Talking OCD & Sexuality with Dr. Jan Weiner

Read the full transcript below:

1) How can OCD affect someone’s sexuality?

OCD affects things that are emotionally relevant to people. Sexuality is often important to people, which is why OCD can grab hold of it in numerous ways.

One way is sexual orientation OCD, or HOCD, which is when a person fears that they’re homosexual, or if they’re homosexual they fear that they’re heterosexual. It makes people doubt whatever sexual orientation they are. Another form, is Relationship OCD, or ROCD, which is when a person doubts their attraction or love for their partner. And finally, Pedophile OCD, or POCD, is when people fear being around children out of concerns that they’ll hurt them.

All of these are centered around the theme of sexuality and what one is either going to turn into, or what they're capable of. They also all tend to have features of perfectionism within them. Oftentimes people believe that they have control over their brain’s thinking. When their brain produces a thought that they're not in agreement with — like "what if I might be gay" — the brain seizes that thought and attaches a fear statement to it. It then becomes a topic of the OCD. For example, worrying that you’re gay and that you could harm a child.

2) What are some potential day-to-day challenges?

With sexual orientation OCD, people often spend their days questioning things like: am I ruining my partner’s life? Am I pretending to be a good spouse or pretending I want kids when I really want to be off with another person? Should I break up with them now? All of these are troubling for the individual themselves in that they don’t know what value system to ascribe to — I don’t want to be homosexual, but what if I am? That kind of daily confusion.

Pedophile OCD can damage relationships or cause avoidance with a person’s own children. A sufferer may start asking their spouse to change the diapers. They may ask their spouse to never leave the room when they’re playing with the kids, or they may avoid their child and other children altogether.

So what happens is a large scale avoidance of the fear stimuli (i.e. children or a partner). They become the central topic piece of a person’s OCD.

3) How do intrusive thoughts affect intimacy with partners?

A lot of sufferers who experience intrusive thoughts while having sex may end up avoiding sex with their partner. They’ll find excuses to not have sex, which over time can whittle away at the intimacy of a relationship. Most of the time, you should encourage physical intimacy despite having intrusive thoughts. Instead, focus on learning to push past them instead of allowing them to harm your relationship. Avoidance can be very hurtful to a spouse. They may not understand why the intimacy is gone, or why they're being avoided. And intimacy is a central part of a healthy relationship.

4) What is an example of an intrusive thought one might experience during sex?

An example of an OCD thought that may take somebody out of the moment, is a girlfriend thinking about sleeping with her boyfriend’s best friend, or a man thinking about his best friend swapping places with his girlfriend. These thoughts often make a person suddenly stop having sex.

I have a client who every time she goes to have sex, she thinks of a family member. That image is very scary to her, and so she avoids dating or having any type of sexual relations with a man. This can also occur during masturbation. For some, their intrusive thoughts focus on children. It can really be anything that a person doesn’t want to see — a child, a person of the same or opposite sex, a parent, a friend.

5) What should you do when you experience intrusive thoughts during sex?

If you experience an intrusive thought while having sex, continue the course. Try to stay in it as much as possible and allow the thought to be there. Be mindful and accepting of your intrusive thought. It may take you out of the moment for a second or a couple of minutes, or you may not feel 100 percent connected to your partner, but that's ok. Not everyone is connected throughout the entirety of sex, even people who don’t suffer from OCD. It’s common for minds to wander. It’s a faulty assumption that when you’re having sex, you’re always in the moment. The more you can accept the thoughts going in and out, the easier it will become to filter them.  

For more videos from our OCD3 series, head to our YouTube channel here.