Question & Dancer: What is “Normal” with OCD?

question-and-dancerI’m an artist not an expert, one who is learning to embrace questions more than answers.

These are some questions I got last month. Ask yours here.

My question is this.. I have hocd but whatever I do it just seems like I get afraid or concerned when a guy comes around me.. it’s like sometimes I look just to check if im attracted to them.. and it’s annoying because the action is becoming involuntary and it’s scary because people read what you send them .. and people are starting to think that I’m gay! And thats very false! What should I do to combat that?

Exposure and response prevention (ERP) therapy, which I’ve written about extensively on this blog: check out http://www.jackieleasommers.com/OCD, friend. Educate yourself on ERP; then seek out an ERP specialist or track down one of the books I recommend so that you can do ERP on your own. Either way, ERP is the solution.

Please read here about Self-Directed ERP.

i’ve met we a psychologist- but she doest seem to have any experience with HOCD and thus has not really been catching it’s symptoms/mentioned it, she does think i have an anxiety disorder and excessive worry- but not specifically anything on OCD. Note she is relatively inexperienced psychologist, as i’m a student and needed to find someone low cost. Not the psychologist has little experience as i’m a student and need a low cost specialist. She has mentioned CBT and ERP as helping methods though. so, what i wanted to ask is form what i have described do i sound like i have HOCD or an i in denial. I am not trying to seek reassurance but guidance, I don’t have anyone to turn to (from a very backwards society in asia) – should i be looking for an OCD specialist or a general psychologist to help me come to term with who i am?

Hi dear! You need an OCD specialist, specifically an ERP specialist. If you can’t afford to meet with one in person, then definitely track down a book (I list four on my website) that will guide you through doing ERP on your own! And kudos to you for being ultra-aware of seeking reassurance. That is one of the primary compulsions for many who suffer from HOCD– the more you are aware of it and resist it, the better! Click here to read more about the Problem with Reassurance.

Hi Jackie. I was wondering if you have any strategies to just letting the thoughts be thoughts in your head. On the web (when I looking for reassurance yes I know its sooooo bad but I can’t help it), people say to let those intrusive thoughts wonder in your mind, but do I just sit there and think nothing as those thoughts wreak havoc on my emotions? Do I just try to calmly breathe through it when my heart is beating super hard? It’s also so hard to not check for reassurance online! How did you have the strength to not reassure yourself? What did you say or think to yourself to prevent it? (I can’t afford a diagnosis, much less ERP so I’m scared that my HOCD may be actually be in denial, but I do know that I’ve had many obessions and compulsions in the past and when the professor talked about OCD, my first thought was THATS ME but then it’s also never been severe to the point where it has disrupted too much of my life. I would just cry myself to sleep most of the time when I’m obsessing)

When I read questions like this, it takes me back to specific memories– horrible, manic ones where I could not calm down, could not do much of anything except to cry and ask for reassurance. It feels so helpless and hopeless in those moments, but I promise it’s not! First of all, since you can’t afford an ERP therapist, please track down one of the books I recommend on my site so that it can guide you through ERP at home. For me, I had a set amount of time when I was intentionally practicing ERP– for me, it was about 40 minutes, twice a day (total of 80 minutes). In the grand scheme of the day, that’s under an hour and a half of putting myself through these exercises (which sometimes felt like torture). Although I did try to avoid compulsions throughout the day, it was only during these 80 minutes that I was specifically triggering myself (exposure) and resisting compulsions (response prevention). It is hard. Don’t let anyone tell you differently. It’s hard and exhausting and feels masochistic. But for me– and for many others– it worked. And it was worth 80 minutes a day for 12 weeks in order to experience this freedom– I’m coming up on nine years of it.

Hi! I’ve been having what I (hope)think is HOCD for two months now and it’s been an intense hell for me. I’ve always been confident that I’m straight and I’ve even intensely championed for gay rights and everything. I used to read articles about gay people and watch videos about people coming out and be fine. But now I avoid all of those and even romance novels because I’m basically terrified of being aroused for the wrong reasons (like if I read a love scene from a guy’s point of view that means I want to do that to a woman when I dont!??!?!?!?). I’ve been trying to do self-ERP and I’ve read that I’m suppose to embrace those “you are gay” “you are turned on because you actually want to do that to a woman” thoughts and the arousal that comes with it. My question is, if I embrace these thoughts for 10-12 weeks, will I really be healed? I JUST WANT THIS HOCD THING TO END.

