Understanding and Addressing POCD (Paedophile-Themed OCD)

Updated: January 13, 2025
Categories: Obsessive-Compulsive Disorder (OCD)
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Introduction

If you’re reading this article, I want to start by letting you know, you’ve made a good start in your aims. Because you’re likely here because you or someone you know is feeling frightened, worried, anxious, low, confused, ashamed, terrified, or even suicidal. You may be experiencing some or all of these feelings because you’re experiencing what is now known as Paedophile-Themed Obsessive Compulsive Disorder. So, what is POCD OCD? Paedophile-themed OCD is one of the subtypes of OCD, or Obsessive-Compulsive Disorder. Like other forms of OCD, a core feature of POCD is intrusive, unwanted, and distressing thoughts that may be mistaken as being sexually arousing. What differentiates it from typical OCD however, is that this time the thoughts are about harming children, despite having no desire to act on these thoughts. Now we’ve answered the question of what is POCD, so we’ll understand it further by discussing the differences between POCD and paedophilia. This article aims to be your guide in further understanding what POCD is, distinguishing the difference between POCD and actual paedophilia. We will then review POCD symptoms and signs, causes and risk factors, as well as diagnosis options. But, more than this, we’ll explore treatment for POCD and briefly explain what each involves. In summary, this article aims to help you understand how to cope, manage, address, and work through this incredibly devastating and all-consuming condition.

What is POCD?

Even though we have provided the definition of POCD, there is more to understand when we ask: What is POCD? This is because POCD is a complex mental health condition that is driven by anxiety. This anxiety is often related to distressing thoughts about inappropriate actions involving children. One of the POCD symptoms that should be mentioned is that people with POCD feel profound guilt and fear about their thoughts because these conflict with their values. These intrusive thoughts trigger compulsive behaviours which are aimed at alleviating the anxiety. This leads to other symptoms like avoidance, or reassurance-seeking. A key thing to understand when wanting to answer the question of what is POCD disorder, is to remember that, crucially, POCD is a mental health disorder. It does not reflect someone’s desires or intentions. As with other forms of OCD, the thoughts that are experienced by a person with POCD, are what drive the anxiety, and create reassurance-seeking or avoidance behaviours that are common symptoms of this disorder. What can make POCD stand apart from some of the more common forms of OCD is how POCD deeply impacts a person’s identity and sense of who they are.

POCD vs. Real Pedophilia

Often those with POCD are desperate to understand the differences between POCD and actual paedophilia, once they’ve come across the term ‘POCD.’ They then ask the question: What is POCD OCD? They soon learn it involves intrusive thoughts, high distress, and no desire to harm. Whereas, paedophilia involves persistent sexual attraction to children, often without guilt or distress. But, there’s much more to it so let’s compare symptoms of POCD with paedophilia:

Core Desire vs. Fear: POCD is characterised by intrusive, unwanted thoughts that cause distress because they go against the person’s values, whereas paedophilia involves a persistent and genuine sexual attraction to children.

Emotional Response: People with POCD feel intense guilt, fear, and shame over their thoughts and often go to great lengths to avoid situations involving children, whereas individuals with paedophilia may not feel distress or shame about their attractions.

Compulsions vs. Intentions: People with POCD often engage in compulsive behaviours, such as seeking reassurance or mentally “checking” their thoughts to alleviate anxiety. In contrast, paedophilia is defined by the presence of a sexual interest in children, not by compulsive responses to anxiety.

Action vs. Inaction: POCD sufferers are terrified of acting on their intrusive thoughts and take extreme precautions to avoid children, while paedophilia involves a sexual preference that may or may not lead to criminal actions.

Mental Health Disorder vs. Paraphilia: POCD is a subtype of Obsessive-Compulsive Disorder (OCD) and is anxiety-driven, whereas paedophilia is classified as a paraphilic disorder in the DSM-5 when it causes distress or leads to harmful behaviour.

Common Symptoms of POCD

Intrusive Thoughts

Often, one of the first symptoms of POCD that an individual will experience is intrusive thoughts. We have mentioned this term a few times, but what does it mean? Intrusive thoughts are thoughts that happen suddenly and feel intrusive because they are experienced as unpleasant and therefore, unwanted. The individual has no control of the thoughts which is highly unsettling, due to the nature of the thoughts. They can take various forms, for example, they may be mental images related to children. Another of the POCD symptoms is the intense distress that is felt by the person who has these thoughts. This happens because these kinds of thoughts are in stark conflict with the person’s core values and beliefs. They cause intense anxiety and worry because individuals fear acting on these highly distressing thoughts which they feel strongly opposed to.

