YOU PROBABLY HAVE that one friend who talks about sex a lot and seems to think about it all the time (or maybe you’re that person in your friend group). And, you may think, “He’s obsessed with sex” or “He’s OCD about his sex life.”
While sexual obsessive-compulsive disorder (OCD) is a real thing, too often, the term OCD is overused, says Patrick McGrath, Ph.D., a licensed clinical psychologist and chief clinical officer at NOCD.
“Having OCD focused on the theme of sex is not at all the same as just thinking about sex a lot,” he says.
OCD is a mental health condition defined by two kinds of symptoms: obsessions and compulsions. The obsessions are a series of invasive, unwanted thoughts, ideas, or sensations. To get rid of those thoughts and the distress they cause, someone feels compelled to engage in certain behaviors, known as compulsions, according to the American Psychiatric Association.
“People who think about sex a lot do not necessarily find these thoughts disturbing or distressing, and in most cases, the thoughts don’t interfere in their lives,” McGrath says. “In fact, they may simply enjoy these thoughts and try to pursue situations where they may have chances to engage in sex or sexual activities.”
Sexual OCD, on the other hand, is when someone experiences overwhelming distressing sexual obsessions, but they don’t necessarily experience a sex-related behavioral compulsion, says Meaghan Rice, Psy.D., L.P.C., a Talkspace therapist. The thoughts are highly disturbing and might cause a trauma response.
Having sexual OCD can affect your sex life, relationships, and overall mental health. Here are a few things to know about sexual OCD, what causes it, and how it’s treated.
What Is Sexual OCD?
The obsessions and compulsions that come with OCD can revolve around themes, like contamination, religion, identity, or sex, according to the International OCD Foundation.
“People with sexual OCD think about disturbing sexual thoughts that create an aversion,” Rice says.
For instance, unwanted thoughts or mental images linked to sexual OCD might include a fear of acting on a sex-related impulse, a fear of sexually harming others, or a fear of aggressive sexual behaviors towards others, according to the International OCD Foundation.
“By having these thoughts, they experience a great deal of shame, guilt, anxiety, and difficulty concentrating,” Rice says.
What Does Sexual OCD Look Like?
Sexual OCD features obsessions and compulsions. Here are some examples.
Sexual OCD Obsessions
Rice says people who experience sexual OCD have obsessions (or, obtrusive, unwanted thoughts) like:
- Sex with animals
- Sex with children
- Sex with family members
- Sex with public figures
- Sex that’s violent, gruesome, contaminated, or unwanted
- Sexual sadism or masochism
- Forced changes in sexual orientation
Many sexual obsessions revolve around “what if statements,” McGrath says, such as:
- What if I stare inappropriately at people’s genitals?
- What if I were to molest a child?
- What if I were to suddenly not love my partner and started to love someone of a different gender?
- What if I am not attracted enough to my partner?
But, the person having these thoughts doesn’t actually want them to happen—and, they take measures to prevent them from happening, McGrath says.
“Obsessions in OCD are known as ego-dystonic, meaning they go against the thoughts, beliefs, morals, and identity of the person experiencing them,” he adds.
Sexual OCD thoughts aren’t the same as having a sexual fantasy, which is related to pleasure or desire. Sexual obsessions are unwanted and cause a great deal of distress, shame, or anxiety, McGrath emphasizes.
Sexual OCD Compulsions
People with sexual OCD don’t typically act on their obsessions. Instead, to cope with the anxiety from the unwanted thoughts, they often develop certain behaviors, or compulsions, according to The Gateway Institute. These include:
- Avoiding situations where they’ll encounter a subject of their obsessive thought
- Performing mental rituals, like seeking reassurance, showering, or counting, to replace the thoughts
- Avoiding sex
- Checking for sexual arousal when encountering the subject of their obsession
- Thinking about past sexual behaviors for signs of perversion
Sexual OCD Effects
Often, people’s sexual OCD is triggered before, during, or after a sexual act, Rice says. “So, it naturally provokes a sexual aversion.”
People may avoid sex altogether, which causes problems in relationships and prevents them from experiencing intimacy, she adds. “Because emotional and sexual intimacy act as triggers for these shameful thoughts, partners of people with sexual OCD can feel that their partner is not attracted to them or that they might be fulfilling their sexual needs somewhere else.”
Still, healthy relationships are possible. It just requires extra work communicating openly and honestly about the situation, Rice adds. And, the person with OCD needs treatment for the condition.
OCD of any kind can affect someone’s ability to carry out their daily activities and cause anxiety and mental distress.
“As long as people with OCD learn to recognize that they need not do what OCD tells them, and that OCD is not a source of truth, they can learn to live with it and stop it from controlling their lives,” McGrath says.
What Causes Sexual OCD?
Several factors can play a role in someone developing sexual OCD. It could be related to experiencing a sexually traumatic event, Rice says.
Some people might also have a biological predisposition to OCD, she adds. It might run in your family or you might have an imbalance of a neurotransmitter in the brain.
How Is Sexual OCD Treated?
Too often, people think someone can simply stop thinking intrusive thoughts, McGrath says. But, sexual OCD is a serious mental health condition that needs treatment.
Exposure and response prevention (ERP) therapy helps treat OCD by triggering someone to experience the intrusive thought or urge in a controlled environment and guiding them through living in their discomfort, instead of trying to neutralize it with a compulsion, he adds.
“By bringing these thoughts, images, and urges up directly, your brain can learn to treat them like any other thoughts, rather than as dangerous threats,” McGrath says.
Talk therapy can help work through past or hidden traumas that contribute to OCD and learn distraction techniques to help people feel more in control of their thoughts, Rice says. Eye movement desensitization and reprocessing (EMDR) helps release blocked trauma that you might not be aware of.
Medication can also decrease the intensity of the anxiety that you feel, she adds. “So, we’re able to focus on new coping skills and habits that will improve the quality of our lives.”
Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.