I don’t think I or anyone can guarantee that 12 weeks of ERP will work for you. But it is an evidence-based treatment, meaning that the statistics of ERP working are in your favor. One thing I can almost for sure guarantee is that if you don’t do ERP, then your OCD will not go away on its own. I suppose it’s possible; miracles do happen. But, for 99% of us in the OCD community, we had to do the hard work of ERP.

Hi Jackie! I’m doing self-ERP for my HOCD right now and although I feel like it would be best with a therapist, I can’t afford it 😦 (maybe one day!) But anyways, my question is that I know when I’m doing ERP, I’m suppose to accept and AGREE with those thoughts of “Yes, you’re probably a lesbian” (gosh it was hard to even type that), but when I’m not doing ERP, do I still have to agree with my intrusive thoughts or should I just let it float around in my head? I know for my past OCD fears (earthquake, breast cancer, blackholes, intersex, death, etc) I would just stop checking and doing my compulsions and would let the thought float around in my head (never did ERP for those things) and a couple hellish months later it would disappear, but HOCD is taking my anxiety to another level (especially since I’m 20 and never been in a relationship with a guy because I’m soooooo shy so now my HOCD is using it as ammunition). Also when I have those OCD-free moments, can I go back to thinking about my crush and the imaginary life we may have one day (wow I’m so weird, I can’t believe I confessed this on the internet) or is that counter-productive to my ERP?

No, I don’t think that’s counter-productive to your ERP. That’s the goal! But during the moments where you are doing your ERP exercises, then yes– you will want to be all in: experiencing the anxiety completely, resisting the compulsions as completely as you’re able. One thing that you wrote specifically interests me: “I would just stop checking and doing my compulsions and would let the thought float around in my head (never did ERP for those things)” … this sounds like it was ERP, friend. Letting thoughts come and not doing compulsions to alleviate the anxiety … that is what ERP is. You can do this.

Hi Jackie, I’ve recently stumbled upon your blog because I am suffering from hocd. I’ve been dealing with it for around 9 months now. I feel so lost because it’s the worst time to really be dealing with all of this. I am a sophomore in high school and all around me people are questioning their sexualites or coming out etc. I line up with all hocd symptoms and anxiety runs in my family. The intrusive thoughts just popped out of no where one afternoon. All my life I’ve liked boys! I talked to my therapist about ERP but she’s not a specialist and I’m scared to even try it. My psychiatrist prescribed medicine that ended up making me worse. Like you I am an avid Christian, but I have always been doubtful and indecisive with everything. I FEEL SO LOST. I’ve lost my hope and feel like nothing is gonna work. I have a hard time believing this could be a disorder. I feel like I should just accept my intrusive thoughts are real but that just depresses me further. What do you think?

Hi honey. If your intrusive thoughts were real, I don’t think they would be intrusive or cause this intense anxiety. For a short time, just suspend your concern that you are dealing with anything other than OCD and tell yourself, “Yes, it IS OCD, and I will treat it.” There is no harm to doing ERP even if you didn’t actually have OCD. Be kind to yourself: accept your self-diagnosis at least for three months while you do ERP on your own with a book to guide you. “Doubtful,” “indecisive,” “so lost,” “lost my hope and feel like nothing is gonna work” … all of these described ME. For nearly 20 years, this is how I would have categorized myself. And, for whatever it’s worth, my sophomore year of high school was HELL, one of the worst and hardest years of my entire life, as I dealt with all of this while undiagnosed. When I was your age, I still faced another 12 years of clawing my way through this alone before I found and did ERP. Please don’t wait as long as I did.

These three questions all reminded me of each other:

1. I have been diagnosed with OCD (HOCD) and have been doing CBT and ERP. I feel as though I am getting better and the intensity of my obsessions and compulsions has reduced but I have this strange feeling of sowmhing not being right and as whole as it use to be? My attraction and desire for relationships and such seems very reduced. It just doesn’t seem to feel or come authentically – is that normal?

2. Is it normal to feel no attraction or interest in romantic relationships when suffering with HOCD, even when recovering (reduced obsessions and compulsions, but the feeling of not knowing your sexuality and not being attracted to the gender you always have been attracted to?

