HOCD: 4 Steps to Freedom

Every month, the majority of questions I am asked are related to HOCD, and many of the questions come from teens. Below, I want to show you the list of HOCD-related questions I received this month; I am hopeful that these question-askers can read through this list and understand that there are so, so many others going through the same experience right now.

Because I have said just about everything I think I can say about HOCD– and had several guest bloggers add their thoughts about HOCD– I am going to answer all of these questions in one response at the very end. I hope it will help.

I wanted to know if you can get aroused by the same sex and not be gay. I do this but the thought of being with the same sex repulses me. also I recently got a crush on someone of the opposite crush and I had a good feeling.   I get anxiety when thinking of being with the same sex for society reasons and just the fact of being gay. Sometime I feel gay, frustrated and not right.
I feel so scared. I don’t know for sure if I have HOCD or not, and I’ve been doing so much research on the topic that I’ve become bored of reading everything. But now I’m scared that this means I’d rather be gay, and that if I looked for treatment I’d just turn out to be gay. I don’t want to be, I’m even starting to doubt that, too and it’s scaring me so much. I don’t know what to do, anymore.
I’m a 14 yr old female and I was recently reading fanfiction smut aka sexual description and it was boy x girl, I was comfortable with it and then got a compulsion to look up girl x girl to see how I reacted, I read it and felt a little aroused but mainly disgusted, I think the arousal was left over from the earlier stuff but I can’t get it out of my head! I’ve had HOCD for a while now, help?
Just an update on my earlier post (I was the 14 year old smut one) I attempted to read another girl x girl story without reading boy x girl before and I had no reaction just a bit of grossed out-ness (I don’t mean to offend anyone). I wanted to also say that I have had anxiety age 7 and talked to a therapist about HOCD, so this isn’t new, and I have never had doubts that I wasn’t hetero before
Hi Jackie. I’m a female with hocd, and I’ve had it for nearly 1.5 years. I know it’s common to be uncomfortable and scared around your friends, but I just can’t stop being so anxious and terrified around my best friend. We talk normal and everything but as soon as I’m alone I start seeing her face in my head or the way she dresses and I dread seeing her. I don’t want to like her is this my OCD?
Hello! I believe I’m suffering HOCD (I’m 14-16), and I’ve definitely had it more than once (I was unaware though). I feel absolutely numb, devastingly though, I can tell my anxiety is lurking in the background. Although I don’t feel it quite yet. I still notice I’m very subtlety panicking and checking, but without the intensity of before. Is this normal? (Well obviously not, but you get my point).
Im a 14 year old girl who has been diagnosed with HOCD, and every time I think it’s gone I see something that brings it back. For instance today I saw an article about someone who thought they was straight and fell in love with a girl and here it comes again. Any suggestions as to how I can stop this cycle?
I have been struggling with unwanted, intrusive thoughts for almost a month now. It just started out of nowhere when this weird sounding voice in my head said, “I’m gay.” It didn’t feel like me at all, but I have suddenly lost all interest in boys (I’m a girl). I had a massive panic attack about this, and my medicine was changed. I am talking to a boy right now, but the thoughts keep coming back!
Sometimes I admire other girls and really wish I was them, but I don’t want to be with them, I just want to be them . . . I have HOCD and it scares me that it might be a crush and I just don’t know it? Sometimes I just get intense feelings of admiration and having HOCD makes me terrified! Any suggestions?
I am 15 years old and really confused. Before this I never worried about it and didn’t question it at all, because I would never be gay. Now these unwanted gay thoughts and urges are driving me crazy. I don’t know if I have HOCD because I was never diagnosed with OCD but I have always been an anxious person. Can puberty make me gay or is this just HOCD? I want my old life back so bad.
Hello! I am an 18 year old girl and believe I am suffering from HOCD. For my whole life, I have had crushes on guys NEVER on a girl (I did watch lesbian porn in the past and it’s really bothering me that I did). I wake up worried that my past was a lie and that i am a lesbian and just repressed it. I just moved in to college and these thoughts of “you’re probably a lesbian” will not leave me alone
I have been struggling with HOCD for over a month now. I hate the intrusive thoughts that I have. I went on a date with a guy I like a few days ago, and I had an amazing time! But now the thoughts are flooding back again, and they feel way more real this time. Please help!
Hi there, I believe I have suffered with hocd for 8 months now and I still doubt whether I am gay or not, growing up I used to be very shy and didn’t really do anything with girls, recently I have been looking at my past to see if there are any gay expierences. Can it take 8 months to realise your gay or is it all just hocd
I’m 15 and my hocd is pretty bad. When I was young I was a part of some “experimental” play and this is the origin of all these thoughts. Anyways I at this point feel way less anxiety but these thoughts are still always here. Whenever I look at a girl and she is pretty I know that I want that but I get worried because I don’t have the same reaction I used to. Is that normal

