POCD: It Doesn’t Have To Be a Life Sentence
What Is POCD?
POCD is a type of OCD that can be anything from annoying to devastating for those who have it. Read on to learn about this condition and the recommended treatment for POCD.
Pedophilic obsessive-compulsive disorder (POCD) is an informal term for a subtype of obsessive-compulsive disorder (OCD). POCD sufferers experience intrusive, unwanted thoughts or images related to pedophilia. For those who experience it, having POCD can range from annoying to devastating.
POCD is sometimes considered a version of “pure O” OCD (short for purely obsessive OCD). “Pure O” refers to cases of OCD in which obsessions are more apparent than compulsions. (Note: Research shows that even when compulsions aren’t visible, people often engage in unobservable or mental compulsions. So, the “pure O” concept is probably a myth.)
People with POCD often perform internal and external compulsions in response to their intrusive thoughts. These behaviors are aimed at reducing anxiety or proving to themselves that they would never act on the thoughts. Unfortunately, these same behaviors tend to strengthen the OCD cycle.
Read on to learn more about this condition and the recommended treatment for POCD.
What Are Pedophilic Obsessions?
An obsession is a thought, image, or impulse that is usually repeated, unwanted, and/or inappropriate. Obsessions cause significant anxiety when they occur.
Pedophilic obsessions are repeated thoughts, images or impulses related to concerns about being a pedophile. Here are examples of obsessive thoughts, images, and impulses that an adult might encounter if they were worried about being a pedophile:
A pedophilic obsessive image might be imagining that you are engaging in a sexual action with a twelve-year-old child.
A pedophilic obsessive impulse might be experiencing an urge to perform an inappropriate or sexual action with a twelve-year-old child.
These obsessions can be about children who are familiar or not; family members, friends, strangers, or even one’s own children may be the foci of POCD obsessions. As described above, these obsessions occur repeatedly and are unwanted. Typically, they have a terrifying effect on the person with POCD because they suspect that having these thoughts, images, or impulses means they are a pedophile. Importantly, having these intrusive thoughts does not mean a person is a pedophile or poses a danger to others. The distress comes from the fear of what the thoughts might mean, not from actual attraction or intent.
How Common Is POCD?
One of the largest and most comprehensive research efforts ever made to measure the prevalence of conditions like OCD was a study called the National Comorbidity Survey Replication. It assessed thousands of people. The study found that over a quarter of Americans have obsessions or compulsions at some point in their lives. They also found that 2.3% of Americans have OCD during their lifetime and, at any given time, about 1.2% of Americans live with OCD. This means that, right now, around four million Americans have OCD!
The study referenced above did not specifically measure how common POCD was because POCD is not an official psychiatric diagnosis. However, the study gives us some helpful clues about how frequently POCD occurs in the American population.
There are several categories of obsessions. These include, but are not limited to, perfectionism, sex and sexuality, religion, contamination, losing control, and harming others. POCD involves a sub-type of sex and sexuality obsessions.
Although research doesn’t give us exact figures, it is reasonable to surmise that less than 10% of people presenting for OCD treatment have POCD.
What’s It Like to Have POCD?
People with POCD often describe their obsessions as demoralizing. They suffer from a lot of shame and doubt, and may feel isolated.
Because of the nature of their thoughts, many people with POCD do not confide in loved ones. This is because when they do, they are often met with kind reassurance, such as, “Oh, you’ve got nothing to worry about. I’m sure you’re not one of those people. Please don’t stress about that.”
Sometimes this feels helpful, but only for a short while. Other times, responses like this feel so disconnected from one’s anxiety and concern that they feel impossible to believe. This leaves the POCD sufferer feeling misunderstood and ashamed.
Adding to this isolation is the stigma surrounding POCD. Because the content of these obsessions involves children, people often fear being judged or even accused if they disclose their symptoms. As a result, many suffer in silence, fearing that sharing their experiences could have serious personal or social consequences.
Uncertainty Avoidance
The engine that drives POCD is a deficit in tolerating uncertainty. This experience drives a sequence of events that creates significant anxiety.
Here’s a typical example of how it works for a person living with POCD:
- You see a cute kid on a TV show.
- You think to yourself: Am I sexually attracted to that kid?
- Then — despite the fact that all your previous romantic and sexual relationships have been with age-appropriate partners — you feel terror accompanied by the suspicion, I think maybe I am attracted to that kid!
Unhelpful POCD Coping Efforts
1. Distraction
Either out of calm strategizing or outright panic, someone with POCD may decide to focus their attention on something totally unrelated to the obsessive thought, image or impulse. They do this in the hopes of being productive with their time — or of just escaping the obsession. This often works in the short term, but not in the long term.
