POCD.

Studies also suggest that environmental factors, like pregnancy, health, lifestyle choices, family dynamics, substance abuse, trauma, and/or other mental health conditions (i.e., depression) may contribute to OCD and POCD. It is important to note, however, that most people with OCD and POCD have a predisposition to mood disorders (depression).

What Are the Symptoms of POCD?

People who struggle with POCD, describe it as a “questioning disorder.” When you have this condition, you have a hard time applying logic to situations. Although the intrusive and distressing thoughts are unwanted, you may still feel compelled to perform certain actions or engage in specific behaviors to receive relief.

Deep down you know the thoughts and behaviors are irrational, but you feel powerless to stop them. Thus, a person with POCD may “question” if he or she is sexually attracted to young children and teens, while a pedophile knows without a doubt that he or she is sexually attracted to these individuals.

How is POCD Diagnosed?

Because POCD is a subtype of OCD, it cannot be officially diagnosed. However, you can be diagnosed with OCD with pedophilic thoughts and “avoidance” behaviors.

A POCD diagnosis is normally made after observing the individual and listening to his or her symptoms. In other words, a POCD diagnosis primarily stems from self-reports of sexually-explicit thoughts and urges, a loss of control, and/or “avoidance” behaviors.

Being accurately diagnosed with OCD with pedophilic thoughts can be tricky because sexually-explicit thoughts and “avoidance” behaviors are sometimes misdiagnosed as “pedophilia” when it is OCD. Thus, it is important to find the right therapist for your form of OCD (POCD). A proper diagnosis is essential for getting the OCD help you need to stop these troubling thoughts and stressful behaviors.

Researchers suggest that the most effective treatment for OCD and POCD is exposure and response prevention (ERP) therapy. ERP therapy addresses the ego-dystonic nature of POCD so the behavior fits the person’s morals, values, beliefs, and ethics.

When searching for an OCD therapist it is important to ask the following questions:

  • Where did you receive OCD training from?
  • Do you have experience treating OCD? If so, how long have you been treating it? And, what is the success rate?
  • Are you familiar with POCD or pedophilic OCD? If so, how much experience do you have with this form of OCD? And, what is the success rate?
  • What is your approach to treating POCD?
  • What other methods or techniques do you use to treat POCD?
  • What would a POCD treatment plan look like?
  • What percentage of your cases are geared towards treating OCD and POCD symptoms?

Note: The International Obsessive-Compulsive Disorder Foundation (IOCDF) can help you find OCD and POCD specialists in your area.

Is Pedophilia OCD The Same as Being a Pedophile?

No, although, the two terms sound alike, they are not the same thing. There are some notable differences between pedophilia OCD and being an actual pedophile.

First, it is important to understand that OCD “obsessions” are ego-dystonic, which means that the thoughts and behaviors are dissimilar or opposite of a person’s true values, morals, ethics, desires, and/or self-image. Thus, a person, who is struggling with POCD, is likely to become extremely upset by their inability to stop the intrusive thoughts (obsession) – even though he or she desperately wants to make them go away. This person may want to stop the thoughts because he or she has grown weary of performing certain actions – actions that only yield temporary results.

Note: Pedophiles enjoy sexual thoughts, urges, feelings, images, and fantasies, which means the thoughts and behaviors are ego-syntonic or aligned with their true self-images, values, morals, ethics, desires, etc.).

What Are Some Common POCD Obsessions?

Most people equate being “obsessed” with someone or something with joy and happiness. For instance, “I am obsessed with cookies and cream milkshakes! They are so good and I crave them all of the time!” This is not a true obsession.

Rather, a true obsession involves constant, unwelcomed thoughts, images, beliefs, feelings, and/or urges. These intrusive thoughts cause stress and anxiety, which triggers an OCD cycle (stress, anxiety, and obsessions that could lead to compulsions). Contrary to popular belief, most people do not enjoy intrusive thoughts and compulsive behaviors, primarily because they cause distress. In other words, these unwanted thoughts are “haunting,” making them hard to ignore, dismiss, or forget.

