Healed Not Cured: OCD Remission & Relapses

I got an email this past weekend from a lovely blog reader who has found victory over obsessive-compulsive disorder through exposure therapy. It’s such a joy any time someone shares a story of freedom, and it does my heart so much good. It reminds me of the reason I preach the benefits of ERP therapy. It reminds me of when I first went into OCD remission back in 2008.

But I also find it important to mention that while the person with OCD has experienced healing, it does not mean that they are cured. In the vast majority of cases, OCD is never cured; it is treated and maintained. What does this mean?

First of all, it’s definitely something to celebrate. I revel in my remission, and in fact, after eight years of this freedom, sometimes I even find myself taking it for granted. It’s a victory to come out of exposure therapy with a new tolerance for uncertainty. It’s a joy and a relief and, for me, at least, a whole new life.

But it doesn’t mean that I don’t have OCD. 

not you again

There are days of intense stress where I buckle a bit and find myself having some obsessive thought patterns or even resorting to old compulsions. This disorder is mostly dormant in me … but it is still in me. And it can wake when I am stressed or fearful. Every once in a while, there is something that will trigger my OCD, and it’s like there’s a CLICK in the way my brain works, a little BLIP in the new system.

But, usually

  1. I recognize it for what it is. I am able to do this because of ERP.
  2. I do not beat myself up over it or assume “all is lost.” It’s merely a step back. I don’t have to start the race over.
  3. I refuse compulsions. (Notably, I allow myself to ask a group of people [usually my coworkers] ONE TIME for what they would deem the appropriate response, and then I DO IT, whatever they say. I know that when my OCD is triggered, I have a hard time understand what is or isn’t a valid response. So I give the decision to others.)
  4. If it’s particularly bad, I listen to my ERP audio track.
  5. I go to sleep, as early as I need to. It is–almost without fail–better in the morning.

I don’t mean this to be bad news–not at all; rather, it’s just something to take note of, something to have in the back of your mind for those stressful days, for those moments when your OCD wakes up and starts to whisper in your ear.

Here’s some anecdotal data about my remission and relapses:

  • In the first 1.5 years after completing ERP, I didn’t experience obsessions or practice compulsions at all.
  • In the years after that, I have had about 1-2 relapse incidents a year.
  • Each incident has lasted on average just a couple of hours. One lasted about two days.

This is nothing compared to my life before ERP. This is manageable. This is freedom. This is remission.

This is good news, people.

If you want to learn more about the exposure therapy that got me to this point, you might want to check out the following links:

jackieleasommers.com/OCD: a collection of my posts about all things OCD
jackieleasommers.com/OCD-help: a letter from me to OCD sufferers, along with a list of next steps
jackieleasommers.com/twin-cities-OCD: resources for OCD sufferers living in or around Minneapolis and St. Paul

Question & Dancer: August 2017

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.

Is it normal for you to feel as though you’re losing your attraction to the sex you’ve always desired bc of HOCD? I know I want to be with a man and only a man but focusing on checking and reassuring myself has started to make me lose my passion for the opposite sex:( will my attraction ever come back (I hope so)? And is it also normal to lose your sex drive bc of HOCD? 

Friend, you are describing HOCD. All this is typical for HOCD and can be treated with exposure therapy. The joy and passion that you so desperately want can be yours again if you work hard through ERP.

I’ve done ERP and reduced my HOCD symptoms drastically. Yet, I still have some worries about my sexuality. I’m no longer sure if this is normal lingering of OCD doubts or a real concern- my compulsions are less but i still do remunerate and  try to imagine my self in a same-sex relationship to cope. I don’t know if this inability to find clarity means that there a real concern as well as the OCD. 

Hi dear, it sounds like you are on the right track! I say keep up the hard work of doing exposure therapy– and don’t forget the “response prevention” part. That means keeping yourself (as best you can) from all the ruminating and checking. I am not a therapist, but I know that for my own ERP, I practiced approximately 40 minutes a day for 10 weeks before everything “clicked” for me.

Hi Jackie, I have hocd. Unfortunately there are no OCD specialists near me or anyone certified to do ERP training. The therapist I see now is only a trauma specialist but it was the best I could do. I know I can always do ERP on my own but I’m too scared and it feels too overwhelming. What should I do?

I can completely understand feeling scared and overwhelmed, my dear one. How would it feel if you were to just begin by exploring ERP, by learning about it but not actually doing it yet? I would recommending getting a book about ERP and reading it strictly for the sake of education. You will still be moving yourself forward, and perhaps it will take some of the fear and mystery out of ERP for you.

I recommend a few books to choose from here.

Hi, recently I’ve been seeing a lot of hocd related questions on your blog. Does it surprise you how many people suffer from hocd? Most people don’t even know what it is, or even believe it to be a real issue. 

You know, at first it surprised me, but after a couple years of hearing from primarily HOCD sufferers, I am no longer shocked. I suspect that people might end up on my blog because HOCD is not talked about as frequently elsewhere on the internet. I don’t know if that is true, but I do know that if you google HOCD, my blog appears twice on the first page. This month I received 16 questions via my blog, and 15 were about HOCD. I promise you: it is very, very real.

my OCD is currently under control but i wonder how it is i’ll ever learn to live with this mind of mine? the endless doubt- never knowing whether something is just OCD or Real?

Hello dear one, wow, I can remember feeling that same way, and for SO LONG too. Life is no longer like that for me, and I trust that you can have the same experience. Part of it for me was having doubt lose its power over me (this was via ERP therapy), and part of it is starting to recognize which of my thoughts fit the “community standard” and which did not.

I talk a little about “community standard” here.

Jackie, I feel so lost and scared. I’m a female with hocd and there are sometimes when I get terrifying thoughts like, I should just try being with a female and not care because I might like it, and then I see a female I know in my head. My worries never end. Besides doing ERP, what other advice can you give me?

Well, of course ERP is always my #1 suggestion. Other things that might help can include medication like an SSRI. Many people with OCD have found relief via mindfulness, but that is not something I have explored much on my blog, since I always recommend ERP. If you are not ready for exposure therapy, consider at least taking the time to read a book about it. Education is a great weapon against OCD.

Jackie, the phrase “don’t knock it till you try it” is really scaring me because I have hocd and this is making me feel like I should try a same sex relationship!!
😦

I know what it’s like to have a phrase seemingly take the rug out from under my feet. But try not to assign so much meaning to a phrase. There are certain things that phrase makes sense with– like trying new vegetables or taking an art class. There are plenty of things it doesn’t make sense with– like trying cocaine or quitting your job to start a crocodile petting zoo. It’s just hard for someone with OCD to sort through it all. The best suggestion I have is exposure therapy. Lots of details here.

Hi Jackie, I have had hocd for a while now. I was texting a friend from church (we are both females) and suddenly I got a thought that, I keep checking my phone because I want her to text me back. I like the attention she’s giving me etc. it’s got me all worried now that maybe I’m crushing on her? Or this is attraction?

Hi dear, this is so similar to many stories I have heard about how HOCD suddenly flared up for them … thinking a friend looked pretty that day, wanting to hear from someone, etc. We assign too much meaning to it. Theoretically, I’m sure you know that most people love attention from their friends, love to hear from them, especially if the conversation is an exciting one. But most do not suddenly worry that means they like that friend romantically. That is where someone with OCD shows how differently their brain is wired. You can rewire it through ERP.

Okay I am 100% sure I’m straight but this is where it gets weird. For some reason nothing was turning me on so instantly my mind thought I was gay. Dumb, right? I thought it’d eventually go away but it got worse. When I’m not thinking about it I can watch normal videos fine but when I watch a video of a male and it pops up I think I’m about to get turned on but mind you, I’m completely soft.

