OCD and Fake News - The brain is a machine for jumping to conclusions.

OCD is just fake news that your brain makes up.
But there is effective treatment.

By now, virtually anyone with even a passing interest in politics and current events has heard the term “fake news”. If you haven’t heard this term, just turn on a cable news channel on any given day and you are bound to hear a news story (or ten) about how we are being inundated with fake news that is designed to alter our political beliefs (and our votes). Regardless of your political persuasion, a Google search of the term “fake news” will lead you to a multitude of articles that describe somebody (or some country) that is presenting reality in a distorted fashion in an attempt to persuade you to see things their way. So what does this have to with Obsessive Compulsive Disorder (OCD)? Allow us to explain…

The writers and producers of fake news stories manipulate reality, sometimes by taking facts out of context, and other times by entirely fabricating story details (i.e., lying). Fake news stories always build their narrative on what can most charitably be called “unsubstantiated claims”. But even a cursory examination of these claims would lead any objective observer to conclude that these stories are at best misleading, and at worst, utterly untrue. The stories aren’t backed up by facts, but they sound just real enough to seem feasible.

And this is exactly what OCD does – it offers up scary thoughts for which there is no factual support, yet which appear plausible enough to lead one to believe that they may actually be true. OCD takes unimportant thoughts that occur in one’s mind completely out of the context of the real world and who the individual actually is as a person, and fabricates nightmarish scenarios (i.e., obsessions) that are not even remotely based in reality. But because these obsessive thoughts initially manifest in the sufferer’s own mind, they seem realistic, even though there is no compelling evidence to support them. In other words, OCD is fake news written, produced and directed by your own wayward brain.
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HOCD - 30 Things You Need To Know - 300

HOCD is a misunderstood and under-recognized variant of Pure Obsessional OCD (Pure O).

HOCD (Homosexual OCD) is ostensibly a variant of OCD in which the sufferer obsesses about being gay. Of course, like most subtypes of OCD, it’s a lot more complicated than that. Unfortunately, the numerous myths and misconceptions surrounding HOCD lead to this condition being poorly understood, under-reported, and ineffectively treated. Here are 30 things you should know about HOCD and its treatment:

1. The term HOCD is not a formal diagnostic term. It is simply a slang term for OCD in which the sufferer’s obsessions focus on their sexual orientation. Some naysayers claim that HOCD doesn’t really exist simply because it is not a formal diagnosis that can be found in the Diagnostic and Statistical Manual of Mental Disorders. That’s a lot like saying broccoli is not really food because it’s not listed as a category of food by the USDA. Broccoli is a type of food and HOCD is a type of OCD.

2. The term HOCD is a bit misleading. While most people with HOCD obsess about secretly being gay, a significant number of gay people who struggle with OCD obsess that they are secretly straight. This is why some people prefer to call HOCD “Sexual Orientation OCD”. The bottom line is that, no matter what you call it, the core obsession in this variant of OCD is the fear that one is secretly not living in accordance with what they see as their their “true” sexuality.

3. Similarly, some people obsess that they are secretly bisexual, or that they are secretly transsexual or transgendered. Basically, people can and do obsess about almost anything, especially when it comes to their sexuality. Read More »

For many people struggling with OCD, the fear that they do not actually have OCD and are merely “in denial” becomes one of their most intractable obsessions. Lauren McMeikan, MA, and Tom Corboy, MFT, of the OCD Center of Los Angeles discuss “The Denial Obsession” and how to treat it.

Doubt, Denial and OCD

Fear that one doesn’t really have OCD and is “in denial” is a common obsession in OCD, especially “Pure O”.

Obsessive Compulsive Disorder (OCD) has often been called “the doubting disease”. OCD certainly lives up to this moniker, especially for those struggling with variants of the disorder that are often informally described as “Pure Obsessional OCD” or Pure O”. OCD plays on an individual’s greatest fears, leading sufferers to question fundamental aspects of themselves and their character. While those without OCD effortlessly dismiss most of the unexpected thoughts that pop into their consciousness, those with OCD get trapped in a seemingly endless loop of obsessions and compulsions. Some of OCD’s more common refrains include:

“What if I’m a murderer?”
• “What if I’m secretly gay?”
• “What if I am secretly straight?”
• “What if I don’t really love my partner?”
• “What if I am a pedophile?”
• “What if I have committed a terrible sin?”
• “What if, at my core, I am a bad person with bad intentions?”
• “What if reality, as I experience it, isn’t reality at all?”