3. Is it normal to become hypersensitive to the looks of your same sex with the onset of HOCD? even if you’ve known and seen the person before they just appear a lot more attractive now? Is that a symptom of a change in sexuality or another Possible HOCD Symptom?

Yes, my dear ones, all of this is normal for someone with HOCD. Please don’t give up. ERP can help.

Hi Jackie, Did you ever feel like your hocd would never end? As a current hocd sufferer, I feel a lot that it’s never going to be over. I question and doubt even the most logic of facts I’ve been told to use in order to help cope with the intrusive thoughts. Everyday it’s a new “what if” question and it makes me terrified and sad.

Hello sweetie, YES. I felt that way about all of my OCD themes … that things would always be this way and that, to me, was probably the scariest thing about it. We can go through any pain so long as we see an end in sight, don’t you think? But OCD lies to us, makes us believe there is no end in sight, and that robs us of hope and joy. Please read this blog post I wrote back in 2014: THINGS WILL NEVER BE OKAY AGAIN [& other lies I sometimes still believe].

I am 54 years old recently my ocd has become worse for last 6 months since i changed my job and because of ocd anxiety i am not able to work at present. My ocd is mostly god related i have to pray and touch god photos everytime i pass through them and think i have not prayed properly and become anxious. Also there are lots of thoughts coming and going in my head always about touching god photos etc and i am not satisfied with my praying i tried medicines and they made my condition worst,Please help me Sir

Hello friend, have you heard of ERP therapy? My OCD was also based primarily around religious obsessions; I battled this for 20 years before undergoing ERP, and just 12 weeks of ERP therapy snapped my OCD in half. The last nine years have been so peaceful, so free. Here are a few posts that might help:

OCD & Christianity
(or other religious scrupulosity)
OCD, ERP, and Christianity
I’m a Christian and Take Meds!
Unashamed of my OCD
Is the thought from OCD … or God?

God’s Sovereignty, OCD, the Cross, & His Purposes
Is Mental Illness a Spiritual Issue?
Is ERP Sinful?
OCD & Faith (or Lack Thereof): a Double Interview

Hi Jackie, I have been suffering from hocd for a while now. One of my biggest problems besides the intrusive thoughts and fear I can’t shake off is the EXTREME SADNESS I have. I feel like I get sucked into this dark hole where I can’t get rid of feeling hopeless and sad. I lose all motivation to do my homework and just feel angry at god. Have you ever felt this way? If so, what did you do to help yourself?

My gosh, YES. 100% yes. I am guessing that you have depression comorbid (alongside) OCD, as I did. For me, the OCD was the root issue and what was causing the depression, so when I treated the OCD, the depression alleviated as well. I talk about my anger at God a little bit in this post. Ultimately, I got so sad and felt so lost that I hit rock bottom– and God was there. He looked like a Korean psychiatrist who gave me hope, a prescription, and a phone number for a local ERP therapist.

Hi Jackie, I finally realized my problem is OCD. My question is, do people with this “doubting disease” have the capacity to have faith? I’m so worried I might lose faith altogether, because of what’s wrong with me.

Yes, absolutely! In Yes Novel (my work in progress that has been temporarily set aside), the main character has this interaction with his professor:

He nodded, headed toward the door. But before he left, he turned around and asked, “What you teach us in class, do you really believe it?”

Dr. Morgant pursed his lips thoughtfully. “On my worst days and my best days, yes. But not every day. There’s only one thing in I believe every day.”

“Doubt,” said Asa, as his teacher said, “Faith.”

“Same thing,” said Dr. Morgant with a smile.

Anne Lamott has said it best:

I have a lot of faith. But I am also afraid a lot, and have no real certainty about anything. I remembered something Father Tom had told me–that the opposite of faith is not doubt, but certainty. Certainty is missing the point entirely. Faith includes noticing the mess, the emptiness and discomfort, and letting it be there until some light returns.

Thanks for all the questions, folks! If you have questions for me about anything (but especially faith, creativity, and mental illness), add yours here.

As I said, I’m an artist not an expert. I will leave you with these, some of my favorite questions in one of my favorite poems, “Questions about Angels.” Click here to hear Billy Collins himself read it. (P.S. It starts with questions, ends with a dancer.)

