POCD (Pedophile-themed Obsessive Compulsive Disorder)

People will feel sorry for me if I get cancer. They’ll accept me if it turns out I’m gay. They’ll chalk it all up to me just being mentally ill if I lose my mind and push someone in front of a bus. But if these thoughts mean something, I am dead to the world and everything is wrong. What if I’m a pedophile?

This is the plight of the POCD sufferer (sufferer jargon for pedophile-themed obsessive compulsive disorder). OCD is a disorder characterized by obsessions (unwanted, intrusive thoughts and feelings) and compulsions (rituals designed to neutralize the obsessions). Many of the things people with OCD obsess about have to do with loss of identity. Someone with contamination OCD may be as concerned with being thought of as a fool for failing to wash appropriately as he is of dying from a disease. POCD is an obsessive fear of being or becoming a pedophile, what to many is considered the ultimate loss of identity. Justified or not, understood or not, the pedophile is the one character nobody can ever vouch for.   It is the last thing a person wants to be. So it comes as no surprise that the mother lode of horrifying ideas finds its home in the mind of so many OCD sufferers. Fear of being a pedophile combines the worst of several common obsessions, from Harm OCD (fear of acting violently against the vulnerable), sexual orientation OCD (fear of being attracted to the “wrong” kind of person), and moral scrupulosity (fear of breaking society’s strictest moral codes).

POCD obsessive thoughts may present themselves in different contexts:

  • Intrusive unwanted sexual thoughts/images/sensations around children (often but not exclusively one’s own children)
  • Fear that early experiences were signs of suppressed pedophilia (e.g. When I was 10 I had a crush on and kissed a 9 year old, which means I like 9 year olds.)
  • Fear that common childhood sexual play makes one a pedophile
  • Fear that having been a victim of childhood sexual abuse condemns one to become an abuser.
  • Fear that incidental contact with children was somehow intentional or pleasure-driven (e.g. a little girl sits in her father’s lap while he reads to her, he shifts her to be more comfortable and notices a shift in his groin – Did I move her for the purpose of pleasuring myself? he wonders)
  • Fear that positive emotions towards children could be sexual in nature (e.g. a woman feels overwhelmed with love for her son, wonders if the love is somehow romantic or sexual)
  • Fear that noticing beauty, cuteness, handsomeness, prettiness, etc. in a child is a sign of sexual intentions
  • Fear that noticing adult characteristics (e.g. specific body parts, body positioning, style of dress) of prepubescent children, pubescent adolescents, or of anyone “too young” is an indicator of pedophilia
  • False memory obsessions, such as obsessive concern that a pedophilic act occurred and was somehow blacked out of memory (e.g. Did I molest that little boy I walked by earlier and not remember? Why am I wondering?)
  • Not fearing being a pedophile but fearing that the presence of intrusive pedophilic thoughts will either ruin the possibility of being happy or somehow convert the thinker to become a pedophile over time.

POCD compulsions run across the spectrum of the disorder

  • Avoidance of children in multiple environments (home, school, playground, etc)
  • Avoiding potentially triggering imagery, such as the children’s clothing section of a store or a children’s television program
  • Avoiding holding children in ways that may involve accidental contact with sensitive body parts (e.g. trying to hold a toddler in such a way that their feet don’t accidentally bump into your groin)
  • Avoidance of adult relationships, intimacy, or sexual behavior for fear of triggering unwanted pedophilic thoughts
  • Mental review of all behavior and thoughts/intentions around children
  • Mentally reviewing/rationalizing whether noticing a person of a certain age is ok (e.g. I may have had a sexual thought about that teenager but she looks 18 and that would mean she is the legal age of consent but that girl over there may be 16 and I also noticed her and that means I could be a pedophile)
  • Reassurance seeking from others that inappropriate behavior did not take place, that you are not a pedophile, etc
  • Confessing of pedophilic thoughts to either manipulate others into reassuring you that you have OCD or reassure yourself that you are not hiding anything
  • Reenacting or repeating events (e.g. repeatedly picking up a child and putting him down again) for the purpose of proving no sexual act was done or intended
  • Researching the subject of pedophilia, trying to get certainty about what separates an actual pedophile from someone with POCD
  • Checking children for signs of abuse that you imagine could have occurred in your presence
  • Documenting where you’ve been as a form of self-reassurance that you could not have been molesting a child
  • Checking your body for signs of “inappropriate arousal” in the groin or elsewhere in the presence of children or thoughts about children.

