The person feels the urge to perform compulsions, or safety behaviors, to alleviate anxiety, prevent something bad from happening, seek certainty that they are not a pedophile, etc. For example, a mother might experience unwanted sexually intrusive thoughts about her toddler (obsession) and thus avoid (compulsion) holding or playing with her child because of how terrified she is of the thoughts.
Pedophile OCD Is Not Pedophilia
The obsessions of obsessive-compulsive disorder are ego-dystonic or opposite to a person’s desires, values, and self-concept. The person with POCD is deeply disturbed by their obsessions and does not enjoy them. They want more than anything to escape the thoughts because of how terrorizing they are and go to great lengths to do so by performing compulsions. A pedophile experiences sexual thoughts, urges, attraction, and fantasies that are ego-syntonic, or align with a person’s self-concept, feelings, and desires. The sexual thoughts and feelings about children are pleasurable to the pedophile.
Symptoms
OCD, by nature, is the doubting disorder. The OCD brain has difficulty connecting to logic. While the obsessions are unwanted and distressing, the person feels the urge to perform compulsions to seek absolute certainty that the obsessions are not true. A pedophile knows that they are attracted to children without a doubt.
Common Pedophile OCD Obsessions
In society, the term “obsessed” is often used to indicate something that a person really enjoys. For example, “I am obsessed with Milk Bar ice cream!” Psychologically speaking, this is the opposite of what an obsession really is. An obsession is a persistent, unwanted thought/image/urge that causes distress. The obsession is not enjoyable. It haunts the person experiencing it and cannot be easily let go of. Common obsessions of POCD include, but are not limited to:
Unwanted sexual images of children that pop into the mind Unwanted sexual thoughts about children that pop into the mind What if I am a pedophile? What if I snap and do something sexual to a child? What if I turn into a pedophile? What if I fall in love with a child? What if the sexual abuse I suffered as a child turns me into a pedophile? What if I am aroused by or attracted to children? What if I did something sexual to a child in the past and do not remember? What if I never stop obsessing about this, and it ruins my life? Fear that being around a kid will turn a person into a pedophile (magical thinking/emotional contamination) Fear that a sexual thought of a child popping in during sex makes someone a pedophile
Common Pedophile OCD Compulsions
Compulsions are physical or mental acts that a person feels driven to carry out in response to an obsession. They do not want to be or like performing compulsions but do so to try and prevent a dreaded outcome. While the most well-known compulsion of OCD is handwashing, many people with OCD perform covert mental compulsions. This can make it difficult for others to recognize that someone is struggling and—in addition to the immense shame people with pedophile obsessions feel—can act as a barrier to the person accessing proper treatment. Common compulsions of POCD include, but are not limited to:
Avoiding being around children, looking at children, holding children, etc. Avoiding media (TV shows, movies, photographs, social media platforms) that have children in them Avoiding sexual intimacy with themselves and others for fear that a thought or image will pop in during the act Mentally checking feelings internally (for example, Do I enjoy this thought?) to prove or solve obsessions Mentally checking bodily sensations (for example, checking their groinal area to see if they are aroused) to prove or solve obsessions Purposely bringing on the thoughts/images to gauge their reaction to them Staring at kids to check that they do not arouse them Doing something appropriate with a child (i.e., high-fiving them or holding them) to check that they are not aroused by or attracted to them Ruminating (analyzing, trying to solve, attempting to seek certainty) about the obsessions Mentally reviewing past situations to make sure that they have not acted inappropriately Excessively searching the internet for reassurance that they are not a pedophile Repeatedly asking others for reassurance about the content of the obsessions or reassuring themselves mentally Washing hands after touching kids or objects that kids have touched so as not to be “contaminated” Keeping a mental note of, or writing down, markers throughout the day to use as reassurance that they have not acted inappropriately Neutralizing thoughts by replacing a “bad” thought with a “good” thought Confessing intrusive thoughts to others Punishing themselves (not eating enough, calling themselves mean names, etc.) for having the thoughts Sanitizing their groinal area if they felt something down there after having a thought Redoing something if they had an intrusive thought during to neutralize it (i.e., If someone walks into a room and has an intrusive thought, they may walk back out and walk in again while trying not to have the thought)
Causes
While there isn’t an exact identifiable cause of obsessive-compulsive disorder, research shows that there are both genetic and biological causes of OCD. Specific areas of the brain are impacted in those with OCD. UCLA School of Medicine conducted PET scans to measure the brain activity of those with and without OCD. When compared, the brain with OCD is much more hyperactive than the brain without OCD. What about environmental factors such as trauma, pregnancy, other mental health conditions, etc.? These can contribute to the onset of OCD, but the person with the disorder had a biological predisposition to develop it.
