S1C5. Complex Incest OCD: Real Events, False Memories, Magical Thinking, and Mental Contamination

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OCD is a complicated disorder and most subtypes have some interconnections that are important to understand. Even with Incest OCD, some presentations of OCD do have overlaps as we shall see below.

The first presentation that can have an overlap with Incest OCD is one of the layers – Guilt OCD or Real Event OCD (REOCD). It is possible that as a child, someone may have been infatuated with their sibling that they later mistakenly consider as sexual attraction. In their opinion, since the sexual act has already been ‘committed’ and it isn’t something that may be committed at some time in the future, they believe that they are indeed a pervert, further complicating the issue.

The second presentation that has an overlap with Incest OCD is another layer – False Memory OCD (FMOCD). In FMOCD with Incest OCD, the fear is not about committing a sexual act with a family member in the future, but a strong suspicion that the horrible deed has already been done in the past. The person may try to ‘remember’ the details to confirm their fear and failing to remember the details clearly (because they do not exist) may cause anxiety.

The third presentation that has an overlap with Incest OCD is the third layer – Magical Thinking OCD (MTOCD). In MTOCD, the link between cause and effect is impaired and the person may obsess about irrational connections. For example, they may obsess that if they step on a crack on the road, they may act upon their Incest OCD thoughts.

Another presentation that may have an overlap with Incest OCD is yet another layer – Meta OCD. The person may be confused about whether the thoughts are their own or caused by their OCD, or worse, if they even have OCD. Even in Incest OCD, sometimes a particular obsession that has been distressing at some times, may not cause as much distress at other times, making the sufferer wonder if they indeed have Incest OCD, or whether they do not feel distressed because they secretly enjoy the thoughts. The anxiety is not only about the perverted thoughts but also about whether they have OCD at all or not.

One more presentation that may have an overlap with Incest OCD is Mental Contamination OCD. The person may have an unacceptable thought and to get rid of the thought they need to perform some washing and cleaning rituals. For them, the ‘dirty thought’ would get neutralized only by washing up.

Based on this information, discuss with your family what symptoms of Incest OCD you experience and fill in the same information in Worksheet 1.3.

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