HOCD Story: Meet Mae, Part 2

Yesterday on my blog, I introduced you to Mae. Today, her story continues with a detailed explanation of her experience with exposure therapy. (For more information about ERP, go to jackieleasommers.com/OCD).

mae erp

First of all, if you go to a therapist and they tell you that you are not gay or try to tell you that it’s just a fantasy, look for someone else. This person does not understand ERP and OCD. The goal of ERP is to EXPOSE you to your deepest fears. I know that sounds like the most terrifying thing, especially if  your obsessions are causing so much anxiety.

I will continue to reiterate this- ERP CHANGED MY LIFE. I don’t say this lightly AT ALL. I was extremely doubtful when it first began that any change would take place. I was ready to fight this OCD beast, but I was also scared of what exposures I would have to do.

Your therapist will personalize your therapy to YOU.

At our initial consultation, my therapist helped me rate my anxiety and we started with the things that made me the least anxious and worked up front here. By the end of ERP, the things that once made me the most anxious were not as bad…

For me it began with a few different recordings, or scripts that I listened to several times per day. It also consisted of not allowing myself to continually ask for reassurance from family members, or google anything having to do with OCD. Anyone with OCD knows that the Internet is a big, dark, deep hole that is nearly impossible to escape once you enter.

I began by listening to the scripts and trying my damn hardest to not neutralize thoughts (ex: not telling myself “this isn’t me” or “I’m not really a lesbian”). I was supposed to just simply (was it really that simple?!) listen to the scripts. The first one began with my therapist recording a script in his voice. I listened to this script as much as possible over the course of 2 weeks (5-10 times per day). Some moments it didn’t cause much anxiety at all; at other moments it was EXCRUCIATING. Sometimes the anxiety was just my mind racing, while other times it was a sinking feeling or my chest would get tight. Sometimes, I just cried.

The next script was one in my voice. This one was a little more convincing and harder to listen to… I listened to this one for about 2 weeks as well.

After four weeks of scripts, my therapist and I came up with some “real-time” exposures. For instance, I didn’t avoid any articles that I saw on the Internet regarding homosexuality. I was supposed to read them or at least acknowledge them. I honestly had never really had issues with homosexuality or gay people before this thought popped into my life. I also didn’t have my heart skip a beat or a queasy feeling in my stomach when I would see any kind of news story on homosexuality before this obsession wreaked havoc on my life.

I also had to sit with different thought patterns I had. If I was with a same sex friend that I found attractive, I was supposed to just let my mind wander and let the thoughts be there. I wasn’t supposed to neutralize them or reassure myself.

I went to the gym a lot and if I thought a woman’s butt was hot, I was supposed to  just appreciate her beauty and not doing anything else with the thought. The gym was probably the hardest exposure for me because there were so many different variables. I wouldn’t know who would be there on any given day. For awhile I even avoided a class taught by someone who is openly gay. I thought going to her class would make me suddenly “become a lesbian” or she would know I was having these thoughts…

It wasn’t until about my tenth or eleventh session that I actually noticed my thoughts shifting. I went to 14 ERP sessions. It all depends, but my therapist said ERP can be anywhere from 10-20 sessions.

I am going to list a few things I that have improved in my life since ERP:

1. SLEEP!
2. Being present with friends and family (I felt like I was in a continual fog for quite a few months).
3. An enjoyment of begin at the gym, work, stores with out feeling like I am constantly checking between people.
4. The ability to read a book or watch a show without thoughts/obsessions/compulsions taking over.
5. Weight- I honestly kind of appreciated losing weight at first, but then it became real sucky to not enjoy food at all.
6. A renewed faith in God. I was very, very angry at God for quite some time. Mental illness is no joke. People don’t talk about it and its a very real thing to so many. My brother has struggled with a wide variety of OCD themes since he was 11. This journey has actually made us a lot closer.
7. I have become more “selectively vulnerable.” If I notice someone seems to be struggling, I gently ask some questions. If anxiety, depression, etc. come up I tell them a piece of my journey. I KNOW that my story has been used to impact others. Also, Jackie Lea’s vulnerability helped me to get help. We are all part of this OCD/ERP puzzle.
8. Work- I enjoy my job so much, but during this struggle it was really difficult for me to focus. I actually feel like I have improved at my job since ERP.
9. I’ve embraced the fact that each day is new. You might still experience setback, frustrations, fear, doubt… Yet, each moment and each day are new.
10. People with OCD have been said to be some of the most intelligent and creative people. I will own that. 😉 For real though, I’ve started doing more creative art projects to really hone in on that gift that I’ve been given. I’ve also looked at my “steel trap” memory as an asset instead of a curse. During my darkest days of OCD, I would get so incredibly frustrated by my ability to recall the most random, detailed memories in my life. Now, I use this skill to make people feel valued and honored by acknowledging important details about them.
11. Sex is something I look forward to now. For a period of time, I was going through the motions in every area of life. I actually feared sex with my husband  because I was worried that the thought would pop in during something that was supposed to be enjoyable.

