Mark* was generally confident in his therapy, but bringing up sex….well, he got a little sheepish. He had these small avoidances that he never realized were behavioral and cognitive avoidances. For example, he would never have sex with his wife when the kids weren’t away from home. He intentionally steered conversation away from topics with his spouse that could make him think about anything outside of his spouse if it was likely they would make love later, telling himself that “my focus should be 100% on her” (he meant it literally, not figuratively). He would this use thought suppression to not think of anything else outside of her (which doesn’t work by the way- we have all sorts of random thoughts that appear in our consciousness).
It’s Complicated….Until It’s Not
If you suffer with Anxiety, OCD, or PTSD, sex might be a little more complicated for you (and trust me, it already can be bewildering in general). It will help if you first understand a “Maintenance Model” of Distress (see the below flowchart) through the lens of Cognitive Behavioral Theory. If you interpret something as distressing, you will naturally continue to associate and interpet not only that thing as distressing, but all things that are connected. For example, in OCD, many clients have a heightened disgust response. A common obsession is, “What if I get sick and die?” in response to seeing a dumpster emptied by a trash truck. This will often be paired with a visceral response like a facial wincing or physically pulling away. Disgust is the “disease avoidance emotion,” which is great and all when working properly, but when disordered, can cause some trouble.
Naturally, the more we see things as problematic, the more we want to avoid, suppress, neutralize, etc. If you are experiencing things like heightened fear, you will often also notice:
- Increased hypervigilance
- Activation of the Sympathetic Nervous System
- Lots of biological stuff (check out Medical News Today for a great article):
- Release of cortisol (the stress hormone)
- Heart and Lungs increase activity
- Digestive activities reduce (which can lead to “butterflies” in the stomach)
Now Back to Sex
You don’t have to think very hard to imagine that someone who has a disorder and experiences increased “doses” of fear/disgust/discomfort throughout their day will likely run into feeling a bit uncomfortable around sexual things, at times, too.
The Excitation Transfer Theory looks at how the body, excited by one stimulus can, can carry physiological excitation forward in the context of a different stimulus. Folks with anxiety and worries often have thoughts like, “Did I just have a sexual urge towards that person? Does that mean I want to cheat?” or “Why do I feel turned on while I’m around these random people?” Perhaps the most intense experience of this is in those who have “POCD,” or “Pedophilia OCD” (for those of you who don’t know, this is an intense fear of being/becoming a pedophile- NOT the same as it being true). Some people who suffer with these intrusive thoughts and urges may go so far as to even avoid having children of their own, or on a smaller scale just avoid going to a park or watching t.v. shows featuring children.
When we feel distress, the body is doing all sorts of crazy stuff. Day to day life is not as neatly compartmental as we might like it to be. In the average day, people can seamlessly experience happiness, anger, arousal, sadness, and any number of feelings. But with anxiety, intolerance of uncertainty makes it difficult to accept that it’s okay to feel mad about something at work, come home, see the kids, and make love to your spouse after dinner.
Getting Aroused With Anxiety
Here’s the good news- an experienced clinician will be able to help you sort through what maybe feels like chaos. If you’re like Mark and at the crossroads of shame and moving forward, I hope you’ll get some good, trusted support around you and Get Unstuck.
Therapy and related resources can help you learn to tolerate uncertainty, feel your feelings, notice your thoughts, and act on your beliefs and values rather than focusing on what isn’t important. How cool is it to know you can experience all these uncomfortable things AND stay mindfully present as to what’s of value?!