Sex

My OCD Makes Me Anxious About Being Dirty. Here's How I Have Sex

“Maybe it doesn’t matter if my underwear touches the couch. Maybe something bad will happen, or maybe not. I’ll deal with that later.”
September 14, 2020, 1:42pm
My OCD Makes Me Feel Freaked Out About Cleanliness. Here's How I Have Sex: illustration of two people in bed
Illustration by Cathryn Virginia
A series about sex and stigma.

People often throw the phrase "obsessive-compulsive disorder" (OCD) around as jokey shorthand for being excessively particular or high-strung, casting the disorder as a sort of innocuous, yet desexualizing, set of anxieties.

But OCD isn’t a quirk. It's a mental health condition that more than 2 percent of people experience at some point. It takes the random thoughts that flash through people's heads—that irrational fear of having done something wrong, or an unbidden, bizarre fantasy—and, instead of allowing them to quickly fade, forces them to the forefront of their minds in distressing spirals. Because these obsessions don’t respond well to reason, people with OCD develop rituals in an attempt to bring themselves relief from those anxieties. But that relief is fleeting, and people get stuck in this cycle of obsession and ritual. Many become dependent on a growing list of compulsions, which can become their own sources of anxiety and shame.

Although many people with OCD develop similar obsessions and rituals (concerns about contamination or harming one’s self or others seem to be especially common) everyone’s experience of the disorder is unique in its severity, contextual complexities, and ebbs and flows in their lives.

OCD often does negatively affect people’s sex lives. The anxiety and depression it breeds, or the medications used to treat it, can limit libido. Lengthy rituals and constant obsessions can rob people of time for intimacy, or take them out of the moment. Embarrassment and shame can lead people to hide their condition, obsessions, and rituals from their partners, creating tension and confusion.

Obsessions and rituals can bleed directly into sex, as well. People with contamination obsessions often talk about fixating on the perceived dirtiness of genitals or bodily fluids and putting up hard limits on how they have sex. By some estimates, at least one in 10 people with OCD will also at some point develop obsessions about sex, constantly questioning their sexualities or worrying they might be developing harmful urges and building rituals into their relationships, their masturbation habits, their engagement with porn, to test or reassure themselves about their desires. Fears of being misunderstood—or actually dangerous—force some people with sexual obsessions to avoid intimacy altogether. Often, current or potential romantic partners who face the realities of OCD write those with the condition off as just too much.

Most people with OCD can develop satisfying sex lives and strong relationships. Established treatments can help them to decrease the power of their obsessions and talk about their conditions with partners. Doctors are also increasingly aware of and able to help patients navigate the sexual side effects of OCD medications.

Over the past decade especially, people with OCD have started publicly sharing stories of the ways the disorder has manifested in their sex lives. However, several individuals VICE spoke to said there is still relatively little information out there about how the partners of people with OCD should interact with obsessions and rituals and support people in treatment.

VICE spoke to Petra, who has severe OCD, and her neurotypical partner, Quinn, about their experiences with the condition as it relates to their sex lives. (Their names have been changed to protect their privacy.)

This interview has been edited for length and clarity.


Petra: When I was in college, I was living alone for the first time and there was time for my mind to dwell on things. I suddenly developed religious-based scrupulosity obsessions [informed by my Mormon upbringing and faith]. I became worried about things like, Am I allowed to burn CDs? I threw out all of my burned CDs and bought new copies. I didn’t date many people in college because I didn’t believe people would want to be in a relationship with me. After [my obsessions] started developing, I dated one guy, and I remember always feeling so guilty, like: Did we cross a line? Do I have to tell my church leader about this?

Quinn: They were just doing things like kissing.

Petra: Yeah, or taking naps on his bed. In Mormonism, we were not allowed to be in another person’s room of the opposite sex. Those obsessions put a damper on the relationship.

My mom’s a nurse, so I called her to ask what was going on with me. She’d say, “Snap out of it. Pray more. These things don’t matter.” It was hard. Eventually, I went to my college’s medical center and they diagnosed me, but they didn’t explain anything about OCD. They just put me on some [SSRI] pills and were like, “OK, go live your life.” My obsessions weren’t too bad after that.

I met Quinn around then. We were long-distance for the first three years of our relationship, which helped me move into a physical relationship. We knew each other so well by then that I wasn’t hyper concerned about what he’d think of me. But we didn’t have sex before marriage.

Quinn: Petra never told me she had OCD. She said, “I have anxiety, and I take medicine for it.”

Petra: I’d actually forgotten that they had diagnosed me with OCD.

