5 Months of OCD Questions

Back in November, I noted that 99% of the questions I’m asked are related to HOCD. So I tried to write ONE GIANT REPLY (which you can read here), but it didn’t stop the questions from pouring in.

Frankly, I was exhausted and overwhelmed by HOCD questions, especially when I felt like I’d shared everything I could on the subject. But of course, everyone wants a personalized answer. I understand that, but I’m also not an HOCD expert or any kind of therapist.

So I let the questions sit for a while. Especially when I have a link to the above article right in the form where people can ask their questions.

But today, home sick on the couch, I wanted to tackle some more. A lot more. 🙂

Here we go.

I’m doing self-directed ERP now but I don’t know when should I stop doing exposure works. Do you have any clue?

I do. When you begin, you should rate your anxiety level 0-100. Continue to rate your anxiety level before, during, and after each exposure. Keep doing the exposure until your anxiety level drops to 50% of your original level.

Since my onset of OCD, I’ve become plagued with these fears and dark thoughts…especially the feeling that i am an a ‘bad’ person. Who will hurt others or myself. i feel unworthy and yearn to be the person i was before this illness- light and ‘good’ and kind. I fear greatly that I am an awful and terrible person. Is this normal and what can be done to help?

It is normal for OCD. 🙂 This sounds a lot like a combination of harm OCD plus hyper-responsibility plus depression, if I had to guess! ERP therapy will help. Check out http://www.jackieleasommers.com/OCD.

I don’t know anymore if it’s compulsive or not.. I used to watch different kinds of porn like gay or cuck*old to figure out what I may like.. I watched it but didn’t think about it a lot afterwards but felt disgusted.. like hijacked..maybe I’m looking for an excuse.. Just tried to sleep when images of a porn came and scared me.. like that must be the final proof that its not HOCD.

Proof that it’s not HOCD? To me, being scared or feeling wrong about it is proof that it is HOCD. ERP will help!

Please read https://jackieleasommers.com/2017/11/01/hocd-4-steps-to-freedom.

I live in a country where there is probably no erp therapy available (I’d be very surprised if there was), and these apps you listed are for iOS, i have an Android :(. Do you have any other tips/resources for self therapy? Thanks ❤ much love. I appreciate what you are doing :))

(My kind of ocd is religious one if that matters, I’m a christian) 

Hello dear one, yes, if you have Facebook, try the Pax the OCD Bot (just search it in your Facebook searchbar). This article might also help: https://jackieleasommers.com/2014/10/05/self-directed-erp-therapy.

You don’t have any intrusive thoughts then? Or you do, and just don’t care?

I don’t have them nearly so often! When I do, I am usually able to pass them off now because ERP has re-wired my mind not to give them more worth than they deserve. On the occasion (usually once or twice a year) that the intrusive thoughts do get to me, I use my ERP tools and exposures and usually can get past it within a matter of hours and a good nap.

What is erp, to be honest? They expose you to your fears until you don’t care/find they annoying? Sorry for my ignorance

ERP is exposure and response prevention therapy. Here are some links where you can learn more:

About CBT/ERP
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
Finding a cognitive-behavioral therapist
Medication vs. Exposure Therapy
Can’t afford CBT/ERP?  Try this app or do self-directed ERP!

 I already am no longer afraid at my thoughts, no longer check, i just find them to be annoying as hell. Will i live with this “annoying friend” forever? Ugh. (i mean i believe one day God will heal me but while He doesn’t, will i just have to tell my brain to shut the hell up everyday? Man is that annoying). Thanks 🙂

Essentially, are you saying that you still have intrusive thoughts but they don’t cause you to perform compulsions? This is just real life, unfortunately! Everyone has ugly thoughts that come and go. The important thing is that when they come, they can also go. If you have a hard time letting them go, then ERP is your answer.

I’m afraid to go thought erp because my ocd is the religious kind. Is the doctor going to “make” me (i know no one can make anyone do anything, it’s just a manner of speech) do bad things (ex denying Jesus, wich i wouldn’t do not now not ever but my brain keeps shouting at me to do so)? I rather live my life like hell then actually going to hell, thank you

Completely understand that. Here’s a fictionalized version of how I had to approach such a tricky concept: https://jackieleasommers.com/2012/09/05/tipping-point-my-entry/

I really don’t want to be gay and I used to be so confident in my sexuality (I’m a girl btw) I just recently got a boyfriend and I didn’t like him that much but I still kinda liked him and I thought being with him would make me know I’m not gay but for some reason I just don’t want to hang out with him does that make me gay 

Doesn’t make you gay at all. Probably just means what you said it does: you don’t actually like him that much. Don’t date a boy as a compulsion to prove your heterosexuality. Date a boy because you truly care about him. ERP can help with both HOCD and ROCD. Check out http://www.jackieleasommers.com/OCD.

