Sexual OCD is one of the various subsets of Obsessive Compulsive Disorder, most commonly distinguished by an individual’s repetitive, intrusive thoughts, ideas, or mental images associated with sexual content of a disturbing nature – usually involving their family members, friends, children, animals, religious figures or other miscellaneous objects, or those involving irrational doubts about their sexual orientation.
Notably, the individual’s distorted thought patterns and fears significantly conflict with their sexual orientation, moral beliefs and character, and are usually followed by intense feelings of guilt, shame, anxiety, despair and fear. In an attempt to reduce or counteract the distress their obsessions cause, they may engage in a series of ritualistic like behaviours (otherwise known as compulsions) – including mental checking, reassurance seeking, and avoidance.
What are the symptoms of sexual OCD?
While there are many different sexual obsessions and compulsions one may experience, some of the common themes associated with sexual OCD include:
- Fear of losing control and impulsively acting on their disturbing sexual thoughts or fears
- Fear of ‘accidentally’ acting out their intrusive thoughts on a subconscious level (without knowing)
- Fear of exposing one’s genitalia in unacceptable circumstances
- Avoiding particular people, places, objects, or topics of conversation that may trigger their sexual obsessions
What are the different types of sexual OCD?
Some of the most common types of sexual obsessions include irrational fears or doubts involving:
- Being or becoming a paedophile (being sexually attracted to children – even their own)
- Being sexually attracted to close family members including their siblings, parents or other relatives
- Being sexually attracted to dead or inanimate objects
- Engaging in acts of aggression or violence during sex
- Being sexually attracted to god or other religious figures
- Fear of acting in a sexually inappropriate manner towards animals
- Their sexual orientation – fearing they may be homosexual or straight (depending on their orientation)
So, when are sexual thoughts considered OCD or dangerous?
The distinctive difference between sexual fantasies and sexual obsessions is that the thoughts surrounding sexual OCD are NOT considered pleasurable (like fantasies) but instead are intrusive, unwanted and contrasting to the individual’s moral values and belief system.
Expectedly, these unwanted thoughts (obsessions) are typically followed by significant bouts of distressing emotions and anxiety – which can significantly impede their concentration levels and therefore ability to carry out day to day tasks – not to mention potentially negatively impacting upon their relationships and quality of life. This is why we class sexually inappropriate thoughts in the context of OCD as “ego-dystonic”, meaning they are unwanted, foreign and very distressing.
How common is it?
Sexual obsessions are in fact quite common, with studies revealing up to 90% of the general population having reported experiencing sexually intrusive thoughts at some stage throughout their lives. Similarly, studies have shown that sexual OCD often coincides with other types of OCD, with up to 25% of individuals diagnosed with OCD having a history of sexual obsessions. Notably, these statistics are representative of the reported cases only – which means these numbers are likely to be even higher still, and due to the “socially unacceptable” nature of sexual topics, the symptoms of sexual OCD are often left unreported and subsequently untreated.
How is it treated?
Just like other forms of OCD, the most successful form of treatment involves Cognitive Behavioural Therapy (CBT), performed by the guidance and ongoing support from a specialising psychologist. The main components of CBT involve firstly identifying the individual’s irrational thought patterns, and from here, working with them to challenge their unrealistic thoughts through gradually implementing exposure therapy.
It is important for individuals experiencing sexual OCD to understand that the exposure component of CBT does not put anyone at risk. Instead, exposure typically involves confronting the individual’s various anxiety provoking scenarios (that only perpetuate their obsessions), by resisting the urge to engage in their avoidant behaviours driven out of compulsion – such as excessive mental checking or reassurance seeking behaviours, including the avoidance of particular people, places, objects, or topics of conversation that may trigger their intrusive thoughts surrounding sexual content.
During therapy, individuals will also learn several techniques on how to handle their distressing emotions more effectively, so that they can implement these when confronted with challenging situations.
Dr Emily O’Leary
What is your experience?
- Clinical Director of Anxiety House and OCD Clinicsince 2010
- Ten years’ experience with clients with OCD and anxiety
- Clinical supervisor and STAP trained
- Worked in public and private sectors for many years
- Worked in acute inpatient and outpatients units
- Regular speaker on radio and social media
- Researcher and presenter at international conferences
Dr Daphne Bryan
What is your experience?
- Completed a doctorate in the treatment of anxiety in children
- Trained as an accredited Triple P Facilitator
- Completed skin picking and hair pulling program through the OCD LA Centre
- Delivered CBT and ACT group programs
- Written a number of programs on cyber bullying and improving self-esteem
- Worked in inpatient and outpatient settings
- Presented her research at the AACBT conference