12. Our family went on a big trip this past year and I was honestly dreading it all year. I thought it would be awful. The trip was actually planned right around the time OCD kicked in. I thought, “There is no way I will be doing better in a year.”

With the trip, I was worried about being away from home, I was concerned that OCD would creep back in with its ugly tactics, I thought that OCD would rob me of experiences on a trip that was intended to be lovely. Guess what?! I had a great time on the trip. It was lovely. I enjoyed it so much, which I consider a huge victory.

I want to once again clarify something. OCD will not completely disappear for many people by doing ERP. What it will do is rewire your brain. I would say my symptoms have improved by 85-90%, which is HUGE. The times that OCD likes to sneak back in are when I am stressed, tired, or duing my menstrual cycle. During these times, I remember to do lots of self care. I make sure I set healthy boundaries, take walks, baths, whatever feels best at that time to make sure I am ok.

Note from Jackie: Thank you for sharing, Mae! I would love to interview someone with HOCD who is homosexual, as HOCD effects both straight and gay people. Both of the people I’ve interviewed so far on this blog have been straight. If you are gay and have struggled with HOCD (in which you doubted your homosexuality and feared you might be straight) and have underwent exposure therapy, contact me! I’d love to feature your story on my blog– anonymously, if you prefer!

HOCD Story: Meet Mae, Part 1

I “met” Mae online about a year ago, when she reached out to me after finding my website. What began as some advice-giving developed into a friendship, and it’s been incredible to watch Mae blossom over the last year as she underwent the difficult, incredible choice of exposure therapy to treat her OCD.

She used to read the “Interviews with a Former HOCD Sufferer” (Interview #1Interview #2Interview #3, Interview #4), and this weekend I asked her if she would be willing to tell her own HOCD story on my blog. She graciously agreed.

Today she’ll share more about her experience with HOCD, and tomorrow she’ll share about her experience with exposure therapy. Mae is terrifically detailed and vulnerable in her story, and I know that will benefit so many of my blog readers.

Thanks,
Jackie

mae hocd

Where do I even begin…

I’ve always been a bit of an “internally anxious person.” When I look back on my life, i had different unwanted thoughts, but it was much easier to dismiss them.

One night after a particularly stressful week at school, my husband and I were having sex (which is normally quite enjoyable!) and the thought “what if I’m a lesbian?” popped into my brain OUT OF NOWHERE.

I could not sleep. Eating was extremely difficult. I lost 20 pounds. I felt like I was in a continual fog. From the moment I woke up to the moment that I attempted to fall asleep, I had continual thoughts surrounding this theme. Sometimes my brain would get bored with the “what ifs” and it would twist and turn things to different things like “you don’t really love your husband” or “hey, check out that co-worker’s butt.” I would walk through a store and continually ask myself, “Is that woman attractive or do I find that man more attractive?”

Every piece of my identity that I had ever known seemed to be crashing before me.

Sometimes I didn’t feel physical anxiety, it was more of a mind game. My head was CONSTANTLY racing with so many competing thoughts. It was extremely exhausting.

Every little thing became an obsession. “Did I like my best friend, she has great boobs and she is smart.” “My instructor at the gym is a lesbian, does she know I’m having these thoughts?” “I’ve always liked boys, I even remember my first crush in elementary school.” “Do I dress feminine enough?” Every.little.thing. consumed me.

