Obsessive compulsive disorder - OCD treatment and therapy from NOCD

How can I deal with sexual dreams about a friend? Advice from a therapist

By Elle Warren

Jan 18, 20247 minute read

Reviewed byApril Kilduff, MA, LCPC

We all have dreams that make us uncomfortable, anxious and fearful. They can be a normal human experience, for sure. But sometimes they might be a sign of a more serious condition. I’ve been there. When I was in the thick of struggling with sexual orientation obsessive-compulsive disorder—a type of OCD that focuses on figuring out your one true sexuality with 100% certainty—I worried that any romantic dreams were emblematic of a true desire that I was just in denial of during my waking hours. After proper treatment and hard work, I no longer hold any stake in these types of dreams. They are what they are, and have nothing to do with me. 

Keep reading for how you can get there, too. With the help of April Kilduff, MA, LCPC, LPCC, LMHC, a therapist and clinical trainer at NOCD, you can learn more about dreams, why you may be so concerned over yours, and how you can get help. 

What do dreams mean?

“We don’t have good, hard science about dreams and what they may mean,” says Kilduff. “But many researchers agree that they can be an important cognitive process that our brains need to do while we’re asleep. Whether it’s working through information from the day, or making sense of things, it does serve some sort of important purpose. We just don’t have all the answers about what that is right now.”

The better question, she says, may be to ask: Why are you so worried about your dreams?

Why are you worried about your sexual dreams?

It’s natural to feel a disturbed by an unwanted sexual dream. “Worrying about dreams probably happens more when the content is violent, very out of character for you, or has to do with a taboo topic,” says Kilduff. “It’s common for people to wonder, ‘Why am I dreaming about something sexual that isn’t what I want in the real world?’”

Most people can have these dreams, acknowledge the discomfort, think huh, strange, and move on with their day. So if you find yourself unable to stop thinking about the dream, feel persistently anxious over what it means, or worry that it says something about you or your friendship, you could be experiencing OCD. 

“OCD loves to come in and say, ‘Yeah, that dream probably means something really bad about you,’” says Kilduff. But that’s the disorder talking, not you.

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What is sexual OCD?

Sexual OCD causes one to have recurrent, unwanted, intrusive thoughts, images, urges, sensations, or feelings about certain sexual acts or situations, typically centered on people or situations that are taboo or inappropriate—perhaps involving family members, friends, or authority figures.

“The nature of any kind of OCD is to go after something you really care about and try to scare you with the idea that you could be a person other than who you think you are, or that bad things will happen,” explains Kilduff.

The precise content of intrusive thoughts (which is shorthand for those images, urges, sensations, or feelings) can vary from person to person. But some examples include:

  • What if I really want to hook up with my friend?
  • What if this dream means I’m harboring some secret desire?
  • What if I act weird toward my friend now and she can tell I had a sex dream about her?
  • What if I’m lying to my current partner about my attraction to them?
  • I had a dream about kissing my friend. Does that mean something?
  • Is it bad that I have an urge to kiss my friend?

Just like everyone has dreams they find disturbing, everyone also has intrusive thoughts. And while many people are able to move on from them, what sets a person with OCD apart is their inability to dismiss intrusive thoughts as untrue to who they are. Instead, they become urgently concerned that the thoughts mean something and must be somehow solved. “OCD wants to convince you that you need to find certainty that doesn’t exist,” Kilduff says. 

Since intrusive thoughts are ego-dystonic, meaning they don’t align with one or more of your values, beliefs, and/or morals, they can cause intense distress. You might experience anxiety, fear, panic, shame, guilt, feelings of doom, or embarrassment. With OCD, these uncomfortable emotions cause you to engage in compulsions—any physical or mental act done with the intent of banishing intrusive thoughts and the feelings they bring. 

Here are some examples of common compulsions:

  • Rumination. This is the act of overthinking or over-analyzing—like replaying a thought, idea, question, sensation, or situation over and over in your mind, even for hours a day. It comes from feelings of needing to get to the bottom, or think your way out of intrusive thoughts and the distressing emotions they bring. You may also have the sense of being stuck in a thought loop.
  • Reassurance-seeking, which is a need to get reassurance from others or yourself. For example, you may ask a friend, “Do you ever have weird sex dreams?” or repeatedly think to yourself, of course I don’t want to hook up with my friend. 
  • Confessing. This happens when guilt and shame over your intrusive thoughts build up, and you confess your thoughts as a means of clearing your conscience and relieving the sense that you’re hiding something from your friend.
  • Excessive research. This is another form of reassurance-seeking, but instead of getting it from another person or yourself, you turn to the internet, or maybe a book, or maybe a book (but the internet, in particular, allows for easy, endless searching, which is what OCD is after). You may read article after article about the meaning of dreams, why you may have sexual dreams, or how to know if you actually want what happened in your dreams. You’re looking for evidence that supports or denies your intrusive thoughts. But no amount is ever enough. 
  • Avoidance. This is the act of avoiding the people, places, situations, activities, conversations, books, movies, or anything else that triggers your intrusive thoughts. There’s a sense that as long as you avoid those things indefinitely, you won’t have intrusive thoughts or the distress over them.
  • Mental review is when you look back on certain memories to search for proof that your intrusive thoughts are or aren’t true. You may, for example, reflect on times you hung out with the friend you dreamed about and ask yourself, Was I feeling desire? Did I do something that indicated that I might be attracted to them? There’s a sense that you can’t trust your memories or your perception of them.
  • Checking can happen in a few different ways. But in the case of sexual OCD, it often takes shape as checking your body for certain feelings, sensations, or urges. For example, when you see your friend who you dreamed about, you may do an intentional scan of your body to see if you are having feelings of arousal

OCD will try to convince you that compulsions make you feel better, but they only keep you stuck. Compulsions say to you, You’re right about your intrusive thoughts—they’re dangerous, and you need to take them seriously. I’m here to help. In other words, they reinforce the idea that intrusive thoughts are way more than meaningless ideas running through your head.

How can I get help in dealing with my sexual dreams?

The good news is that OCD has an effective, evidence-based treatment called exposure and response prevention (ERP) therapy, which teaches you how to face your fears and not engage in compulsions in a step-by-step method guided by a licensed therapist. 

You and your therapist will discuss the nature of your intrusive thoughts, what triggers them, and what compulsions you engage in. From there, you’ll collaborate to develop a plan for exposures. They will happen gradually, starting with those that bring low levels of anxiety, and working up to those that bring the most. Exposures are tailored to each person’s unique triggers, but here’s a few examples:

  • Writing out a worst-case scenario, such as, I actually want to hook up with my friend, then…
  • Watching a friends-to-lovers movie without comparing your situation to theirs.
  • Going to dinner with your friend, and not avoiding them.

Access therapy that’s designed for OCD

NOCD Therapists have helped thousands of people who struggled with OCD regain their lives. I encourage you to learn about accessing ERP therapy with NOCD.

Learn about ERP with NOCD

Exposures strategically bring an initial spike in anxiety that allows you to get used to the feeling, and be able to sit with it, with the guidance of your therapist. Over time, you realize that it’s not dangerous—that you can withstand the uncertainty and discomfort. Thus, intrusive thoughts cease to have as much power over you.

While you’ll still have intrusive thoughts from time to time—because it’s normal, and everyone does—you won’t feel the need to react to them. Trust me. I know how it feels to be distressed by dreams, but after putting the work into therapy and ERP, I now know how it feels to be indifferent towards them. That’s possible for you, too.

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