I know this can feel so scary, as if you’ve lost all attraction, but that is commonly reported by people with HOCD. The only question you (technically) asked is, “Dumb, right?” To which I would say, “No. Not dumb. Just HOCD.”

Hi Jackie, I have hocd and it’s terrible. Every time I hear or watch something that just has a normal positive message of, “be your true self, never hide who you are and love yourself ” I automatically think that I’m gay and should come out and not be afraid. Is this just my OCD?

It sure sounds like it. Many people with OCD twist well-intentioned words, giving them too much meaning. The best thing that you can do for yourself is pursue exposure therapy. Read more at http://www.jackieleasommers.com/OCD.

I’m a female with hocd. Why does it FEEL like I’m gay when I know I don’t want to be with girls, when I know I don’t want to be in a relationship with them? Often times my brain feels like it tries to convince me to even like a pretty girl I know! Please help I’m so confused 

It feels that way because of OCD. In non-OCD minds, there is a gate that opens and closes easily– thoughts can come and go as they please, and with fairly little stress. But in an OCD mind, a thought enters and the gate locks shut, which means that that thought just goes around and around and around and around. It is hard to find relief. With exposure therapy (ERP), that gate begins working properly again.

I’m worried. I have hocd and sometimes when I do get my attraction to guys back I’m a female btw, I now worry I’m bi??? Because I’m still thinking about girls and being afraid to look at pretty ones and worrying if I might like one. So I’m all confused that now I’m bi since I’m thinking about both??

I know that this probably sounds like the opposite of what you want, but the truest relief and freedom comes from not having to be certain about these things. I detail the benefits of that here. Please, please read it. I think it might help to make ERP make more sense.

Jackie I have hocd and I’m scared because I keep getting groinal responses every time I look at girls. It feels so automatic like I can always expect for it to come and I’m so aware of it. I have read that a lot of other people experience this too but I’m still pretty worried. 

It feels like your body is betraying you, doesn’t it? You’re right– that’s a very common experience for those with ERP. Start by not assigning it too much meaning, and please read these interviews with Hannah, who formerly struggled with HOCD. I think they will help.

Interview with a Former HOCD Sufferer
Another Interview with a Former HOCD Sufferer
A Third Interview with a Former HOCD Sufferer
A Fourth Interview with a Former HOCD Sufferer
Q&A with Former HOCD Sufferer

Hi I’m 15 years old, I’ve never thought I was gay/bisexual before. Always like boys (I’m a girl by the way). Never had a girl crush. But now everytime I see a girl I think Could I kiss her, have sex with her or could i see a future ( like dating or marriage) with her? Whenever I think about it I frown and get upset. I have OCD/Anxiety disorder, which I was diagnosed with.

Hi dear, a very common experience amongst those with HOCD. I recommend ERP. This might help: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

Hi I’m 14 and I found out I have OCD I’ve told my parents and I had a really bad panic attack bc of thinking I will hurt my family then months go by and my sister called me a lesbian to impress her crush. Then I have theses thoughts of being bisexual but I’m not bc I like guys and not girls I freak out bc if I see a girl who is pretty my thoughts are all like your bisexual and I know I’m not 

Hello friend, I’m so sorry that your sister did that. I’m guessing she didn’t know what kind of agony it would cause for you. Please read this post and consider sharing it with your family if you think it might help: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

Is it part if HOCD to experience an errection while watching gay porn? Like first there is an extreme tension in the chest followed by an errection. 

Yes, this can definitely happen! Exposure therapy is the answer!

Jackie, I have hocd and I’m worried about the whole “sexuality is fluid” thing. I know it’s different for everyone, but the it’s scaring me that I often see for example, celebs who have been with the opposite sex, just start relationships with the same ones and say they like it? So now I’m wondering, well what if I do the same, and I end up liking it too?? 

Hi friend, I hope this post will help.

Hey. So I know that many of us look up to celebs and think they’re very pretty or love their movies and songs etc. I have hocd, but I’ve always really liked Jennifer Lawrence. I was watching an interview of hers and suddenly it made me feel like I am gay for her and wouldn’t mind being in a same sex relationship with someone like her. Now I’m very confused/worried. Help??

Is it causing you anxiety? If so, it may very well be HOCD. Check out these posts about it and see if you can relate!

HOCD
A Closer Look at HOCD
Interview with a Former HOCD Sufferer
A Big Ol’ HOCD Post
Another Interview with a Former HOCD Sufferer
A Third Interview with a Former HOCD Sufferer
A Fourth Interview with a Former HOCD Sufferer
Q&A with Former HOCD Sufferer
HOCD Story: Meet Mae, Part One
HOCD Story: Meet Mae, Part Two

Hi Jackie, I’m a teen with hocd. Recently I decided I’m not gonna be scared of the thoughts and to stop avoiding stuff that triggers my anxiety. However, as I was doing exposure today by watching a coming out video which explained how the girl didn’t enjoy sleeping with men, I suddenly got worried wondering. well what if I’m the same? I’ve never had a bf. How do I know I’ll even like it??? 

I know that people with HOCD can see or hear one thing and then– BAM!– their minds are off to the races, so to speak. You are doing the right thing by not avoiding stuff that triggers your anxiety; next, you need to stop doing things that alleviate that anxiety (the compulsions, whether that means seeking reassurance, checking your body for reactions, etc.). This is how exposure therapy works. Read more at http://www.jackieleasommers.com/OCD.

I consider myself a straight man suffering from HOCD. i am completely cured, but when I think of having romantic attraction to same sex, i feel grossed out but at the same time I feel a sensation in my groinal area. It has occurred atleast 3 times now. I have not experienced anything similar for girls being a boy. So, is this a sign of being gay or is this just a groinal response?

Does it cause intense anxiety for you? That sounds like HOCD. You say you’re completely cured, but OCD is not cured typically (though I have heard of a couple miraculous recoveries). Usually it is just managed and maintained.

Hi! 4 years ago my obsession about my sexual orientation started. A couple of months ago I heard about HOCD & felt completely identified. I was wondering whether is possible to have this disorder without being previously diagnosed with OCD. I’ve been through my past trying to find OCD signs & some things made me think that they were ocd’s behaviors. I also went through anorexia. What do u think?

Remission
Healed Not Cured: Remission & Relapse
OCD in Remission
Life after Treatment
When to expect a relapse
Am I Bitter?
Lies I Sometimes Still Believe
Managing OCD-in-Remission

Im a female with hocd but I’m not trying to ask for reassurance, but more so recognize the way OCD likes to behave. Whenever I read a book or watch a video in the perspective a guy, and he’ll be talking about a girl, just ordinary stuff, it makes me feel as though I’m in his situation and I can see myself with the girl, and it makes me anxious. Is this my hocd? 

Sounds like it, yes. I’m a young adult author, and right now, half of the book I’m writing is from the male perspective. It can definitely be interesting to write about “oh she’s so gorgeous,” etc. 🙂 If the anxiety becomes intense, please don’t hesitate to pursue exposure therapy, which you can learn about at http://www.jackieleasommers.com/OCD.

Do you know many people who did self-oriented ERP and succeeded? Thank you very much Jackie :D.

The best example I know is Shannon Shy, who is now president of the board of directors for the International OCD Foundation. Follow him here. He is endlessly encouraging.

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.