OCD likes to latch onto something that is central to our identity or a theme that is close to us. This thought was all consuming for 3-5 months. I tried EVERYTHING. I did mindfulness exercises, I prayed, I tried to eat “whole foods,” I did acupuncture, I worked out SO much, I tried essential oils, I tried natural supplements. I was desperate, but SO SCARED to go on meds and SO SCARED to try ERP. [Jackie interjects: ERP = exposure and response prevention therapy. This is the frontline treatment for OCD.]

I went to three different counselors before I found one that truly did ERP. Do not be dismayed if that freaks you out. I didn’t really understand what ERP was until the tail end of my therapy search. I thought CBT (Cognitive Behavioral Therapy) and ERP were the exact same thing. They are not. ERP is the BEST possible thing you could do for yourself.  I cannot say that I am “cured” or that I waved a magic wand and my obsessive thoughts went away. What I can say is this, for 13 months I felt like I was in hell on Earth in so many ways. I can now say the only time the obsessive thoughts bother me is during my menstrual cycle. Sometimes I will still get a bothersome though outside of my cycle, but now I’m able to let the thought float on by. Whereas 13 months ago these thoughts consumed SO many hours of my day. These were hours that I could have been enjoying time with family, friends, my husband, and I could have been enjoying delicious food too! I had ZERO appetite for quite some time. It sucked.

I can now say that 90% of my life is great thanks to ERP and medication. I understand and honor any individual’s choice on medication. I was very, very skeptical of going on meds. I finally had to acknowledge that a combination of ERP therapy and medication helped SO much.

I’ve accepted and acknowledged that its perfectly normal and ok to enjoy someone else’s appearance (same sex or opposite). We are sexual beings created to admire beauty. I still fully love my husband and find him incredibly attractive. Do I still admire some women’s butts or their outfits? YES! And, instead of that thought and admiration cycling out of control into n endless number of questions I  let the thought be there.

I have written my ERP therapist since finishing session with him. I continually have told him how grateful I am for the work and transformation that took place in my life. Therapy sessions are over, but ERP is a continual practice. It gives you tools in your toolbox to live a healthy life, one that isn’t consumed by doubt, questioning, and anxiety.

The biggest thing I want each of you suffering with HOCD to know is: You are brave. You can do hard things. ERP is scary, but if you are willing to put in the hard work and effort the flip side is incredibly worth it.

HOCD Questions?

Out of the OCD sufferers I hear from, 9 out of 10 are battling HOCD.

In the past, a friend “Hannah,” who has come out on top of HOCD, has been happy to answer questions about her hocd questionsexperience with HOCD.

Hannah’s 1st Interview
2nd Interview
3rd Interview

If you have HOCD-related questions for Hannah, please read the above interviews first to see if she has already answered them. If not, you can anonymously submit your question(s) for Hannah by clicking here.

Once I collect a handful of questions for her, I’ll send them her way and post the answers!

Thanks!

HOCD: A Letter to Loved Ones

Here are a couple hard truths:
1) I hear from more OCD sufferers dealing with HOCD than with any other theme.
2) Many of these sufferers are quite young, still in school, unsure how to seek out help, and scared to share their hard-to-explain concerns with parents or other trusted people in their lives.

I want so much to do something meaningful to help them find their footing.

So, I’m writing here a letter that they can show their parents/trusted advisors. I’m hoping to be a voice if they can’t find their own.

Friends, feel free to share this as needed.

hocd letter

Dear friend of a reader of my blog, hello.

You’ve likely been sent to this blog post by someone who wasn’t able to articulate what he or she is going through– suffering from– or someone who was too scared to trust their own voice and explanation. I hope I can help explain a few things.

The person who sent you this has a strong suspicion that he or she is suffering from what is called HOCD or “homosexual OCD.” Two things to know up front: one, this type of OCD affects both gay and straight people, and two, it does NOT mean that the person who sent you here is gay (if they identify as a straight person) or straight (if they identify as gay).

Confused yet? 🙂 Let me explain.

Obsessive-compulsive disorder can take a lot of forms. What most people think about when they hear OCD is someone who is overly worried about germs or order. While those concerns can be true of an OCD sufferer, the stereotype really misses the point, which is that an OCD sufferer has obsessions– the “O”– unwanted thoughts or images that plague them and cause intense anxiety. They try to relieve the anxiety with compulsions– the “C”– which can take almost any form … really, anything that alleviates the panic they feel. For people who have obsessions about germs, illness, or death, the compulsions often include washing their hands, visiting a doctor, or asking for reassurance (“Do you think I’ll get sick? Do you think I’ll die? Do you think I’m okay?”). For those who have religious obsessions, the compulsions often include repetitive prayer, confession, and (again) seeking reassurance (“Do you think that was sinful? Do you think I’ll go to heaven?”).

