Sexual obsessions and OCD - WATSA

1 ,Montclair,NJ07043,USAS exualandRelationshipTherapy^ , ,2002 BrunnerRoutledge^heSths'denttsABSTRACTS exualobsessionsarecommon symptoms of obsessive-compulsive disorder(OCD).Theliteralcontentofthese obsessions superficially resembles other typesofiterativesexualideation,as seenin theparaphUias,PTSD, ,theirform,function,andeffect different the contentandform ofsexualobsessions,clarifysalientdiffere nces betweensexualobsessionsandotherrepetitiv esexualthoughts,andfinallydiscuss waysoftreatingsexualobsessions whenth^ ,anotherpresentinggroupworrymoreaboutthe irsexualthoughts, ,whoexpressconcemabouttheirsexualideatio n, ,perverse, ,werefertoit ,impairedconcentration,lowself-esteem, ,comparesexualobsessionswithotherrepetit ivesexualideation, ,persistent,unwantedthoughtsorimagesthat causepersonaldistressandand/orinterferew ithfunctioning(APA,1994). (Wegner,1994). ,aggression,illnessandsex, ,224 LorraineAvenue,Montclair,NJ07043, ;italsooccursintheparaphiliasjpost-traum aticstressdisorder(PTSD), ,feelingsandimagesin alloftheaboveconditionsaresometimesloose lyreferredtoas' sexualobsessions '.

2 Yettheircontent, , (Kinseyetal.,1948) , ; ' ( )ormoraljudgments( 'saslutorI'maqueer).Theyinducehi^ ^somesexualfantasiesalsoinduceguiltanddi stress(Leitenberg&Henning,1995),suchfant asiesarefarlessfrequent, ,intrusive, ;obsessionsinOCDrepresentfictitious, , , , ,theafflictedindividualmaypanicandfearlo singone' ' ,ahistoryofchildhoodsexualabusehaspreced edtheonsetofbothOCDandPTSD(Freeman&Leona rd,2000).Inthesecases, , , , ,forexample,someonewithrepetitivesexualt houghtssymptomaticofOCDislikelytoshowoth ernon-sexualsymptomsofOCDaswell, (Goodmanetalj1989) , ,consultationshouldbesought, ,patienteducation, (ERP)providesthecritical, ,deviant,weak, , ,patientsshouldleamtoadoptadispassionate , ,however, atypeofdyadicOCDinwhichthepatientobsesse s,labelsit asOCD,doubtsthelabel,andthenengagesinrea ssuranceseeking(thecompulsion) ,temporarilyallaysthepatient'sanxiety, ,'DoI reallyhaveOCDoramI apervert?'.Therapistsneedto ,thetherapistshouldreplythatthegoaloftre atmentislearninghowtocopewithobsessions ^ ,open, ' 'sshame(Newth&Rachman,2001).

3 , (OCPD). (Alsobrooketal.^1999),definitivepsychoso cialcausesbeyondgeneralstressarenotimpli catedin ,it ,focusesontheliteralcontentoftheobsessio n,becomesincreasinglyconfused,andthensta rtstoobsessaboutpastissuesas well :pharmacotherapyandcognitive-behavioralt herapy(Marchetaiy1997). , , , ,multiplesexualobsessions, , , achildsheoverheardherparentshavinginterc ourseonnumerousoccasions,becausetheylive din , , ,atasweetsixteenparty, , ,shenoticed'vaginalsensations', , , "likeasixthfinger". ; ,however, ,sheblurredalldistinctionsbetweensexuali deation, , ,alongwiththemonitoringofherthoughtsforl esbianideationwhenactuallyaroused, , 'vaginalsensations', , ,Leckman, ,Goodman, ,Rasmussen,S. &Pauls, ,(1999). ,88, (1994).Diagnosticandstatisticalmanualofm entaldisorders(DSM-IV).Washington, ,L.(2001).The imp of , ,Goodman, , (1999). ,60, , , (2000). ,39, ,R.,Ladoceur,F.,Gagnon,N.,Thibodeau,J.,R heaume,H.,Letarte, ,A.(1997).Cognitive-behaviouraltreatment ofobsessivethou^ ,65, , ,R.(2001).

4 , ,Price, ,Rasmussen, ,C.(1989).TheYale-Brownobsessivecompulsi vescale(Y-BOCS):developmentuse, ,46, , ,POMEROY, , (1948).Sexualbehaviorin , , ,Uebowitz, , (2000).