OCDTYPES

Obsessive-compulsive disorder comes in many forms

Pedophilic OCD

Obsessions Caused by P-OCD

Obsessive-compulsive disorder (OCD) is a severe and disabling condition that includes intrusive obsessions and repetitive compulsions. OCD can take on many forms, including fears of harming others. Pedophilia-themed obsessions may produce an even greater level of discomfort, anxiety, and shame for sufferers due to the distasteful and offensive nature of the obsessions. When the OCD is severe and persistent, clients are often unable to manage the disorder without specialized psychological help.

Mother and Child: Unwanted sexual thoughts in OCD can cause shame and despair.

Clients with P-OCD (or POCD) typically fear that they are sexually attracted to children, including their own, if they have any. Some may also fear that they will commit sexual crimes against children, either consciously or unconsciously. Essentially, clients with P-OCD suffer from recurring mental thoughts and images of children in sexualized contexts, which often raises doubts about whether they will engage in acts of sexual violation toward them. Sometimes fixating on the thoughts can even lead to a groinal response, causing more distress.

Unlike pedophilic disorder (those we might call “pedophiles”), the thoughts in P-OCD are unwanted and cause severe shame, disgust, and anxiety in sufferers. Whereas clients who have pedophilic disorder enjoy and are aroused by sexualized thoughts and images of children, clients with P-OCD fear that they may actually enjoy or find pleasure in these images. As a result, clients with P-OCD can spend several hours throughout the day worrying about the possibility of being or becoming pedophilic. People with P-OCD tend to have great difficulty carrying out professional, academic, and social/interpersonal routines because of the amount of time and mental resources they devote to their pedophilia-themed worries.

Difference Between Pedophilic Disorder and P-OCD

Pedophilic DisorderP-OCD
Sexual attraction to childrenFear of sexual attraction toward children
Prefers the company of children and desires to be intimately close with themAvoids or minimizes contact with children or reminders due to feared thoughts
Performs grooming behaviors toward children for sexual contact Avoids or minimizes contact with children or reminders due to feared thoughts
Experiences sexual gratification from sexual contact with childrenExperiences extreme distress and possible suicidality with feared thoughts or reminders

Compulsions Caused by P-OCD

Clients who suffer from P-OCD tend to engage in many types of repetitive rituals, whether overt or covert. Mental compulsions or rituals are very common. These often include excessive mental review of one’s interactions with children (Moulding et al., 2014). The mental review process may involve mentally replaying past scenarios or situations in which children were present, in order to check for any sexually inappropriate thoughts or actions during one’s interactions with or around children. Clients with P-OCD who engage in mental review may ask themselves questions such as, “When I was talking to that little boy, did I think about or look at his genitals?” or “When I was changing my daughter’s diaper, did I look or touch her vagina longer than necessary?” Mental review of interactions with children can haunt clients with P-OCD as they attempt, albeit unsuccessfully, to ascertain whether or not they have violated the children sexually.

Rumination is very common in P-OCD. Rumination appears to be linked to the use of mental review in an attempt to achieve some form of resolution of the uncertainty, or some semblance of confirmation that no sexually inappropriate or perverse actions occurred when interactions with children.

Other mental compulsions may involve repeating certain words, phrases, or visual images multiple times, in an effort to soothe or distract oneself from triggering situations and events. For example, in one client, if an intrusive sexual image of her daughter came to mind, she would attempt to replace that with a ‘safe image’ of her daughter sitting in a chair smiling. She would also sometimes try to replace any intrusive sexual image of her daughter with a comforting image of her husband’s face.

Clients with P-OCD may specifically check their body for signs of sexual arousal or attraction to children. In this checking process, any physical sensation or movement experienced in the genital region in the presence of children and/or during pedophilia-themed obsessions may be misinterpreted as a sign of sexual arousal or attraction.