One common “theme” of OCD is to question one’s sexuality. We call this theme HOCD. It often comes out of nowhere. Someone who is perfectly comfortable with their sexuality, someone who has never, ever questioned it before, can suddenly be triggered– and now, it’s the only thing they can think about. It becomes their obsession, and to alleviate the anxiety, their compulsions are often things like continually checking their bodily responses to men and women, comparing them, seeking reassurance (sometimes from others, sometimes just from themselves). Often, they will end up spending a great deal of time on the internet, trying to find out why they suddenly are worried they are gay (or straight). I’ve talked to many HOCD sufferers who fit every profile of a straight person– except that they cannot shake the obsession of “what if I’m gay?” Some of these sufferers (both gay and straight, remember) feel absolutely tortured– and no wonder! Our sexual identities are so close to our core. I might hear from a young girl who wants nothing more than to fall in love with a man and get married, but all she can think about is “what if I’m actually gay? what if I get married and years from now, have to leave my husband because it turns out I’m a lesbian?” She will start looking at other young woman, wondering, “Do I find her attractive?” She may start losing her usual attraction to men. She might want to stop hanging out with her girl friends for fear of “turning gay.” (Again, note that HOCD can happen for both men and women, those who identify as straight and gay.) The inability to be 100% certain about their sexuality causes them tremendous distress.

(Even that– “tremendous distress”– is not saying enough. HOCD is sheer torture. And for those who are young and not sure where to turn or who are scared that vocalizing their worries will label them as something they are not– or that they deeply fear being– it is hell.)

A conversation with someone struggling with HOCD can be very confusing.

“So, you like men and want to date and marry a man, but you think you like women?”
“No. I mean, yes. I mean, I’m not gay. I mean, I *think* I’m not gay. I don’t want to be gay.”

“So, wait, you’ve identified as a homosexual man and told us all that you are attracted to men, but now you think you might be straight?”
“No. I don’t know. I don’t want to be straight. But I’m scared I might be. I just need to know for sure.”

That– “I just need to know for sure”– is the battle cry of every person with OCD (whether it manifests itself as HOCD or not).

What you need to know is that, no matter what this looks like, HOCD is not really a battle over sexuality– it is really a brain disorder in which the sufferer’s mind demands a certainty that is quite simply not available in real life. A “normal” mind lets thoughts come and go as they please, but someone with OCD has a mind that traps thoughts so that they only go around and around in circles.

That is why, in the proper treatment of OCD (HOCD or otherwise), we don’t treat the symptoms– the obsessions or compulsions. We treat the OCD and the desperate need for certainty.

Treating the symptoms is like reacting to a fire while the arsonist sets another one somewhere else.
Treating the OCD is like going after the arsonist itself.

How is that done? Through ERP (exposure and response prevention) therapy or through ERP plus medication.

ERP is a therapy in which the brain is re-wired to be able to better deal with uncertainty. It uses exposures that trigger the patient’s anxiety but requests that the patient not respond with compulsions. Instead of getting out of the cold water, the patient is taught to stay in the cold water and get used to it. After a time, as most of us know, it no longer feels cold.

ERP therapy can be done with a professional therapist (there is a great database on the International OCD Foundation’s site) or, with dedication, it can be done from home on one’s own, or with the help of family and friends. I have a list of books that will explain how to do that here.

The most important thing for you to know is that this is not really a battle over this child’s sexuality. It is really a larger, overarching brain disorder and inability to handle uncertainty. OCD will typically move on to harder and scarier themes until it is treated, so I recommend that you help the person who directed you here to get professional help sooner than later. Although this might seem like the time for the family (or even a talk therapist) to “talk it out,” that is the equivalent of putting out fires while the arsonist is still at large. ERP therapy takes out the arsonist.

There are lots of additional resources to help you understand OCD, ERP, and your options at jackieleasommers.com/OCD.

Thank you for being a trusted person for my blog reader.