You might notice something that ties all of these phrases together – the struggle to answer the question “what if …?” This phrase strikes terror into the hearts of those grappling with OCD. These two short words introduce enough doubt and anxiety into the minds of sufferers that they feel compelled to repeatedly perform compulsive behaviors in a seemingly endless attempt to reduce or eliminate their distress.
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One of our clients with Skin Picking Disorder ( aka Dermatillomania ) recently wrote this essay about her long-standing issues with her dermatologist. She has asked to remain anonymous. 

Dermatillomania: A Skin Picker's Guide to the Dermatologist

Those struggling with Dermatillomania (Skin Picking Disorder) often have complicated feelings about their dermatologists.

A skin picker’s relationship with their dermatologist is, to put it lightly, fraught.

It’s a vicious cycle:

The skin picker picks their skin.
The skin picker is unhappy with the way their skin looks.
The skin picker goes to the dermatologist.
The dermatologist, with the medical authority of a white lab coat, tells the picker:
“Don’t pick.”
The picker spirals into shame.

Next time there is a problem, the picker avoids the dermatologist.
Then, maybe, the picker’s picking results in an infection.
The picker remembers:
“Don’t pick.”
“Don’t pick.”
“Don’t pick.”
Those words ring in the picker’s head.
No way is the picker going back there.
All that waits at the dermatologist is more humiliation.

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Imaginal Exposure for OCD and Anxiety

Imaginal exposure is a powerful treatment technique
for OCD and related anxiety disorders.

What is Imaginal Exposure

For many people struggling with OCD and related anxiety disorders, one of the most beneficial treatment tools is imaginal exposure. In order to best understand this technique, it is first necessary to understand the basic idea of Exposure and Response Prevention (ERP).

ERP is a specific type of Cognitive Behavioral Therapy (CBT) that has consistently and repeatedly been found by researchers to be the most effective treatment for OCD. Simply put, ERP is the “B” part of CBT. Using this technique, a client learns to become less afraid of fearful situations by challenging the behavioral compulsions that they employ in an effort to reduce their fear. The basic principle behind ERP is that, by repeatedly confronting their fear (exposure) without doing any compulsive anxiety-reducing actions (response prevention), the client will become less afraid when faced with anxiety-provoking situations. This process is known as habituation, which is really just a fancy way of saying that we become less afraid of things as a result of repeatedly being exposed to them. Read More »

    

ROCD (Relationship OCD)

ROCD (Relationship OCD) is often misunderstood by
mental health professionals and the public.

Relationship OCD (ROCD) is a form of Obsessive Compulsive Disorder (OCD) in which the sufferer experiences intrusive, unwanted and distressing thoughts about the strength, quality, and “true nature” of their love for their partner. Obsessions in ROCD include a preoccupation with a partner’s appropriateness as a mate, overall level of attractiveness, sexual desirability, or long-term compatibility, and often arise in otherwise entirely healthy relationships.

When most lay people think of OCD, they envision hours of hand washing or compulsive lock checking. However, there are numerous equally exhausting sub-types of OCD in which the compulsive symptoms are less overt, and which together are colloquially described as Pure Obsessional OCD, or “Pure O”. But this term is a misnomer, as people suffering with Pure O exhibit numerous, albeit less obvious, compulsions. And while these compulsions are less noticeable by others, they still take a huge toll on sufferers. ROCD is one such sub-type.

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This is the third installment in our ongoing series on Scrupulosity, a sub-type of Obsessive-Compulsive Disorder (OCD) focused on religious or moral perfectionism. This article focuses exclusively on identifying and challenging common cognitive distortions seen in “moral” Scrupulosity.

Moral Scrupulosity

Those struggling with Moral Scrupulosity OCD can
learn to challenge their distorted thinking.

Previous articles in this series have focused on religious Scrupulosity, which is most easily described as a pattern of intrusive, unwanted thoughts related to one’s religious beliefs. These unwanted thoughts are counter to the sufferer’s faith, and lead them to perform compulsive behaviors in an attempt to nullify or extinguish the anxiety they experience related to these thoughts.