2. Successful Effort to Attain Reassurance
Seeking reassurance — which is also a compulsion — is perhaps the most popular strategy to calm the anxiety of those with pedophilic obsessions. POCD sufferers who find themselves obsessing are very tempted to find “proof” that they are not a pedophile. The ways people do this vary widely.
Here are some examples
- Explicitly asking for a loved one’s opinion (“I’m probably not a pedophile, right?”).
- Laying a reassurance “trap” when talking to a loved one (“I wasn’t being weird at our 6 year old cousin’s birthday party last weekend — was I?”).
- Looking at children or images of children to gauge one’s reaction / attraction toward them.
- Looking at adults or images of adults to gauge one’s reaction / attraction toward them.
- Masturbating while imagining children / adults to gauge one’s level of arousal. (See also our separate page on sexual arousal and POCD.)
- Seeking / having sex with adults to gauge one’s attraction toward them.
- Researching pedophilia on the internet.
3. Unsuccessful Effort to Attain Reassurance
The strategies listed above may or may not result in achieving reassurance. Looking at an attractive adult of one’s preferred gender may not produce a feeling of attraction. Internet research on pedophilia may not yield comforting information. When this happens, the person with POCD often feels even more distress.
Typically, this leads to more reassurance seeking behaviors. The POCD sufferer might think, Well, I didn’t feel attracted to that woman, but I’ll find another one. This often spirals and leaves them feeling even more despair and shame than ever. Depression often results if this pattern is frequently repeated.
4. Avoidance Behaviors
In addition to the compulsive ways that people with POCD try to seek reassurance, they may also take steps to prevent any possibility of inappropriate contact with children. These are called “avoidance behaviors” and are driven by fear rather than risk. The following are examples of avoidance behaviors:
- Ensuring one is never alone in a room with a child, including family members.
- Finding excuses to not attend parties for children, even if they’re marking important milestones.
- Intentionally arriving late — after children are likely to be sleeping — to family gatherings.
- Avoiding normal physical contact with children who are relatives or children of friends (e.g. lap sitting, hand holding, hugging, etc.).
- Crossing the street or maximizing physical distance on the sidewalk to avoid an approaching child.
- Taking a seat unnecessarily far away from a child on a bus or train.
An Addiction — to Reassurance
Despairing POCD
POCD Treatment
The most effective treatment for POCD is exposure and response prevention therapy (ERP). ERP is a form of cognitive-behavioral therapy typically delivered once a week for several months. During this therapy, patients learn about OCD, how OCD works in general, and how it works for them in particular. Patients learn to identify their obsessions and compulsions and gain critical strategies to handle these symptoms when they happen. Eventually, patients receive training in exposure exercises. Exposures are ways to practice improving tolerance for the unpleasant emotional states that precede a compulsion.
By improving your tolerance for these feelings, you hone your ability to refrain from compulsions. This is true for either observable (behavioral) compulsions or for invisible (mental) compulsions. In doing so, you weaken the OCD gradually over the course of therapy.
Medication Options
Prescribers primarily use two classes of medication to treat OCD. Selective serotonin reuptake inhibitors (SSRIs) are medications that increase the amount of a naturally occurring chemical in the brain called serotonin. SSRIs include medications such as Luvox, Lexapro, Prozac and Zoloft. SSRIs are the first type of medications prescribed for OCD, and they are prescribed at high doses. Unfortunately around half of people treated for OCD with SSRIs do not respond well enough to meet their goals.
If SSRIs aren’t effective, prescribers will sometimes use other medications sometimes used to manage OCD. These include Anafranil (a tricyclic antidepressant) and medications called novel antipsychotics such as Abilify.
So Which Treatment Works Best?
Which is more effective, ERP or medication treatment? This question needs more research, but studies have suggested that ERP without medication is slightly more effective than medication without ERP (e.g., this study and this study). Many people have a greater comfort level with one of these two options over the other; if you strongly prefer one, seek it out! Treatment can change lives — life after OCD can be a whole new ballgame.
What’s the Prognosis for POCD?
As mentioned, ERP is the treatment of choice for POCD. Studies typically show ERP for OCD to produce meaningful improvement in two-thirds of patients who receive it. One in three recovers completely.
Advice for Those with POCD
- Many of the people who do not benefit from ERP do not complete the homework exercises that are assigned by their therapist as part of their POCD treatment. Others drop out of treatment. If you don’t follow the therapist’s recommendations — or if you stop going to therapy — there is little reason to believe you will improve. So, this part is under your control!