POCD obsessions may include, but are not limited to the following:

  • Unwelcomed and inappropriate sexually-explicit thoughts, images, feelings, and urges toward young children and teens
  • Disturbing thoughts that you may be a pedophile “What if I am a pedophile?”
  • An extreme fear that you may one day do something “sexual” to someone, who is underage
  • Intense worry that you may eventually turn into a pedophile because of your inappropriate “sexual” thoughts and urges
  • Concern that you may one day fall in love with an underage person
  • An unrelenting fear that the sexual abuse you experienced as a child will cause you to sexually abuse other children
  • Distress because you are sexually aroused by young children and teens
  • Excessive worry that you may have done something “sexual” to young children or teens in the past, but are unable to recall the event
  • A non-stop concern that these worrisome thoughts will never go away, ruining your chance at a “good life”
  • A feeling of dread at being around young children and teens because of a fear that being around underage people will somehow turn you into a real pedophile (magical thinking/mental contamination OCD).
  • Having “sexual” thoughts, concerning young children or teens, while having sex with a partner or spouse

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What Are Some Common POCD Compulsions?

Remember, compulsions (rituals or routines) can involve physical and/or mental acts, which cause you to feel driven or compelled to act in a certain way to ease your stress and anxiety. A person with OCD rarely wants to perform the actions or engage in these behaviors, however, there are unable to prevent, reduce, or stop them.

Although the most common OCD compulsions involve cleaning, checking and re-checking, and handwashing, some compulsive behaviors are mental, which means other people cannot see them – even though you are “performing” them. Because these compulsions occur in your mind, it is often hard to identify them. People, who experience mental compulsions are less likely to seek treatment for them, especially when they are linked to pedophilia-related thoughts or obsessions (feelings of shame and guilt).

POCD compulsions may include, but are not limited to the following:

  • Avoiding being around, looking at, and/or cuddling young children and/or teens
  • Avoiding watching or looking at television shows, movies, videos, images, or photos, and/or reading books or browsing social media pages featuring underage people
  • Refraining from masturbating or being sexually intimate with others for fear that certain thoughts and images will pop into your mind while performing these actions
  • Constantly questioning your thoughts and feelings, and/or constantly trying to prove to yourself that you are not a pedophile – “Do these thoughts excite me?” “Do these inappropriate thoughts make me a pedophile?”
  • Constantly questioning what is happening in your body while having these disturbing thoughts – For instance checking and re-checking your sexual regions (groinal responses) to see if you are sexually aroused by the thoughts, mental images, and urges
  • Deliberately thinking about sex with underage people to gauge your reaction to them
  • Staring at young children and teens to determine if looking at them elicits a certain sexual reaction in your body
  • Behaving inappropriately with young children and teens, for instance holding them a little too tightly, kissing them on the lips, and/or touching their private areas to ensure you are not sexually aroused or attracted to them
  • Ruminating on, analyzing, problem-solving, and/or seeking certainty when thinking about young children and teens in a sexual way
  • Repetitively reviewing past conversations and actions to make sure you did not behave inappropriately towards young children and teens
  • Repeatedly googling the term “pedophilia” to reassure yourself that you are not a pedophile
  • Repeatedly asking others to reassure you that you are not a pedophile or mentally reassuring yourself that you are not a pedophile
  • Continuously washing your hands or cleaning your body after touching young children or teens, or items that these underage people have touched so you do not contaminate the kids or the objects they touched
  • Documenting or making a mental note of certain “markers” or “determinants” throughout the day, as reassurance, that you have not behaved inappropriately towards young children or teens
  • Blocking inappropriate sexual thoughts by replacing them with positive non-sexual ones
  • Telling someone you trust and respect about your “sexual” thoughts and fears
  • Punishing yourself (i.e., starving yourself, isolating yourself, degrading yourself, etc.) for thinking about young children and teens in a “sexual” way
  • Excessively cleaning your groin after sexual thoughts towards young children and teens arise
  • Re-doing or re-checking something to neutralize sexually-inappropriate feelings, thoughts, urges, etc., towards underage people – for instance, leaving a child’s birthday party after experiencing sexual thoughts towards the young attendees – only to return later with the hope that the thoughts will stay away the second time

How is POCD Normally Treated?

