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Intrusive Thoughts During Sex—Is it OCD?

8 min read
Cody Abramson

By Cody Abramson

Reviewed by Patrick McGrath, PhD

Nov 8, 2023

Obsessions are intrusive  thoughts, images, or urges that are involuntary, unpleasant, and misaligned with one’s genuine beliefs or desires. 

While they can occur anytime, they often pop up when you least want them to. One of the more common and stressful moments in which intrusive thoughts can occur is during sexual encounters. While they can be about anything, intrusive thoughts during sex often focus on concerns about one’s sexual partner or sexual arousal. For example, one might have intrusive thoughts about incest or sexual aggression. 

Intrusive thoughts during sex might seem so unusual that they are interpreted as a sign of obsessive-compulsive disorder (OCD) or another mental health condition. But is that right? And if not, when are intrusive thoughts during sex a sign of something serious? To find answers to these questions, we spoke to Dr. Mia Nuñez, Regional Clinical Director here at NOCD. 

Is it normal to have intrusive thoughts during sex?

“It is absolutely a normal human experience,” shares Dr. Nuñez. “People without OCD have intrusive thoughts, and they occur in all aspects of life.” 

This might come as a bit of a surprise, but that’s probably because intrusive thoughts during sex may be thought of as taboo or disturbing, so people may be reluctant to admit having them. For example, one study found individuals with OCD are more hesitant to reveal that they have sexual intrusive thoughts than other types of obsessions, like ones about contamination, because of the associated stigma. Another found that 25 percent of college students reported feelings of guilt or shame about experiencing a sexual fantasy during sex

This shows not only how common intrusive thoughts during sex are, but that they are connected to emotions that are likely to prevent people from talking about them, which may explain why they seem less prevalent or common than they actually are. 

What causes intrusive thoughts during sex

Though intrusive thoughts seem to pop up out of nowhere, there are some general explanations for why they occur.

First, it’s worth pointing out what they are not caused by. Specifically, intrusive thoughts during sex don’t occur because the person having them is aroused by them. “People will misattribute the source of their thoughts,” says Dr. Nuñez. “You see this a lot with pedophilia themes of OCD. They may think, ‘I’m aroused and thinking of children now. That must mean I’m a pedophile.’ Instead, it actually goes more like this in their brain: ‘I’m aroused. I better not think about children. Oh no, I’m thinking about children.’” 

As Dr. Nuñez highlights in the quote above, believing that you shouldn’t have a thought is one of the most reliable ways of making sure you think it. For example, if I told you not to think about a pink elephant, that’s probably going to be the next thought that pops into your mind. Moreover, the harder you try not to think about the pink elephant, the more you will.

People will misattribute the source of their thoughts. They may think, “I’m aroused and thinking of children now. That must mean I’m a pedophile.” Instead, it actually goes more like this: “I’m aroused. I better not think about children. Oh no, I’m thinking about children.”

Dr. Mia Nuñez, PhD

When you combine the “pink elephant effect” with the fact that sexual obsessions or intrusive thoughts during sex are heavily stigmatized, meaning people generally feel they shouldn’t be having them and experience feelings of shame and guilt if they do, so it’s no surprise that they’re so common. 

Dr. Nuñez notes that attentional biases might also trigger intrusive thoughts during sex when we are anxious or stressed. “When we are acutely anxious, we are going to notice and attend to the things that cause us anxiety,” she shares. “If you are somebody who’s been avoiding sex because of your OCD, and you experience anxiety whenever you have sex, your  mind will be primed to notice, or even look for, and attend to any distressing thoughts during sex.” 

Do intrusive thoughts during sex mean something?

Part of what makes intrusive thoughts or experiences during sex cause as much anxiety as they do is an underlying worry that they reveal something significant about oneself or show that one has some morally unacceptable urge or desire. For example, if you were to have a sexual intrusive image of a relative, you’d likely be very upset if you thought that it was a real sign of sexual desire.

Dr. Nuñez is quick to highlight that these experiences are not evidence that you want or are aroused by what they represent. As she notes above, they don’t happen because you are aroused by the thoughts you are having. Instead, they say more about what you think would be wrong to experience or desire during a sexual encounter.