Compendium

I was just writing up a giant blog post about Charlottesville, and I decided to sit on it for a day or so before posting. So, even though this post might be about everything BUT Charlottesville, know that it is at the forefront of my mind and in the center of my heart. I am just wanting to ask a friend to read my post before it goes live. ❤

OCD Study
Last week, I read about this Cambridge study, which found that OCD sufferers might be able to find relief through watching someone else perform their compulsions. The article suggests that maybe a video series could be created to help bring relief to sufferers. This actually troubles me because it ignores the root issues– and I think that you run a HUGE risk of now having those videos become the new compulsion. Compulsions are NOT the solution to OCD– they are a temporary alleviation of anxiety that will almost always become an uncontrollable monster in their own right. In exposure therapy, on the other hand, immediate relief is not the goal. The goal is learning how to live with uncertainty (which is ultimately what causes the anxiety for OCD sufferers) and letting that new way of behavior re-wire the brain for more long-lasting relief. Exposure therapy is clearly the better option.

Salt Novel
I feel so good about where I’m at with this, and especially since we decided to push all the deadlines back a tiny bit. I believe this means it will come out early 2019, which feels far away, but truly, I think it’s perfect timing. I want this book to be the very best it can be, and I’m so grateful for an editor who is on the same page!

Work
Work has been absolutely insane this summer. For those of you who don’t know, my day job is working in enrollment at a local university. We have been up 12% in visitors this year, even as three of our coworkers left this summer for other jobs. Busier than ever, fewer people, plus adding to that interviewing, hiring, and training. It’s just been wild. I’ve worked there 14 years, and we’ve never had a summer like this one.

Reading
Has been slower than I’d like. I finished Hallelujah Anyway by Anne Lamott, which was lovely and like having an auntie whisper healing words over you. I am reading The Smell of Other People’s Houses by Bonnie-Sue Hitchcock right now, and next up I’m excited to dive into If Birds Fly Back by Carlie Sorosiak (check out the incredible cover!).

Balance
This is the key, isn’t it? How do I balance writing, recruitment, healthy routines, and finding time for the greatest set of friends on earth? I guess I’ll start by being grateful.

20991582_10101869764754350_592358811_o

 

Question & Dancer: This & That

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.

I have hocd, and I’m a 17 year old girl. I was wondering, is it weird if I still get crushes on guys during this? sometimes I doubt if I even do like them and the feelings feel fake and forced. Other times, no. Since my hocd started I haven’t been able to really like a guy. If I do, my crush goes away quickly. This makes me worried and makes me think that I can never truly like a guy ever again. 

Dear one, not weird at all. HOCD will do whatever it can to confuse you. Please be sure to read about HOCD and ERP at http://www.jackieleasommers.com/OCD.

Hi Jackie! My question concerns telling my significant other about my HOCD. I have already told him a bit about my same sex attraction fears (around 1.5 yrs ago) but at the time, I didn’t realize it was HOCD. Now that I know HOCD is the culprit I am wondering if you have any advice as to how to explain… I am afraid he won’t believe its HOCD and indefinitely doubt my affection for him. 

This is definitely up to you. I think this is the one of the hugest fears for someone with OCD. I did write a letter you can give to your SO to try to explain things better. It’s available here: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

I just want to say, a massive thank you. I´ve been on hell for the past six months, or maybe more. i even thought about killing myself. and i trully did search for so many blogs, but they are mostly about guys so i didnt feel like i found answers. But this is the first site that is from a girl. Made me feel like there is hope. I hope eventually i get to tell you how truly straight i feel i am.

Thank you for your sweet message. I promise you there is hope, and I look forward to hearing from you after you’ve undergone treatment. In the future, if you are feeling suicidal, don’t hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255 or chat with them here.

I feel like I have accidently made vows to give up things that i enjoy and i didnt want to give them up. I have OCD, but would the vows be binding? For example: “if i step on a crack, i have to stop doing this activity” but sometimes i feel like i mentally agree to it for a split second after the thought comes in my head. Like its 90% intrusive, but 10% my intentional.

I experienced this intrusive vow-making too, back when I was in high school, and it was a dark, dark time of my life. I don’t think that you are bound to these because it is OCD making the vow, not you. In any case, it is better not to focus on “solving” the vow-making but on treating OCD with exposure therapy. Best wishes!

Another vow question. I just feel so stressed because I really feel like I have to give up my two favorite activities according to the vows. After that I am left with no form of enjoyment. Even when I try ERP,  i feel like i am sinning by breaking promises to God and I dont even enjoy doing the activities anymore because of the anxiety.I feel like there is no hope. What do I do?

I also worried that my ERP might be sinful. I hope this post will help you: https://jackieleasommers.com/2014/08/03/ocd-scrupulosity-is-erp-sinful.

Hi Jackie, I have hocd. What worries me a lot is that I don’t have any attraction to guys (I’m a female). I want to like someone but I feel empty and don’t feel any attraction even though they might be perfect for me. What do you think?

Hello lovely, this is perfectly normal for someone with HOCD, and you can defeat it with exposure (ERP) therapy, which you can read about at http://www.jackieleasommers.com/OCD. There are resources there too in case you can’t afford therapy but would like to do it on your own.

Jackie, I’m a female with hocd. I know it is common for people to lose attraction to the opposite sex during this, but will I ever like another guy again?? It honestly feels like I won’t. 

Oh dear one, yes, I truly believe that you will. ERP therapy can help. You are not alone by any means, and I hope that as you read through the questions in this post, you will see that.

Hello! I believe that I have been suffering from HOCD for the past 8 years (this started when I was only 12, unfortunately). I’ve never been diagnosed or treated. However, my question is: is it normal/common for OCD compulsions to change over time?? 

Yes indeed! As obsessions and compulsions shift, we call this “theme hopping,” and you can read about it here: https://jackieleasommers.com/2014/01/19/theme-hopping.

I’ve been told I have HOCD. I have worried about this  on and off. My first time I was 12 & I remember crying to my parents & I think I said something along the lines “I’m staying straight & then I don’t have to be made fun of” now that scares me because that means I’m afraid of society & that’s what gay people go through. Now I feel like I want to be straight just for society reasons. Please help

It is very common for people with OCD to think back on old memories (even ones that have never bothered them before) and suddenly become fixated on them. Sounds like your experience is very consistent with OCD/HOCD. Have you explored ERP therapy? You can read about it at http://www.jackieleasommers.com/OCD!

Hi, I’m a 16 year old girl who has been suffering with HOCD for roughly 8 months now. I have come to the conclusion that the only way to overcome this is through therapy, but I’m scared to ask for help and recieve it. How do I ask my parents? I feel like if I sit them down to ask them for help, they will assume that I’m coming out or they’ll try to get too much information out of me. Help!

I hope that this will help, my dear: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

How can I begin ERP for my HOCD by myself?

Hi friend, you can read about self-directed ERP therapy here: https://jackieleasommers.com/2014/10/05/self-directed-erp-therapy.

Should I open up to family & my boyfriend about my HOCD? It terrifies me to think about telling them about it. Can I deal with it alone?

You can choose to do whatever makes YOU feel most comfortable. Please don’t overthink this (I know that’s a silly think to say to someone with OCD, but I want to give you permission to do what you choose). The links in the answers to the two questions just above yours will be useful (I hope!) in choosing whether it is a better option for you to tell your family and boyfriend or whether to go after ERP therapy alone. Best wishes.

Jackie, I’m scared. I had a dream last night in which I married a female I know. (I’m a female with hocd). It was very detailed, including me being with her in bed. This is the second time this female has appeared in my dreams, I have no idea why. I was unhappy in my dream but I’m lost and terrified that this is a prediction to my future???

I know why: because you have HOCD and have been obsessing about this. It makes sense that it would carry over into your dreams. In this interview with a former HOCD sufferer, she talks about having the same experience: https://jackieleasommers.com/2013/10/20/interview-with-a-former-hocd-sufferer. It is not a prediction of your future, dear. It is natural for our waking concerns to sometimes leak into our dreams.