I think I have HOCD but I’m not sure. My therapist is doing CBT but I don’t think it’s ERP and it’s making me anxious. Like what if this therapy goes know where and just becomes me talking about my problems.(what happened with my last therapist). Should I trust that she knows what she is doing? Her Website says she does CBT so by saying she does CBT does that mean she is also an expert on ERP? 

CBT (cognitive behavioral therapy) is the umbrella term, and ERP (exposure and response prevention therapy) falls beneath the CBT umbrella. The best way to know if your therapist knows what he or she is doing is by educating yourself about what ERP looks like. I suggest reading the posts at http://www.jackieleasommers.com and also going through the list of questions to ask a therapist at https://iocdf.org/about-ocd/treatment/how-to-find-the-right-therapist.

am I actually recovering from HOCD? I am trying to manage my intrusive thoughts and no checking as well. I’m feeling much better however what’s causing me anxiety is that all my straight attraction is gone for a toss. I have had no history of experimenting with girls or having a crush on them. But I feel  scared. I have always wanted to be with a guy. Will my attraction for guys ever come back?

ERP cannot change your sexual orientation. But I do hear from many sufferers that their attraction to others (the opposite gender if they are straight and have HOCD; same gender if they are gay and have HOCD) vanishes for a time. It’s normal for OCD.

Hi Jackie, I’m not having any kind of anxiety over my thoughts anymore. So I woke up and I got a feeling which said “I want to be lesbian” but there was no anxiety that followed. Which freaked me out. And today I was like okay fine, what if I am? That doesn’t change anything. But i know i want to be with a guy. Does that mean I’m recovering or does it mean I’m gay? I want to be with a guy.

This is meant gently and tongue-in-cheek, hon: “there was no anxiety” is followed immediately by “which freaked me out.” Which means there was actually still anxiety. 🙂 Your thought process here is actually correct! But I suspect it will still be bothersome for you until you do ERP. This will help: https://jackieleasommers.com/2017/11/01/hocd-4-steps-to-freedom.

G~Always thought of myself as straight,loved women and the female body always had 100s of crushes. Lately ive watched some gay porn and it actually has excited me to a certain point and i hate it so much.have felt like i would enjoy doing certain things and cant believe im thinking like this. Even been losing my attraction for the female body which i used to be crazy for. Is all this hocd related?

Very, very consistent with the HOCD experience. ERP can help! https://jackieleasommers.com/2017/11/01/hocd-4-steps-to-freedom/

So I’m a 16 year old and a female, for he past few months I’ve been having a thoughts like “what if I’m bi?Âť Or a lesbian?” I know deep down that I’m not but these thoughts are making me think I am. I’ve always liked guys my whole life and have had crushes on them. I’ve never had a crush on a girl or liked one either. It makes me anxious every time I’m around a girl could it be HOCD?

Sounds exactly like HOCD! Exposure therapy can help: https://jackieleasommers.com/2017/11/01/hocd-4-steps-to-freedom/

I keep on crying idk what to do I feel alone I keep on thinking about having s*x with other girls but when I think about i get discussed I’m only 14 years old I can’t be going through this please give me advice on how to control it or get rid of it please I cant even look at my friends anymore without thinking do I like hereading? It’s really uncomfortable and weird I can’t stop crying please help

Oh you poor dear! OCD is hard at any age, but to be 14 and dealing with it … and with something as personal as HOCD … so uncomfortable and lonely and difficult. Exposure therapy can help. It’s up to you whether you’d like to tell your parents what you’re dealing with in detail, or whether you’d like to just tell them you’re confident it’s OCD but you want to discuss details only with a therapist, or if you’d prefer to do ERP on your own. Here are some links that might help:

Can’t afford CBT/ERP?  Try this app or do self-directed ERP!
https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones/
Also please considering trying Pax the OCD Bot on Facebook. Just look it up in the FB searchbar and enable it. It’s a computer program, but feels like you’re chatting with a therapist for real!

