How Can I Stop My Sexual Intrusive Thoughts?

Do you ever have sexual thoughts that are so unlike who you are that they seem to come from outside of your mind? You may imagine impulsively touching someone inappropriately or have disturbing thoughts involving family members or coworkers. Well, the first thing you should know is that unwanted, sexually intrusive thoughts can be normal. Many people have them from time to time. 

“It’s very common to have sexual thoughts. Often your brain can produce these intrusive thoughts, but they don’t mean anything to you. They’re just blips of mental activity, even when they are strange or bizarre,” says April Kilduff, MA, LCPC, LMHC, a licensed therapist and Clinical Trainer with NOCD. 

So what sets thoughts apart from those that might be associated with a more serious mental health disorder? If a distressing sexual thought suddenly crosses your mind and then quickly goes away—you can dismiss it as random and untrue—that’s the type of thing that happens to lots of people. 

But if your thoughts are frequent and upsetting to the point that they disrupt your life, it may be a condition called sexual obsessive-compulsive disorder (OCD), says Kilduff. Sexual OCD involves unpleasant, intrusive, recurring sexual thoughts, mental images, sensations, and/or urges (called obsessions), and incessant, mental, or behavioral actions (compulsions) that are done to relieve the distressing feelings caused by these thoughts. 

You should know that it’s a highly treatable condition—more on this shortly! Still, sexual OCD continues to be widely misunderstood and often misdiagnosed. This article will debunk some common myths about intrusive sexual thoughts and provide expert insight into how to get help. 

What Is OCD? 

Before we get into the specifics of sexual OCD, it’s important to get a baseline on what OCD is in general. People with OCD can experience various situation-related obsessions—some may have to do with contamination or cleanliness, or a need for symmetry, while others may involve a fear of harming themselves or others, or distressing sexual thoughts. 

So here are some of the common signs and symptoms.

OCD-related obsessions involve a persistent pattern of unwanted thoughts, urges, sensations, feelings and/or mental images that may:

• Cause constant worry, doubt, fear, or anxiety
• Result in shame or guilt
• Result in intense distress 
• Threaten your sense of safety 
• Make you question your beliefs or values

When you have OCD, you experience intrusive thoughts that happen so often that they interfere with your ability to work or carry out day-to-day tasks. Your thoughts might distract you from focusing on important things, like personal relationships, and you may spend a significant amount of time dealing with your obsessions every day.

Because you can’t suppress the disturbing thoughts that show up in your mind, OCD will demand that you engage in compulsions. A compulsion is something you feel you must do to manage the anxiety and distress caused by your obsessions. Compulsions may involve:

• Physical activities, such as tapping
• Behaviors, such as repeatedly asking for reassurance from others
• Mental activities, including ruminating
• Using numbers, like the need to perform a compulsion a certain number of times

Compulsions can be very time-consuming, making you feel exhausted and overwhelmed. Despite this, you may need to continue performing these rituals until your distress disappears. The problem is that the relief is usually short-lived. Your compulsive actions can cause you to get stuck in an ongoing cycle of unwanted thoughts and compulsive actions, followed by more obsessive thoughts, and more compulsions. 

OK, So Explain Sexual OCD

Sexual intrusive thoughts can occur in people of any gender or age. Research suggests that approximately 24% of people with OCD have intrusive sexual thoughts. But because of the stigma associated with sexual obsessions and common misperceptions about the condition—like the idea that sexual obsessions are the same as fantasies—these figures may under-represent the actual number of people suffering from it.

With sexual OCD, your obsessions can involve various themes. Some common ones include obsessive thoughts or mental images about:

• Having sex with friends
• Engaging in sadism, enslavement, masochism, or other uncommon sexual interests
• Having contradictory sexual thoughts, such as having heterosexual sex if you are gay 
• Fantasizing about sex with family members
• Cheating on your partner
• Having sex with animals (bestiality)
• Enduring sexual abuse or violence 
• Engaging in sex with children (pedophilia)
• Having sexual thoughts about religion as a form of blasphemy

The Truth About Sexual Obsessions

It’s important to understand that intrusive thoughts linked with OCD conflict with your values and personal beliefs. In other words, if you have OCD you do not wish to act on your thoughts.

To demonstrate this dichotomy, here are some examples of sexual OCD symptoms, and how they can contradict a person’s ethical and moral beliefs.

• A dedicated minister lives in fear of losing his ministry due to repetitive, intrusive sexual thoughts about a married church member.

• A happily married school teacher, devoted to family and educational values, is overwhelmed with feelings of disgust and anxiety related to ongoing intrusive sexual thoughts about a student.

• A popular teenage athlete, who is committed to a long-term heterosexual relationship, is obsessed with sexual orientation doubts resulting from repetitive disturbing mental images about a same-sex member of the football team.

Sexual OCD Compulsions

Compulsions in sexual OCD may involve mental compulsions that play out in your head, behaviors, or both. But Kilduff notes that often people with sexual OCD may experience mental rather than behavioral compulsions.   

