Q My 11-year-old son is feeling plagued by sex thoughts every second of every day. It is affecting his ability to function well. The more he tries to control the thoughts, the more they come, he says. He says kids at school and on the bus are constantly talking about sex and, in his trying to fit in with the group, he has joined in the talk and now feels an overwhelming guilt about it. He has mentioned that he has wished he never heard of sex and that he has sometimes wished he wasn't alive due to the overpowering guilt and shame of it all. That concerns me. We've tried to explain how normal the curiosity is and that he is not a "freak" and that he can continue to talk openly with us, which he has done. It seems that the more intensely he tries to control his thoughts, it only makes the thoughts more powerful. He does have an OCD element to his personality in some ways. How do we help this boy?
I can’t offer a diagnosis without having met your son, but it does seem like he has many aspects of obsessive-compulsive disorder. He is bothered by intrusive thoughts that he can’t stop and spends a lot of time trying to do things to get rid of the anxiety that comes with these thoughts. Also the intrusive thoughts are easily triggered — other people’s conversations and even just memories of the thoughts can set him off. And no matter how much you try to reassure him, he can’t move on, which is a core feature of OCD.
That said, there are other disorders that also involve obsessive thoughts and narrowed interests. It’s also possible that he could have more than one disorder, which would affect his treatment. I think your first step should be getting your son a very thorough evaluation from an experienced cognitive behavioral therapist.
With something as pervasive as sex, he really is hearing about it everywhere — on TV and the Internet, on the bus and at school. He’s not making it up, but while most people can cope, the obsessive part of his brain isn’t letting him. Treatment will likely involve teaching him the skills to handle his intrusive thoughts once they come.
As a parent, you will likely also play a role in treatment. Parents can learn to be two steps ahead in terms of expecting symptoms and knowing how to respond to them.
Medication could also be a good idea. If he’s having so many thoughts that they are present all day, every day, medicine can help by decreasing the frequency of those thoughts and diminishing the anxiety he feels, which could make it easier for him to engage in therapy.
The good news is that, with treatment, your son should feel better and have more control over his thoughts within a relatively short time.