Is it a normal symptom to feel an urge to kiss the same sex then get extreme anxiety during hocd? I feel so lost.

That is almost the literal definition of HOCD! ERP therapy can help: https://jackieleasommers.com/2017/11/01/hocd-4-steps-to-freedom/

Jackie, I need help. My boyfriend and I are believers and he has been struggling with OCD. Much of it is related to his faith. He just graduated Bible college and he can convince me it’s all spiritual warfare. I’m exhausted, he is too but he doesn’t think he’s OCD. I’ve looked all over for a therapist who does ERP near Rochester NY and I can not find a male. He won’t go to a woman. Plz help!Thanks

My OCD specifically attacked my faith. It goes after the things that are most important to a person, so that makes sense that– for someone like your boyfriend who cares about scripture and God– it would attack that in his life. I hope he will read through the following posts:

OCD & Christianity
(or other religious scrupulosity)
OCD, ERP, and Christianity
I’m a Christian and Take Meds!
Unashamed of my OCD
Is the thought from OCD … or God?
God’s Sovereignty, OCD, the Cross, & His Purposes
Is Mental Illness a Spiritual Issue?
Is ERP Sinful?
OCD & Faith (or Lack Thereof): a Double Interview

The past year I have been struggling with a  fear of selling my soul through intrusive thoughts. I recently had a thought that if I didn’t write everything I write in perfect grammar, then my soul belonged to Satan. I didn’t fight the thought as I usually do, and this was before I learned that I was supposed to ignore the thought. Does that mean that I meant the thought?

I’ve had similar thoughts before. I think most people have, except that for those of us with OCD, it’s far harder to say, “Well, that was ridiculous!” and move on. 🙂 ERP therapy changed my life in this manner; I’m not being dramatic. I hope it will help you too. Lots of details at http://www.jackieleasommers.com/OCD.

I think I am suffering from hocd I’d like to talk to you about it please

Hi friend! I am not a therapist. Here’s how to find one: https://iocdf.org/about-ocd/treatment/how-to-find-the-right-therapist/

Also consider trying Facebook’s Pax the OCD Bot. It’s just a robot, but it feels like chatting with a therapist!

Is it normal to feel false attractions and feelings towards the same sex with OCD. I was clinically diagnosed by 2 doctors with OCD yet I still doubt I have it and am scared that some things aren’t OCD even tho I never felt them before this obsession started. Sometimes I notice that the “attractions and feelings” are just normal feelings and such but they feel really real and unwanted and scary.

This is all normal for OCD. In fact, doubting that you have OCD is also normal for OCD– I’m not sure I’ve ever met someone with OCD who hasn’t doubted that they truly have it! Exposure therapy is the key to disarming the doubt. Check out http://www.jackieleasommers.com/OCD.

Continuing from the false feelings and attractions thing. So they don’t feel good and I get them for my sister and mom too!!! And objects like random objects! They confuse me because they feel like attraction or something but I know it can’t be cause it just doesn’t make sense but it can feel pretty real. How do I know for sure they aren’t real??? What if I’m bi/gay??? I fear both I fear all attra

cont’d below

Continuation again these attractions and such Do not feel good no matter how much my mind convinces me they do like I don’t lay back and just think about them and be happy no I fear them and hate them and when they show up it’s like LEAVE ME ALONE YOU RUON MY LIFE. Ok do u think I really have hocd???? How do I know for 100% sure I don’t feel anything for the same sex I don’t want to feel anything 

OCD is a real beast, isn’t it? It goes after things that are most important to us, like our personal sexuality and even the pure feelings we have toward our families. You can take down this beast of an illness with exposure therapy. Check out http://www.jackieleasommers.com/OCD.

Our son, Nick is 17 yrs old, turned 16 yrs old, and developed signs of depression. He appears to have HOCD. Older brother revealed to family that he was gay. Nick was then 13. Nick was a very social and talkative kid until the last 2 yrs. One love – very gifted competitive swimmer. Seeing a therapist and psychiatrist,, taking meds- not seeing great results. No ERP close by? Struggling terribly.

First of all, it’s clear you are an amazing parent. Great work!! ERP is truly the answer here, and the great thing about it is that you don’t need a professional in order to do it.

Read this post about self-directed ERP. Also consider the free app nOCD or the Facebook bot Pax the OCD Bot. They are both amazing tools.

