Types of Obsessions
Sexual Thoughts in OCD
Sexuality Concerns in Obsessive-Compulsive Disorder (OCD)
Many people with obsessive-compulsive disorder (OCD) have sexual obsessions, or unwanted sexual thoughts. This may include sexual orientation fears, which is sometimes referred to as sexual orientation OCD (SO-OCD) or HOCD. Theses are not the same as fantasies or being homophobic.
Sexual thoughts in OCD may include the following:
- the obsessive fear of being or becoming LGBTQ
- intrusive, unwanted mental images of upsetting sexual behaviors
- the fear that one may become a pedophile
- the fear of becoming sexually aggressive
If you have unwanted sexual thoughts, please complete our online survey so that we can learn more about this issue.
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The Worst Kind of OCD
Although people with OCD may obsess over any number of concerns, one of the most upsetting types of OCD involves worries about causing sexual harm to a child, sometimes called pedophile OCD or POCD. Although this type of OCD typically receives little attention from the media, the Power to Change recently aired the story of a man whose POCD was so severe he contemplated suicide before he was treated by Dr. Monnica Williams. Hear his story online and learn about OCD treatments from Dr. L. Kevin Chapman. Read his story or watch it now.
OCD Therapy Going Nowhere?
Although any medical doctor can take your blood pressure, only a few can do heart surgery. Likewise, any therapist can help someone who is feeling a bit blue, but only a few can effectively treat OCD. OCD treatment is a type of therapy that requires a specialized protocol called Exposure and Ritual Prevention (ERP or EX/RP). Learn about the Top Mistakes Made by OCD Therapists.
Top Seven Myths About OCD
One stereotype is that people with OCD are neat and tidy to a fault. Actually, nothing could be further from the truth. Although many people with OCD wash because they are concerned about dirt and germs, being tidy is actually not a typical symptom of the disorder. Almost two-thirds of people with OCD are also hoarders... Learn more about the Top Myths about OCD.
Take The OCD Self Test
The OCI-R is a short, reliable, scientific test of common obsessive-compulsive symptoms. This measure was developed by OCD experts. Take our OCD Self Test.
Religious Obsessions in OCD
by Ghazel Tellawi
Obsessive-compulsive disorder (OCD) is considered a type of anxiety disorder that involves recurring, unwanted obsessions and repetitive compulsions. Obsessions are intrusive thoughts that cause severe distress, despite the fact that the individual realizes that the obsessions represent exaggerated fears that are not likely to occur. These obsessions are worries that reach beyond anxiety about everyday problems. So upsetting are the obsessions that the individual attempts to counteract them with a specific behavior or neutralizing thought called a compulsion. The individual feels as though their compulsions must be performed in response to the obsessions. Compulsions are implemented strictly to reduce anxiety or prevent a feared outcome.
Religious OCD Subtype
Religious thoughts can become intrusive and become distressing in individuals with OCD. These thoughts can involve intrusive religious blasphemous thoughts, compulsive prayer, hypermorality, unwarranted concern about committing a sin, and cleaning/washing rituals (Himle, Chatters, Taylor & Nguyen, 2001). These thoughts sometimes become problematic, and are referred to as "scrupulosity." Scrupulosity describes the relationship between religiosity and the symptoms of OCD, and individuals with these obsessions often focus on certain details of their religion while ignoring others. A measure called the Penn Inventory of Scrupulosity (PIOS), identifies the fear of sin and the fear of God as the two domains of scrupulosity (Olatunji, Abramowitz, Williams, Connolly, & Lohr, 2007).
Foa & Kozak (1995) found that scrupulous obsessions in OCD were ranked as the fifth most common obsession, with 6% of participants endorsing it as their primary obsession. Additionally, it has been estimated that religious obsessions occur in 25% of individuals with OCD (Antony, Dowie, and Swinson, 1998). One study showed that OCD symptoms presentation can be influenced by one's religion and culture (Sica, Novara, Sanavio, Dorz & Coradeschi, 2002). Abramowitz, Deacon, Woods, & Tolin (2004) highlighted this point by finding that Protestant individuals with high levels of religiosity had the highest severity of OCD symptoms.