Can HOCD turn into straight OCD, i´ve spent many times on internet which made it worse. and since truly gay ppl have straight ocd, its now like i kinda have that. To be honest i am about to take sleep pills. Hope there is light

There is light. I promise. Firstly, if you are feeling suicidal, don’t hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255 or chat with them here. OCD can twist and morph through the weeks and years, so that is not unusual. It will do what it can to make you miserable until you learn to be comfortable with uncertainty. The best method for doing so is the evidence-based approach of ERP (exposure and response prevention) therapy, which you can learn about at http://www.jackieleasommers.com/OCD.

Where’s the best place to get diagnosed in the Twin Cities? I’m positive I have HOCD but I’ve never been diagnosed with any form of OCD and I’m worried I’m in denial.

Hi friend, here are a couple resources for you:
https://jackieleasommers.com/twin-cities-ocd
https://jackieleasommers.com/2017/07/24/qa-with-an-erp-therapist

If I’m struggling with hocd, do you think I should stay away from psych forums? I’m already getting help for therapy and medicine though. But do you think it’s my way of just reassuring myself? 

Yes, I really do think it is unhealthy for you to be on the psych forums. Part of your ERP should be avoiding compulsions, and I think this way of seeking reassurance is one. I’m so excited for you that you’re doing therapy and meds though! Are you doing ERP and not talk therapy, I hope?

Please read the following: https://jackieleasommers.com/2014/11/16/talk-therapy-vs-erp-therapy.

I have Hocd been going for 4 months.i always got aroused from girl and lez porn,but I did not wanted to do anything with girls.I once thought about kissing a girl and these things are fuelling my hocd.Yesterday I was horny.I decided to watch lesbian porn to check and I got really aroused i tried to think about having sex with a girl and I felt real arousal like i feel with men.Is my hocd or Im bi?

Does it feel intrusive and unwanted? This is part of how we define OCD.

What do you think of group therapy like DBT for OCD? Specifically hocd

I’ll admit that I’m not very familiar with DBT, though I have heard great things about it, especially in regard to treating things like borderline personality disorder. The evidence-based #1 treatment for OCD is exposure and response prevention (ERP) therapy, a type of cognitive-behavioral therapy (CBT).

Have you read, “All the light we cannot see” by Anthony Doerr? “Everything Everything” by Nicola yoon? And “Unbroken” by Laura Hillenbrand? Those are very good reads. Also, what’s your most favorite book of all time? 

I have read the first two, and I own the third book, but I haven’t had a moment to read it yet! My most favorite book of all time? Man, that’s difficult! I am going to go with Saving Francesca and its companion The Piper’s Son by Melina Marchetta. But everything Marchetta writes is magical. I also love The Chronicles of Narnia by C.S. Lewis, The Book Thief by Markus Zusak, The Scorpio Races by Maggie Stiefvater, The Last Unicorn by Peter S. Beagle, Peace Like a River by Leif Enger. (Sorry, it’s just so hard for me to only say one!!)

https://jackieleasommers.com/2014/08/04/read-these-10-novels-and-we-can-be-friends

Jackie I’m scared. I find myself constantly fearful because of my OCD. I have hocd, and I’m always terrified of the “what if..” although I have never questioned my sexuality, I feel as though nothing helps convince me I’m not gay. Some days I’m just depressed. My mind also wanders a lot. I’m not ready for ERP, but what should I do?

If you are not ready for ERP, the next best thing you can do is start to learn more about OCD and ERP. Education matters. It’s an incredible way to fight back. Track down some books and learn. You begin to steal back power this way.

I’m a female junior in high school, and I sometimes feel hopeless if I will ever get a guy. Every where I look people are in relationships. I’ve never had a boyfriend or even a first kiss. I know god always has a plan, but how can I trust him and know I won’t be alone forever?

Hi honey. I’m 35 and single. I completely get it, I promise. In fact, just this last week, I found myself asking my friends this same question, “will I be alone forever?” I guess that is where trust comes into play. We just don’t know, do we? BUT I do believe that when we love and honor God and follow him, he is the one who gives us our desires– in two ways. He gives us the actual desire– and then fulfills it too. I am being inarticulate. Let me try again. I think that God has given me the desire to be in love. I trust that he will also fulfill that God-given desire with a partner.

Is it normal for HOCD to play a part into ur relationship and make u question ur feelings for a person when u know in ur heart that you love/are attracted to them? Where when ur having guilt&questioning yourself about ur sexuality bc of HOCD u feel like maybe ur not in love w ur s/o or that ur not attracted to them when you know you are but ur intrusive thoughts try to make u think otherwise. 

HOCD and ROCD both cause havoc in relationships, yes. The best thing you can do is to treat the OCD itself with exposure therapy. You can do this, if not for yourself then for your relationship.

I have had HOCD it’s only getting worse. im starting to feel like I’m not in control of my mind. Sometimes Ill convince myself I want to be w a girl when really I just think they’re pretty! I feel like I have to accept being gay to get rid of these awful thoughts&everytime I try to I get so mad bc I know that isn’t me. I’ve always wanted to be with a man, never a woman. I’m scared of my own mind. 

Oh dear one, you are not alone. I promise there is help and hope and light. In exposure therapy (ERP), your brain gets rewired in a healthy way, a way that allows room for uncertainty. That might sound terrible, but it is one of the greatest gifts ever: to be able to let thoughts come and go without having to be sure about everything. It’s a new life. It’s freedom. Please read more at http://www.jackieleasommers.com/OCD.

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.

Q&A with an ERP Therapist

Erin VenkerMeet Erin Venker. I know her through the leadership team for OCD Twin Cities. Erin is lovely, thoughtful, and smart– and she has a unique experience of having OCD and being an ERP therapist. I’m so pleased to be interviewing her on my blog today!

Tell us a little about your background in regard to OCD, Erin.

I first had symptoms in 5th grade but I wasn’t officially diagnosed until 7th grade. At that time, my OCD was mostly rituals of “breathing in” and “swallowing on” the letter A so I would get A’s in my classes. I also did a lot of magical thinking, for example, having lucky and unlucky colors. It soon evolved to include repetitive praying and confessing to mom thoughts, worries, and “bad” things I did, or else I believed something bad would happen. I frequently had horrible intrusive thoughts, both sexual and violent. That period of my life is fuzzy; I just remember it was extremely painful. Daily life was exhausting. I thought I was a horrible person and in constant fear that something bad was going to happen to my family.  I was too embarrassed to talk about my intrusive thoughts, so I didn’t realize that was a part of my OCD until years later.

In college and post-college, my OCD evolved into primarily mental symptoms with rumination, trying to“figuring things out” by replaying scenarios over and over in my head, a constant fear of offending people, and reassurance seeking.

What led you to become a therapist? What are your educational credentials?

I didn’t receive the proper treatment for OCD until 14 years after I was diagnosed. It was at the OCD conference in Boston where I learned that exposure and response prevention therapy was the evidence based approach to successfully treat OCD. I also learned there how common taboo intrusive thoughts were, and that was a huge relief. I decided to become a therapist to help raise OCD awareness and expand the availability of treatment.

I received my master’s in counseling psychology at the University of Saint Thomas and have attended several workshops on exposure therapy. I currently work under the supervision of Dr. Vernon Devine who has 46 years experience treating individuals with anxiety disorders while I work toward my license as a professional clinical counselor.

What services do you offer, and what is payment like?

I specialize in OCD, agoraphobia, hoarding, body dysmorphic disorder, social anxiety disorder, phobias, panic disorder, basically all forms anxiety. I use exposure and response prevention therapy and integrate mindfulness and some dialectical behavioral therapy techniques.