Hi jackie, I’m suffering from i think religous OCD, i keep on praying until i am satisfied with my praying. Also i am thinking about Jesus Christ is different from God, can you help me please? Thanks jackie

The important thing here is to understand that OCD is an illness, treated like an illness. You don’t treat OCD with learning theology. You treat it with ERP therapy and meds, okay? Once you do that, then you will be able to enjoy your relationship with Christ and dive wholeheartedly into theology in a healthy way. Check out https://jackieleasommers.com/2017/07/25/does-my-erp-therapist-need-to-share-my-faith.

I am being treated by a Psychiatrist for depression/anxiety. I am also rather sure i have OCD, as I have all the symptoms but I am afraid to tell my doctor about my intrusive HOCD related thoughts as they are strange and taboo. I am also worried she will think I am crazy and maybe not know about HOCD. My HOCD is also under control now and that making me procrastinate telling the DR. Any advice?

I can appreciate the fear that goes into telling someone about taboo intrusive thoughts. If your therapist or psychiatrist is an OCD expert, they will not be shocked at all. This is common territory within OCD. Unfortunately, many doctors and therapists are still unfamiliar with OCD/HOCD and end up giving awful advice that only makes things worse. The more you educate yourself on OCD and HOCD, the more you will be able to recognize whether or not your therapist/psychiatrist knows about it!

This article may help: https://iocdf.org/about-ocd/treatment/how-to-find-the-right-therapist/

Dear Jackie, sorry for another HOCD question (I am a straight male), I know HOCD can make you feel a loss of attraction to the sex you’ve always been attracted to, but can it make you fearful of that sex? This occured after reading an account from a female perspective of HOCD that got me really confused, like I’m now afraid of women despite wanting to be attracted to them like my normal self.

I hear narratives like this all the time. I always say “normal for OCD.” 🙂 ERP can help, friend. Check out http://www.jackieleasommers.com/OCD.

Hi Jackie,

I’ve been suffering with hocd or what I think is hocd for just over 3 years. I have just recently started to see a cbt therapist. I was wondering when you went through this did you have a nagging feeling constantly in your head. Also how did you accept the uncertainty that all of this brings to get rid of the obsessional ruminations. 

First of all, check out https://iocdf.org/about-ocd/treatment/how-to-find-the-right-therapist. It’s important to find a therapist who truly understands OCD and how to treat it with exposure therapy.

Secondly, ERP therapy is how you learn to accept the uncertainty. It takes about 12 weeks, and it’s very hard, but it’s life-changing. It re-wires your brain back into a healthy pasture. 🙂

Hi I’m not sure if Hocd or am I gay or bi I keep checking gay porn hundred times a day but my mind telling me I like it but I have no arousal then when switch to female I get aroused instantly so I can’t figure what going on 

The key word here is “checking”– that is a very, very common compulsion. ERP therapy can help: https://jackieleasommers.com/2017/11/01/hocd-4-steps-to-freedom/

Was diagnosed with other types of ocd, but now not sure if I have HOCD or gay? Always had crushes on boys/had straight relationships.I feel like my personality is straight but once I started worrying I was gay i put pressure on sexual arousal to men/penises and now it feels like I’m no longer sexual attracted to men but am to women..emotionally speaking/crushes never wanted to be with a woman. 

You can have OCD and then experience many different “themes” within it. For me, until I treated OCD with exposure therapy, my themes just got harder and worse as I went along untreated. Once I treated OCD for one theme, it took care of them all. 🙂 Read about it at http://www.jackieleasommers.com/OCD.

Hi Jackie I’ve think I’ve been suffering from pocd but I can’t tell it started once I graduated high school I’m an 18 yo male I had never worried I was attracted to kids but now I’m constantly worried about it all of a sudden I started having thoughts of kids but in sexual situations and they tormented me I’m seeing a therapist and she says it’s ocd but I’m scared it’s not

Ahhh, the doubting disease … where it even causes us to doubt whether we have it! What you wrote is the textbook description of POCD, and it means that you actually value healthy sexuality and would never hurt a child. That’s why you have all the anxiety and torment! (A pedophile would enjoy it.) Exposure therapy can help, even though it is really difficult. It’s 12 hard weeks, but it is wayyyyy better than a lifetime plagued by such thoughts. Check out http://www.jackieleasommers.com/OCD.

