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Working With Sexual Intrusive Thoughts in OCD

This worksheet explains how sexual intrusive thoughts are a common—but distressing—symptom of obsessive compulsive disorder. Practical prompts help users identify thought patterns, normalize the experience, and practice mindfulness and response prevention to reduce shame and mental rituals.

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by Insight Timer

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How to Use This Worksheet

Begin by reading the introductory content that explains intrusive sexual thoughts as symptoms of OCD, not reflections of identity or intent. Work through each common scenario included—such as doubts about identity, graphic thoughts, or fears of acting—using the prompted reflection and “self-strategy” boxes.

Who This Worksheet Is For

This worksheet is for individuals experiencing sexual intrusive thoughts or obsessions, especially those who find these symptoms distressing or shameful, and for therapists or loved ones supporting someone with sexual OCD symptoms.

Expected Outcomes

  • Increased ability to recognize and normalize sexual intrusive thoughts
  • Improved skill in identifying, interrupting, and reducing mental compulsions and avoidance
  • Greater tolerance for uncertainty and distress using ERP and mindfulness strategies
  • Stronger foundation for self-compassion and readiness to seek effective therapy

References

Williams, M. T., Crozier, M., & Powers, M. (2010). Treatment of sexual-orientation obsessions in obsessive-compulsive disorder using exposure and ritual prevention. Clinical Case Studies, 9(5), 337-353. https://pmc.ncbi.nlm.nih.gov/articles/PMC3230880/

 

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