Diagnosis
Pedophile OCD is just a nickname and not an actual diagnosis. The diagnosis is obsessive-compulsive disorder, regardless of the content of the obsessions. The nicknames for subtypes of OCD help give people a name for what they are experiencing, as many people associate OCD with fears of contamination and are unaware of all of the ways that OCD can manifest. Getting a proper OCD diagnosis can be difficult for people because of misconceptions about the disorder held by the general public and even clinicians. People with pedophile obsessions face an added layer of shame and stigma that may deter them from seeking treatment. They are often afraid to access help because they fear a therapist or medical professional will report them to the police. It is imperative to find an OCD specialist when seeking help to ensure an accurate diagnosis and effective treatment. A true OCD specialist utilizes exposure and response prevention (ERP) as a primary treatment modality and will not be surprised in the slightest bit by pedophile obsessions. They understand the ego-dystonic nature of OCD and how it attacks what people value the most. When searching for an OCD specialist, here are some questions to ask:
Where did you receive specialized training to treat OCD? How much experience do you have treating OCD? How do you treat OCD? (Tip: listen for exposure and response prevention (ERP); someone saying they utilize cognitive behavioral therapy (CBT) is not specific enough) What would a treatment plan look like for me, given what I have told you about my symptoms? What percentage of your caseload is in treatment for OCD?
The International Obsessive-Compulsive Disorder Foundation (IOCDF) has a Find Help directory on their website where you can search for OCD specialists near you.
Treatment
In reality, the content of obsessions does not matter in regard to treatment because it is all OCD. The gold standard treatment for OCD, regardless of the theme, is exposure and response prevention (ERP).
Exposure and Response Prevention (ERP)
ERP is a behavioral therapy that falls under the cognitive behavioral therapy (CBT) umbrella. It involves exposing a person to feared stimuli while simultaneously cutting out compulsions. For example, a dad might change his baby’s diaper and tolerate the anxiety/discomfort that arises without checking to see if he was aroused by it. ERP can facilitate:
Habituation, in which a person’s anxiety or discomfort decreases after repeated exposure to feared stimuli. Inhibitory learning, in which a person learns that there is not as much danger or risk as their brain is alerting them of. Inhibitory learning is about learning new safety information (I can be around a child without snapping and harming them) to inhibit the obsessional fear (being around children is not safe for me). The person also learns that they can tolerate anxiety and discomfort associated with the feared stimuli.
OCD must be treated utilizing ERP, as behavioral change is necessary to recover. There are therapeutic modalities, like traditional talk therapy, that are ineffective at best and harmful at worst when treating OCD. People with OCD over-attend to their obsessions, which leads them to over-respond to them compulsively. Compulsions are the problem, as they alert the brain that they should pay attention to the obsessions (false alarms from an overactive fear center in the brain). The brain then fires off more obsessions. Analyzing and attempting to find meaning in the obsessions in talk therapy is one big compulsion. The person is paying a talk therapist to over-attend to their obsessions, which only feeds the obsessive-compulsive cycle.
Mindfulness Skills Training
Mindfulness skills training is also effective in treating OCD. It helps the person learn to accept the presence of intrusive thoughts/images/sensations/urges without engaging in them compulsively or resisting them. Naturally, the person with OCD wants to get rid of the intrusive thoughts because they are so disturbed by them. However, we are not in control of what we think and feel a lot of the time. Attempts to suppress thoughts and feelings usually exacerbate the very things we are trying not to think or feel.
Coping
While the theme of obsessions does not matter regarding treatment, it absolutely matters regarding the shame and stigma that a person faces. Telling a friend you are afraid you are contaminated after touching a doorknob is far less stigmatizing and shameful than telling a friend you are afraid you are a pedophile because you have relentless unwanted sexual thoughts about children. POCD can impair a person’s functioning across various domains: work, sex, relationships, schooling, etc. The person who once felt like they were born to be a mother might feel like having kids is too difficult when living with POCD. The new parent might avoid contact with their baby for fear of being triggered. The young adult in his 20s might avoid intimate relationships and sex because having sex with a partner does not feel as enticing when unwanted sexual thoughts about children constantly pop in.
A Word From Verywell
This being said, OCD is treatable, and many with the disorder go on to have rich and meaningful lives. They get married, have children, travel, pursue their dream careers, etc. ERP is an effective treatment modality that has been proven to reduce symptoms for most people significantly. Recovery is possible!