The focus of your obsessions does not matter when it comes to POCD treatment because it all falls under the category of OCD. Therefore, a multi-treatment approach is usually used to address OCD concerns. Exposure and response prevention (ERP) therapy is usually the first-line treatment for OCD; however, acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) are also often used to treat OCD and POCD.

Lifestyle changes, self-help tools, and medications (anti-anxiety meds and SSRIs) may also be used to “quiet” your mind, so you do not feel “forced” to perform certain actions to receive relief from your stress and anxiety. During ERP therapy, CBT, or ACT, you learn more about OCD and POCD, for instance, what causes it, the signs and symptoms of it, how it is diagnosed, and how it is treated. You also learn healthy coping strategies to help you deal with your OCD urges. Therapy may occur once or twice a week for several months.

What is the Most Common Therapy Approach for POCD?

Exposure and response prevention (ERP) therapy is the gold standard treatment approach for OCD and POCD.

Exposure and response prevention (ERP) therapy is a “type” of cognitive-behavioral therapy (CBT). With ERP, you are exposed to a feared stimulus (which in the case of POCD is young children and teens), while simultaneously discouraging you from performing compulsive behaviors to ease your angst. For instance, a new mother with POCD may allow herself to experience stress, anxiety, and discomfort while changing her newborn’s diaper. This mother is making a deliberate choice not to act upon her feelings – i.e., neglecting her baby.

ERP supports the following tenets:

  • Habituation or the belief that stress, anxiety, and/or discomfort will decline with repeated exposure to the feared stimuli (i.e., sexually-explicit thoughts, urges, and/or mental images towards young children or teens)
  • Inhibitory learning or the belief that if a person learns and accepts that he or she is not at risk of sexually abusing young children or teens or of becoming a pedophile, he or she is less likely to exhibit “avoidance” behaviors. Inhibitory learning helps people with POCD learn they are “safe” and unlikely to sexually abuse young children and/or teens. For instance, “I can be around toddlers without hurting or touching them in inappropriate ways” vs. “I cannot be around toddlers because I may sexually abuse them or touch them in their private areas.”

ERP helps people with POCD learn how to make the necessary behavioral and lifestyle changes to have happy and productive lives. Repeatedly exposing people to their fears can help them become desensitized to them. Once a person becomes desensitized to intrusive thoughts, they can control their behavior (compulsions).

Can Mindfulness Training Help Me Get a Grasp on My POCD Symptoms?


In the case of POCD, mindfulness training teaches you how to accept your intrusive thoughts, images, urges, beliefs, feelings, etc. In other words, it teaches you how to experience intrusive thoughts, feelings, urges, etc., without reacting to them. Thus, the ultimate goal of mindfulness training is to promote self-awareness without overreacting to your thoughts and emotions.

Note: Learning how to let your intrusive thoughts and feelings come and go – without judging them or engaging in them is the first step in the POCD recovery process.

What is the Best Way to Cope with POCD?

Coping with POCD can be difficult and upsetting. Thus, the best way to cope with POCD is to seek OCD support from friends, loved ones, and/or a partner or spouse, and OCD treatment from a mental health professional. You do not have to tackle your POCD by yourself. There are tools, resources, and specialists that can help you deal with your OCD symptoms. You just have to seek help for your sexually-explicit thoughts and “avoidance” behaviors.

So, when you feel POCD urges creeping up on you utilize healthy coping skills and strategies by getting out of the house, calling or visiting a friend, taking a walk around the neighborhood, going to the gym, notifying your therapist, or playing with your kids and/or pet. Or, sign-up for an online OCD program, like Impulse Therapy. Impulse Therapy can help reduce your sexually-explicit thoughts and “avoidance” behaviors, so you can have the life you have always dreamt of – without the intrusive thoughts and annoying rituals.

Ultimately, keeping busy will prevent you from obsessing over the sexually-explicit thoughts.

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DR. R. Y. Langham

Dr. R. Y. Langham has a B.A. in English, an M.M.F.T in Marriage and Family Therapy (Psychology), and a Ph.D. in Family Psychology. She is currently a medical, health & wellness contributor, copywriter, and psychological consultant

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