Intimacy

If you find yourself in the beautiful position of having young children of your own or having a connection with a young niece or nephew or some other child you care about, the issue of intimacy with children can be a source of great pain if you have OCD. Consider a man with OCD holding his young daughter in his arms. She’s wrapped up in him, her head pressed against his chest, her little hands clutching his back or neck. His face is firmly planted in the top of her head, breathing in the smell of baby shampoo and, well, baby. He thinks, “I love this little girl.” This closeness, and the way in which it slows down time, is called intimacy.   But before having children, intimacy was what he experienced with his wife, and sometimes, as intimacy grew, it became sex. Long before that, intimacy was when he was a child, clinging to his parent, but that was too long ago to recall. No, the most recent association with intimacy was largely sexual. So the POCD sufferer finds himself struggling with two realities. One is the very genuine, present moment of intimacy he is sharing with his daughter. The other is the memory, the association of intimacy, with adult sexuality. It begins to feel like storing a cache of pornographic pictures in a computer file along with baby pictures and calling it “pics I enjoy.” It feels unacceptable, dangerous even, for these incongruent thoughts to share any mental real estate. So for the POCD sufferer, who is largely incapable of not noticing this incongruence in the mind, there comes an overwhelming urge to de-contaminate the file, so to speak.

Compulsions therefore derive from an attempt to create a sense of certainty that the two intimacies do not share the same space. The belief is that this shared space, of love for a child and sexual love must define pedophilia or some other kind of sexually unacceptable deviance. But if he can prove to himself that the two intimacies do not share space, any space, then he might feel safe from this internal accusation. The problem is that the very behaviors designed to solve this issue (hyper-analysis, checking for sensations, avoidance, etc.) actually magnify the unwanted thoughts and make them more intrusive, more invasive.

Can’t stop talking about it… and also can’t talk about it

You may feel stuck between a rock and a sick place. Part of you won’t shut up about how you had a sexual thought about a child, compulsively confessing, desperately needing your significant other to know you had the thought and tell you it doesn’t mean anything. Maybe, just maybe, your partner will even let you off the hook when it comes to dressing the kids this morning, seeing how distraught you are. Yet at the same time, part of you can’t even verbalize the words, so shameful, so horrifying, and so unsure you may be of how the other person will respond. So before you can get the confessing under control or before you can open up about even having the unwanted thoughts at all, you may need to speak with an OCD specialist trained in understanding what’s going on.

But what if they think I am a danger to children and they file some kind of mandated report?

This can be a serious and legitimate barrier to treatment, especially in the event that you are not seeing an OCD specialist. Therapists are trained to diagnose mental illnesses, but many are trained poorly in the diagnosis of OCD, disregarding anyone who doesn’t struggle with handwashing. Therapists are also trained in assessing safety risks, and in most cases are mandated by the government to report suspected danger to children. So this highlights the importance of seeking help from someone who specializes in the diagnosis and treatment of obsessive compulsive disorder, who can both identify the symptoms for what they really are and make the environment safe for you to overcome this obsession. If you are looking for OCD treatment, here’s a good list of questions to ask the provider: http://iocdf.org/about-ocd/treatment/how-to-find-the-right-therapist/

Anyone familiar with OCD knows that reassurance is part of the problem, not the solution.  But a basic reality check is not always compulsive reassurance and basic reality may be that this nightmare is just OCD and OCD is treatable.

Click here for POCD Part II: Treating Pedophile-Themed OCD

Jon Hershfield, MFT is a psychotherapist in private practice licensed in Maryland and California, specializing in the treatment of OCD.  Follow him on Twitter and Facebook