Hi my dear ones, my dear, dear ones.

I am so sorry for the torment you’re going through. I really am. Can you see above how you are not alone? I’m sure you feel alone because OCD is not something most of us like to talk about, not even with the people we’re closest to.

So, here is my best advice:

1. Please read the following posts:

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

Also, please check out the question and dancer tag since most of those questions are about HOCD.

2. Read about treatment:

Gaining Certainty through Embracing Uncertainty
Resisting treatment?

What life was like before & after CBT
Obsessing vs. Brainstorming: before & after
A Detailed Post about ERP
ERP is the RIGHT Answer
Better than a Band-Aid
Embracing Uncertainty
What CBT was like for me
Will treatment change me?
Why You Need CBT/ERP
Have Reservations about ERP?
Preparing for CBT/ERP
ERP & Imaginal Exposures
Uncertainty is the Key
The Problem with Seeking Reassurance

3. Decide on your next step. Here are your options:

A) Do nothing. This is not recommended. OCD usually continues to switch to harder and harder obsessions and compulsions the longer it is untreated.

B) Continue to educate yourself. This is always recommended because one of the ways we fight OCD is with education and knowledge. You might find that you are only at this step and can do no more at this time. That’s okay. Keep learning about OCD and ERP so that you are ready for the next step when it comes.

C) Pursue ERP on your own. If you choose to do this on your own, you will still want a book or app to guide you. Here are my suggestions:

Self-Directed ERP with a Book
Self-Directed ERP with an App

D) Pursue ERP with the help of a parent/loved one and a therapist. It is always up to you which people you feel safe telling about your OCD and how much detail you want to share. It is fine to say, “I have been doing research on my own and I believe I have OCD. I’d like to see a specialist for a diagnosis.” If you want your parent or friend to know more about what you are dealing with, feel free to send them to the top link. The second link will give you ideas on how to find and interview an ERP therapist.

HOCD: A Letter to Loved Ones
Finding and Interviewing an ERP Therapist

E) Consider meeting with a psychiatrist to add medication to your treatment plan. Don’t neglect ERP therapy in lieu of medication. Medication is best when combined with ERP therapy.

Medication vs. Exposure Therapy

4. Take that next step toward freedom. 

a step

 

No Shortcuts

When Jeff Bell, spokesperson for the International OCD Foundation, spoke for our OCD Twin Cities event, one of the things he said that really stood out to me was that there are no shortcuts in treating OCD.

Woman and maze

That’s true, or at least it was in my case. I wanted easy answers: for deep theological conversations to solve my problems, or for comfort and reassurance from friends to be enough, for an hour-long conversation with a therapist each week to take away the anxiety, for an easy prescription to fix everything.

I definitely did not want the hard answer: exposure and response prevention therapy.

My psychiatrist didn’t mince words in his description: “It will be hell.”

It was one of the hardest things I’ve ever had to do in my life, but one of the most necessary and most rewarding. For me, there was no shortcut to healing, and since I was already living in OCD hell, the best way out was to keep going.

So, believe me, friends: I get it. ERP therapy is hard, so hard. You might think you won’t survive it. You might think your loved ones won’t survive your going through it. You might think it’s sinful or disgusting, and your exposures are probably going to be loathsome and repellent to you.

If you need to, go ahead and look for shortcuts. I know I had to.

But in the end, there were none for me, and I’d only wasted time looking for them.

While experiencing it, ERP was hell. But on the other side? It was my rescue.