Quinn: I’d had a short relationship before I met Petra with this girl who had mental health issues. I wasn’t prepared for that. My mom also has severe bipolar disorder, so I knew how hard that is. I remember thinking, I’m never going to date another girl who has a mental health problem after this—that was too much. I’d heard from some mutual friends about Petra’s “quirks,” how she was obsessed with perfectly following rules. So, when she said she had anxiety, I was like, Oh, no—do I want to go into a relationship with someone who has this issue? It sounds awful, but I was weighing if I could handle it. But she was charming and nice, so I decided it was worth it.

I didn’t know anything about OCD, except that I’d dated a woman in college whose mom had it and she washed her hands a lot to the point that they were raw. So, if she had said that she had OCD, I don’t think I’d have known enough to assign any more stigma to it than I did to anxiety.

Petra: After we got married, my OCD didn’t really affect sex at first. Quinn wasn’t an active Mormon and he’d had a previous sexual relationship. I did worry that maybe he was judging me and I wasn’t as good—not that we talked about that very much. Those thoughts may or may not have been related to my OCD. I was still on the medication, so that was helping.

I was always more on the asexual side of the spectrum, so I felt like, Yeah, I’ll have sex but I don’t need to have it. We’d have sex once or twice a week. He’s more into sex than I am.

Quinn: Yeah, I feel like [imbalances of desire] like that are super common in relationships. But things were OK. She was never into spontaneity. She’d be like, “I’m watching a show now, leave me alone.”

At some point I was like, “Do you want to just schedule a regular time for sex?” It worked for us. When you were pregnant, you were a lot hornier, though.

Petra: I didn’t know what my medication would do to the baby, so I stopped taking it and never started again. That probably raised my libido. We had two kids. Then I had a miscarriage and my OCD snapped back. But it wasn’t about scrupulosity anymore. I started worrying about fecal contamination because I had little kids. I would freak out when they’d mess their underwear or bed. I started washing and bleaching everything all the time. I couldn’t color with them because I thought all their crayons were dirty, because they were dirty children. I didn’t know that I had endometriosis, as well, so I was always feeling sick, and I worried I would get other people sick.

Quinn: At some point, I asked, “Do you maybe have OCD?”

She was like, “I don’t think so. I’m not washing my hands all the time.” We just thought, It’s some kind of anxiety.

Petra: Yeah, you think, OCD is washing your hands all the time and keeping things organized. I didn’t realize until I got into therapy later that it has all of these fingers in other parts of your life, and that it can change all the time based on what’s on your mind.

After fecal matter, it became, All bodily fluids are dirty. Our private parts are dirty. It was a quick onset. I started having us have sex not on the sheets we’d sleep in, but on a sheet on top of that, and only on the bed. If Quinn touched something I considered unclean, even the dirty laundry, I’d be like, “You’re not allowed to come into bed until you’ve washed your hands.” He’d be like, “No, I’m not going to do that.” And then we’d get into a fight about that.

Quinn: It had all sorts of weird effects. I have a strong memory from around then of walking by Petra and brushing my arm across her backside—which was pretty common for us. She was just suddenly like, “Why did you do that? Why would you do that?! How dare you do that!" It was like, Why would you touch this part of my body that’s so dirty?

I was like, Hold on, what? OK, we are at a new level right now. In that initial period, when the OCD started coming out, everything was tense—not just sexually. Nobody could do anything right at home.

Petra: If anyone sat in my chair, I’d freak out.

Quinn: No one was having any fun.

Petra: There was no romance there.

Quinn: Yeah, things got really heavy for a few months. We’d have to work really hard for just, like, the basics. If we were kissing or caressing and I touched the outside of her underwear, she’d be like, “Go wash your hands.” Or she’d say, “OK, just don’t touch my hair now,” because she didn’t want to wash her hair again. If I did accidentally touch her hair, there’d be this huge sigh, and the mood would be dead. I got so worried about touching her in the wrong place or, if we were taking off our clothes, about if I folded our underwear the right way and put them in the right place. If we ended up fighting about where I put our clothes, I wouldn’t be able to get it up anymore. Sometimes, she’d feel let down. There were 100 little paper cuts to our intimacy.

Petra: That’s another thing about intrusive thoughts: I felt this strong sense of duty, like, I need to make him cum or whatever, and if he doesn’t, then I’ve failed, and it’s all my fault.

Quinn: Even if it’s my body, or my fault, or whatever. When we’d fight, I’d be like, “OK, I’m going to go sleep somewhere else.” She’d be like, “No, you need to wash your hands and come back to bed.” I think she felt like it was her duty as a wife for us to stay in the room together.

Petra: Yeah.

Quinn: I never felt like I learned all her rules around sex. There’d always be new ones.

