Understanding Sexual and Aggressive Obsessions in OCD

The Difference Between Fantasy and Reality

Man assaulting woman (blurred motion, cyan tone
Getty Images/Dennie Cody and Duangkamon Khattiya

Sexual and aggressive obsessions, such as molesting children, sexually assaulting strangers, or harming your children or partner, are among the most distressing forms of OCD obsessions. People experiencing these obsessions are often terrified to disclose them to health care providers—even trusted therapists or physicians—for fear of being diagnosed as psychotic and/or being abandoned by loved ones. And in some cases, the health care provider may be legally required to report your disclosure.

By definition, OCD obsessions are unwanted, intrusive, distressing thoughts that the affected person works very hard to push away, suppress or avoid.

Much research has demonstrated that the content of obsessions often relates to the very things that the person finds to be the most repugnant.

Thus, while a true pedophile, rapist, or sadist would become excited and aroused when fantasizing about (or worse, carrying out) the behaviors outlined above, someone with OCD who experiences sexual or aggressive obsessions would be mortified by such thoughts and, as a result, work very hard to suppress or push them away. They may even engage in rituals such as counting, washing, or prayers to “neutralize” such thoughts.

One mental glitch that can complicate everything for someone with OCD, and especially someone who is grappling with such thoughts, is something called thought action fusion. Thought action fusion causes many people with OCD to equate the occurrence of a thought with actually having carried out the behavior contained in the thought.

Some struggling with this may also believe that the presence of a distressing thought makes it more likely for them to engage in that particular behavior.

In reality, however, around 90 percent of the population reports having identical thoughts to those with OCD. As such, the simple presence of a thought is not nearly enough to label someone as a “good” or “bad” person.

Moreover, there is absolutely no evidence that simply having a thought pop into one’s mind makes it more likely that they will carry out the associated activity. In fact, in the case of people with OCD, it is usually the opposite that occurs, mostly because they are so vigilant against such behavior.

Finally, it may be helpful to keep in mind that the vast majority of mental health care providers are highly trained professionals. They are trained to be attuned to nuances in symptoms and understand the nature and underlying cause of seemingly bizarre symptoms.

Your therapist or physician will be in the best position to help you with your symptoms if they are aware of the full range of obsessive thoughts you are experiencing. A problem cannot be dealt with if it is not acknowledged. So if you are experiencing recurring thoughts that are sexual or aggressive in nature, please be open about them. This openness will give you the best chance at working through them.

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