 

Sweet Freedom

freedom in redAlison Dotson, president of OCD Twin Cities, and I were emailing recently about how sometimes we feel as if we say the same thing post after post, article after article, especially since they usually involve our own stories with OCD, and history doesn’t change.

But I reminded her that even if we’ve heard our stories over and over, someone else might be hearing it for the first time. Not to mention that sometimes those of us with OCD need to hear the truth multiple times before it is finally able to sink into our heads and hearts.

So here it is again:

I was in bondage to obsessive-compulsive disorder for twenty hellish years. I was plagued by ugly, intrusive thoughts that caused me intense anxiety and even terror. Many days I felt completely out of control of my own thoughts, and I hated the ugliness that polluted my mind. I was sad, lonely, depressed, lost, engaged in an ongoing war where the battlefield was my own brain.

And then an amazing psychiatrist named Dr. Suck Won Kim gave me not only a prescription but also the phone number to a cognitive-behavioral therapist in the area, along with the warning that ERP therapy “will be hell” and the encouragement that I had to do it anyway.

And I did. For twelve grueling weeks, I practiced the exposure therapy assignments set out by Dr. Christopher Donahue, and after twelve weeks of hell … I was free. Free for the first time since I was seven years old. I could barely even remember what freedom felt like, what it felt like to be master of my own thoughts, to rule over my OCD instead of having it rule me, and so it was actually a little scary at first.

But let me tell you: you get used to freedom, joy, and light pretty darn fast.

The last five years have been magnificent.

Please, please ask me questions if you have them.

For (lots!) more about OCD and ERP, go to jackieleasommers.com/OCD

Image credit: Jesus Solana

A War in the Mind

war in my mindI remember the Sunday mornings in church when my mind was a war zone.

An intrusive thought would show itself, and with my Pure-O compulsions, I’d mentally bat it down (usually with repetitive prayer).  I was a ninja with my compulsion moves, but OCD was just as fast and furious.  Back and forth, back and forth, like a relentless game of Whac-a-Mole.

And no one knew.

All these happy people around me, worshiping God, taking in the sermon, happy and safe in their suburban church sanctuary– and, for me, it was a battle field.

Pure-O: so invisible, so dark, so exhausting.

I praise God that those days are a part of my past.  If you want to learn how I survived (and WON) this war, click here.  Your mind doesn’t have to be a scary place.

For (lots!) more about OCD and ERP, go to jackieleasommers.com/OCD.

Image credit: unknown.

A Detailed Post about ERP

ERPI have written many times about Exposure and Response Prevention therapy, and lately, many people have been contacting me for more details about it, especially how they can do ERP on their own from home.

GIANT DISCLAIMER:
I AM NOT A THERAPIST.  NOT EVEN CLOSE.  

I am an obsessive-compulsive 31-year-old female who successfully underwent a twelve-week ERP experience four and a half years ago.  I say “successfully” because at the end of the twelve weeks, I then spent the next year and a half without obsessions or compulsions.  (Can you even imagine?  It sounds like a different life, right?  It was.)  In the three years after that, I have only had a handful of obsessive bouts (probably fewer than five), which I have been able to manage well with my ERP tools and which didn’t last longer than one day.  You can gauge for yourself if that sounds like success to you.  For me, it has been like happy freedom after spending twenty years in slavery to OCD.

With all of that said, I’m going to give my very best advice in this post.

SKIP TALK THERAPY AND PURSUE EXPOSURE AND RESPONSE PREVENTION THERAPY.  Talk therapy (where you spend an hour with a therapist discussing your problems) can actually, in some cases, perpetuate your OCD, especially if your compulsions include confession and seeking reassurance.  Your talk therapy sessions will essentially become one-hour opportunities for you to confess to your therapist and seek reassurance from him or her.  That is the opposite of what you want to do.

FIND A COGNITIVE-BEHAVIORAL THERAPIST WHO IS SKILLED IN ERP.
Begin by asking him or her questions about the techniques they use to treat OCD.  If the therapist doesn’t mention cognitive-behavioral therapy or exposure and response prevention therapy, keep looking.  You don’t want to waste your time spinning your wheels with someone who doesn’t know how to do exposure therapy.