Compulsions

Cognitive behavioural therapy tells us that our thoughts affect our behaviours. When it comes to any form of OCD, behaviours arise in the form of compulsive behaviours because actions are driven by a need to reduce anxiety. Compulsions are ritualistic behaviours because they aim to reduce anxiety by offering short term relief and a false sense of control. In many forms of OCD, including POCD, one common compulsion is reassurance seeking. Individuals seek reassurance against that which they fear. For example, a POCD sufferer may repeatedly mentally “check” that they have not acted harmfully, or they may call someone they know and talk through an experience to confirm that they did nothing wrong. They may also carry out a behaviour a specific number of times or in a very particular way because they believe doing it wrong will affect them negatively by making their fears come true.

Avoidance Behaviors

Another common symptom of POCD that I’ve observed in almost all of my clients who experienced this condition is the need to actively avoid situations involving children, like family gatherings or public places. This has even gone as far as avoiding seeing their siblings or friends who have young children. If they have to see them for a special occasion, they feel extreme dread leading up to the event and cannot enjoy it. Some sufferers even avoid media content featuring children and I also recall some who would not go outside at the same time that school children would be going to, or leaving from school. Another client would avoid driving a particular route to avoid going past a school, even when the children were indoors. This meant he had to go out of his way and add time to his work commute. As you can imagine, all of these avoidance tactics are quite disruptive and ironically, only maintain the fear and anxiety.

Emotional Distress

Considering the kinds of unpleasant and intrusive thoughts that affect individuals who experience POCD, it’s natural that they’re going to feel quite distressed. But distress is quite complex and can be made up of other emotions too. For example, any kind of OCD is an anxiety problem. But people who experience POCD also often feel guilt, shame, and self-loathing, alongside the anxiety, and sometimes depression. These can impact their sense of self-worth. POCD is also a unique form of OCD in the way it affects a person’s identity. As mentioned, the sufferer finds the idea of paedophilia morally reprehensible and will feel disgusted at the idea that they might be a paedophile. This conflicts with their idea of who they thought they were and who they believe they could be. The two feel at odds and it can be highly confusing, which further adds to the emotional distress felt.

Constant Doubt and Reassurance-Seeking

The persistent fear of being a “bad person” is a hard thing to have to contend with. It can feel torturous as one constantly questions one’s goodness and feels unsure and afraid. It is also quite an isolating experience so individuals seek certainty and validation from others. They need to know that their intrusive thoughts about themselves are irrational and do not reflect them in a bad light. The problem with this approach is that it keeps the doubts alive and constant because it does not offer long term assurance. Why is this? Think of the old adage: “Give a man a fish, and you feed him for a day; teach a man to fish, and you feed him for a lifetime.” This nicely explains that when one is dealing with an anxiety disorder like POCD, others’ validation is a short term relief and its benefit will only last until the next intrusive thought takes hold. You have to learn to manage the anxiety yourself, but you don’t have to do it alone – more on this below.

Signs of POCD

Behavioral Signs

Before we go to causes and treatment options, let’s clarify and summarise some signs of POCD. Some of the behavioural signs are things like avoiding interactions with children or avoiding places where children might be present. Then there are excessive checking behaviours, record keeping, and reviewing past actions to help reassure oneself that they have not acted in a wrong way. Another reassurance seeking behaviour is asking for it from those around you who are aware of your issues. Then there is the act of withdrawal and isolating oneself. This is because when people avoid places where children might be, this can extend to almost anywhere. One client didn’t even want to be in a supermarket in case she heard a child’s voice.

Cognitive Signs

These behavioural signs and symptoms of POCD arise out of the persistent intrusive thoughts that individuals experience about harming children. The thoughts can make it difficult to concentrate due to their contents, intensity, and the frequency of them. The individual becomes preoccupied with these thoughts. This is no surprise as these kinds of thoughts are not easy to ignore. Think of them as a loud and bright siren, blaring for attention, and incredibly hard to ignore or unsee. They can grind a person down, affecting their resolve. These thoughts are borne out of anxiety but they also add to it.

Emotional Signs

So if you know anyone who experiences POCD, or if you are affected yourself, you will know about the intense feelings of guilt, shame, and anxiety about the thoughts that come with this condition. For a person with POCD, depression can soon follow from believing they are morally flawed or dangerous. People who experience these kinds of feelings can start to feel alone because of how abnormal they may believe they are. As mentioned, this can cause them to isolate themselves from people but this only worsens their condition. They become stuck in their anxiety and depression, and may start to feel hopeless, and even suicidal. This is why it is important to get help for this serious and debilitating problem.

