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Understanding sexual OCD: Sexual thoughts and obsessions

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Written by Parth Sharma

Obsessive-Compulsive Disorder is when a person experiences persistent thoughts, images, and unnecessary, disturbing, anxiety-provoking, and unsettling ideas. OCD can manifest in a comprehensive display of subtypes, including sexually-based thoughts. The person experiences obsessive thoughts about sexual themes ranging from mild to violent. While the mind may daydream about sex daily, these thoughts or impulses come without any desire to think sexually. They are highly disturbing to the individual experiencing them.

What are Sexual OCD thoughts?

Research suggests that many people diagnosed with OCD have these intrusive thoughts sexual. Still, these figures could hide the actual number of people suffering from this type of OCD due to the unwillingness of others to admit to this. Obsessions of this nature occur equally in both men and women. They can stop or disrupt intimate relationships due to the fear, anxiety, and distress caused by the individual's obsessive thoughts. Although a person may encounter a wide range of sexual obsessions under this subtype of OCD, common themes are present.

Common Obsessions of Sexual OCD

  1. Bestiality
  2. Incest
  3. Underage sex
  4. Sexual abuse or violence
  5. Sex as a form of blasphemy
  6. Sexual enslavement, sadism, or masochism

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Sexual Obsessions Are Not Sexual Fantasies 

Sexual obsessions are often mistaken for sexual fantasies. While sexual fantasies are typically related to pleasure or desire, attainable or not, sexual obsessions are unwanted and uncomfortable thoughts associated with fear, guilt, or self-loathing. People with OCD will constantly worry that a prohibited or illegal sexual obsession may one day lead them to act upon those urges, whether it be about pedophilia or sexual violence. In contrast to someone who might be at risk for working on these impulses, a person with OCD will find the obsession evil and feel repulsed at acting upon it.

Under OCD, an obsession is accompanied by a compulsion to end the anxiety of the obsession. If accompanied by sexual compulsion, a person with OCD may become distracted with pornography and/or masturbation as "outlets" for their unwanted thoughts.

Obsessions and Compulsions under Sexual OCD: Symptoms of Sexual OCD

Some common obsessions that are associated with this form of OCD include:

  1. Extreme fear of being attracted to family, animals, dead people, or children.
  2. Intense fear of executing a sexually heinous act.
  3. Extreme fear of engaging in violence during sex.

As individuals experience these obsessions, they develop compulsions or behaviors employed to cope with the anxiety caused by their sexual intrusive thoughts, such as 

  1. Avoiding situations where they may interact or encounter a subject of their intrusive thoughts
  2. Performing mental rituals to replace unacceptable sexual thoughts with acceptable sexual thoughts
  3. Checking for genital arousal when engaging or interacting with the subject of their obsessions
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Treatment for Sexual OCD

People who suffer from sexual obsession will never act upon disturbing thoughts because they are so far from their nature. However, the contempt they develop for themselves due to having these thoughts can construct a crippling fear that can impair daily functioning, forcing them to shutter themselves at home or avoid interaction with people, even friends, and family. Other complications include:

  • Intense shame and guilt.
  • The anxiety of social rejection.
  • Overuse of a self-punishing thinking style to prevent or repress thoughts and images.
  • Less self-compassion than other forms of OCD and other conditions.

Although this painful condition may feel embarrassing to discuss, trained mental health care professionals ensure that help is available. Leaving the Disorder untreated or self-treating may intensify the severity of the condition. People suffering from Sexual OCD are encouraged to seek treatment from a mental health provider specializing in the treatment of OCD.

Sexual OCD can be treated with Cognitive-Behavioral Therapy (CBT), such as Exposure to Response Prevention (ERP) and Mindfulness-Based Cognitive-Behavioral Therapy.

Individuals will also learn that intrusive thoughts have no power over them. By responding to their thoughts through compulsive behaviors, their thoughts are given more strength and credibility and their fears and obsessions are strengthened and reinforced. Through this understanding, they understand how to avoid sexual thoughts.

ERP reveals patients to problems related to their intrusive thoughts that cause them anxiety. This therapy aims for the patient to stop themselves from achieving their compulsive behaviors when triggered by intrusive thoughts. The situations will strengthen over time until the patient can face and overcome their most stressed scenario. Once they can stop themselves from responding to their intrusive thoughts with compulsive behaviors, they can experience tremendous relief from the symptoms of OCD.

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