Pedophilia OCD

Newgon memed POCD in 2022

Pedophilia OCD (POCD, sometimes styled pOCD) is a supposed subtype of Obsessive Compulsive Disorder, in which an individual is mentally crippled by anxiety that they might be a pedophile. These obsessions are accompanied by compulsive behaviors, in which the individual attempts to prove or disprove their hypothesis. Online guides that profess of this new disorder, claim that the pedophilia these OCD sufferers believe they are experiencing is "not real", and the recommended treatment is to spend time alone with children. POCD is sometimes alluded to in "10 reasons" type clickbait articles, for obvious reasons.

Adding to the confusion, some MAPs who suffer from OCD related to pedophilia (for example, concerning its lower age boundary), also describe themselves as POCD sufferers. Other MAPs and allies object to the use of this subtype/(self) diagnosis as often inaccurate and stigmatizing, preferring "Sexuality OCD" among other options, or only support the use of POCD as a label where the sufferer is an acknowledged pedophile.

What proponents of POCD say

As POCD is a relatively new subtype of OCD and is not widely accepted in the clinical community, information about it can be sparse. Oftentimes, these summaries contain negative value-judgments about pedophiles - one supposes to soothe the mental turmoil of POCD sufferers (or people with non-preferential attraction to minors, depending on your perspective). Others appear to be trawling for new patients to diagnose and medicate:

Are you terrorized with unwanted thoughts that you may be attracted to kids? Do you assess your groinal response while looking at underage individuals or when you are in the same physical space as kids? For example, thinking things like “Do I feel more aroused by an attractive woman than this 8-year-old? Am I sexually aroused right now? Are you avoiding places where kids may congregate such as parks, museums and zoos out of a fear of being physically aroused by children? [...] Do you scan your sexual history for signs that may represent inappropriate behavior? For example, “When I was 10 I grabbed my sister’s butt. Does this mean I’m a sexual deviant? [...] Have you chosen to watch pornography that clearly does not contain someone who is underage or abstained from pornography/any sexual behavior altogether?

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Typical explainer on pOCD showing a number of problematic assumptions

Pedophiles are sexually attracted to children and prefer children over age-appropriate partners. Many refuse to acknowledge that it is harmful to children and justify acting on their preference. In POCD, on the other hand, the focus is on the OCD. People with POCD are afraid they might be attracted to children, know that it is both illegal and harmful, and check and double check their own thinking to make sure they aren’t pedophiles. [...] Having the thoughts of POCD doesn’t make a person a pedophile. Molesting children does. [...] Genuine pedophilia and POCD are both treatable conditions. Prozac has been used for both. [...] I wish you well. Dr. Marie

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Some people, though, have a form of obsessive-compulsive disorder referred to as pedophilia OCD, or POCD. Like other OCD subtypes, POCD involves obsessions (intrusive, unwanted thoughts) and compulsions (repetitive behaviors aimed at getting rid of the distress caused by obsessions). [...] outrage makes a lot of sense: nobody is more vulnerable than kids, and sexual advances on them are inherently violent [...] Many non-pedophiles experience similar intrusive thoughts and urges, spontaneously and in opposition to their real desires. Someone with no history of pedophilic thoughts or urges might be hanging out with a child and suddenly think, What if I touched that kid right now? Although the thought seems very strange and disturbing, most people shake it off: That isn’t me. I didn’t like that. Oh well. It’s by no means enjoyable, but the thought causes them no real disturbance. [...] But another group responds very differently to these thoughts, which feel like a challenge to everything they believe they really are. They have a form of obsessive-compulsive disorder (OCD) referred to as pedophilia OCD, or POCD. [...] A young mom with pedophilia OCD: Kate’s story: [...] I remember frantically ringing my father and telling him all of my worries while crying on the living room floor. I honestly thought I could turn into a pedophile overnight and harm my daughter. From then on, I was terrified to change her, bathe her—any time a body part of hers was exposed, I would have a panic attack.