WHAT WILL USUALLY HAPPEN IN ERP:
Your therapist will begin by asking lots of questions to get a real understanding of your OCD.  Remember, there are several different kinds of OCD, and in order for your therapist to really mold your treatment plan around you as an individual, he is going to need to ask for lots of details.  If it seems like he is zoned in on what will cause you the most anxiety, you’re probably right.  In ERP, your therapist is looking to trigger your anxiety and then prevent you from doing anything to alleviate that anxiety.  (Good times!)

You will probably create a fear hierarchy, a list of various things that would cause you intense anxiety.  Then you’ll probably start with the least scary item and work your way up to the top.  The top item on your fear hierarchy will probably seem IMPOSSIBLE.  Continue anyway.  By the time you actually get to that item, ERP may have already re-wired your brain enough to be able to handle it.  I need to repeat: focus on the item you’re at, even though the temptation is to stress about the next, scarier item.  Your therapist is not going to force you to do anything, and it’s going to be a better experience for you if you simply focus on each individual day and what you have to do that day.

Your exposures will be specific to you, though, in general, if you have contamination fears, you will probably have to interact with things that you deem unclean (in fact, probably with things that really are!).  If your OCD is more concerned with order, you may be asked to sit with things out of place.  If you have HOCD, you may be asked to read LGBT literature or to look at scantily-clad members of your same gender.  If you have harm thoughts or other anxieties that you’re not able to actually expose yourself to, you’ll likely need to do imaginal exposures, which may involve writing graphic stories and then reading them or possibly recording the story and listening to it on repeat.

If you’re doing this on your own (and are not guided by a therapist), I recommend doing the recording.  It was more anxiety-inducing for me to listen to a recording than it was for me to quickly read over the story I had written.  Make the story bad– the worst things you can imagine.  And perhaps opt to use lots of details: instead of just using large, blanket statements like “I am thinking a blasphemous thought, and I will go to hell for it,” try “I think of cursing God, and I know I will go to hell, where I will be lost and alone forever.”  Describe it.

The first time you do your exposure, keep track of your anxiety level, 0-100, where 0 is no anxiety at all and 100 meant you were clawing at the ceiling.  Then, every time you do your exposure, rate your anxiety level at the beginning, middle, and end of it.  Keep doing that exposure until your anxiety level is half of what it was when you first started.  Then, you can probably move on to a higher, scarier exposure on your fear hierarchy.

If your exposure (when you start it) is not causing you much anxiety, then chances are you have something a little off.  You’ll need to talk to your therapist or think through your exposure to see if you’re hitting the nail exactly on its head.  (I read a story once where the OC thought her obsession was one thing, say, worrying that she would hurt her child, but the exposures weren’t causing intense anxiety, so she and her therapist took a closer look at it, and together they realized that her actual, larger fear was that she would never know if she would hurt her child … similar but a little different, enough that they changed her exposure to fit better.)  If you have been doing your exposure for a while and the anxiety levels are dropping, then that is a good thing, my friend.  That means that ERP is re-wiring your brain correctly.

Keep all your anxiety ratings in one place so that you have a visual representation of how ERP is working as you watch the anxiety levels drop.  It may be a while before you start seeing a downward movement.  That’s okay.  Keep going.  In my experience, my anxiety levels didn’t start to drop until about week ten.  After that, they plummeted quickly.

ERP is a scary experience, so I do recommend paying the money to see a therapist IF you can afford it and IF the person is well-trained in exposure therapy.  If you decide to create your own ERP experience, buy a book that will guide you, such as Stop Obsessing! by Edna Foa or Freedom from Obsessive-Compulsive Disorder by Jonathan Grayson.  Talk to your friends and family ahead of time and spell out for them what your compulsions are, asking them to not aid you in these, even when it is difficult.  It may be helpful for you to tell them that aiding your compulsions is akin to them being on Team OCD instead of Team You.

Many people choose to pair ERP with medication.  I did.

I spent fifteen years with OCD before I was diagnosed, then another five before I began ERP.  That was twenty years that OCD stole from me, so when I began ERP, I essentially knew it was my last hope, short of some supernatural miracle.  You might not be mentally in that place yet, ready to put your nose to the grindstone and make it happen.  You’ll know when you’re ready.  Just know this: most obsessive-compulsives I talk to who have gone through ERP say their big regret is not pursuing ERP sooner.  ERP is hard … but it is not (not-not-NOT) harder than living daily life with OCD.