Again, this goes back to the “pink elephant” effect. Because thinking you shouldn’t have a thought makes it more likely to happen, the intrusive thoughts you have during sex can reflect your beliefs about what you shouldn’t feel or experience during sex. Also, as intrusive thoughts are a normal experience that even people without OCD experience, sometimes odd or off-putting thoughts just happen to occur during sex. 

Do these thoughts sound familiar? Learn how you can overcome them.

Here at NOCD, we understand firsthand how distressing intrusive thoughts can be—especially when they come at worst times, like during sex. But you’re not on your own, and you can speak with qualified professionals who can help you learn to take the power away from intrusive thoughts.

Learn more

Could it be OCD?

OCD is a mental health condition characterized by two main symptoms: obsessions and compulsions. Obsessions are intrusive thoughts, images, or urges that occur involuntarily and give rise to negative emotions like anxiety, shame, or guilt. Compulsions are physical or mental actions performed in response to obsessions in an attempt to alleviate distress or prevent a negative outcome. 

While intrusive thoughts during sex are normal, they may also be a sign of OCD. Here’s what to look out for in order to determine if your thoughts may be a sign of OCD:

#1 Do you worry that they are significant?

Individuals with OCD feel that their obsessions are significant, regardless of the theme. If you attach a lot of meaning to your sexual intrusive thoughts or spend a lot of time trying to understand what they might mean, OCD could be the culprit.  

#2 Do they cause a significant amount of distress?

Most people who have intrusive thoughts aren’t all that bothered by them. If the intrusive thoughts you’re having during sex are causing you significant distress or anxiety, they might be a symptom of OCD.

#3 Do you engage in compulsions?

As noted above, compulsions are one of the hallmark features of OCD. If you engage urgently in mental or physical actions in an attempt to reduce your anxiety or distress after experiencing an intrusive thought during sex, OCD is likely behind it. 

#4 Can you brush them off easily?

Typically, people can shrug off the intrusive thoughts they have during sex. People with OCD have a much harder time doing this. For them, these intrusive thoughts demand much more attention and are far more challenging to move on from. 

#5 Do you avoid triggers, like sexual encounters?

As common as intrusive thoughts during sex may be, they usually don’t get in the way of one’s sexual activities. Generally, people continue to have sex as much as they otherwise would have. So, if you find yourself avoiding sex altogether or stopping during sexual encounters on account of intrusive thoughts, they’re likely a sign of something else, like OCD. 

Is it possible to stop having intrusive thoughts during sex?

As with all intrusive thoughts, it’s not possible to avoid them entirely and forever. In fact, the harder you try to force them away, the more frequently they will come. However, as Dr. Nuñez notes, “with successful treatment, you can expect that the thoughts will be much less distressing, and you won’t have to engage in compulsions or avoidance in response to them. There is a good chance that they will also decrease  in frequency.” 

Access therapy that’s designed for OCD

Specialists have used ERP for decades to help thousands of people who struggled with sexual OCD themes regain their lives. I encourage you to learn about accessing ERP therapy with NOCD.

Learn about ERP with NOCD

What’s the best way to respond to intrusive thoughts during sex?

Though there’s no way to guarantee you’ll never have another intrusive thought during sex, you can respond to them in different ways so that they impact you less.

#1: Remember that many people have them

Intrusive thoughts during sex can make you feel worse if you believe you’re alone or unusual for having them. Educating yourself (by reading this article!) about how frequently people experience them can help relieve stigma and feelings of shame.

#2: Allow them to be present

Because of the “pink elephant” effect, fighting against your intrusive thoughts during sex will only make it more likely that they stick around. Instead, simply let them exist and pass on their own. 

#3: Continue as usual

As counterintuitive as it may seem, Dr. Nuñez advises that if you experience an intrusive thought during sex, you should “keep going” in whatever situation you’re in.

As with all intrusive thoughts, it’s best not to let them interfere with the way you live your life. So if they occur while you’re having sex, carry on as usual. This helps to show your brain that these intrusive thoughts don’t actually pose any danger or hold any significance, which means that they’ll be less likely to pop up in the future. 

#4: Don’t try to neutralize them

Because intrusive thoughts during sex can be so unpleasant, you might be tempted to engage in a compulsion in an attempt to “neutralize” them. While this may provide short-term relief, it will only reinforce the OCD cycle and make your intrusive thoughts more powerful in the long run. 

NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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