Intrusive Images of my Partner's Sexual Past - OCD?

[causality]

I am a 30 year-old male. I am in a relationship with a younger woman, aged 23. Recently, I have become fixated on her past sex life. This most often does not take the form of conjecturing about her past, but making very quick assumptions about who she has partnered with. Shortly after a mental image of her having sex with that person develops. For instance, I saw an acquintance of hers put a hand on her hip in a bar in such a way that I immediately assumed they'd had sex. From there a picture formed of that possible reality. This, or the image of hand-on-hip, ceasely pop into my head now. They, and others, are triggered by a number of things. First among them is seeing the people that I have created this image of, followed by any kind of discussion of her past life, and finally by my mind wandering. Once these images pop into my head, they are followed by feelings of anxiety and then avoidance. A cycle begins where the images reoccur shortly after I shut them out of my mind. I can spend an hour walking around my house, trying to cease it. Often I resort to striking myself, or drinking alcohol, or pursuing other sexual relationships. When the cycle plays out, depression sets in. I feel like abandoning the relationship altogether because of her perceived promiscuity. I often want to move to a large city where my partner's past is hidden, or find a woman less experienced. Though experience has nothing to do with it. This has been happening since my earliest relationships - regardless if I'm less or more experienced. Moreover, I'm not prudish about my own sex life. I don't feel that others should be either. But these images and feelings persist. My counselor, who's been helping me deal with depression, and I have made little progress on this. I wonder if this is a form of OCD? She's resistant to this idea, as I have few compulsions. Do you have any insights? Should I consider a specific type of therapist? Are there online resources addressing similar problems?

[Abhijeet Deshmukh, MD]

I have a question as well as comments.

The anxiety you are experiencing can indeed seem to be very illogical, especially when issues or ethics and morals are not involved here, as you have mentioned you can deal with the idea of your partner having a history. And this is perhaps the only difference that I can think of at the moment, between your situation and Pure-O. (The issues of morals and ethics, which are almost invariably aspects of pure-O). However, the process of anxiety may not be illogical here, if you consider the ‘head-gut split’ (having a good intellectual insight, but not being able to feel it) and a possibility that the content itself, of the images may be seemingly anxiety-provoking, rather than just the frequent appearance of the images.

The question I had in mind is whether you seem to be more disturbed by the fact that you have to deal with the thoughts and images, or by the images themselves. In other words, do you perceive the images to be creating the anxiety or does their frequent appearance seem to make you more anxious? I have carefully used the words here as I do not want to further the idea that the images or their frequency (trigger events themselves) actually cause the emotional disturbances. They don’t! And the reason I make a mention of this concept here is that it can answer the question 'what makes your stray thoughts contorted to the noxious ones'. Perhaps, what makes this change is ‘something’ that is coloring your interpretations / inferences of the images to turn them into noxious thoughts and feelings. Once again, a hypothesis worth exploring in your situation.

[causality]

Thank you for your response. I appreciate the limitations of our communication. I guess what is the hardest for me to grasp, and part of my desire to classify this issue, is the very illogical nature of the anxiety produced. I know very well that everyone has a history. I also could intellectually deal with the idea of my partner sleeping with anyone or everyone. However, the ceaseless nature of these images and thoughts are not effected by rationality. Moreover, the seeming randomness of their onset is equally disturbing. Upon reflection, I suppose their is usually a trigger - if not an empirical one, then a mental. The images are a continuation of some stray thought, perhaps. Is that the difference between pure-O and some other, perhaps anxiety related, state? But the maddening question is what makes my original stray thoughts so easily contorted to such noxious ones? I'm unsure. Regardless, thank you again for your insight.  

[Abhijeet Deshmukh, MD]

This was a hypothesis I had in mind as I read your description. Of course, it can be wrong. It appeared from the description that the images were brought on by triggers such as seeing someone or even your mind wandering. The mention of 'OCD without overt compulsions' was meant to refer to pure-O, but I am not convinced that is the case (keeping in mind the limitation of this medium for me to get the whole picture as well as the details). I also don't think 'to react internally with negative emotions' is a compulsion. Thoughts lead to (not necessarily cause) emotions, which in turn lead to new thoughts. And this chain may go on for a while. Having said that, it could in fact turn out to be what you are thinking of, on clinical assessment. Any online resource has its limitations as well as as benefits.

[causality]

Unfortunately, it does not feel as if the events are the triggers which produce the images. As I've been paying more attention to my thoughts, I've noticed that the image pops in long after there is any outside relation or interaction. For instance, sitting in the coffee shop this afternoon, I was continuously bombarded with the thought that she had been having sex with an old boyfriend. This is a reality, she had obviously had sex with with an old boyfriend. This is also not consciously upsetting to me, as I've had girlfriends and sex as well. Yet the image/thought reoccurred and were anxiety provoking. I almost feel as if the image if the obsession, the compulsion is to react internally with negative emotions. Are you familiar with "purely obsessive" OCD?

[Abhijeet Deshmukh, MD]

I will think twice before categorizing these symptoms into the OCD spectrum. It seems obvious that the images are intrusive and you do carry on certain actions to push them away. But I'm afraid these are not sufficient for a diagnosis of OCD. However, I have not assessed you clinically. And there are forms of OCD without overt compulsions. Your treating mental health professional is in the best position to diagnose.

I can see that the images are brought on by trigger events. Seeing certain people, discussions of her past life, etc. are these events that lead you to the imagination and 'seem to' cause the emotional unrest or disturbance. These mini events are the triggers. The images do not seem to be intrusive per se. On the other hand, these images seem to be coming mostly from assumption about your partner’s past and inferences about the events such as the hand-on-hip incidence. You may need to challenge those!

Walking around the house, striking yourself, drinking alcohol, etc. do not seem to qualify as compulsions as you don't 'have to' do these actions to release the anxiety. These actions are more likely to be the behavioral consequences. Compulsions are actions/thoughts which are aimed at releasing anxiety, or prevent the triggers from coming into picture. The definitions are often subjective and hazy. And I can see that your situation is such that OCD can be considered a possibility. But you may need to explore your core beliefs about relationships. It would probably be beneficial to explore why similar disturbances have been occurring since your earliest relationships. Your current counselor might be able to help you with that. Cognitive Behavior Therapy or Rational Emotive Behavior Therapy are good therapies. The help you find out core beliefs that often lead to inferences and emotional disturbances. You might want to find someone who does one of these, if not your current counselor.

You can explore this website for more information you are looking for. There are various communities and expert forums. I can’t think of a better online resource than this at the moment. Let me know if this answers your queries adequately.