And what is happening while you go through these exposures?  I meant it when I said that your brain is being re-wired.  In this therapy, the brain changes, allowing an obsessive-compulsive more room to live with uncertainty (the root of it all).

ERP gave me back my life.  I am happy again, have joy again, love life.  I no longer fight a daily battle with my own mind.

Related posts:
OCD, ERP, & Christianity
ERP & Imaginal Exposures
Preparing for ERP Therapy
Medication vs. Exposure Therapy
All About CBT

Do I have OCD?

Before my diagnosis and, hence, before I’d done a lot of personal research on obsessive compulsive disorder, I thought of OCD as “that disorder where you wash your hands a lot” or “the one where people tap the doorknobs” or “when you’re a really big neat freak.”  In some ways, my diagnosis was a surprise to me because I didn’t do any of those things.  But on the other hand, just the term obsessive sounded so much like my situation that I was willing to listen.

Maybe a year or so into my original search for medication (I ended up taking a year-long hiatus from the search after Luvox stole all my energy), I suddenly started worrying (or maybe even obsessing) that what I had wasn’t really OCD.  I seem to talk to a fair amount of obsessive-compulsives who also reach this point, worrying that maybe someone has plastered a name on them that is incorrect.  The interesting thing about this is that the OC usually feels guilty about it– as if they are receiving compassion and medical advice and help from friends and family for nothing, or what they are worried is nothing.

Interestingly, such a huge worry and incredible guilt only point to OCD all the more.

The more I have learned about OCD, the easier it is for me to see it in others.  Though I am by no means a doctor, I now believe that OCD is pretty easy to diagnose.

birdcage2

 

It’s all in the name.

Obsessive-compulsive disorder.

 

1) Do you have obsessions?  Basically, do you have intrusive thoughts that you find ugly or disturbing but that you can’t seem to stop thinking about?  Common themes center around questioning your sexual orientation or if you really love your significant other, thoughts about harming yourself or others (even children), blasphemous or sinful thoughts, worries that you or people you love are going to die, sexual obsessions, intense fears about contracting a disease.  Ask yourself, do I have intrusive thoughts that cause me serious anxiety?

2) Do you have compulsions? The answer to this question might not come as easily, but what it is really asking is this: when I have those intrusive, anxiety-causing thoughts, what do I do to attempt to relieve that anxiety?  Maybe your fears about germs cause you to wash your hands, making you temporarily feel a bit of relief about that possibility.  Maybe your fear about harming a child means that you won’t allow yourself to hold your baby girl.  Maybe it even means that you avoid driving down the street where a lot of children play.  If you have blasphemous thoughts, perhaps you repeatedly ask God for forgiveness or you’ll ask other people if you think that means you are now going to hell.  Sometimes compulsions seem a little “magical” too– for example, you relieve the anxiety caused by your intrusive thought by tapping your foot a certain number of times or by avoiding stepping on cracks.  Even if it doesn’t logically make sense, it’s still something providing you some temporary relief.  Seeking reassurance is a huge compulsion for a lot of different kinds of obsessions: we glimpse relief when friends reassure us, No, you’re not gay.  No, you’re not going to get sick.  No, you would never hurt a child.  No, you’re not going to hell for that.

There is a third question to ask too, although this one may or may not be reached immediately, which is
3) Have your compulsions gotten out of control?
Most obsessive-compulsives reach a stage where the compulsions (that began as an anxiety-reliever) become too much and begin to add to the anxiety: you can’t stop washing your hands, you ask for reassurance so constantly that your friends are annoyed, you are driving a long way out of your way to avoid the street with children, you are tapping doorknobs and counting and repeating phrases in your head to the point that you’re starting to look a little silly.

Like I said, I’m no doctor, but when I talk to someone who wonders if they have OCD, these are the three simple questions I ask.  If you can answer yes to the first two, then you have OCD.  

So, what next?
1. Get an official diagnosis from someone who went to school for it. 🙂
2. Skip the talk therapy and go right for cognitive-behavioral therapy.  This is treatable.