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What to Know About Sexual Obsessions and OCD

Medically Reviewed by Poonam Sachdev on November 24, 2022

Whether it’s you, a family member, or a friend, living with obsessive-compulsive disorder (OCD) can be challenging. This is especially true for less-discussed OCD types like sexual OCD because of the stigma associated with discussing subjects of a sensitive, controversial, or sexual nature.

Here’s what you need to know about sexual OCD, sexual intrusive thoughts’ examples and types, how to deal with them, and more.

What Is OCD? 

OCD is generally considered a type of anxiety disorder. If you’re experiencing this disorder, you might have some repetitive and unwanted obsessive and compulsive behaviors like frequent cleaning and handwashing, hoarding, counting and arranging things in a specific way, and repeating words in your head.

Professionals believe that you develop obsessions because of uncontrollable, forceful thoughts that seem to invade your mind. These thoughts usually represent deep-seated fears that may have become exaggerated in your mind. Fears of unlikely events and worries about common, everyday problems exceed the normal levels of anxiety and turn into obsessions.

The worries often feel so burdensome and upsetting that you begin to look for ways to relieve your anxiety. One way to do that is to develop compulsive behaviors or rituals. The comfort and familiarity of a ritual give you relief and make you believe that you’re doing something to prevent what you’re afraid of happening.

You become convinced that your compulsive behavior is a response to your obsessive thoughts, fears, and worries, resulting in OCD. For example, if you have a deep-rooted and obsessive fear of germs and disease, you may develop compulsive cleaning or handwashing habits.

What Is Sexual OCD? 

OCD is broadly classified into four types based on the types of invasive thoughts you experience. These include:

Obsession with cleanliness. You develop compulsive washing and cleaning behaviors due to a fear of germs or being unclean. 

Obsession with safety. You display compulsive safety-checking behavior due to a fear of accidental harm.

Obsession with order. You exhibit compulsive touching, arranging, and tapping behaviors due to a feeling of “incompleteness” and an intense need for symmetry and order.

Obsession with forbidden thoughts and behaviors. You experience obsessive thoughts about taboo subjects like religion, violence, and sex or sexual orientation. This is considered a purely obsessional (pure "o") type of OCD because most people don’t develop any specific or obvious rituals to handle these obsessions. 

Instead, they’re likely to experience mental compulsions and a strong desire for reassurance.

This is because the obsessive thoughts that affect you in this case will most likely contradict your morals and values (e.g., thoughts of religious blasphemy or sexual molestation). Therefore, you won’t want to act on your obsessions but would rather try to control and suppress your thoughts.

If the forceful thoughts that take over your mind are of a sexual nature, this is called sexual OCD. In sexual OCD, your mind is plagued by sexually intrusive thoughts.

What Are Sexually Intrusive Thoughts?

Sexually intrusive thoughts or sexual obsessions are not sexual fantasies but genuine worries about your own sexual tendencies. This can take many forms like obsessions about:

  • Incest (sex with family members)
  • Bestiality (sex with animals)
  • Sexual violence, molestation, or sexual abuse
  • Pedophilia (sex with children)
  • Blasphemous sex (e.g., sex in a place of worship)
  • Deviant sexual interests like sadism, masochism, or enslavement 
  • Socially inappropriate sexual behavior (e.g., an extramarital affair)
  • Sexual interest that contradicts your orientation (e.g., thoughts of gay sex if you’re straight and vice versa)

Who Experiences Sexually Intrusive Thoughts? 

Such thoughts can occur in people of any age and gender. Sexually intrusive thoughts are normal, and sexual OCD might be more common than you think. Around 6% to 24% of people with OCD are likely to experience some form of sexual obsession. This doesn’t even include people who remain unwilling to confess their forbidden thoughts.

Effects of Sexually Intrusive Thoughts 

Unlike sexual fantasies that bring pleasure, sexual obsessions cause immense fear, worry, guilt, and self-disgust. You might be both worried and judgmental about having these thoughts. You’re likely to be constantly afraid that your sexually intrusive thoughts could urge you to act on your impulses one day.

But the truth is that people with OCD are the least likely to act on their sexual obsessions because they’re actually repulsed and disgusted by their own thoughts. They consider such behavior immoral and want to suppress their thoughts. They’re not seeking any self-gratification but relief from their worries instead.

If you’re experiencing sexual OCD, you might become preoccupied with masturbation and pornography as an outlet to cope with your anxiety over unwanted sexual thoughts.

How to Stop Sexually Intrusive Thoughts? 

Sexually intrusive thoughts can often feel overpowering and leave you feeling helpless. You might develop avoidance behaviors (e.g., avoiding childcare because you’re worried about having sexual thoughts about children), create mental rituals to substitute for taboo sexual thoughts, and become worried about getting aroused inappropriately. These feelings of shame and guilt and worries over social rejection can damage your intimate relationships and hamper your quality of life.

You can try to self-manage your thoughts through distractions, breathing exercises, and other methods, but if these thoughts are taking over your life and affecting your relationships, it might be time to seek professional help.

How to Treat Sexual OCD? 

Once mental health professionals have recognized the symptoms of your OCD, they can address your concerns, help you cope with the nature of your obsession, and soothe your anxiety. Through counseling, your mental health care provider will help you recognize that these thoughts have no power over you. On the contrary, it’s your response to these thoughts that strengthen them and reinforce your fears and obsessions. You can then learn to avoid and deal with intrusive thoughts.

Some of the methods for treating sexual OCD include the use of medications (e.g., SSRIs) and cognitive behavioral therapy (CBT). CBT has different types like exposure and response prevention (ERP) and mindfulness-based CBT. 

In ERP, you may be asked to describe and record your sexual obsession. After that, you’ll be asked to listen to the recording multiple times until these thoughts no longer make you feel anxious. Depending on your sexual obsession type, your doctor may also recommend different exposure exercises.

Be honest with your mental health professional, consistent with your appointments, and persistent in your efforts to overcome these thoughts. Remember that you aren’t alone. Don’t feel ashamed to seek help and be patient with yourself. Getting treatment may be difficult at first but will significantly improve your life in the long run.

Show Sources

SOURCES:
Annals of Neurosciences: “Psychodynamic Perspective of Sexual Obsessions in Obsessive-Compulsive Disorder.”
Child Mind Institute: “Sexual Obsessions and OCD.”
Clinical Case Studies: “Treatment of Sexual-Orientation Obsessions in Obsessive-Compulsive Disorder Using Exposure and Ritual Prevention.”
Cognitive and Behavioral Practice: “Differentiating Sexual Thoughts in Obsessive-Compulsive Disorder From Paraphilias and Nonparaphilic Sexual Disorders.”
Indian Journal of Psychiatry: “Exposure and response prevention for obsessive-compulsive disorder: A review and new directions.”
Mayo Clinic: “Compulsive sexual behavior.”
New England OCD Institute: “Sexual Worries in OCD,” “Taboo Categories OCD,” “The Four Types of OCD.”
Psychiatria Polska: “Sexual obsessions in obsessive-compulsive disorder. Definitions, models and cognitive-behavioural therapy.”
Sexual and Relationship Therapy: “Sexual obsessions and OCD.”

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