Due to the rising costs of health care, insurance benefits have increasingly become more complex. Self pay ensures that the client’s records and diagnoses are entirely confidential documents as I will not have to submit them to insurance or a third party payer. The content of the sessions stays between myself, the client, and Dr. Devine.

Treatment often involves appointments that need to be longer than an hour, multiple sessions a week, at-home sessions, and public exposures. Self pay allows for treatment freedom as well as the time to get to the root of the problems the client is facing. It makes treatment much more effective. Typically treatment lasts no longer than three months before going to an as-needed appointment basis.

What are the benefits of exposure therapy? How does it work?

Exposure therapy works by essentially helping you confront what you fear the most. For example with contamination OCD, I’ll have clients work on touching and interacting with whatever they believe to be contaminated. If a client has a mental obsession fearing that they are attracted to a family member, we will make a script that they are in fact attracted to that family member. Basically whatever they avoid to protect themselves from their fears, we work up to doing that by creating a hierarchy. We start with whatever trigger the client finds the least distressing and expose them to that trigger until their anxiety decreases. We then gradually move up the hierarchy until the client is ready to confront the most difficult exposures.

Can you briefly describe how you guide a patient through ERP, especially what the first couple sessions might look like?

In the first session, I get to know the client, gather some background information, and go over an assessment I have them fill out before the appointment. We go over details about their presenting symptoms and explore their triggers.  We then begin to build a hierarchy of ways to expose the client to the thoughts, images, objects, and situations that they find distressing and provoke obsessions/compulsions. ERP is no walk in the park, but it is an evidence-based approach that has shown to be incredibly effective.

Many of my blog readers are very concerned about being judged by a therapist who doesn’t truly understand OCD. What advice would you give to them?

Know that whatever intrusive thoughts or rituals you have, no matter how embarrassing, weird, or perverted you believe they are, I guarantee they are extremely common in OCD, and thousands of individuals have similar if not the same thoughts and compulsions. Everyone has intrusive thoughts– people with OCD just get them stuck in their head and distressed. Whatever you find most upsetting, OCD will latch onto it and continuously project it in your head like a song stuck on repeat.

Find a therapist who truly understands OCD. It breaks my heart when I hear about individuals who saw a therapist, tell them about sexual or violent intrusive thoughts they are experiencing, and the therapist does not recognize these symptoms as OCD. This can create further isolation, shame, and hinder the therapeutic process.

Erin Venker 2One last question: reassurance is often a compulsion for OCD sufferers. How can a therapist practice compassion without reassurance? What is your approach to this?

I use a lot of humor in treatment. I try to help clients notice when there OCD is sneaking up on them. Depending on the context and the individual, I will push the exact opposite of the reassurance they are seeking.

I have a rule of thumb that in the appropriate moment, I will only reassure once. I know you are not a pedophile, this is the one and only time I reassure you. After that, it’s all about accepting uncertainty. Well, maybe that thought does mean you want to kill someone, let’s make a script of it happening. At the same time, I validate the client that ERP is extremely difficult, and what they are doing is brave and hard work.

Thank you so much to Erin Venker for a great interview! If you are in the Twin Cities and think you could benefit from working with Erin, click here for her contact information. 

Question & Dancer: I Promise There is Hope

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.

