Obsessive Thoughts and Fear of Rape

Reader’s Question

Is the fear of being raped by one’s brother a psychotic symptom for a bipolar patient? The brother in question has epilepsy.

Our Consulting Clinical Psychologist’s Reply

Fear, as you might imagine, is a personal reaction to a situation. Many fears are without question realistic and very appropriate — they protect us. Some fears are more apprehension and being uncomfortable, such as mild phobias — being afraid and uncomfortable of heights for example. We can also have fears that are unrealistic or inappropriate when we consider the level of true risk involved. I don’t spend a lot of time worrying about the earth being hit by a large meteorite because although it’s possible, it happens only about once every 100,000 years. If I spent a lot of time fearful of that situation, I’d need to see a mental health professional.

One way we develop inappropriate fears is when we don’t understand a situation. For example, while most folks are afraid of sharks, donkeys typically kill more people than sharks. If the brother’s epilepsy is not understood, family members may become fearful of seizure episodes, fearing he is out-of-control and may harm other family members. Unless the brother has a history of sexual offending, fears of being raped by him, especially in a seizure, may be unrealistic.

When you mention Bipolar Disoder however, there is still another possibility. While we typically think of Bipolar Disorder by imagining the Manic mood — being elated, hyperactive, energetic, spending sprees, etc. — most folks with Bipolar Disorder spend their time dealing with severe depression. Depression can produce obsessive thoughts and when this happens, the obsessive thoughts are typically highly uncomfortable — emotionally and morally. While we often think of obsessive suicide thoughts in depression, we can also be tormented by obsessive sexual, religious, or other thoughts as well. The fear of being raped by one’s brother can be related to Bipolar Disorder, especially the depressive swing. If this fear is highly unrealistic, I’d consult the attending psychiatrist or physician and view the fear and obsession as a symptom that may need to be addressed in the treatment process.

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