Groinal Responses & OCD: Why do they happen?

Specific OCD subtypes can experience the groinal response as a physically intrusive and unwanted sensation. 

While everyone experiences groinal responses, in relation to OCD, they are confusing and distressing as they appear in response to an obsession in which the context often disturbs the individual.

They are what we call ‘egodystonic’.

This means that they go against the sufferer’s true values and desires, which is why they can be a source of great distress. Individuals experiencing groinal responses as a physical reaction to their obsessions are often left wondering what it must mean about them.

What is a groinal response?

Imagine a time when you’ve met someone new. They make you smile ear to ear, they have stories that captivate you, and to top it all off…they’re pretty good looking too!

You’re out for dinner in a romantic restaurant, it’s the third date.

You’re comfortable now, but there’s still lots of mystery and excitement in the air. They brush their hand over yours as you lock eyes across the table… And, you feel something happening ‘down there’.

This is a groinal response.

They are described as a change in sensation in the groinal or genital regions. This might present itself as a tingle, a slight swelling, or a small movement.

As you can see from the picture we painted above, it’s a perfectly natural and common physiological response. However, the groinal response does not always appear in times of pleasure, it can often pop up seemingly out of nowhere.

For the OCD sufferer, this sensation is unwanted, alarming, and not in response to something they deem pleasurable or sexually pleasing.

Within the context of particular subtypes (which we will touch on soon), the obsessions that trigger these groinal responses are not ones they feel ‘should’ arouse them in this way.

The Groinal Response: An Obsession

Groinal responses firmly land themselves in the ‘obsessions’ category within OCD.

Obsessions are characterized as intense thoughts, images, feelings, urges, or sensations that trigger extreme anxiety, uncertainty, and discomfort. The groinal response is very much an unwelcome and confusing sensation to the OCD sufferer.

It can be an obsession in and of itself, or it can follow an intrusive thought, image, feeling, or urge.

The reason this response is so jarring (and often abhorrent) to the one experiencing it, is that they don’t have any true sexual desires within the context of these obsessions. It goes against who they are as a person. It goes against their values.

This is why this obsession clings on and sticks around.

It is precisely because it confuses or disgusts us that we feel compelled to fixate on understanding why it happens, what it means about us, and how we can stop it.

Is it a groinal response or real arousal?

As mentioned above, a ‘groinal response’ very specifically describes a change of sensation within the genital region.

Alternatively, arousal is described in The Psychology Dictionary as, 1. a state of physiological alertness and readiness for action. 2. a pervasive state of cortical responsiveness believed to be associated with sensory stimulation and therefore, the activation of fibers from the reticular activating system. See also physiological arousal– sexual arousal. 3. a state of excitement or energy expenditure linked to a strong emotion.

In the OCD world, this groinal response is not an indication of true sexual desire, and instead of leaving the individual with a feeling of pleasure, it leaves them feeling disturbed and repulsed.

Arousal, on the other hand, is grossly misunderstood. 

As you can see above, arousal does not simply relate to the physiological state of being sexually aroused. Different emotions also evoke different states of arousal to varying degrees.

High arousal emotions, for example, may include joy, excitement, or fear. And whereas the groinal response is very specific to the sensation we feel ‘down there’, arousal encompasses a more full-bodied experience.

How does the groinal response feel?

A groinal response may conjure up any of the following:

• Tingling
• Swelling
• Vibrating
• Increased heart rate
• Increased moisture (in females)
• An erection (in males)
• Partial erection (in males)
• Increased temperature in genital regions
• Small movements

This is how the groinal response may feel on a physiological level.

Emotionally, within specific OCD subtypes, the groinal response only offers reason to doubt who we are as a person. Leaving us uncertain about what we want, what we desire, and feeling out of control.

What causes a groinal response?

Let’s look at three different reasons as to why you’re feeling these physical sensations in the groinal area:

1. Arousal Non-concordance

In basic terms, arousal non-concordance is the disconnect between your mental/emotional arousal response and your body’s arousal response.

What this means is, mentally and emotionally you could experience pleasure (I really love how they make me feel) but your body doesn’t respond (your vagina doesn’t naturally lubricate, or your penis does not erect, for example).

And the same can happen IN REVERSE.

