Sex. Most of us associate the word with enjoyment, excitement, and even exploration. It is a time when we can get lost in passion and pleasure, forgetting much of the outside world. But imagine if you were constantly bombarded with self-doubt and anxiety surrounding sexual preference and performance – then the bedroom is the last place you’d want to be. Sex would be a source of worry and fear leading to discomfort and avoidance. Sexual obsessions are one of many ways that obsessive-compulsive disorder (OCD) can present itself.
OCD afflicts between two and four percent of the American population and its symptoms can be unrelenting and incapacitating. Due to its disruptive and persistent nature, the World Health Organization has recognized OCD as one of the most disabling illnesses worldwide. OCD includes repeated thoughts, images, or impulses (obsessions) that cause a great deal of distress. In other words, the worries just keep coming. In an attempt to reduce the distress caused by the obsessions, an individual engages in behaviors or mental responses (compulsions) over and over. While obsessions can appear in different forms, those including disturbing sexual content may be especially damaging to a person’s sexuality and relationships.
“I suddenly had a thought that I may not be turned on by my partner,” says a 29 year old male with OCD. “I questioned my attraction to her, and then suddenly, I was telling myself, ‘you can’t get it up,’ over and over again.” Unfortunately, the “monster,” as he calls his OCD, did not stop. OCD relentlessly chipped away at his virility, leading him to worry and question aspects of his sexuality that he had never questioned before.
Everyone has fleeting thoughts, some of which are more disturbing and upsetting than others, but they are able to flow through the mind as simply thoughts, and do not consume notable amounts of time. The obsessions and compulsions associated with OCD are extraordinarily distracting and impair daily functioning. The above patient continued, “I had a constant tape recorder of thoughts. It didn’t matter what I was doing – tying my shoes, opening doors – I was constantly worried that I could not perform with women. Sometimes God would give me a five-minute break from the thoughts, but at its worst, they were nearly every minute.” As a result, he did not want to be around anyone for fear that he would be aroused by men and turned off by women. His anxieties led to performing compulsions, which included frequently checking himself for arousal and mentally revisiting each of his sexual partners. “I tried to avoid women and sexual situations, but it only made things worse.”
The upsetting nature of OCD may cause an individual to avoid the thoughts and situations related to the anxieties. While it may be natural to not want to expose oneself to negative or disturbing subjects, research supports the observation that the avoidance can make OCD thrive.
The detriment caused by OCD can be wide spread through its impact on close relationships. The wife of the patient above describes some challenges she faces with her husband’s OCD. “While engaging in intimacy, I try to just embrace the moment, but sometimes you can’t help but wonder what is going through his head.” She notes that OCD affects communication and interactions between them not just physically, but also emotionally. Understandably, when her husband is hurting she hurts, and at times she feels helpless. “For my husband, it is an all day experience, and I feel awful that there's nothing I can do to stop the pain and suffering.” She has found some benefits, however, in working collaboratively with her husband and his therapist, learning about the disorder and how to not enable it further.
If you or a loved one has OCD, it can be a scary and intense struggle. Reading about OCD may ease some of the fear and shame surrounding the disorder, as a greater understanding may help couples and individuals cope with many of the daily challenges posed by OCD.
For the treatment and management of OCD, therapy has proven effective through the use of exposure and ritual prevention. While most therapy is at an individual level, between the patient and a therapist, a partner can be helpful by showing support and encouragement for participation in therapy. It may also be beneficial for a partner to participate in therapy as needed, and couples therapy can be part of this.
Additional support and resources can also be found in support groups, through online communities, or your local chapter of the International OCD Foundation.
If you are married and either you or your spouse has OCD then consider participating in an online study to help researchers better understand this issue. For more information and to participate, please click here.
By Jen Viscusi & Monnica Williams