It’s human nature for people to have sexual thoughts. You may experience them frequently, or just every once in a while. Sexual thoughts can help you learn about who and what you’re attracted to, and they can influence your sex life. Having sexual fantasies is typically harmless, but there are instances when your thoughts about sex don’t bring pleasure and instead cause a lot of distress. These are known as sexual obsessions.
Sexual obsessions are symptoms of the many themes of obsessive-compulsive disorder (OCD), a highly treatable mental health condition. Read on to learn more about sexual obsessions OCD and how you can manage it with treatment.
What are the differences between sexual fantasies and sexual obsessions?
According to Tracie Zinman-Ibrahim, LMFT, CST, therapist and Chief Clinical Officer at NOCD, fantasies are things that you imagine, and are often something you enjoy. She adds that fantasies can be magical, such as the idea that you’re going to marry your favorite actor, or can be sexual in nature, such as becoming physically intimate with that same actor.
Sexual fantasies, in particular, are often desirable and, according to Zinman-Ibrahim, are still enjoyable despite not being attainable.
On the flip side, Zinman-Ibrahim describes sexual obsession as “something you can’t stop thinking about, even when you don’t want to think about it. It could become intrusive or uncomfortable. You might start questioning why you’re thinking about it,” she explains.
It’s possible for sexual fantasies and sexual obsessions to intertwine, says Zinman-Ibrahim. “I’ve noticed people who really enjoy certain video games, anime, or manga and being like, ‘I have sexual fantasies about this character, but this character is not 18, so that’s a problem,’” she explains. “They can crossover and get weird.”
Sexually intrusive thoughts are a common symptom of OCD and can understandably become a cause for concern.
We can help you tackle sexual intrusive thoughts
OCD themes that may cause sexual intrusive thoughts
According to Zinman-Ibrahim, all themes or subtypes of OCD can cause distressing thoughts about your sexuality. Below are a few examples of how sexual intrusive thoughts can manifest in different OCD subtypes:
- Contamination OCD: With this OCD subtype, your obsessions may be tied to coming into contact with bodily fluids—either your own or someone else’s—during intimate moments.
- Pedophilic OCD: Sexually intrusive thoughts about children are a common symptom for people with pedophilic OCD. If you have this OCD subtype, you might question if you’ve sexually abused a child in the past or if you’ve ever clicked on child porn by accident.
- Harm OCD: This could entail intrusive thoughts about sexual violence, such as fears about being a rapist. This could involve a fear that you’re going to sexually attack people, or intrusive images of sexual assault from movies or TV.
- Sexual Orientation OCD: This OCD subtype typically involves a persistent worry about who you’re sexually attracted to, such as fears about being straight and vice versa. “Let’s say you’re heterosexual, and now you’re afraid that you’re gay or lesbian. Or you’re gay or lesbian, and you’re afraid you might not be,” says Zinman-Ibrahim.
- Relationship OCD: This can make you constantly question your attraction to your partner(s). Someone with ROCD may repeatedly wonder if they are still in love with their partner, or have an obsession about their partner cheating on them.
- Scrupulosity (Religious) OCD: If you have this OCD subtype, you may have unwanted sexual intrusive thoughts that are against your religious beliefs. You may have thoughts like, “‘I like such and such, and that goes against my religion, and now I’m going to hell,” says Zinman-Ibrahim. “I’ve had people stop going to church because they think that they’re too dirty to go in because they have sexual thoughts about religious figures.”
This is by no means a complete list, as several other OCD themes may cause you to have unwanted and intrusive thoughts about sex.
Regardless of how your OCD presents, having sexually intrusive thoughts can have a significant impact on your life. “They can be extremely upsetting,” says Zinman-Ibrahim. “Sometimes they can be about your family members, loved ones, friends, kids, and pets. OCD always only attacks things you care about.”
Sexual thoughts can lead to compulsions
When it comes to OCD and sex, with any sexual obsession you have, you may perform a compulsion to deal with the distress. “People tend to do a lot of checking compulsions,” Zinman-Ibrahim. “They’re like, “Okay, I’m going to look at the girl that just walked by. I had a groinal response [physical sensation in your genitals], which means I must like girls.”
However, there’s a misconception that sexual obsessive compulsive disorder causes sexual compulsions, such as masturbation or watching pornography. This is because people who have unwanted sexual thoughts are often repulsed and disgusted by them and would rather suppress them than act on them. This is known as thought suppression. However, what makes OCD OCD is the cycle of obsessions and compulsions that can be hard to break without treatment.
Managing sexual obsessions
If your OCD obsessions about sex are affecting your relationships and your overall quality of life, it’s time to seek help to get those thoughts under control. Thankfully, OCD, in all manifestations, is highly treatable with therapy, medication, or a combination of both. Here are the treatment options for managing sexual obsessions OCD.
Exposure and Response Prevention (ERP) therapy
Exposure and response prevention (ERP) therapy is the gold standard treatment for managing sexually intrusive thoughts. This evidence-based therapy involves intentionally putting yourself in situations that trigger your intrusive thoughts—exposure—and then learning to resist doing compulsions with response prevention techniques.
“They can go to an ERP therapist to learn how to sit with uncertainty and possibly stop, or mostly stop compulsing,” says Zinman-Ibrahim. ERP is considered the first-line treatment for OCD and has a reported success rate of 65% and 80%, with people seeing improvement in symptoms in about two months or so.
Acceptance and Commitment Therapy (ACT)
Acceptance and commitment therapy (ACT) is a talk therapy that incorporates mindfulness and acceptance strategies to help you change your relationships with your obsessions, rather than directly confronting them. It is often used as a supplemental therapy to ERP to treat symptoms of OCD. “I also like to use ACT to help allow your values to guide your decisions,” says Zinman-Ibrahim.
ACT can help you overcome your sexually intrusive thoughts so you can do the things you really want to do. “You might not go to children’s birthday parties because you have pedophilic OCD and get groinal responses. But maybe you want to go because that’s your niece or your sister, so you would go anyway.”
Medication
If you’re not seeing improvements in your sexual obsessions with ERP and ACT, you may need to try medication. “If you still feel like, ‘Wow, my intensity is extreme,’ and you’re not compulsing, and you don’t know why, you can try and see if a medication or combo might help,” says Zinman-Ibrahim.
If you do visit a psychiatrist for OCD medication, Zinman-Ibrahim recommends you bring this resource from the International OCD Foundation (IOCDF) to ensure you receive the proper dose. “It is very important that people understand how to dose for OCD, as it’s very different from what most people think,” she says. “The IOCDF has a list of medications that have been shown to help some people with OCD, as well as what the appropriate doses are.”
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Bottom line
There’s a stark difference between a sexual fantasy and a sexual obsession. While one can bring pleasure and desire, the other causes distress and discomfort. Discussing sexual obsessions can be seen as “taboo” to many, but if they’re affecting your life, it’s best to seek treatment so you can focus on the things that make you happy.