- If you don’t improve from ERP, you can try medication treatment.
- Whether or not you take medication, you can always try ERP again in the future. It is possible that, even if you do not benefit from the therapy initially, you may benefit from it later on.
POCD is a treatable disorder, just as OCD is. If you suffer from POCD and are looking for help, please contact us using the blue “schedule an appointment” button below. We are happy to work with you or help you find someone local who can help.
Now It’s Your Turn
Let us know about your experience in the comments below. If you have questions this page did not address, please mention them and we will try to address them as the page gets updated over time.
Please contact us
If we can help you in your efforts to find therapy for POCD here in New York. Our CBT therapists are doctoral-level psychologists. We also have student therapists who offer reduced-fee services. Our offices are in midtown Manhattan, but we offer teletherapy services to people elsewhere in New York State, New Jersey, and Florida. If you’re looking for therapy for POCD in another part of the country or world, please contact us — we are happy to help!
POCD Frequently Asked Questions
Because POCD is a subtype of OCD, POCD is likely caused by the same factors as other types of OCD. These include a combination of environmental, genetic, and neurochemical factors.
A burning desire to know the answer to this question is characteristic of those who suffer with POCD. Please consider consulting with a therapist who specializes in treating obsessive compulsive disorders.
POCD can get better or worse on its own; it can also shift into another form of OCD. Exposure and response prevention therapy and some medications have been shown to be effective for OCD; there is little reason to believe POCD is any different.
Last updated: March 8th, 2026
54 Comments
Hi, m.c . I can completely relate to how you are feeling. I am a 20 year old who has had OCD for 4 years. I started out with religious OCD but then it included contamination OCD and the religious OCD stopped when I became agnostic and then for the last year and a half or so I’ve had POCD.
I don’t think I’ve seen anyone my age and gender with this type of OCD yet so if you’d like to talk to me then I would be more than happy to just for some kind of support or to share what you’re experiencing because I know it is incredibly difficult.
Dr Greene, I’m not sure if she will see this but could you potentially offer her my email address if that’s not breeching any kind of rules and if she would be interested in that?
Thank you, m.c., for your comment. It’s true, thoughts like these can certainly make life feel hellish. But you’re not alone. We will reach out to you separately to make sure you’re ok.
So this just started completely random for me. Im 18 and ive just finished a show where the characters were younger than I thought they were. I was attracted to on and then I saw someone saying he was 14. My brain automatically went “Thats disturbing.. maybe i can make your life a living hell with this.” And BOOM. Intrusive POCD thoughts bloomed. I didn’t know what to do.. i still dont know what to do. Cause now im I’m looking at people I would find attractive searching for proof that my thoughts are wrong and i would look at babies and kids trying to see if i felt anything. All i felt was disturbed really. It’s so annoying because I was just making a pact with my friend two weeks ago to have babies at the same time and just last month I was expressing to my mom how excited i was to be a young mom… and now i just feel like my entire life is falling apart. Im not a stranger to intrusive thoughts, I’ve had religious ones for a year and a half now so I know what this is but… I’ve never actually contemplated dying before until this. Like i dont wanna die but I dont wanna live with these thoughts either.. children don’t deserve anything that my thoughts are conjuring up. I will kill myself before i ever do something like this.
Im gonna try and talk to my mom about seeing my doctor and then I’m gonna talk to her about OCD and intrusive thoughts and see if she can help me out with therapy or some medicine to fix this.
The comment section has really helped me see that im not a completely horrible person even though i feel like i am for something i have no control over. Hopefully I get the help I need and I can kiss these thoughts goodbye.
I”˜m dealing with this thoughts since august and I’m always hoping that it’s “žonly“ POCD and that I’m not a pedo. I”˜m 17 and it feels like my whole life is breaking apart I always wanted children and be in a happy relationship but I could never achieve this. 3 Weeks ago it started that I got the same thoughts about our dog and it makes me so sad I want my life back but in my area are 2 therapist and I can’t go there bc I’m a minor. I hope we will be better soon stay safe !
Seeing this article and reading these comments have really helped me. I suffer with this, and it SUCKS! I go days feeling so down on myself, even though I know they are just thoughts. But getting rid of the thoughts is the hardest part. I haven’t talked to anybody about it yet (a doctor or therapist) only a few of my family members because sitting around and letting it linger is the worst feeling. Reading this article and seeing the comments have helped me in realizing that I need to get help with this, I need to speak up to someone and get the help I need. I’m not the only one. I’ve never been the only one. We are good people that OCD had decided to visit, and the visit has been too long! Thank you all for helping me for even though it wasn’t your intention!