 They usually decide they are having these problems because they are defective in some way, and they are often too ashamed to seek help.Because sexual obsessions are not as well-described in the research literature, many therapists may fail to properly diagnose OCD in a client with primary sexual obsessions.Mental health professionals unfamiliar with OCD may even attribute the symptoms to an unconscious wish (typically in the case of psychoanalysts or psychodynamic therapists), sexual identity crisis, or hidden paraphilia.