Fears about incest – What do they mean?

If you’re experiencing fears that you could be attracted to a family member and you’re finding them upsetting, you’re not alone. As an experienced therapist, I’ve worked with many people who have this fear, and I’ve helped them uncover the reason behind it.

What I’ve learned is that these worries are often connected to obsessive-compulsive disorder (OCD), believe it or not. While it’s most commonly associated with themes of contamination, cleanliness, order, and symmetry, OCD actually encompasses many more themes, including taboo sexual fears. Let’s shed some more light on this highly misunderstood condition.

What is incest OCD?

Incest OCD involves intrusive thoughts, images, or urges about sexual contact with or desire for family members. Someone with incest OCD fears may also experience obsessions surrounding the potential ramifications of acting on urges or of another person becoming aware of their obsessions.  As in other manifestations of OCD, doubt and uncertainty are a key feature of incest OCD. One will often question whether their behavior around family or the presence of obsessions are based in attraction and arousal. Some individuals also become preoccupied about past events and whether inappropriate contact occurred in the past. Some people with fear of incest OCD may even experience what is referred to as a groinal response. A groinal response may be a subtle or very obvious sensation in one’s genitals which can include twitching, pulsing, tingling, an erection, or increased lubrication. Groinal responses can actually happen as a result of hyperawareness and hyperfixation on one’s genital sensations due to OCD fears, and are not true indicators of sexual attraction. Obsessions associated with incest OCD are ego-dystonic, meaning that they are unwanted and do not align with a person’s actual values or desires.

Incest OCD – Common obsessions

• Fear of acting on a sex-related thoughts or impulses
• Fears about sexually harming relatives, or closely related family members
• Fears about aggressive sexual behaviors towards others
• Images of a family member naked
• False memory obsessions, such as obsessive concern that a sexual act occurred in the past

Situations or events that may trigger intrusive thoughts in people with incest OCD may include:

• Being around family
• Speaking with other adults about family
• Perceiving a diminished attraction to individuals outside one’s family
• Seeing news reports or media related to incest 
• Physical sensations of attraction
• Pictures of family
• Positive emotions about family 
• Listening to, viewing, or reading media about sex or attraction

How can I tell if it’s OCD, and not anxiety, cautiousness, or stress, or true feelings of attraction?

Incest OCD can result in anxiety, cautiousness, and stress. You are likely experiencing incest OCD if you are engaging in behaviors aimed at reducing anxiety or preventing sexual thoughts about or contact with family members.

As an example, you may find that you are avoiding being around family members, or avoiding eye contact or looking at certain parts of their bodies. The obsessions present in incest OCD are ego-dystonic, meaning they are at odds with one’s values and true intent. Remember that even if you’re experiencing groinal responses, they are not indicative of true attraction or values, and that the doubt associated with OCD may make you question whether the thoughts are secretly truly wanted. If you find yourself spending a lot of time trying to untangle this, you are likely engaging in a compulsion associated with incest OCD.

It is important to find an OCD specialist when seeking help to ensure an accurate diagnosis and to rule out other diagnoses. Feelings of shame and stigma, as well as fears about negative consequences surrounding these thoughts may prevent you from seeking treatment. With knowledge and understanding about how OCD works, a trained professional will be able to provide an accurate diagnosis and effective treatment, and will not cause any harm to you based on your thoughts and worries.

Common compulsions

When people with Incest OCD experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in mental or physical rituals known as compulsions. Compulsions are aimed at preventing a feared outcome or reducing anxiety and distress in the moment. When someone engages in a compulsion, the OCD cycle is strengthened: short-term relief from compulsions will lead to long-term distress, and compulsions reinforce OCD over time.

Some common compulsions found in people with incest OCD are:

• Checking thoughts and behaviors
• Reassurance-seeking
• Researching
• Repetitive behaviors
• Checking for groinal responses
• Avoidance of family members
• Mental review of past events
• Distractions 
• Substance use
• Staring at family members to check that they do not arouse you
• Monitoring one’s emotions towards family members
• Rumination
• Neutralizing thoughts by replacing a “bad” thought with a “good” thought
• Confessing intrusive thoughts to others

How to treat a fear of incest

Incest OCD can be debilitating for people who struggle with it, but it is highly treatable. Exposure and Response Prevention (ERP) therapy is a form of behavioral therapy that was developed specifically to treat people experiencing OCD. 

In ERP, people with OCD learn how to identify and cope with triggers in their lives, which are internal or external factors that bring about intrusive thoughts, images, or urges that cause distress or anxiety. Individuals will engage in exposures, or situations that cause some level of distress based upon their obsessions. During exposures, they can practice different response prevention skills, which teach them to resist engaging in compulsive behaviors in order to relieve distress. 

ERP is done with the collaborative aid of a therapist. The goal is to help people with OCD break the OCD cycle and manage their obsessions and anxiety while learning not to engage in compulsive behaviors. Through the ERP process, people may gain greater comfort when faced with triggers, and reduced urges to engage in compulsions as a response to them. With ERP, people with OCD can learn to accept the presence of obsessions, and live with uncertainty without it taking over their lives.

You can learn to overcome your fears

If you’re struggling with OCD, please know that there’s hope for you to get better and return to enjoying your relationships with your family, rather than being controlled by doubt and worry. Here at NOCD, all therapists specialize in OCD and receive ERP-specific training, and they’re skilled in approaching treatment without judgment, even if you’re struggling with particularly taboo intrusive thoughts about family members.

I encourage you to learn more about NOCD’s evidence-based approach to treating incest OCD—you can regain control of the relationships that mean the most to you, and learn to live with confidence in your own values.