What is POCD?
POCD stands for Paedophile Obsessive-Compulsive Disorder and is a type of OCD that refers to complex and disturbing intrusive thoughts regarding children. Both men and women can have these complex thoughts.
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I wrote this article because few people understand what is happening when they first have unwanted thoughts about children, and fewer will seek help. This could be due to the shame experienced by the individual, or lack of understanding and attitudes towards individuals with these types of intrusive thoughts. (1)
I have been working as a psychologist for almost two decades, and not once has a client come to me asking for help with POCD. I have, however, worked with many clients who have obsessive unwanted thoughts about children, but this only materialised in session after we have built considerable trust between us.
Most of these clients were not aware that their thoughts could be part of a mental health condition; OCD. Instead, they were deeply ashamed of the thoughts. Still, they experienced relief once they became open to the idea that they were experiencing obsessions and compulsions relating to OCD as opposed to the terrifying thought that they might be a paedophile.
Possibly due to the type of thoughts, these types of obsessions are not as well known as the more mainstream obsessive thoughts that occur with OCD.
Some of our knowledge comes from media representations, which means we glean wisdom from TV and newspapers. Several years ago, I researched where mental health professionals’ understanding of personality disorders came from. I found that some of their knowledge about the condition came unwittingly from TV shows!
Suppose I asked you about the work done by psychologists, even though you might not have attended one. In that case, you could offer an answer as you will have seen some on TV and can reference that knowledge in your mind.
Suppose a person becomes more concerned with contamination and germs and starts washing more often or differently. In that case, they may think they have OCD as their behaviours are recognisable from things they have seen in the media. They have a knowledge base in their head relating to OCD.
Likewise, if the person needs things organised in a certain way and becomes anxious if someone changes the order, this is also recognisable as OCD.
However, there are many ways that OCD can arise, and only some are popularised in the media. Suppose you start to have unwanted thoughts relating to children. In that case, the chances are the only knowledge you have in your head relating to this is that something is very wrong with you, and you might be a paedophile. You will not think OCD.
How is POCD diagnosed?
There is not an official diagnosis of POCD. Instead, it falls under the umbrella of OCD and its associated intrusive thoughts. But sometimes, labels such as POCD help us to know what we are discussing.
The purpose of this page is to help you understand what is happening, point you in the right direction if you are looking for treatment or self-help, and provide you with some level of reassurance that you are okay.
How do I know I have POCD?
Let me start by clearing something up for you. There is a stark difference between someone with POCD and a paedophile. A paedophile is someone who is sexually interested in children. Someone with POCD has no sexual interest in children and more than likely has a partner, husband or wife. Still, the person with POCD has unwanted, unwelcome intrusive thoughts regarding children. This is a significant difference.
These are your unwanted and unwelcome thoughts. I need to tell you that you are not choosing to have these thoughts. The following are some examples, but this is not an exhaustive list.
Having these types of thoughts and images is extremely disturbing, and because of the thoughts, many people, maybe you, tell no one about it or seek help. You remember that this is just another manifestation of OCD; it says nothing about you as a person.
These are the things you do to help you cope with your thoughts.
You might keep searching in your mind for something to explain what you are now feeling. For example, you might go over things that happened when you were a kid, such as playing ‘doctors and nurses, but instead of this neutralising your thoughts, you could now see it as evidence that something is wrong with you.
You might stay away from children, as you are concerned you present a threat.
You might have changed your behaviour around your children, especially in terms of bathing and dressing.
You want the same style of treatment that you would get for OCD. The recommended treatment is CBT–Cognitive Behavioural Therapy, but I also recommend mindfulness and Acceptance and Commitment Therapy.
How the different therapies will help you.
CBT will help by helping you to form more realistic appraisals of your thought processes. It shall also help you change behaviours that are not helping you. For example, suppose you have adjusted your behaviour towards your children or avoid children. In that case, CBT shall help to change this back for you.
Mindfulness and Acceptance and Commitment Therapy will help you accept your thoughts for what they are; they are just thoughts.
- Colter Snethen, Debbie M. Warman,
Effects of psychoeducation on attitudes towards individuals with pedophilic sexual intrusive thoughts,
Journal of Obsessive-Compulsive and Related Disorders,
Snethen, C., & Warman, D. M. (2018). Effects of psychoeducation on attitudes towards individuals with pedophilic sexual intrusive thoughts. Journal of Obsessive-Compulsive and Related Disorders, 19, 92–98. https://doi.org/10.1016/j.jocrd.2018.10.001
Bruce, S. L., Ching, T. H. W., & 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. https://doi.org/10.1007/s10508-017-1031-4
Glazier, K., Swing, M., & McGinn, L. K. (2015). Half of obsessive-compulsive disorder cases misdiagnosed: Vignette-based survey of primary care physicians. Journal of Clinical Psychiatry, 76(6), e761–e767. https://doi.org/10.4088/JCP.14m09110