Your body can be ‘turned on’ which may present itself in the form of a groinal response. But mentally and emotionally, you do not have any feelings of arousal or pleasure.

Our bodies are often simply responding to what is considered sexually relevant, an involuntary response to external stimuli. Rather than responding to what we want or value.

This is why you can experience a groinal response even when thinking of something that abhors you.

2. Anxiety is a high-arousal emotion

As we mentioned before, different emotions evoke different levels of arousal. Anxiety is considered a high-arousal emotion. Much like excitement or exhilaration, we experience the same dump of adrenaline.

This adrenaline pumps through our body and increases heart rate and blood flow. Including blood flow to the genitals.

In both sexual arousal and fear arousal, we experience those very same symptoms. During heightened states of anxiety and fear, this is why it is very common to experience sensations down below. 

3. Arousal focuses its attention on the source of pleasure (or danger)

When we are aroused, we are hyper-focused on either the source of pleasure or in the case of OCD, danger.

Now, in OCD cases the groinal response itself can be interpreted as danger. 

What happens, in this case, is we fixate on those unwanted sensations and find ourselves caught in a loop. You enter an anxiety-inducing circumstance, you are afraid of the groinal response you may feel (fear-arousal symptoms), and so you focus your attention on that area of your body.

The focused attention increases those physical sensations which amplify the anxiety associated with them.

4. Attention & repetition are increasing your sensitivity

Over time, repeatedly putting your attention on the groinal response (hyper-attention) only goes to increase your sensitivity.

It becomes a tricky loop to escape from (but by no means impossible!).

By consistently focusing your attention toward your genitals, checking for sensations, being alert to any changes you may feel… you become overly sensitive to any minor tingles or movement. 

You strengthen the neural pathways and lower your tolerance for any slight changes.

Why does a groinal response continue to happen in OCD?

For the individual with OCD, the groinal response typically appears in different scenarios or from different triggers depending on the subtype.

For example, someone with POCD, may experience a groinal response walking passed a park with children playing on the swings. 

In this circumstance, they fear they may harm a child through inappropriate sexual conduct. Or become trapped in unwanted sexual fantasies. And so, when they walk beside this park and feel a groinal response, they get lost in the ‘what if’ thoughts.

What if this means I am a bad person?

What if this means I am attracted to children?

What if this means that I am a pedophile?

But as we have already discussed this groinal response is not sexually relevant. The groinal response is like any other obsession that tricks us into believing things that are not true. 

Yet, this individual above now finds themselves engaging in the OCD cycle. Because they want to ‘make sure’ that those thoughts or images don’t become true, they may begin to avoid places where children might be – such as this park.

They may partake in reassurance seeking, asking loved ones if they believe they are a good person, for example. These compulsions are performed in a bid to relieve themselves of the terror of those obsessions, if only for a brief while.

But in doing so, the OCD cycle continues.

Types of OCD affected by groinal responses

1. Pedophilia OCD

Someone with pedophilia OCD typically has obsessions and fears about sexually violating a child. In this instance, the groinal response may appear in the presence of children in which case they may avoid going to places where children are likely to be.

2. Sexual Orientation OCD

Someone with sexual orientation OCD typically has obsessions and fears around being attracted to someone who does not align with their gender preferences. For example, a heterosexual male may have intrusive thoughts about being with other men, which may cause a groinal response.

3. Relationship OCD

A groinal response is not always present in relationship OCD. However, it could become present if someone is worried about whether they are attracted to someone who is not their partner. They may experience groinal responses with thoughts or images of being with someone else.

4. Sexual Obsession OCD

Someone with sexual obsession OCD fears irregular sexual attraction or acts. This may involve fears of sexual attraction toward a family member, objects, or even animals. For example, someone may have intrusive thoughts of being sexually attracted to their sibling or parent and experience groinal responses around them.

5. Harm OCD

Someone with harm OCD typically has obsessions and fears about hurting themselves or others. In some cases, this may include fears of raping (or sexually assaulting) others or being raped themselves which may trigger a groinal response.

Does a groinal response make you a bad person?

We can say categorically, that having a groinal response does not make you a bad person, especially within the context of OCD.

OCD is a common mental health disorder, and the groinal response is a common sensation to have in reaction to external stimuli and/or obsessions.