Best,
Jackie Lea Sommers

P.S. I suffered from various themes of OCD for twenty years. Just twelve weeks of ERP therapy brought my life back under my control. It really works.

P.P.S. As always, a reminder: I’m not a therapist or medical professional– I just have OCD and know a lot about it.

A Third Interview with a Former HOCD Sufferer

First, a note from Jackie: I hear from more OCD sufferers about HOCD than about any other kind of OCD, and nearly every story– when boiled down to its bones– looks the same. In the past, I’ve interviewed “Hannah” (she’s asked me not to use her real name on my blog, though she’s very forthcoming about everything else!) about her experience of having HOCD and being set free from it through ERP (exposure and response prevention) therapy.

Hannah’s first interview
Hannah’s second interview

And now … a few more questions for Hannah.

Outdoor portrait of pretty young girl riding bike in a forest.

Hannah, do you see any common themes amongst HOCD sufferers?
Hannah: YES!! I really, really do. One, a lot of HOCD sufferers seem to have a trigger at some point in their young adult or early adult years, and then they go back to their childhood and start collecting “clues.” In other words, something that happened at the time that they haven’t thought about since (she kissed a girl friend on the cheek, for example), but then when they think about it now, it plagues them (“Oh my goodness, that kiss on the cheek was the first indication that I was gay!”). This is obviously unhelpful and unproductive. Two, a lot of HOCD sufferers tend to lose their attraction to the gender they are normally attracted to. This is scary for them, of course, and seems to enforce what HOCD is telling them.

Did this happen to you?
Hannah: No, but it seems to happen for most HOCD sufferers

Do you know anyone who is homosexual who has HOCD?
Hannah: I do. He is a gay man who loves men, but he has HOCD and gets terrified that he is straight. Even though HOCD stands for “homosexual OCD,” it actually doesn’t only attack straight people. OCD can affect anyone.

I agree with you there. I am online friends with an atheist who has scrupulosity, and most people would think that is an incongruous combination. So, Hannah, I’ve been hearing from some HOCD sufferers who are quite young (under 18), living with parents, and unsure how to approach treatment. What do you suggest?
Hannah: I can completely understand not wanting to tell your parents about your struggles– in fact, when I was going through HOCD, I never told my parents. I didn’t tell anyone until many years later. So I get that. But hopefully those young people can tell their parents that they are struggling with OCD, leave out the HOCD details, and still get help. I think it’s best to meet with a therapist who specializes in ERP therapy, but– as you say on your blog– you can do ERP therapy on your own if you’re very driven. [Jackie interjects: see this post for more info!] The important thing is that, one way or another, you do the exposures of ERP therapy.

Recently, I saw an interview with Elizabeth McIngvale, spokesperson for the International OCD Foundation, in which she said, “With the appropriate treatment (ERP or ERP and medication) you can gain control of your OCD and learn to manage your illness.” I loved that, no matter what, she was insisting on ERP therapy. I know you did ERP therapy. Did you/do you take medication too?
Hannah: I do. Every day. But just like you’ve said before, Jackie, I would choose ERP over meds, if I could only pick one.

Blog readers are looking for hope. Can you give them some hope?
Hannah: A lot of hope! I’m an adult woman who once struggled with HOCD, but today I am 100% sure of my sexual identity. I can even be turned on by women and still know– without a doubt– that I am straight. This is achievable. But it takes the hard work of exposure therapy. But even though ERP is hard, it’s worth it.

What is your best advice?
Hannah: Research, not reassurance. In other words, learn as much as you can about OCD, HOCD, and ERP therapy, but don’t resort to the compulsion of asking anyone (including the world wide web) for reassurances. Study HOCD like a medical subject, not from an angle of “Somebody tell me what I want to hear.” Reassurance feels good for about ten minutes; then you go off in search for more reassurance. It’s a compulsion, and it’s unproductive and ultimately unhelpful. Instead, learn about HOCD and how to treat it (ERP), then DO IT. You can research broken bones– or you get get it set, get a cast, have it heal. Push yourself to get the help you need. There is no other solution besides ERP therapy, so what are you waiting for?

Thanks, Hannah! As always, it’s a pleasure to have you on my blog!

Friends, if you have questions for Hannah, please post them below. And please read my letter to OCD sufferers at http://www.jackieleasommers.com/OCD-help.