Social and Interpersonal Signs

This leads to another of the POCD signs; the social and interpersonal impact. When people avoid places where children might be, as mentioned, this could be a lot of people they know and a lot of places. This is because they will often avoid children in the family, and the parents of the children, who are also family. Essentially, they withdraw not just from places and people but from close relationships. This is upsetting for all involved and relationships can become strained and even non-existent. For the one experiencing POCD, they avoid due to a fear of judgment or misunderstanding and a fear of harming children. But for the one(s) being avoided, they can feel ignored, frustrated, and may take it personally because they simply do not understand what the issue is.

Causes and Risk Factors of POCD

Genetic and Biological Factors

So what causes POCD? Even though there is no biological physical structure in the body to denote a mental health condition like POCD. We cannot rule out genetic and biological factors. This is because it has been seen that a family history of OCD or anxiety disorders increases susceptibility to them. This may relate to brain structure and function. For example, some argue that imbalances in brain chemicals like serotonin may contribute to such conditions. However, it is difficult to determine if low production of certain neurotransmitters like serotonin are the cause, or if they occur because of a mental health condition.

Environmental Factors

When considering the causes of POCD or any mental health condition, we cannot exclude one’s environment. Those who experience this particular condition may have experienced traumatic things in the past, or may have had early exposure to inappropriate behaviours. For others who have had a fairly unremarkable upbringing, a present day stressful life event may trigger intrusive thoughts. I have had clients who have experienced both of these routes to POCD; a one off, inappropriate sexual encounter as a child (with another child), and someone who had no such experiences but heard a news story about a paedophile. But, to be clear, the emergence of POCD does not have to relate to paedophilia or sex. It is a condition about anxiety and a need for control.

Psychological Factors

POCD causes also relate to psychological factors. Those who experience any form of OCD may describe themselves as perfectionists. They may have a heightened sense of responsibility and be more rigid in their thinking. For those who experience the form of OCD we’re discussing here, they may have a moral rigidity. There is also, as mentioned previously, a strong need for control because the individual has difficulty tolerating uncertainty or doubt. As you may gather, these indicate a certain type of personality. In my work, I have noticed a connection between OCD and people who seem to have ‘anxious’ personalities. As well as those who describe themselves as having obsessive tendencies, or a keen attention to detail. These overlaps indicate a possible susceptibility of OCD and certain ‘types’ of people.

Co-occurring Mental Health Disorders

Another aspect that may make individuals vulnerable to POCD are other mental health problems. For example, conditions like generalized anxiety, depression, or other OCD subtypes often overlap with POCD. It appears there may exist an escalation of other conditions toward POCD and this indicates the importance of getting help for general anxiety, depression, and OCD, especially if not addressing them can create a vulnerability, and therefore, risk for POCD. I have rarely come across clients who experienced only POCD, without anything else before it. This does not mean it cannot happen, as there have been cases, but even these may be linked to other mental health issues that may not have been identified.

Diagnosis of POCD

Diagnostic Criteria

POCD diagnosis is based on OCD criteria from the DSM-5. This is the manual used by psychiatrists to diagnose mental health disorders. The criteria for OCD, and POCD is the same; intrusive thoughts, compulsive behaviours, and significant distress or impairment. So even though the theme is different for each type of OCD, they have certain aspects in common – essentially, they are each a different ‘flavour’ of the same type of disorder, one that is based in anxiety. This means the signs and symptoms of POCD will be similar to other forms of OCD. For example, intrusive thoughts and compulsive behaviours, like reassurance seeking. However, the content of the thoughts will differ, but they will always be linked to anxiety and fear and a need to alleviate this. A POCD sufferer may experience an intrusive thought about a child and seek assurances about not being harmful to children. People with OCD who fear germs may experience the thought they will become ill or die because they touched a door handle, even after washing their hands, so may seek reassurance from a medical professional.

Assessment Tools

So how does someone get diagnosed with POCD? This can only be done formally by a psychiatrist. A formal diagnosis will involve structured clinical interviews, and psychometric questionnaires like the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Self-reports and therapist-led evaluations will also be taken to identify symptoms. In the UK, a non-medical therapist, like a psychologist may use these same methods but currently cannot offer a formal diagnosis, even if you both believe you have POCD. Nonetheless, they may be able to help treat the condition if they have experience with OCD. It is recommended that you seek a therapist who has experience specifically with POCD, due to its nuances. This is necessary as some therapists who do not have enough experience or training with POCD, may confuse the symptoms of the latter with actual paedophilia or vice versa, which can be harmful. So make sure that the therapist you seek is knowledgeable about OCD, and the nuanced similarities and differences between POCD and paedophilia.

