boy with butterfly

Pedophilia…one of those horrid topics that makes people shudder and speak in hushed tones.  Child sexual abuse is the most hated crime one can commit in society, one that is taboo in all cultures. Even among murderers and other felons in the prison system, the child sexual predator is the pariah of the group, and for good reason.  Abusing a child sexually is the worst way to steal the human spirit and affect a child’s being for the remainder of his or her life.

I use the word pedophile more than the general population, so much so that I have habituated to using the word.  I realize this fact when the word nonchalantly rolls off my tongue and I see the looks on people’s faces.  It has become ‘just a word’ for me because I don’t work with actual pedophiles; I work with intrusive, unwanted thoughts about pedophilia as my clients suffer from Obsessive-Compulsive Disorder (OCD).

My clients with this detestable OCD theme, pedophilia OCD (POCD), suffer with intrusive and unwanted thoughts of being in denial about their sexual orientation towards children.  POCD sufferers are often very relieved to observe my non-reaction to pedophilia-themed thoughts when they finally become brave enough to share them.  Many clients are somewhat relieved after the initial session, as it may be the first time they discover these thoughts don’t have any meaning about their inner core and are not a pre-cursor to sexual actions toward children.

Here are some obsessions experienced in POCD:

  • Unwanted thoughts / images of sex acts with children
  • Unwanted thoughts / images of naked children
  • Thoughts of acting on unwanted sexual thoughts about children
  • Thoughts of having sexually violated a child through incidental contact
  • Thoughts that one sexually abused a child in the past but has forgotten, blacked out, repressed the memory or is in denial
  • Unwanted arousal sensations that accompany thoughts or visits with children
  • Intrusive thoughts of sexual play in childhood being a precursor to pedophilia

Keep in mind, just because an obsession is not listed here or in other OCD literature, doesn’t mean it is not POCD.  OCD thoughts can be as individualized as your fingerprint.  An individual with POCD often has uncertainty about whether his situation meets the criteria for OCD, fearing this answer may render him a pedophile.  Even if one realizes POCD exists for some people, there is fear that he is the exception to the rule and in this case it is real pedophilia bubbling under the surface.  It makes one question his very being, and ability to feel like a good and moral person.

With the amount of suffering that is taking place, individuals with POCD look anywhere for certainty and relief.  Compulsions are behaviors that are performed in response to obsessions that are used in an attempt to gain certainty about being a pedophile or to seek comfort from anxiety and guilt for having such decidedly taboo thoughts.

Here are some compulsions related to POCD:

  • Avoid normal physical contact with children such as hugs and hand holding
  • Avoid giving children baths or changing clothing or diapers
  • Avoid watching movies, television shows with pedophilia themes
  • Avoid reading books or articles with pedophilia themes
  • Internet research to determine if one fits the mold for pedophilia
  • Asking for reassurance from trusted loved ones about fears
  • Checking for physical arousal around children, sometimes resulting in unwanted sensation
  • Mentally reviewing past events for indicators of pedophilic behavior
  • Mental analysis of sexual orientation and self-reassurance about a preference for adults

Individuals with POCD are usually very afraid to speak to a therapist for fear he or she will be misdiagnosed as a pedophile.  They may even have had bad experiences where untrained mental health professionals suggest they were abused as children, that the intrusive thoughts mean something deep about who they are as people, or worse.  For this reason, individuals with POCD often suffer in silence for months or years before getting help.

Despite being a common OCD theme I see regularly in my practice, it is not a well-known theme to the general community.  People don’t talk about their POCD with others for fear they will be misunderstood and judged as horrible people.  Even clients who have successfully treated their POCD only usually feel comfortable sharing their theme with other sufferers, close family or their mental health team.  For this reason, public awareness has been slower than for other forms of OCD.  It is also invisible.  It is much harder to observe the symptoms in someone suffering with POCD, because the obsessions and compulsions often occur in the sufferer’s head.  You may know people suffering with POCD and not even know it.

Successful treatment for POCD is available and there is a lot of hope with the right kind of therapy.  The gist of therapy for OCD is to recognize how OCD has hijacked the brain and how it distorts thinking to trick the sufferer into feeding it with compulsions.  If the person can learn OCD’s tricks and not trust the messaging, he or she will start to respond to OCD in a way that weakens rather than reinforces it.  There are special skills to learn to manage POCD and other forms of OCD throughout the sufferer’s lifetime.  Be sure to see an OCD specialist who uses cognitive-behavioral therapy (CBT) which includes exposure and response prevention (ERP) and mindfulness-based therapies such as acceptance and commitment therapy (ACT).

Stacey Kuhl Wochner, LCSW is a psychotherapist in private practice in Los Angeles, CA specializing in the treatment of OCD.  Follow her on Facebook.