Individuals with scrupulous obsessions may have anxiety related to their religion, sinning, and guilt, which can cause religious practices and rituals to become compulsive (Deacon & Nelson, 2008; Gonsalvez et al., 2009). Also, these individuals are often more religious and more likely to seek out religious counseling and less likely to receive medical treatment (Siev, Baer, & Minichiello, 2011). They also found that a negative concept of God was associated with higher symptom severity, and that one in five did not subscribe to a particular religious affiliation. In line with the negative God concept, those that believe that their God is punitive will likely engage in more severe compulsions to make up for minor sins, even though the clergy is aware that their sins are minor and do not need compulsive actions (Gonsalvez et al., 2010). In addition, 20% stated that their OCD symptoms help them in observing their religion.
While it may be easy to assume that people with these types of worries are from very religious or strict traditions, these worries can strike the very orthodox, non-religious people, or even atheists. Scrupulosity should not be confused with being obsessed with religion or being very devout. People with this type of OCD do not feel more spiritual or fulfilled by performance of OCD-related rituals, which may include repeating prayers, seeking reassurance, or mental rituals.
Treatment for Religious-Themed OCD
Elliott and Radomsky (2008) suggest that through collaboration with clergy counselors and members of the religious community, psychologists could provide adequate support for individuals suffering from scrupulous obsessions. Religious leaders can determine within their doctrine which rituals are extreme and which are appropriate, and they may be able to offer guidance and treatment. Additionally, highly religious individuals often consult their religious leaders rather than clinicians for help (Miller et al., 2008), so providing OCD education and specialized treatment trainings in religious settings could be beneficial to bringing therapies that have been shown to be effective to more people suffering from these obsessions.
- Receiving extra change from a cashier
- Accidentally omitting any loved ones from their prayers.
- Concerns with sacrilege or blasphemy:
- For example, someone might worry that they have inadvertently offended God or even accidentally worshiped the devil.
- Excess concern with right/wrong, morality:
- For example, someone may worry about always doing the morally right thing, in every circumstance.
- Performing a religious task or ritual in the wrong way
- Having committed a sin
- Behaving morally
- Going to hell
- A loss of impulse control
Abramowitz, J. S., Deacon, B. J., Woods, C. M., & Tolin, D. F. (2004). Association between Protestant religiosity and obsessive-compulsive symptoms and cognitions. Depression and Anxiety, 20, 70-76.
Antony, M. M., Downie, F., & Swinson, R. P. (1998). Diagnostic issues and epidemiology in obsessive–compulsive disorder. In R. P. Swinson, M. M. Antony, S. S. Rachman, M. A. Richter, R. P. Swinson, M. M. Antony, M. A. Richter (Eds.), Obsessive-compulsive disorder: Theory, research, and treatment (pp. 3-32). New York, NY: The Guilford Press.
Deacon, B. & Nelson, E. A. (2008). On the Nature and Treatment of Scrupulosity. Pragmatic Case Studies in Psychotherapy, 4(2), 39-53.
Elliott, C., & Radomsky, A. (2008). Blasphemous obsessions in obsessive-compulsive disorder (OCD): Collision or cooperation between psychology and spirituality? Counselling and Spirituality/Counseling et spiritualité, 27(1), 51-69.
Foa, E. B., & Kozak, M. J. (1995). DSM IV field-trial: Obsessive compulsive disorder. American Journal of Psychiatry, 152, 90-96.
Himle, J. A., Chatters, L. M., Taylor, R. J., & Nguyen, A. (2011). The relationship between obsessive-compulsive disorder and religious faith: Clinical characteristics and implications for treatment. Psychology of Religion and Spirituality, 3(4), 241-258.
Miller, C. H., & Hedges, D. W. (2008). Scrupulosity disorder: An overview and introductory analysis. Journal of Anxiety Disorders, 22, 1042-1058.
Olatunji, B. O., Abramowitz, J. S., Williams, N. L., Connolly, K. M., & Lohr, J. M. (2007). Scrupulosity and obsessive-compulsive symptoms: Confirmatory factor analysis and validity of the Penn Inventory of Scrupulosity. Journal of Anxiety Disorders, 21, 771-787.
Sharma, D. D., Kumar, R., & Sharma, R. C. (2006). Starvation in obsessive-compulsive disorder due to scrupulosity. Indian Journal of Psychiatry, 48, 265-266.
Sica, C., Novara, C., & Sanavio, E. (2002). Religiousness and obsessive-compulsive cognitions and symptoms in an Italian population. Behaviour Research and Therapy, 40, 813-823.
Siev, J., Baer, J., & Minichiello, W. E. (2011). Obsessive-compulsive disorder with predominantly scrupulous symptoms: Clinical and religious characteristics. Journal of Clinical Psychology, 67(12), 1188-1196.