Reassurance-seeking can take many forms, including constantly reassuring the self, persistently seeking reassurance from others, confessing to others, or compulsively searching the internet and/or scrutinizing relevant reading materials for explanations for one’s obsessions

Avoidance is also a common response to the agony of these unwanted thoughts. In order to prevent the thoughts or the feared manifestation of pedophilic tendencies, clients with P-OCD may avoid children at all costs. This can be a major problem when clients have jobs that require working with children or if they have children of their own.

What to do if you think you have P-OCD

Despite the high rates of sexual obsessions among clients with OCD, many mental health professionals are still poorly informed in terms of recognizing, assessing, and/or tailoring specifics of treatment to clients’ intrusive sexual thoughts. Thus, P-OCD, may be misunderstood and improperly attended to by mental health professionals. It is not uncommon for uninformed hospital staff or social workers to report such sufferers to child protective services. As a result, it is vital that anyone with P-OCD seek treatment from a qualified OCD expert.


OCD by the Numbers

It is estimated that between 2 and 3 million people are suffering from obsessive-compulsive disorder in the United States. About one in fifty people have had symptoms of OCD at some point in their lives, with 1% suffering within the last year. OCD afflicts people of all races, faiths, nationalities, and ethnic groups. OCD causes great suffering to patients and their families, as up to 10 hours per day may be devoted to performing rituals. OCD has been classified by the World Health Organization as one the leading causes of disability worldwide.

References

Bruce, S. L., Ching, T., & Williams, M. T. (2018). Pedophilia-themed obsessive compulsive disorder: Assessment, differential diagnosis, and treatment with exposure and response prevention. Archives of Sexual Behavior, 47(2), 389-402. doi: 10.1007/s10508-017-1031-4

Glazier, K., Calixte, R., Rothschild, R., & Pinto, A. (2013). High rates of OCD symptom misidentification by mental health professionals. Annals of Clinical Psychiatry, 25, 201-209.

Gordon, W.M. (2002). Sexual obsessions and OCD. Sexual and Relationship Therapy, 17(4), 343-354.

Moulding, R., Aardema, F., & O'Connor, K. P. (2014). Repugnant obsessions: A review of the phenomenology, theoretical models, and treatment of sexual and aggressive obsessional themes in OCD. Journal of Obsessive-Compulsive and Related Disorders, 3, 161-168.

O’Neil, S.E., Cather, C., Fishel, A.F., & Martin Kafka, M. (2005). “Not Knowing If I Was a Pedophile . . .” - Diagnostic Questions and Treatment Strategies in a Case of OCD. Harvard Review of Psychiatry, 13, 186-196.

Sexual Thoughts in OCD

Unwanted Concerns in Obsessive-Compulsive Disorder (OCD)

Many people with obsessive-compulsive disorder (OCD) have sexual obsessions, or unwanted sexual thoughts. This may include sexual orientation fears, which is sometimes referred to as sexual orientation OCD (SO-OCD) or homosexual (HOCD). These are not the same as fantasies or being homophobic.

Sexual thoughts in OCD may include:

  • the obsessive fear of being or becoming LGBTQ
  • intrusive, unwanted mental images of upsetting sexual behaviors
  • the fear that one may become a pedophile
  • the fear of becoming sexually aggressive

The Worst Kind of OCD

Although people with OCD may obsess over any number of concerns, one of the most upsetting types of OCD involves worries about causing sexual harm to a child, sometimes called pedophile OCD or POCD.

Although this type of OCD typically receives little attention from the media, the Power to Change aired the story of a man whose POCD was so severe he contemplated suicide before he was treated by OCD expert, Dr. Monnica Williams.

Hear his story online and learn about OCD treatments from psychologist Dr. L. Kevin Chapman.

Read His Story
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At New England OCD Institute you will learn about the many types, symptoms, signs, and forms of obsessive-compulsive disorder (OCD) and related OC Spectrum Disorders. OCD is a brain disorder that can cause repeated washing, compulsive cleaning, obsessions about harming children, anxiety, and depression. Visit the experts who wrote the book on pedophile OCD. You can take a self-test for OCD, find a treatment program, and get online help for OCD.