What People Should Understand About "Pedophilia OCD"

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Jennie Kuckertz, PhD, and Martha Falkenstein, PhD, contributed to this post. Drs. Kuckertz and Falkenstein are clinical psychologists at McLean Hospital’s OCD Institute.

Intrusive thoughts are normal. Have you ever waited for a train and wondered, “What if I jumped in front of it?” Or maybe you touched a doorknob at work and thought, “What if I just contracted a disease”?

If you’re like 94% of people (Moulding et al., 2014), chances are you’ve had at least one intrusive thought within the past three months, shrugged it off, and moved on with the rest of your day.

But if you’re like the 1-2% of people who have Obsessive-Compulsive Disorder (OCD), you may have noticed the intrusive thought and had the reaction, “This thought must mean something about me and I should do everything possible to make sure the bad thing never happens.” That thought may have ruined the rest of your day. For some people with a diagnosis of OCD, having one of these thoughts can feel like it increases the chances of their feared action actually happening, like imagining a loved one in a car crash might mean it's more likely to actually happen, or that you must want them to get into an accident because you had the thought.

In OCD, intrusive thoughts tend to latch onto someone’s worst possible fears, such as thoughts about whether they might harm someone. For example, some people might worry that they will accidentally run someone over with their car, which leads them to obsessively check their rear-view window or stop driving altogether.

Pedophilia OCD

Another common intrusive thought in OCD is whether one might be sexually attracted to children. Unlike pedophilia (sexual feelings or desires toward children), for someone with OCD, these thoughts elicit a strong negative emotional reaction such as fear, disgust, or shame. Such fears are often referred to as Pedophilia OCD (POCD). People with POCD constantly question whether or not, deep down inside, they are actually a pedophile who has or could harm children and seek constant evidence to either confirm or deny their worst fears.

While people without OCD have the luxury of feeling certain most of the time, OCD can create doubt about almost anything. For example, a grandmother with POCD might change her grandson’s diaper and wonder, “Did I accidentally touch him inappropriately?” or might ask, “Was I sexually aroused?” and scan her body for signs to make absolutely sure she was not.

People with POCD may also make efforts to ensure that they are not in situations where they could harm children because they are so fearful of the possibility of doing so. A man who fears the idea of being aroused when seeing children may skip all commercials on TV so as to not accidentally see an advertisement for diapers. He may even avoid using the internet altogether so as to not unintentionally stumble upon illicit child content. A new mother may be so fearful that she could molest her child that she is unwilling to be alone in the room with the child, asking a relative to be present with her at all times to provide reassurance.

Clearly, these efforts to seek certainty and reassurance can be hugely disruptive and cause emotional torture for the person with OCD.

These fears persist despite a lack of any reasonable evidence that they have pedophilia or have any sexual attraction to children. In fact, OCD tends to latch onto the things most precious or valued in one’s life, the things that represent their worst fears. For many new parents, the most important thing in their lives is suddenly their new baby, so unsurprisingly OCD latches onto the fear that they might harm that child. While POCD can affect anyone regardless of gender or age, women may be especially vulnerable around pregnancy. An estimated 3-5% of new mothers experience perinatal OCD and 13% experience postpartum depression.

POCD is not a specific diagnosis, but instead falls under the broad category of OCD. People with pedophilia-themed intrusive thoughts often experience other OCD intrusive thoughts as well, such as concerns about contamination or religious scrupulosity.

POCD is treatable

The good news is that if you have OCD about pedophilia or any other number of intrusive thoughts, there is help that works. Exposure and Response Prevention (ERP) is a specific form of Cognitive Behavioral Therapy (CBT) designed to help the individual face one’s intrusive thoughts head on without allowing the thoughts to rule one’s life. ERP can allow people with OCD the freedom to enjoy parenting their newborn, find value in teaching schoolchildren, or walk freely through the grocery store without having to leave when a child enters with their parent.

People with POCD experience intense stigma and shame and are often scared to talk to anyone about their intrusive thoughts. Let's deconstruct this stigma together.

To find a therapist near you, visit the Psychology Today Therapy Directory.

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