Ok I am so confused lately. I am a 27 year old male and has had what I consider to be HOCD for at least 4 years now When I was younger people used to ask if I was gay, and that never bothered me until more recently since I started to have this OCD. More recently however I am starting to doubt myself because it is starting to feel realer and realer. Wanna do ERP but I am very anxious about it.
I was so anxious to do ERP too! In fact, I almost bailed partway through– right before everything ended up “clicking” for me. Read up about it beforehand so that you have an idea of what to expect. I always say that you will be ready for ERP when the hell of daily life with OCD is worse than the anxiety over ERP. I will say this: it was one of the greatest things I have ever done for myself. Twelve weeks of ERP vs. twenty years of OCD (with no end in sight)? There’s a clear winner there.
Can HOCD actually begin to feel real? At the start, it caused me loads of anxiety but now I’m starting to believe it and it scary 😦
Hello dear, yes, I think that most people with HOCD get to that point. I’m sorry for all your fear and anxiety. ERP can help.
Hi! I did the harder exposures for HOCD (I’m a girl by the way) and it really terrifies me to the point of tears while doing the exposure of looking at a androgynous female. It bothered me immensely but I stayed with it. However, I felt fearful and anxious at the same time because I actively avoid it because of the fear of attraction. Is that still HOCD?
If you are fearful that you are sexually attracted to females, it’s quite likely HOCD, yes. I remember crying while doing exposures too. Please don’t quit the exposures– but also, please do be kind to yourself. Give yourself a treat: ice cream, a nap, a new pair of shoes. What would you do for your best friend if he or she was going through all this? Treat yourself just as kindly. But don’t give up on the exposures.
Hi Jackie, I’ve had hocd for over a year now and it’s been rough. For the past three months I’ve been using this new medication and I believe I’ve gotten better. But, whenever I get my intrusive thoughts my brain doesn’t spike much of a reaction anymore and I’m not as scared. This is making me worried because I feel like my fear shows I’m not gay but now I’m not so sure. Can medicine do that?
I feel like this is such a nasty paradox with OCD! We get so much torturous anxiety– and we hate it– but then, if the anxiety lessens or goes away, we start to fear there’s a reason behind that. Please remember that the goal is to not have those extreme reactions when you have intrusive thoughts, so you are moving in the right direction! Thoughts are just thoughts. Everyone has weird thoughts, but most people can just let them go, whereas for those of us with OCD, we hold onto them and give them too much meaning and make ourselves sick ruminating. Let the thought just be a thought. It is good that the anxiety lessens in time.
Jackie, is this a compulsion? Every time I get worried about my hocd thoughts, my reaction is to go God and pray that I’m not gay. I know I don’t want to be gay. I just want to be a straight female and have a guy. But I feel like god is my only true hope for getting better although I’ve been doubting him a lot with all of this hocd stuff
Ritualistic prayer was also one of my compulsions. I would pray to “ward off” blasphemous thoughts and curse words that would pop into my head. But I also could tell a difference between my true, heartfelt prayers and the automatic ones that I was using as a compulsion. I kept doing the former, but the latter ones, I stopped. At first, because it was so automatic, it was very hard to stop, but I would actually interrupt myself and think No. I do not need to pray ritualistically. I didn’t think it would work– but it did!
How long did you personally have hocd for?
I had a brief bout with HOCD in junior high. My primary obsessions through the years were religious ones though.
Jackie I feel like my hocd gets MUCH worse when my period roles around. Could this be true? I just feel way more depressed and my intrusive thoughts get more frequent and intense.
I really do believe this can be true, even though I don’t know enough about the science behind it.  But on my period, my hormones are all out of whack, and everything seems more intense and stressful and emotional for me. I feel sadder and lonelier on my period, and sometimes I have bad cramps, so I’m in actual pain and cranky about it. I am definitely not my best on my period or in the days right before it, and I’ve had the same experiences with my OCD being worse then (I’m not sure if it’s worse– or if I’m weaker– during those days!).
Jackie I’ve had hocd for a while now. How did you stay strong? How did you not cave in and truly lose hope by believing you’re gay?
I spent 15 years with OCD before I was finally diagnosed, then another five before I began the exposure therapy that gave me back my life and freedom. How did I stay strong during that time? Honestly, I was not strong a lot of that time. I cried a lot, but I also surrounded myself with the most incredible people: family and friends and mentors and roommates who let me lean on them in my weakness. My Christian faith is also a ballast for me, although OCD went after that pretty hard, and I had to rely on the faith of my friends and family, if that makes any sense. Make sure that you have an incredible support system, one that won’t enable you but that will let you be honest about your struggles and will love you, even in your darkest, weakest, most hopeless moments.
I lived with my friend Desiree for seven years, and she saw me through some of the very worst times with my OCD. She wrote this post about it, in case you’re interested!
Jackie, my therapist and my mom both say I try and convince myself that I’m truly gay ( I have hocd). I just can’t help being very doubtful all the time. Even when I like a guy through all of this I still doubt if everything is fake. Advice?
This is what the doubting disease does– it poisons everything! The very best advice I have is to treat it with exposure and response prevention (ERP) therapy, which can be done with a specialist or on your own with the help of a book from the library. Be sure to check out my posts at http://www.jackieleasommers.com/OCD for more details and book suggestions!
Hi Jackie I’m a female and I have had hocd for nearly 13 months now. I stare at girls so much! In my head I constantly hear myself saying “wow she’s so pretty” and I can’t stop thinking that. It haunts me later in my day as I keep seeing any girl in my head from school. What should I do?
This is what OCD/HOCD will do until you either switch to another obsession or treat it. I recommend treating it with exposure therapy! Please check out my posts about HOCD and about ERP at http://www.jackieleasommers.com/OCD. It changed my entire life.
I’ve had hocd for a long time now and I know ERP is the right thing but I’m too scared to do it. I just don’t feel mentally mature or ready enough to do it. What do you think? Should I just face it head on?
This is such a good question. I didn’t feel ready for it for a while either. When I felt I had exhausted all my other options, I knew it was time. Most of the time, ERP is not done via “flooding” (which is what I think you mean by “face it head on”) but rather via a strategic hierarchy. You start with the things that make you least anxious and work up to the doozies later on. I think this is probably the best way to go after ERP; it builds confidence early on when you win a few smaller victories, plus your brain begins to change, giving you more tools for attacking the harder things later. I remember on my first day with my ERP therapist, he said we would work up to X, and I thought, “If you think that I will EVER, EVER, EVER, EVER do X, you’ve got another thing coming, mister.” And yet, about 12 weeks later, I was there. Terrified, yes. Anxious, yes. But it had gone from being utterly impossible to being possible-but-scary. And after that, my OCD snapped in half. I’ve had freedom for nine years now.
How do I know if my therapist is good? Upon graduating college, I have developed extreme anxiety and HOCD. I found a therapist who preaches ERP but does not have good reviews online. I met him for the initial consult and liked him but how do I know whether I should trust him.
Do the reviews say that they don’t like him personally or that he doesn’t know his practice? You don’t need to like an ERP therapist for ERP to work. In fact, at the time, I thought my ERP therapist was a monster. (Now he is my hero.) Our personalities did not jive and, of course, he was asking me to do things I didn’t want to do (this is the nature of ERP therapy!). Make sure that you have educated yourself on what ERP should look like, so that you will be able to recognize if he is guiding you correctly. As far as whether or not he’s likable … meh. Not what matters in this situation.
Read about my reunion with my ERP therapist, seven years after I last left his office.
I feel really sad. Some days my hocd is not that intense and I’m sure I’m straight but other days its bad.When I’m convinced I’m gay, I get very depressed. I withdraw and stop doing anything, and spend the majority of my time in bed. They tell you in therapy that if you hate the idea of being gay, that you don’t like the idea of being with the same sex then you’re not gay. Do you agree with this?
I hate to speak in too wide of generalities, but if I am interpreting your question correctly, I would say yes IN GENERAL. Again, I don’t know that it is helpful to speak in such wide-spreading generalities. I did ask some of my friends (both with HOCD and others who are gay) to answer a variety of questions so I could compare them. I thought the results were interesting. Friend, please consider exposure therapy to treat your HOCD. It is the #1 treatment for OCD recommended by all OCD experts, and it changed my life. I know those depressed days spent in bed all too well. You can move past this.
Is there really a light at the end of the tunnel? I feel hopeless. I have hocd and hate my life because I just feel depressed. I want to be better but I can’t bring myself to give effort. I get told, happiness is a choice. But I feel like this doesn’t apply to people who suffer from OCD?
Friend, I promise there is light. And hope. And freedom. Exposure therapy can help you get there.
Ahhh yes, the choose happiness thing. Blah. Let me say first that I agree with you.
Here is my post entitled I Don’t CHOOSE to be Unhappy. Later, post-ERP, I wrote a post where I talked about choosing to be happy. The very next day I posted again and this time included what I called a “thoughtful caveat”:
P.S. I want to clarify: this post is not in contradiction to this one. I still believe that many people with brain disorders do not have the capability to simply choose to be happy. But I am finding in my own life that medication and OCD treatment and talk therapy and prayer are tools that are making that more and more possible for me. I am one of the lucky ones who has had so many opportunities and resources. They are opening up new doors for me that were locked even just a year ago. Would love to hear your thoughts.

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.)

Question & Dancer: OCD & Family, Romanticizing Mental Illness, and What to Expect in OCD Remission

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.

How do you explain OCD to your family? Especially when you’re not sure whether or not your family has mental illness?

First I’ll say that I think that it’s up to each individual to determine whether or not they’d like to share– and how much. With OCD, many of our obsessions are taboo, which– quite honestly– makes the idea of sharing seem terrifying. I hear from a lot of younger sufferers too, who are under their parents’ roof and parents’ health insurance, which complicates treatment.

I heard from so many teens with HOCD that I wrote this post in 2015 so that they could share it with their parents and not have to say a word themselves. I’d be happy to write a general OCD one, if you guys think that would help.

As for me? I gave my mother a copy of Kissing Doorknobs by Terry Spencer Hesser– a copy in which I had underlined all the quotes that resonated with me. At that time, it was the best I could do to explain what I was experiencing. These days, I’m more articulate– but I have lived for longer with my diagnosis, been through treatment, and come out shame-free. I know many aren’t there yet.

Is HOCD a physical illness as well as mental?

Briefly, yes.

Hi, does OCD make you want to confess something even when it’s not true?

I have Pure-O, and confession was one of my biggest compulsions. I would confess to bad thoughts, things I thought might be sinful, anything that my OCD took and throttled me with. And yes, sometimes those were things that I didn’t even need to apologize for. But the anxiety would grow so intense that the only “release” was to confess. I got a lot of weird looks in those days.

Here is the thing: if you (like most people with OCD) can understand when you’re thinking or doing something off (you know it is not quite logical, even if you have created a weird sort of logic for it; or if you know it is something that the general public would not care about or confess), then don’t. This is fighting back against your OCD with the tools of exposure therapy. It will, for a time, feel like the anxiety will go so high that things will never be okay again, but that is the lie of OCD. The anxiety will diminish, and you will be okay. Stay in the cold pool long enough to adjust, and eventually the water will not feel cold anymore. But this can only happen by staying in the pool.

I read your post about OCD and creativity. Could those two ideas be linked to intelligence?

Great question. You’re likely referring either to this post or to this one.

Research has shown that high IQ is correlated with anxiety. Anecdotally, many people with OCD are also very creative (did you know popular YA authors John Green and Maggie Stiefvater both have OCD, along with unpopular YA author Jackie Lea Sommers? ;-))

HOWEVER, OCD is not something to be embraced. I know that in the past, I thought if I didn’t have OCD, I wouldn’t be as funny or quirky or creative. John Green, in a talk I once heard, shared that he also had that false understanding for a time– that his OCD was what fueled his creativity. He’s written about that here. Please read it; it’s very good.

The point is that– whether or not there is a link between OCD (bad, awful thing) and creativity and/or intelligence (good, excellent things)– we need to be careful not to romanticize mental illness or to give props to it. If you are smart or intelligent, kudos go to you, not to the disorder.

