The content of the obsessions varies widely.
While some obsessions involve fears of contamination, concerns about contamination make up a small percentage of obsessional themes.
Obsessions are often “taboo” in nature.
Verywell / Alison Czinkota
For example, someone with OCD may experience violent thoughts and images (i.e.
), or blasphemous thoughts that go against someone’s religion.
Thesecompulsionsare used to reduce anxiety or to prevent something bad from happening.
OCD’s Impact on Sex and Intimacy
OCD knows no bounds.
Intrusive thoughts can and will show up anywhere.
The bedroom, or wherever you decide to have sex, is not off limits.
ERP and mindfulness skills can improve your sex life.
This is what happens frequently for those with OCD.
For others, its unwanted thoughts or images of harming a loved one.
The thoughts are not only highly anxiety-provoking for the individual with OCD, but also a massive turn-off.
The reality is that our thoughts are out of our control most of the time.
Psychologist Daniel Wegner’s research on thought suppression is evidence of this.
In his study, one group of participants was asked to think about a white bear for 5 minutes.
Another group was told not to think about a white bear for 5 minutes.
These findings indicate thatthought suppressiondoesnt workin the bedroom or anywhere else.
It is considered to be the gold standard treatment for OCD.
ERP may facilitatehabituation, in which anxiety is reduced over time after repeated exposure to the feared stimuli.
Enter: sex as an exposure.
Exposure
When someone with OCD engages in sexual activity, their brain may become flooded with intrusive thoughts.
This often terrifies them and leads them to avoid sex, despite how much they value it.
To combat this avoidance, aka a compulsion, a therapist may assign sex as an exposure.
The person will gradually and repeatedly expose themselves to bodily fluids and sexual activity without engaging in avoidance compulsions.
The goal is to tolerate discomfort and have sex mindfully.
When you avoid something, you are directly telling your brain that the thing you’re avoiding is dangerous.
Thus, sex becomes increasingly dangerous to the person living with OCD when danger is not actually present.
The more you attempt to avoid your OCD triggers, the larger your fear becomes.
So, what does the brain do?
Response prevention is utilized in this situation to help treat the OCD.
Common examples of compulsive sex based on obsessional themes are listed below.
This applies to any sexual orientation.
As a reminder, intrusive thoughts of OCD are ego-dystonic.
Sexual orientation obsessions are not denial about one’s true sexuality.
This could look like checking physical arousal or mentally checking internal feelings during sex.
In these cases, the person must utilize response prevention to cut out compulsive sexual activity.
Another harsh reality is that what you look for, you will often find.
OCD Seeks Certainty
Checking is also an attempt to seek certainty about obsessions.
OCD is characterized by an inability to tolerate uncertainty.
The individual with OCD strives to obtain 100% certainty about their sexual orientation, relationship status, etc.
when the reality is that certainty does not exist for anyone.
A core piece of OCD treatment is coming to terms with and accepting uncertainty.
It’s a torturous mental illness.
Medication can also help patients carry out their ERP work.
It’s not a Band-Aid or quick fix.
It is often a complex decision people make because they are deeply suffering.
This can be a difficult and painful decision to make.
It is important and recommended to consult with a psychiatrist regarding all medication management.
Managing OCD Through Mindfulness
Mindfulness skills are a cornerstone of OCD management.
Mindfulness is about accepting the presence of whatever thoughts and feelings the brain has produced without judgment.
The reality is that the thoughts, images, and feelings are not the problem.
Thoughts are, quite simply, words in our mind.
Those words are comprised of letters and those letters make up syllables.
They automatically attribute meaning to the words and feelings, which keeps them stuck in the O-C cycle.
Thoughts Are Thoughts
Not every thought and feeling is important or meaningful.
Not every thought and feeling needs to be paid attention to.
You get to decide what is helpful or not helpful and what you give your attention to.
It is to co-exist with the thoughts during sex without responding to them compulsively.
A mindfulness response during sex looks like: Okay, that was a thought.
It can be here while I re-engage with what is happening in the present moment.
You do not get to choose what pops into your mind during sex or at any other time.
Also, it’s highly likely that the intrusive thoughts will be there.
Thoughts might pop in right before climax or all throughout the sexual experience.
You are not engaging with the thoughts compulsively or making meaning out of them.
You are allowing them to co-exist with you, as uncomfortable as it may be.
Many are so tempted to resist uncomfortable thoughts and feelings, which only keeps them around longer.
Mindfulness has a paradoxical effect on thoughts and feelings.
In other wordswhat we resist, persists.
When we allow and accept the presence of thoughts and feelings, they are free to come and go.
Final Thoughts
While OCD can make sex more difficult, difficult does not mean impossible.
Wegner DM, Schneider DJ, Carter SR 3rd, White TL.Paradoxical effects of thought suppression.J Pers Soc Psychol.
Published 2019 Dec 24. doi:10.2147/PRBM.S211117
Harvard Health Publishing.When an SSRI medication impacts your sex life.
2020;9(1):8. doi:10.1186/s13643-019-1262-7