Is this HOCD or am I in denial?  I am 13 and I suffer from depression and anxiety, a month ago I thought to myself ‘what if I’m gay?’ Which stared this torment. I had never had any crushes on girls only guys and I felt it getting worse each day. Now I feel like I have no orientation but still an plagued with thoughts images and sensations. I don’t know if it’s the antidepressant or I’m in denial. 

May I introduce a third option? What if it’s not the antidepressant OR denial, but you just suffer from HOCD, a treatable illness? ERP therapy can help, truly: https://jackieleasommers.com/2017/11/01/hocd-4-steps-to-freedom/

Hi Jackie, I was in therapy but left because the exposures were too scary: he wanted me to ‘agree’ with my thoughts…I was worried I was aroused by horrible sexual intrusive thoughts, so I would say “yes, I was turned on by that!” I saw that this is basically what you did?  I thought saying “maybe I was” would be effective, too…or even “it’s just OCD.”

I completely understand this. Here’s a fictionalized version of how I was able to side-step things in ERP and still beat OCD: https://jackieleasommers.com/2012/09/05/tipping-point-my-entry/

hi

Hello buddy. 🙂

I’m a 16 year old girl who is struggling w HOCD. I am 99% sure I have HOCD. However, when I read about the difference between gay and HOCD or even about gay, my mind makes me feel like I am truly relating to the gay side of things even if I relate more to hocd when it comes down to it. Is that normal?

OCD/HOCD will make you doubt everything. Does the idea give you anxiety or stress? If so, that’s very telling! Try to take deep breaths and continue to read up on HOCD. Knowledge is powerful!

Hi Jackie, this question is also about HOCD, it’s just that I can’t find anyone who at the moment has the same problem. Not only am I scared of people of the same sex but also of people of the opposite sex because I’m so worried I might not be attracted to them. So basically I am avoiding both genders.. What should I do? Should I be doing ERP for both?

As you can see, I was asked this question (or something similar) by two other people even in this thread! So you are not alone. 🙂 Do ERP for HOCD, and it should eventually kick everything else’s butt too. I did ERP specifically around my religious/spiritual obsessions, but it also took care of any other themes I was experiencing too, because ultimately ERP is restoring a healthy brain wiring to you.

Hi Jackie i am 15 year old girl and i feel like am going crazy. I think i am dealing with HOCD i never been diagnosed with ocd before but am not sure i been dealing with this ever since i was 13 but i never told anyone or gotten help. I feel like it’s different this time i feel like am always in denial. I have lost my attraction to the oppsite sex it it depresses me.i always had crushes on guys

You’re not crazy. As you can read above, what you’re going through is a very common experience within HOCD, even down to losing attraction to the gender you’re usually into.

It’s up to you whether you’d like to tell your parents what you’re dealing with in detail, or whether you’d like to just tell them you’re confident it’s OCD but you want to discuss details only with a therapist, or if you’d prefer to do ERP on your own. Here are some links that might help:

Can’t afford CBT/ERP?  Try this app or do self-directed ERP!
https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones/
Also please considering trying Pax the OCD Bot on Facebook. Just look it up in the FB searchbar and enable it. It’s a computer program, but feels like you’re chatting with a therapist for real!

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. 

Why Meds?

A blog reader emailed me and asked, “If you are okay with sharing this, could you tell me why you chose to stay on your medication after ERP?”

My response:

For me, meds are a chemical tool to slow my serotonin reabsorption. ERP is a physical tool in that it rewires the brain and a mental tool in that it gives me a new mindset toward uncertainty. I’m grateful for ALL my tools. 🙂

 Also in my toolbox: prayer, deep friendships in which I can be vulnerable, essential oils when needed, Ativan when needed, talk therapy for non-OCD anxiety, and self-care (i.e. naps and ice cream).


 What I’m trying to say is that God has given me an extensive amount of assistance. Some tools only come with privilege or money (having insurance and a paycheck to pay for meds and therapy … and ice cream, ha!); some from transparency (I have the greatest friends); all are sheer grace.


I’m at a stage of my life and faith where my hands are open to all the grace I can get.

The Long Journey … to the Starting Line

"Cross That Line" by xLadyDaisyx on deviantArt

“Cross That Line” by xLadyDaisyx on deviantArt

It is SO HARD for OCD sufferers to be correctly diagnosed and then find the right treatment and a good cognitive-behavioral therapist.  In fact, it takes an average of 14-17 years for someone to access effective treatment.