I treated my OCD in 2008, and now I am more creative, more me, more productive, more intelligent. So it wasn’t OCD that made me what I am at all. In fact, OCD was holding me back. Don’t romanticize mental illness. Treat it.

Hi…this is a weird question, but I’m worried ERP won’t work on one of my particular obsessions. I made some account on a website and now feel the compulsive urge to delete it because maybe I don’t like the username and it’s “contaminated.” But at the same time, I don’t want to delete it because I’ve invested some time into building it up (it’s a writing website, more articles you write higher rating you get)…but I’m worried if I don’t delete it, this anxious feeling will never go away!

That is a lie: the anxious feeling will go away … and possibly sooner than you’d think. ERP works great for situations such as these. You can do this.

With OCD, can it be possible that you don’t know the difference between what thoughts are even yours anymore or the OCD’s?

That is possible– and sometimes happens to me when I’m in sort of a manic state.

Most often, I can tell the difference. I know that one thing feels a bit ridiculous. And this is a hallmark of OCD (except in very young children): that people with OCD usually have some understanding that what they are obsessing about is not something that most people would worry over.

My ERP therapist taught me to look at these things through the lens of the “community standard.” That is, how would most people react in this situation? Because if my reaction is way off from that, then for ERP, I need to go with the community standard instead, even if it’s scary or hard.

When I am in the throes of an obsession, I sometimes can’t tell what the community standard is. I have literally sat down my friends or coworkers, explained the situation, asked for the standard response, and then BELIEVED IT and DONE IT, no matter how difficult. Because this too is part of exposure therapy, the very best treatment for OCD. (If you’re not familiar, you can read up on ERP at http://www.jackieleasommers.com/OCD.)

I have thoughts about death and how we will all disappear after this…and if life is meaningless or not I’m diagnosed with OCD and i had HOCD , harm ocd , etc… Is that a new theme or is that something new ?

This sounds like an existential theme of your diagnosed OCD. This was a huge part of my own experience, and what my first novel is about! See http://www.jackieleasommers.com/truest.

With your OCD, do you ever feel that you’re wearing a mask everyday?

Not anymore– but before, YES YES YES.

I used to talk about this with high school students in the midwest, and I would read this poem aloud.

I’ve been struggling with ‘Pure-O OCD’ for a while and because my compulsions are almost exclusively mental, I’m afraid I’ve been automatically engaging the negative sensations associated with the thoughts I get. Although I know the thoughts are very irrational, I can’t seem to be mindful enough to sit with the negative emotions and not have them affect my mood. Little by little, over the years the thoughts are triggered by almost any activity I’m involved in and I feel like I’m running around in a circle and not making much progress. Activities and events that are supposed to be enjoyable are viewed by my brain as hurdles and obstacles to overcome. As far as CBT goes, I tried following the 4-step method by Dr. Schwarz which help a little to put me in the right mind set but I haven’t had much sustainable success. Being a Christian, I feel like I’m wasting time giving in to the negative pull the thoughts I get have on my behavior, which in turn, rob me of valuable time spent acting as a true follower of Christ. Based on your experience with Pure O, what would you say is the best CBT method to effectively manage it? Is it ERP or mindfulness, or a combination of both? Thank you

While I know a lot of OCD sufferers who practice mindfulness, the #1 treatment recommended by all OCD experts is ERP (exposure and response prevention) therapy. Your story sounds so, so, so, so similar to my own. I went around in circles for 20 years before doing ERP. After just 12 weeks of ERP, I have had tremendous freedom, peace, joy, and spiritual growth for the last 9 years. You can do this!

I hope you’ll take the time to read my post about Post-ERP Spiritual Growth. It really summarizes all the healthy changes that came about in my life and faith after treatment. Blessings!

I feel like I might have OCD..maybe ROCD for a while, but that cleared up so I’m unsure about that. I’m 13 years old (a girl) and I think I have been dealing with hocd since the end of 6th grade (11 years old). I have been with my boyfriend for 7, almost 8 months. This hocd is getting better…I think. I always feel like there is another person in my mind telling me that I’m gay. I sometimes don’t feel as disgusted as I usually do when that happens, and that scares me even more. I wish I could tell my boyfriend, but I feel like he would think I actually am gay. Also, Recently i have the tendency to look at girls’ butts and boobs! Is this normal? Is it not hocd? It bugs me so much, and I feel so disgusted and guilty. I’ve never wanted to kiss, date, or do anything sexual with a girl. Whenever I see a girl, I think “she’s pretty.” And then I start questioning myself. And I think “is she attractive? Do u want to do stuff with her?” And soon it calms down. But it comes back as quickly as it goes. It’s so scary. I want it to go away for good. I told my dad two years ago when it wasn’t as bad. So he doesn’t know the full story. My mom knows and I told her recently. She doesn’t understand how horrible it is. I don’t want to tel her everything I question and feel because I don’t want her thinking that I am gay. Even though she would be fine with it. But I’m not. I want that therapy. I’m on medication for anxiety, but it’s not helping too much. This hocd causes me anxiety and depression. I went through a really bad period of this about a month ago, for two weeks. I wanted to die, and I’d use my nails to scratch myself. I don’t know what to do. I wish I could tell my parents, friends and boyfriend, but I don’t know what they would think. Please help me. I want an OCD free life.

Oh sweetheart, please read my answer to the first question above. I think it will help you. Consider sharing this post with your parents. ERP works; it truly does. You are thirteen and have so many exciting things ahead of you– your whole life! The earlier you treat OCD, the sooner you can get to enjoying things again. If you really feel like you can’t tell your parents about your OCD, and if you’re driven, you can treat it yourself at home, using one of the books listed in this post. Don’t give up, honey. Gosh, I can remember being in the same hell that you’ve been living in when I was your age. It feels so horrible and hopeless and exhausting. But you won’t be there forever. ERP will help. Hang in there.

Want to know more about consequences of years of compulsive behavior and thinking haunting life…even after ocd is gone

This is a really good question, one I’ve not been asked much before.

First things first, OCD is very rarely ever gone. Except in the case of a miracle, OCD is a chronic disorder that a sufferer has until death. That said, ERP therapy can subdue it to the point where it feels gone, which is just about as good as the real thing, right?

I’ve written a pretty detailed post about remission and relapses here. While I think it will answer an aspect of your question, the spirit of your question seems to be: what lingers?

For me, not much. (Thank God!) OCD has little to do with my daily life anymore. That said, there are seasons (and in fact, I’m in one right now) when it is like opening a rarely used door in my life only to find that OCD has actually been chilling out there for years, just waiting for you to reenter that old room. (For me, it’s dating. I haven’t dated in a while, and so I haven’t had to deal with the whole ROCD thing. It’s okay. I’m battling it, and I have all the confidence in the world that I can subdue it because I’ve done it successfully now for nine years.) For me, the 12 weeks of ERP therapy I underwent had a far longer-lasting influence on my thought patterns than the 20 years of obsessions and compulsions that came before. It is that powerful. Learn more about ERP at http://www.jackieleasommers.com/OCD.

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.)

 

Question & Dancer: Compulsions, Doubt, & HOCD

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.

Donnann asked: How do i deal with intrusive thoughts in the form of questions which sometimes i feel like i need to answer? They give me anxiety not finding an answer either by googling or asking reassurance.