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The obsessions of obsessive-compulsive disorder are ego-dystonic or opposite to a person’s desires, values, and self-concept. The person with POCD is deeply disturbed by their obsessions and does not enjoy them. They want more than anything to escape the thoughts because of how terrorizing they are and go to great lengths to do so by performing compulsions. [...] A person with actual pedophilia experiences sexual thoughts, urges, attraction, and fantasies that are ego-syntonic, or align with a person’s self-concept, feelings, and desires. The sexual thoughts and feelings about children are pleasurable to the person with pedophilia.

David Veale

David Veale's take (shortened)

Late in 2023, after a proliferation of POCD articles in the medical media, David Veale, an OCD and CBT expert working for the NHS and a London Private Hospital published an article for the hospital's website, advocating POCD as a concept. In a bizarre, rambling Q and A format, Veale advised a man with pedophilic fantasies (who he had apparently never met) that he was instead an OCD sufferer and should aim to establish unsupervised contact with children. In the article, Veale also recycled inaccurate tropes about pedophiles in order to distinguish pedophilia as a harmful disorder of intent that can be easily distinguished from Pedophilia OCD.

"Unhelpfulness" as a concept

In some cases, MAPs on pediverse have ridiculed POCD, rather than directly criticizing it. The denialistic absurdity of (homo)sexuality OCD has also been juxtaposed against the fashionable label

POCD is a controversial subject among MAPs. There are some who endorse its use, and claim to be suffering from it. These tend to be younger, anti-contact MAPs. Others see this clinical concept as deeply unhelpful, conflatory and an invitation to denialism - preferring to limit it to OCD or use other specifiers such as "harm", "sexuality", "psychopathy" or "stigma", depending on nature. "Minor Attraction OCD" has been suggested as an alternative for patients who acknowledge their attraction to Minors, and experience intrusive thoughts related to it. Reasons given for the unhelpfulness of POCD:

Cowboy therapists have repeatedly attempted to sell Gay OCD, with sometimes comical results

• Some attraction to minors, is seen in most men. Even when narrowing the criteria to significant erectile response to prepubescent girls, phallometric tests tend to detect at least 50% response rate in the general population. While this is not indicative of a pedophilic preference, it is likely to be strong enough to trigger feelings of anxiety - should it be ego-dystonic.
• Given the above prevalence rates, and relative normativity of hebephilia, the idea that POCD sufferers are not expressing some form of attraction to minors is statistically improbable. Use of POCD as a diagnosis is therefore likely to be pandering to denial.
• The term is sometimes used to conflate "intrusive thoughts" about "deliberately harming" children with actual pedophilia. It also conflates even commoner hebephilic attractions with pedophilia, and spreads denial about the fact that parents may sometimes have erotic feelings towards their children.
• Taken as a whole, this is unhelpful and offensive - in that it restigmatizes MAPs by perpetuating the dominant discourse.

A recent study has suggested that minor attraction is more often misdiagnosed by professionals as "POCD" than "POCD" is misdiagnosed as minor attraction.

Lack of distinction from Pedophilic Disorder

It has been observed by members of the MAP Activist group PCMA, that should POCD be accepted as a type of OCD, psychiatrists and psychotherapists would be unable to objectively distinguish it from the separate diagnosis of Pedophilic Disorder. Assuming the patient does not act on their feelings:

• Pedophilic Disorder is pedophilic feelings that must cause distress.
• POCD is distressing thoughts that must be caused by "pedophilic feelings".

The objective case for distinguishing OCD has not yet been made, and the rationalizations of POCD-supporting psychotherapists documented in this article appear to vary wildly.

External links

• MAP Wiki article on sexual desire related OCD - Uses "Child abuse OCD" and includes a call for unity between OCD sufferers and MAPs.
• 2019 video explainer on POCD - From an MHP who supports the idea.