Importance of a Professional Diagnosis

When considering what triggers POCD and the signs and symptoms of the condition, and distinguishing it from other conditions like paedophilia or general anxiety, a professional diagnosis is a good first step. This means a visit to your doctor and a psychiatrist who can carry our the necessary diagnostics. Then it is important to find a therapist who is trained in psychology and mental health conditions, this could be a psychologist, psychotherapist, or psychiatrist who is trained and experienced with POCD. These steps are essential for avoiding misdiagnosis and developing an effective treatment plan. If you suspect you have this condition, please be aware that it is more common than you maybe realise, and that mental health professionals are aware of it and will want to help, not judge you.

Treatment Options for POCD

Cognitive Behavioral Therapy (CBT)

POCD treatment, like OCD treatment is often helped by CBT. This approach focuses on addressing intrusive thoughts and changing unhelpful behaviours. A CBT technique called Exposure and Response Prevention (ERP) is a key component in the treatment of POCD. This helps individuals change unhelpful behaviours by learning to tolerate anxiety. This is done at a semi-comfortable pace and gradually makes anxiety less intense and less frequent. This technique should be carried out in a deliberate way with a therapist who will check progress and help navigate any obstacles or challenges that arise along the way. It can feel daunting at first, but will be undertaken at your pace so that you are set up to succeed.

Medications

Some people opt for medication to help them manage their anxiety or low mood. Selective serotonin reuptake inhibitors (SSRIs) are one option for those who wish to reduce OCD symptoms. For best treatment for POCD, and any form of enduring anxiety, therapy is a good option for effective and longer term results. Therapy may feel like a daunting prospect, especially for those with POCD who may experience shame and a need to withdraw. If this is the case, medication can complement by helping reduce anxiety enough. It is important however to point out that medication may not suit everyone, and there are side effects that should be discussed with your medical professional before you start.

Mindfulness and Acceptance-Based Approaches

Treatment of POCD can also be helped by other CBT approaches like mindfulness and acceptance based ones. These techniques help individuals accept intrusive thoughts without judgment or reaction. This does not mean you are saying the content of the thought is okay or acceptable, but rather, that the thought is just a thought and this is okay. By understanding this, individuals can reduce the power and distress that is normally associated with the previously unacceptable thoughts and judgements. This offers a sense of control which is much needed for those who experience any form of OCD because of the lack of control that is experienced with these conditions. As with medication, it’s important to understand that mindfulness based approaches may not suit everyone but may be worth exploring.

Support Groups and Peer Support

As mentioned those who suffer with POCD may decide to withdraw and isolate themselves like a shameful criminal who should be locked up. But, as also mentioned, POCD is a mental health condition and a fairly common one. So sharing experiences with others in similar situations can help to normalise your experience and teach you that you are not doing anything wrong, but that rather, POCD is happening to you. This may help you feel less judgemental and more self-compassionate. You can also experience empathy from others and reduce isolation, whilst taking practical coping advice from others who may be able to help. Again, it is important to consider if this forum suits you or if one to one support from a therapist trained in POCD may be more helpful.

Importance of Continued Therapy

POCD is scary and mustering up the courage to seek support can be too. Once this first hurdle is overcome, it can be frightening to go through the therapeutic process of treating POCD because you have to confront the things you want to avoid. For example, the thoughts and how they make you feel. Depending on the therapeutic approach, you may be asked to tolerate anxiety in a more direct way, which will also be difficult. But its important to realise that this is all necessary to get through the anxiety and to the other side. But remember, when you’re feeling uncomfortable and anxious about the process of therapy itself, you can talk about these feelings with your therapist. They will help you work through them so you can continue with therapy in the longer term. This ensures sustained improvement and prevents relapse. Regular ongoing sessions can also address new triggers or stressors as they come.

Conclusion

In this article we have reviewed what POCD is and distinguished it from paedophilia. We’ve discussed POCD signs and symptoms, what triggers POCD or what we might call POCD causes. Then we looked at POCD treatment. It’s hoped that after reading this you will realise that POCD is a legitimate mental health condition and that there are various options when considering treatment for POCD. This is because, with the right support and professional guidance, it is a treatable condition – this is something I can personally attest to as a therapist who has worked with many people who have experienced this form of anxiety and OCD. So, if you’re experiencing distress, remember the importance of good mental health care and contact us today to get the support you need and deserve.

Table Of Contents
Introduction
What is POCD?
POCD vs. Real Pedophilia
Common Symptoms of POCD
Signs of POCD
Causes and Risk Factors of POCD
Diagnosis of POCD
Treatment Options for POCD
Conclusion
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Rehanna Kauser Private Therapist
About The Author
Rehanna Kauser, Psychologist
Rehanna has studied Psychology and Counselling Psychology at four UK universities. She enjoys working with individuals, couples, and families, and also loves learning, and writing. Having always been fascinated with the human mind and behaviour, her interests marry well with her naturally caring disposition, and affinity toward helping people.
References
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