Deciphering Sexually Intrusive Thoughts with ERP Treatment
Updated June 25, 2024Sexual obsessions or sexual “deviance”? This is a question that will haunt you if you have OCD with sexually intrusive thoughts. We all have thoughts sometimes that go against our true selves and values (even the therapists at Virtual CBT Psychotherapy).
Our society has a “don’t ask/don’t tell” culture, so we tend not to talk about some of our embarrassing thoughts. As a result, people may feel even more isolated with OCD obsessions. If you struggle with OCD, it is treatable with ERP.
Sexual Obsessions in OCD
The key difference between sexual obsessions in OCD and sexual “deviance” is how you act and feel when you have an unwanted thought. A person with OCD would likely never act on their sexual thoughts. They feel shame, guilt, disgust, anxiety, and extreme distress when they think of it. If you have OCD with sexual obsessions, you are likely haunted by these thoughts. You do all you can to avoid them or neutralize them. But, this makes the thoughts come back stronger.
Some common sexual obsessions are:
Questioning your sexual orientation (e.g. Am I gay? Am I a lesbian? Am I bisexual?). Learn more about sexual orientation obsessions.
Having sexual thoughts of children or animals (e.g. I could be a pedophile).
Incest (e.g. What if I enjoy sex with my brother? Or you see naked images of your family members). To learn more about incest OCD, read our blog post.
Combining sex and religion.
Aggressive sexual thoughts (e.g. images of raping someone) about someone.
If you have these thoughts and they are bothersome, you are not alone! You may have OCD with sexual obsessions. Reach out today for a free consultation with an OCD or ERP therapist. Our fees are often covered by your benefits. Call your benefits provider today to see if you have coverage for psychological services.
"Every human being has intrusive thoughts to some degree; it's a natural part of the human experience. However, for individuals with Obsessive-Compulsive Disorder, these intrusive thoughts become persistent, distressing, and disruptive to daily life." (American Psychiatric Association, 2013).
Common OCD Rituals
People with OCD may develop many rituals. They do this in response to sexual obsessions. Some common rituals associated with OCD sexual obsessions include:
Mental Rituals: They involve repeating things in your head, which eases your anxiety. Examples include mentally praying, counting, or repeating certain phrases to counteract the obsessions. It’s common for therapists (who aren’t experienced with OCD) to teach clients to “talk back” and say “It’s my OCD”. People often try to replace their intrusive thoughts with positive ones. Mental rituals are sneaky and sometimes the toughest to break. An ERP therapist can help with this.
Avoidance Behaviours: People may avoid situations. They avoid people or things that trigger their sexual obsessions. This avoidance can limit their daily life and relationships. It leads to loneliness and distress. For example, you may avoid men if you fear being gay. Or, you may avoid children if you fear being attracted to them.
Checking: Some people may repeatedly check their bodies. They do this to look for signs of arousal or problems. They are seeking reassurance that their intrusive thoughts are unfounded. This checking gives brief relief. But, it also feeds the obsession long-term.
Internet Searching: Many with sexual obsessions in OCD browse the internet excessively. They seek reassurance online about sexual thoughts and behaviours. They may spend hours researching or seeking validation. This continues the cycle of obsession and compulsion.
Physical Rituals: People engage in physical rituals. These include washing, showering, and grooming excessively. They do this to cleanse themselves. They feel contaminated by impure sexual thoughts. This behaviour provides temporary relief. But, it also reinforces the belief that the thoughts are dangerous or unacceptable.
Reassurance Seeking: They constantly seek reassurance from others. They ask partners, friends, or therapists about the meaning or morality of their sexual thoughts. Reassurance-seeking behaviours can strain relationships and exacerbate feelings of guilt and shame.
Ritualized Confessions: Some people confess their intrusive sexual thoughts or fears to others. They do this to lessen guilt or anxiety. But, this confession ritual brings temporary relief. Then, it brings more anxiety and the need for more reassurance.
These rituals provide a brief relief from distress. But, they keep the cycle of obsession and compulsion in OCD going. Over time, they can significantly interfere with daily functioning and quality of life. Therapies like Exposure and Response Prevention (ERP) can help. ERP helps people in slowly cutting and ending these compulsive actions.
If you have been seeing a therapist who is not trained in ERP, they have been inadvertently teaching you “tools” that have become rituals. No need to panic - this is very common! An ERP therapist can help you decipher between rituals and healthy coping strategies.
Treatment for Sexually Intrusive Thoughts
It’s best to meet with an OCD therapist. They should be trained in assessment (e.g. a psychologist) or in exposure and response prevention (ERP). Alternatively, you could ask your family doctor to refer you to see a psychiatrist. This is covered by the Ontario Health Insurance Plan (OHIP). However, people often get misdiagnosed, especially if they don’t see someone familiar with assessing OCD.
The gold standard treatment for OCD is exposure and response prevention (ERP). You will want to meet with a therapist who has been trained in this specialized therapy. If you have severe OCD, you may also want to speak to your doctor or psychiatrist about starting an SSRI.
Learn more about ERP for intrusive thoughts (OCD).
Connect with an OCD Therapist
Our online clinic has many ERP therapists to choose from. They have been trained and supervised in ERP: Alpar, Celissa, Anneliese, Jennifer O’Connor, Alana Weinberg, and Dr. Steinhart.
Our ERP therapists can provide therapy to anyone in Ontario (over the age of 12). Did you know that video or virtual EP is as effective as in-person? So why not start therapy from the comfort of your home?
Our fees. Call your benefits provider to see if you are covered for psychological services.
ReferencesAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).