Sexual OCD behavioral compulsions may involve repeatedly:

• Checking body sensations in situations that activate obsessions—like checking your sexual arousal level
• Distancing yourself from people or situations that trigger sexual thoughts
• Repetitive tapping to relieve anxiety caused by intrusive sexual thoughts. While tapping can apply to OCD in general, Kilduff says it can show up in sexual OCD, as well. “Some people believe that tapping something in a specific way is ‘magical’ because it will prevent bad things from happening,” she explains.

And here are some examples of mental compulsions tied to sexual OCD:

• Repeatedly praying for the unwanted sexual thoughts to stop
• Trying to neutralize your obsessions by replacing sexual thoughts about an undesirable entity with good thoughts
• Ruminating on where the origin of the sexually intrusive thoughts came from 
• Reassuring yourself that your sexual urges involving a friend or neighbor are untrue
• Checking whether your emotions remain consistent, regardless of unwanted sexual images involving something distressing, like cheating on your spouse

Sexual OCD Misperceptions

If you’ve been overwhelmed with guilt or self-blame about disturbing sexual thoughts, it may help to learn about some common misperceptions about this subtype of OCD. Knowing the facts may encourage you to seek professional help to learn about managing your unwanted thoughts.

• Myth: I must be a bad person because I have such bizarre sexual thoughts that don’t align with my morals.
• Fact: Many people have random intrusive sexual thoughts that don’t align with their principles. But those who don’t have OCD can let go of these thoughts without compulsions or other symptoms.

• Myth: I am likely to act on some of my disturbing sexual thoughts.
• Fact: People with OCD are not known to act on their obsessions, because these intrusive thoughts go against who they are and their values.

• Myth: My sexual thoughts are the cause of my anxiety and fear. 
• Fact: The underlying cause of OCD symptoms is the reaction to the obsessive thought, not the thought itself. 

It’s not unusual for people with sexual OCD to be confused about the cause of their symptoms. Kilduff says that even psychologists who don’t specialize in OCD can get it wrong: “OCD is commonly misdiagnosed as a sexual problem or condition, such as a pornography addiction, or PTSD.” Research shows that other common OCD misdiagnoses include anxiety, depression, and depressive ruminations.

What Are Some Other Signs That I Might Have Sexual OCD?

If you’ve been having unwanted sexually intrusive thoughts, you may think you have some sort of sex addiction, but often, these thoughts are completely unrelated to a disorder like this. In fact, it might be just the opposite. OCD infamously attaches itself to things you care about the most. So if you value intimacy and relationships, it could latch onto that, and cause all sorts of doubts and fears about yourself that aren’t true, but certainly feel like they could be true. 

Although everyone experiences the condition differently, there are some common characteristics of sexual OCD:

• Sexually intrusive thoughts, which occur equally in males and females
• These intrusive sexual thoughts may start during adolescence and rise and fall in intensity 
• The obsessive thoughts tend to gradually worsen over time
• Unlike sexual fantasies, the obsessions linked with OCD cause feelings of guilt, shame, fear or distress, instead of pleasure
• The more frequent the intrusive sexual thoughts, the greater the distress level usually is
• Sexual obsessions may lead to other mental health conditions, such as anxiety or depression

If you suspect you might have sexual OCD, Kilduff says that it’s important to seek help from a therapist who is specially trained to treat OCD. That’s because the most effective way to manage the condition isn’t your standard talk therapy. (In fact, traditional therapy can make OCD worse.) So what does work? Glad you asked. Keep reading! 

How to Get Treatment for Sexual OCD

Here at NOCD, we know that exploring the possibility of OCD treatment may feel overwhelming. Experiencing intrusive sexual thoughts often goes hand in hand with secretiveness about disturbing the thoughts, images, sensations, and urges you have. And the idea of talking to someone about them may be the last thing you want to do. But keep in mind that OCD therapists have seen it all, heard it all, and will not judge you, no matter how taboo you may think your obsessions are, says Kilduff. 

Please: Take the leap. Because there’s a very effective treatment modality for all types of OCD, including sexual OCD, called exposure response prevention therapy (ERP). It was specifically developed to treat this condition. “I’ve seen patients make significant progress with ERP, often sooner than they expect,” says Kilduff.

In fact, research shows that 80% of people with OCD see positive results after 12 to 20 ERP sessions. 

How does ERP work? First, your therapist will have you list your fears or triggers, ranking them from the least to the most problematic—based on the stress level associated with each one. Initially, you’ll work on facing fears that cause the least amount of stress, and gradually work towards the highest-ranked ones on your list. 

For example, your therapist may ask you to visualize a sexual image you’ve been experiencing, one you consider minimally stress-inducing. But instead of starting to ruminate on why you keep having this picture in your head (as you often do), your clinician will guide you on ways to keep from engaging in a compulsion.

Over time, this trains your brain to stop associating obsessive thoughts with the urge/”need” to do compulsions. The brain learns that OCD is sending out false distress signals for something that isn’t truly a threat. You’ll be able to deal with sexual obsessions better than before, realizing there that all of the fear was linked with hypothetical situations. You might still have obsessive thoughts, but most of the time you can learn to just let them float on by, without getting distressed, or compulsively reacting to them. In other words, you can ultimately find relief—and freedom.