Groinal responses are physiological responses to external stimuli. As arousal non-concordance proves, it does not necessarily mean you are emotionally or mentally ‘turned on’ by any particular trigger.

There’s a great deal of shame for OCD sufferers within the above subtypes.

With a tendency to criticize and beat themselves up for having these physical sensations, the feelings of guilt and self-loathing often leave them feeling isolated. It’s not uncommon for those with the above subtypes to stop themselves from opening up, even to medical professionals, for fear of being misunderstood.

But, we will take this opportunity to remind you – a groinal response does not make you a bad person.

In the context of your OCD obsessions, they disgust you precisely because they are the opposite of who you are.

How do I ignore my groinal response?

In OCD recovery, it is best to think of the groinal response just like any other symptom of anxiety and simply allow it to be.

Just like intrusive thoughts, heart palpitations, an upset stomach, or feelings of unease… the best way to alleviate the symptoms is to simply allow the uncertainty and refrain from responding.

The more attention you give your groinal response, the more you encourage the OCD Cycle to continue and increase those sensations over time. In order to decrease the sensations, you must learn to become comfortable with uncertainty and wilfully tolerate the groinal response.

Whilst you can’t simply ignore it (after all, it is a physical sensation in your body), you can acknowledge it and choose to carry on with your day as non-anxious you would.

This teaches your brain that the groinal response itself is not a source of danger.

Treatment for groinal response

Many who experience a groinal response within the context of OCD wonder how they can stop it. And much like any OCD obsession, trying to stop a groinal response – or thought, image, urge – only makes the obsession stick around longer.

When we try to stop a groinal response, we give it our attention. We believe that if we focus on that area, we can try to catch it and stop it in its tracks. It is our way of trying to take control of this involuntary bodily sensation.

Yet in doing so, we encourage it to thrive.

We teach our brain that the groinal response is a source of danger and that we aren’t capable of tolerating the uncertainty about ‘what it might mean about us’ or ‘are we going to stay in control’.

What we must do is learn to allow it, without judgment.

Change how we respond to the groinal response and work to become comfortable in the triggering circumstances.

1. CBT with ERP

Cognitive behavioral therapy (with exposure response prevention) is the current go-to treatment for OCD. It looks at how we can think about our obsessions in a way that is helpful rather than debilitating, and how we can respond to them in a way that loosens their hold rather than tightens their grip.

ERP asks the OCD sufferer to place themselves in situations that trigger the groinal response, rather than avoid them. 

Only then can they sit with the anxiety it brings and learn that they are capable of managing it.

For example, someone with sexual obsession OCD who has fears about being attracted to their mother would be asked not to avoid their mother but practice being around them. They may experience a groinal response, but the important thing here is not to leave the room or run, but simply be.

Likewise, someone with POCD may be asked not to avoid playgrounds but to walk around them. Or visit the home of a friend and their two young children.

It is in placing yourself in these scenarios where you may experience a groinal response that you can learn that you will not lose control (and that it doesn’t mean anything about who you are as a person).

2. Self-help programs

If 1:1 therapy isn’t accessible to you right now, there are online courses created by highly qualified professionals which can be an incredible tool for recovery.

Over at The CBT School, Kimberley Quinlan has created a self-led online program for people with OCD which walks you through the exact steps we take we take with our own one-to-one clients.

Stop letting obsessions take control of your life and resist the urge to do compulsions, sign up here.

3. Medication

Medication may be appropriate for you and has proven to help many manage the distress that accompanies this particular disorder.

It is possible to treat OCD without medication but this decision must be made under the guidance of your medical professional.

Please see your nearest mental health professional for a full and proper OCD diagnosis and allow them to advise you on whether medication is an appropriate course of action.

4. 1:1 therapy

As always, we would recommend working with a highly qualified, and compassion-based therapist who specializes in OCD. 

It is possible to manage your symptoms alone, but the support and guidance of a professional clinician offer an outside perspective as well as a friendly helping hand.  OCD is not a mental health condition to be taken lightly, and so working with a specialist is highly beneficial in making the recovery process easier.

Our team of compassionate and highly qualified mental health professionals is here to help you if you’re based in the State of California and need 1:1 support in managing your OCD.

If you’d like to talk with us, please click this link to submit an application form.