Noticing a change or reaction in your groin area—such as a tingle or swelling—after an intrusive thought, image, or urge can naturally feel unsettling. After all, intrusive thoughts are not the same as other thoughts that cause arousal, because they are unwanted, unexpected, and often somewhat distressing or unpleasant. When they lead to physical sensations, it can leave you wondering: What’s really going on down there?
In the OCD community, a feeling of arousal that is unwanted and causes anxiety is called a “groinal response.” But how can you really know if the arousal you feel is a symptom of OCD, and if it is, what can you do about it?
What is a groinal response?
Groinal response is a feeling of arousal. It can include, but is not limited to: swelling, tingling, warmth, moisture, lubrication, tumescence (swelling or feeling of fullness), sensitivity to small movements, partial erection or full erection. A groinal response in OCD can present as an intrusive feeling, or as a result of an intrusive thought, urge or image.
As a clinician who has treated many patients with OCD, I have witnessed both the struggle and the coping mechanisms that people have resorted to in order to manage their groinal response.
Take Fatima, for example. In early childhood, Fatima’s OCD manifested as contamination fears and intrusive thoughts about harm, but around her 18th birthday a new symptom revealed itself. After breaking up with her boyfriend, Fatima began to notice intrusive sexual thoughts about her best friend, Jessica, and other women.
Fatima doesn’t believe she is gay and has never experienced any thoughts about being gay before, but suddenly feels very unsure and this causes distress. When she has intrusive thoughts about liking women or being attracted to females, she gets an unwanted feeling of arousal in her genitals. This leads to anxiety and affects her quality of life. Fatima notices that she doesn’t want to move around because movement triggers the arousal to feel stronger.
Instead, when the groinal response happens, Fatima sits down and distracts herself by putting in her headphones, looking on her phone, or staring at boys in her classroom whom she finds attractive. The more she avoids these situations, distracts herself, and redirects her attention, however, the more Fatima’s thoughts, doubts, and fears grow, and her attention returns to her physical responses again and again.
What does a groinal response reveal about you?
Many people, like Fatima, wonder if their groinal response is an indicator that their thoughts and feelings are real. In Fatima’s case, it led her to wonder if she was gay, even though she didn’t believe she was, and felt no further attraction towards her friend or any other women. For others who experience a groinal response to something distressing, like intrusive thoughts about children, they may wonder if they are pedophiles, causing intense fear and shame.
Rest assured, just like any intrusive thought that a person may have, a groinal response is not confirmation that their fear is real. Someone who has OCD and worries about being a pedophile may have a groinal response when they see a child. This can be very distressing. However, just as one can experience physical feelings of anxiety in response to an intrusive thought, the body can respond in other unexpected, unwanted ways like groinal responses, particularly when one’s attention is directed toward groinal sensations.
Why do groinal responses happen?
Anyone with OCD can experience a groinal response. But why does this arousal response happen in the first place?
It’s a phenomenon known as non-arousal concordance. Sometimes, our genital areas will respond to stimuli even though we don’t really find them sexually arousing—it’s a mismatch between our real desires and our body’s response.
Even though a groinal response can be distressing when it occurs due to an OCD fear, rest assured it is a normal physiological response. All bodies may experience this at one time or another, and a groinal response is not always an indicator of arousal. Just because someone with OCD is experiencing a groinal response does not mean that their thoughts are representative of a desire or fantasy.
Does “groinal response” refer to any physical sensation related to arousal?
Groinal response refers to a feeling of arousal in the genital region. However, a person may feel unwanted or distressing arousal in other parts of their body as well, like an elevated heart rate or blushing.
When a person with OCD experiences a groinal response or any other unwanted physical sensation that they associate with arousal, they often feel disgusted, ashamed, and afraid of what it may mean. People make the mistake of thinking that groinal responses only happen due to sexual desire—as you might imagine, it can be quite disturbing for a mother to experience a groinal response when her 10 year old son walks in the room, or a teacher gets this feeling when he looks at his first grade student.
However, there are many other causes that can contribute to these sensations. It’s important to recognize that these responses do not only happen when a person is sexually aroused. Groinal response can happen when one is in a heightened state of anxiety, feeling joy, feeling pain, or excitement. We call these high arousal emotions.
Can people of any gender or sex experience groinal responses?
People of any gender, sex, or age can experience groinal responses. A person with OCD who experiences groinal responses may engage in the following compulsions in order to reduce their distress:
- Seeking reassurance from friends and family
- Searching online to see if groinal responses are normal
- Testing their groin response by picturing intrusive images and thoughts
- Adjusting the way they sit
- Walking a certain way
- Adjusting the way their clothes fit or wearing baggier clothes
- Avoiding public places or groups of people
What is the best way to respond to an unwanted groinal response?
Groinal Response as a symptom of OCD can be treated with a particular form of therapy called exposure and response prevention (ERP) therapy. This evidence-based treatment has been shown to be instrumental in treating all forms of OCD. Most individuals who do ERP with a trained therapist experience a decrease in symptoms, reduced anxiety and distress, and increased confidence in their ability to face their fears and live with uncertainty and doubt. In ERP, people will work with their therapist to build an exposure hierarchy and intentionally face the situations that trigger their obsessions in order to sit with the distress they feel.
When doing exposures, the goal is always response prevention: your therapist will guide you in resisting the urge to respond to anxiety and other sensations like groinal responses by doing compulsions or avoiding triggers. Over time, this allows you to tolerate anxiety without relying on compulsions or avoidance to feel better.
One method of effectively resisting compulsions is by using what we call response prevention messages. Some response prevention messages used to deal with a groinal response may look like this:
- “Who knows if I’ll have this aroused feeling at an inappropriate time. I guess I’ll never know.”
- “This feeling may or may not mean I’m ___________.”
- “I may or may not be a monster because I am feeling this way.”
- “You might be right, OCD. I will never be able to control this arousal feeling. Oh well!”
When a person responds to an unwanted groinal response with these messages instead of engaging in compulsions, the OCD cycle will start to break down. Initially, one’s distress may feel worse, but over time and with practice they will become better able to sit with the distress they feel when groinal responses occur, and they can live without relying on constant compulsions or avoiding important parts of their life.
If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.
We look forward to working with you.