Hi friend, asking reassurance (of friends, strangers, Google, the internet, etc.) is, in this case, a compulsion. Compulsions will never be the solution for an OCD sufferer. In the moment, it might feel good, but it is not a lasting solution. I’ve shared a metaphor before about OCD as an arsonist, setting fires in various corners of our brains. Compulsions are short-sighted in that they try to put out individual fires. It is impossible to keep up this way because while you are putting out one fire, OCD the Arsonist is setting another three. Exposure and Response Prevention (ERP) therapy, on the other hand, goes after the arsonist itself. Compulsions are band-aids; ERP is surgery.

Aurora asked: Is it common for HOCD sufferers to begin questioning whether they really have OCD?

Incredibly common, and not just with HOCD. I think that just about every person who has OCD of any stripe has, at one point or another (or a thousand points), wondered if he or she really does have OCD. Remember, OCD is called the “doubting disease.” It lives up to its name in the fullest sense, even down to a diagnosis. I know that, even when I was diagnosed with OCD and then read a book about it in which I saw myself over and over in the examples, I still faced that question. Everyone I know who has OCD has had this same concern. You are not alone!

Susan asked: What do you do when in church and the bad thoughts come?Also how do you stop ruminating?

This is not going to be a popular answer, but here it is: you let the bad thoughts come. You let them just be thoughts and don’t assign any special value to them. You let them exist and you do not fight them. OCD feeds off resistance. When we quit resisting, it gets bored with us. You learn how to do this in a healthy way via Exposure and Response Prevention (ERP) therapy. Just twelve weeks of ERP set me free after 20 years in bondage to OCD. After I learned to stop resisting and to not give bad thoughts too much value, they quit coming as often. In the first 18 months after doing ERP, I had no obsessions or compulsions. In the years since, I do very little ruminating (maybe one or two obsessive relapses each year, no more than a couple hours each). Compared to my nearly constant ruminating for two decades, this is peace and freedom.

Briana asked: Am I ever going to find someone?

Briana, you and me both, girl. I’m window shopping on eHarmony. How about you?

Halima asked: What have I done to deserve this?

Nothing, dear one. Illness sometimes just is what it is. That said, as one of deep Christian faith, I do have lots of thoughts on this. But I don’t believe it is a punishment at all.

Halima asked: How do you manage your OCD in different times of the day when the feelings of doubt and uncertainty are the most crippling?

It has been nearly nine years since I underwent the ERP therapy that changed my life. I very rarely experience that high-intensity, crippling doubt anymore, even though I was well acquainted with it for two decades. When I do have these attacks, I go back to my ERP toolbox: I accept the thoughts, I do not assign special value to them, I refuse to succumb to compulsions, I assess what the community standard is (or ask friends if I cannot tell this myself), and then I go forward with that standard. I make this sound so easy, and I know (believe me, I know!) that this is not easy, not at the beginning. In exposure therapy, you are trained how to do this, and your brain is actually re-wired so that you are able to do this. The brain actually physically changes. That might sound scary, but for me, it has allowed me to be the very best version of myself in all ways: I am more curious, more thoughtful, more productive, more creative. ERP did not erase my questions. It gave me the tools and strength to approach them in a productive way. Before I would just chase questions around and around and around, like a dog chasing its tail.

I also think naps are awesome. 🙂

Anonymous asked: What if you do see a major loss of attraction to the gender you’ve always been attracted to but don’t see a spike in false attractions to the same sex?

This sounds like so many HOCD stories I have heard over the years. The answer is still the same: exposure therapy. I invite you to read more about this from Hannah and Mae, a couple of former HOCD sufferers who each went through ERP:

Interview with a Former HOCD Sufferer
Another Interview with a Former HOCD Sufferer
A Third Interview with a Former HOCD Sufferer
A Fourth Interview with a Former HOCD Sufferer
Q&A with Former HOCD Sufferer

HOCD Story: Meet Mae, Part One

HOCD Story: Meet Mae, Part Two

Anonymous asked: Hocd or never was? – I was diagnosed OCD about 7 years ago. Had many OCD behaviours, fear of aids, terrified I’d commit a crime and would be arrested, checking I haven’t hit someone with my car, checking food, washing my hands and lips because I felt dirty or was too close to something I deemed dirty. My biggest one is hocd. I was treated for it and had good success, thoughts were still there but I coped. But since starting uni and wanting a career as a beauty therapist it’s come back big time. I have a recurring obsession about a past friend who I still sometimes see that I’m attracted to her. It will kind of rotate friends and aquaintanxes until they’re spent and then come back to her as a ‘failsafe’ as my mum calls it. But recently, I foolishly looked for reassurance on a message board, and found a post that said after therapy for hocd you might find out your gay and apparently that’s ok. Now I’m terrified to do my ERP/CBT homework. I’m also thinking it keeps resurfacing because I’m actually attracted to women and must accept it. I sometimes don’t feel disgusted anymore and not anxious and that makes me even worse. I’m just so scared that I will turn out gay, have to leave my boyfriend give up on my future family with him. I’m so scared sometimes I feel not scared anymore. I’m so lacking sleep right now. I’ve referred myself to a therapist again, but I’m terrified he or she will reveal I’m gay. I’m so afraid, please help? I read your interview with a former hocd sufferer and pray that can be me soon.

This is a very common fear for people going through ERP/CBT– that it will actually “reveal” something about them, whether that is related to their sexual identity, their “life of crime,” their “evil nature,” etc. It’s important to remember that OCD goes after the things that are most important to us, the things we deeply value. That is what makes it so hard to do ERP. If OCD went after things we didn’t care about, it wouldn’t cause that anxiety and all the questions. Stop assigning special value to these thoughts (“it must keep resurfacing because it’s actually true”); it keeps resurfacing because you have OCD and your sexual orientation is of utmost importance to you, that’s all. I’ve talked to MANY HOCD sufferers, and I’ve never heard one of them say they wish they hadn’t done exposure therapy. I am doing my best not to offer reassurances in this response (I don’t cater to compulsions!), but it’s hard! I will just say that I don’t think you can go wrong with ERP.

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.)

 

 

 

Thoughts on ERP, Writing, & Uncertainty

Uncertainty.

For so many years, it was my enemy– or so I perceived it, especially because full-blown clinical obsessive-compulsive disorder made me fear and reject uncertainty even more than the average bear. Everything in my life was about pursuing certainty, answers, black & white.

And, of course, I was miserable.

In 2008, I went through the harrowing but ultimately beautiful process of exposure therapy, which took my OCD out at the knees, giving me the bandwidth to live with uncertainty, questions, and all the shades of gray.

It’s only recently that I’ve recognized exposure therapy as the training ground (or maybe even battle ground) that would let me later pursue my dreams of being an author.

A hard truth: writing is full of uncertainty. 

uncertainty2

Not just writing– but publishing itself too. There is this crazy-making stretch of life in the middle of writing a book that feels both unclear and perpetual. What is this book really about? Who are these characters? Can I do this? Can I finish this? Is this story going to matter to anyone but me? Is this going to even matter to me? Will my writing group like it? Will my agent? My editor? Readers? Will I find success? Will I get another contract?

The writing life is, for many of us (and especially for younger writers), a world in grayscale: a constant state of uncertainty that we have to persist in in order to find any relief or success.

For as many days as I think I’m totally failing at life and writing, I have to remember what it would have been like to be writing and publishing before exposure therapy, back when uncertainty was unbearable. I’m not even sure how it would have been possible to be doing what I’m doing now without exposure therapy laying the groundwork for me to bear the not-knowing, let alone to thrive in it.

“The world doesn’t work that way.” I hear myself and other OCD awareness advocates saying this to sufferers all the time. In context, we mean, “Life inherently is full of uncertainty. You cannot eliminate it.”

The truth of that hits me over and over again in the field of writing.

Exposure therapy was the terrible, grueling practice for the writing life. Uncertainty is rampant; I try to keep my arms open.