That stat stings my heart.  I feel it deeply because of my own personal struggle.

I developed a sudden onset of OCD at the age of 7.  I wasn’t diagnosed with OCD until I was 22.  I started ERP (exposure and response prevention) therapy at 27.  That’s twenty years, folks– fifteen just till diagnosis alone.

Growing up, I just assumed that I “thought too much”– was an “overthinker” and especially sensitive to issues of morality. I didn’t understand that other people were also undergoing the same doubts as I was but were able to move past them with ease.  I, on the other hand, would get trapped.  The exit door to my brain was stuck shut, so all my thoughts just milled and churned and generated intense anxiety.  I didn’t know that others even had the same thoughts as I did, nor did I realize how it would be possible to let such thoughts come and go.

In childhood, I cried all the time.  In fact, I cried every single night for three years in a row.  I never told my parents about this.  I was so scared that they wouldn’t be able to “fix” me that I preferred to just rest in my own sadness, still clinging to the hope that *someday* I could be fixed.  As long as no one told me it was impossible, it still felt possible, and even thought I was terrifically sad, I kept that hope as my lifeline.

High school was a beast.  I got straight A’s (OCD drove me to perfectionism) and graduated at the top of my class.  I was a class clown, and I had some amazing friends.  But I battled intense spiritual doubts and lived in great fear.  My tenth grade year was one of the hardest of my whole life.  Only those closest to me knew it.

My doubts intensified in college.  They escalated to a whole new level.  Thankfully, I had a solid support system in my new friends (people who remain my support system to this day!).  And though they couldn’t understand what I was going through, they loved me.

After undergrad, things fell apart.  In a nutshell, I lost my grip on reality– my doubts had grown so large and out of control that I no longer knew if I could trust my friends or my own human experience.  Finally, for the first time in my life, someone used the words mental illness with me.  It felt shocking.

I was encouraged to meet with a therapist (unfortunately, a talk therapist– not effective for OCD), who also got me in to meet with a psychiatrist, and I was finally diagnosed with obsessive-compulsive disorder.  A diagnosis fifteen years in the making.

I spent about a year with that first talk therapist, and it was more damaging than anything else.  I finally “escaped” and never again set foot in that clinic.  Meanwhile, I was an SSRI lab rat, trying out a slew of various medications to treat my OCD.  I eventually went back to talk therapy– this time to a much better therapist, who was a true blessing, although she still didn’t truly understand OCD, and so my therapy included a lot of reassurances.  In other words, this kind, amazing woman who loved me was just reinforcing my compulsions.  Not good.  I also took a break from trying out medications after one stole all my energy and made me rapidly gain weight.  I was overweight for the first time in my life– all due to a medication– and have struggled with my weight ever since.

Five years after that initial diagnosis, my psychiatrist was out of ideas.  Literally.  She asked me what I thought we should do next.  I, of course, had no clue.  She referred me to an OCD specialist.

This incredible man– Dr. Suck Won Kim– changed my life.  He got me onto the right medication (almost immediately) and essentially required that I begin ERP, even giving me the name and contact information for the therapist who would ultimately allow me to bottle up my OCD and put a stopper in it.  Dr. Chris Donahue, to whom I’m forever indebted.

Twelve weeks was all it took.  In one sense.  In another, it took twenty years.

My life was a mix of depression, anxiety, compulsions, “bad” thoughts, and wrongness, and then twelve weeks later, I felt the burden of OCD lift from my shoulders.  I was giddy with freedom.  Five years later, I still am.

I hear from OCD sufferers every week who are in their 50’s, 60’s, or even older, who are still seeking appropriate treatment.  This absolutely breaks my heart.

On the flip side, I’ve had the incredible experience of meeting Maddie, 11, and her incredible parents, who leapt into action almost immediately and got her into ERP within months of her OCD onset.  In the same year, she developed OCD, was diagnosed, and was treated.  Marvelous!

That’s one of the reasons I blog about OCD.  To help people to understand earlier what they are dealing with and to encourage them to seek appropriate treatment (ERP, with or without medication).  It still just boggles my mind that in 2013, mental health practitioners still don’t know that ERP is the answer.  People get passed around from talk therapist to talk therapist, when the solution should be so ready, so available.