Petra: At some point, I did start washing my hands all the time. and something clicked. I started reading about OCD, and I was like, This is me. Then I read my old journals and was like: I forgot I got diagnosed with this like a decade ago. What do I do now?

I was in such a state that I couldn’t even call a therapist, so Quinn did it for me. We randomly found someone who had an opening in a group session that night. When I heard people telling their stories, and I was like, All of these things have been OCD and I didn’t realize it. Later, the therapist explained the condition to me. I went on medication because it was too hard for me to do exposure therapy, where they challenge you to do things you’re not OK with to push back on the obsessions and anxiety. I got really depressed. I was suicidal for like a week. Then they upped my dosage, and I could do the therapy.

Quinn: After a year or two, she was like, “I’m fine now, on the medicine.”

Petra: I was like, “I can go off it. I know what to do now.” It was a disaster. I had another meltdown. A friend eventually took me to the hospital. She was like, “You need to get back on medication now.” But our sex life never totally shut down.

Quinn: We’re committed to each other, so we’re pretty willing to work through this. It has been hard. In therapy, they taught us that I need to push back on some of her rituals, which has, at times, created a lot of conflict between us.

Petra: It kills the mood.

Quinn: We never shook some of the concerns.

Petra: The underwear placement and sheet rules are still there. Even now, if you put your hand down your pants to readjust yourself, I’ll be like, “Gross, go wash your hands.”

Quinn: I know contamination concerns are going through her head when we’re being intimate now through little movements, like when she adjusts something [to keep us from getting whatever surface we’re on dirty]. It can be so distracting. I still have to be so careful about things that I can do by complete accident. I know the medications can be a problem for her libido, but sometimes I still take it personally, like, She doesn’t want me. Sometimes I’ll whine about that: Is it because I’m unattractive to you?

Petra: Then I’ll feel even worse. I recently started taking Wellbutrin as well as Prozac, and that’s helped a lot with my libido.

Quinn: With things like not touching your hair when we’re being intimate, I have tried to push back. We’ve gotten comfortable talking when we’re not in the moment about, like, “Hey, why do you care what sheets we have sex on?” We talk about how things are symptoms of obsessions and how we can address them. Like, I’ll suggest, “What if, next time, I just throw the clothes right here instead?” Half of the time, it’ll be fine. The other half, it’ll be like, What have you done? It’s a process.

It sounds very mechanical and not fun, but it really does help. She’s pretty willing to at least hear me out if I bring something up. Scheduling sex has also helped us, because when Petra’s feeling anxious, her default is that she won’t want to take time for sex, because it’s dirty.

Petra: Therapy helped a lot in just being open to talking. It’s just about breaking habits, which the OCD doesn’t want you to do. Now he can be like, “Hey, we just washed the sheets, are you OK having sex on them?” And I’m like, “Yeah!” Or, I’ll think, Maybe it doesn’t matter if my underwear touches the couch. Maybe something bad will happen, or maybe not. I’ll deal with that later. You learn to be aware of OCD and say no to it.

Quinn: There are peaks and valleys, but we’re at a point where we can work on things. Like the fact that Petra’s uncomfortable with giving or receiving oral sex because she sees it as dirty.

Petra: Yeah, I mean, you pee out of your penis.

I started by addressing contamination concerns because they were causing the most active harm in my life. We’ve moved to addressing scrupulosity and other little obsessions. Like, when it’d take too long for me to orgasm, I’d just say, “Let’s do something else. I don’t want to waste your time.” I never felt like I deserved that. Also, I don’t want to lose control of my body.

Quinn: We’ve been working on that for a long time. Ever since we got married, I’ve always asked, “What can I do to pleasure you more?” She’d say, “What are you talking about? The only thing that would pleasure me more is if we were done quicker.”

Petra: I felt like if it was taking too long, I must be doing something wrong.

Quinn: Also, anything more than five minutes, and she’s getting sweaty and uncomfortable and thinking about how we’re making things dirty around us. But we get a lot of sex shame education in our religion, like, Don’t masturbate. I get the sense Petra’s uncomfortable touching herself.

Petra: Yeah. But something recently clicked in my brain and I realized, It doesn’t matter if I’m not perfect, or if I don’t get into the highest level of heaven in Mormonism. Then everything started to change. I realized, I’m doing things in sex because I thought I had to do them. We consider ourselves Mormon still. Finally, at 36, I’m learning how to be myself without these walls of scrupulosity. I’m realizing that sex can be pleasurable for me too, and maybe I can assert myself more. And I can use a vibrator and not feel like I’m such a bad person if I masturbate.

Quinn: We’ll see how it goes in time.

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