Conversely, the obsessions experienced in “moral” Scrupulosity are focused not on matters of faith, but rather on one’s personal sense of morals and ethics. Those suffering with moral Scrupulosity experience commonplace thoughts, feelings and actions that they misinterpret as being evidence that they are ethically flawed or morally bankrupt. As with all sub-types of Obsessive Compulsive Disorder (OCD), those with moral Scrupulosity seek relief from their anxiety through various compulsive and avoidant means in an effort to ensure that their obsessive fears do not come true. In other words, they perform compulsive behaviors that they hope will prevent or eliminate the feeling that they are a “bad” person.

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In the first installment of this series, 35-year-old old Robert told his story of childhood obsessions, teenage compulsions, and his eventual diagnosis with OCD and Bipolar Disorder at age seventeen. He went on to describe suicide attempts and Electroconvulsive Therapy (ECT), as well as his experience with medication and treatment with Exposure and Response Prevention (ERP). In part 2, we focus on the impact of OCD on the family, as told by Robert’s mom, Lisa. 

OCD in the family

When someone is suffering with OCD, it can have a
profound impact on their entire family.

We didn’t suspect anything was wrong until Rob was about fifteen years old. Suddenly, he wanted to change high schools, and though we weren’t excited about the idea, Rob’s father and I decided that if that was what he really wanted, we would let him go for it.  Unfortunately, the problem came when every day for the entire summer, Rob demanded that we review his list of pros and cons of changing schools. We would work on it tirelessly, come to a mutual decision, and then redo it all the next day because of Rob’s uncertainty. He finally confirmed his decision to go to the other school and they hosted a mental health day. Rob came home with a pamphlet on Obsessive Compulsive Disorder and told me he had it. I replied, “That is for really sick people.” I regret that I didn’t listen.

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This is the second installment of a multi-part series on Scrupulosity, a specific variation of Obsessive-Compulsive Disorder (OCD) that focuses on religious and moral perfectionism.  This article focuses on how one can learn to identify and challenge common cognitive distortions seen in Scrupulosity.  Please note that this article will focus exclusively on religiously-focused Scrupulosity, and that future installments will address Moral Scrupulosity.

Scrupulosity in OCD

Cognitive Restructuring can be a valuable component of treatment for Religious Scrupulosity in OCD

Scrupulosity is a type of Obsessive Compulsive Disorder (OCD) rooted in irrational, distorted thoughts (obsessions) related to one’s religious beliefs, morals, or personal ethics.  An individual with Scrupulosity experiences these unwanted thoughts as being at odds with their faith, their relationship with God, or their moral and ethical values.

As with all types of OCD, the individual with Scrupulosity responds to their obsessions with compulsive behaviors that they employ in an effort to reduce, eliminate, or reverse their unwanted thoughts and the anxiety they cause.  Scrupulosity becomes a clinical issue when an individual’s behaviors are motivated by a desire to control anxiety rather than the pursuit of a genuine connection to their faith, morals, or ethics.

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Kimberley Quinlan, MFT, of the OCD Center of Los Angeles discusses the diagnostic overlap between OCD and eating disorders.  Part one of a two-part series.

OCD and Eating Disorders

It can sometimes be difficult to differentiate between the symptoms of OCD and those of an eating disorder.

I was recently asked by a client if there was any functional difference between eating disorders and Obsessive Compulsive Disorder (OCD). After all, if OCD is defined as experiencing obsessive thoughts and compulsive behaviors, wouldn’t an eating disorder be categorized in the same way, given that those with eating disorders have obsessive thoughts about their weight and appearance, and respond to these thoughts with compulsive behaviors?

When looked at along these lines, it is obvious that OCD and eating disorders indeed have many similarities.  But it is important to consider certain distinctions between these conditions before formulating a diagnosis.

To provide a better understanding of OCD and both its differences and similarities with eating disorders, clinicians rely upon specific diagnostic criteria.  Recently, the American Psychiatric Association (APA) refined these criteria in the newly published Diagnostic and Statistical Manual (fifth edition), also known as the DSM-5.  This manual is used by clinicians to differentiate between various psychological conditions, thus assisting in the development and implementation of appropriate treatment.

Read More »

  • OCD is Fake News

    OCD is just fake news that your brain makes up. From the OCD Center of Los Angeles. Helping clients in California and around the world since 1999.

  • HOCD: 30 Things You Need To Know

    HOCD is a type of OCD in which the individual obsesses about their sexual orientation. Here are 30 things you should know about HOCD. From the OCD Center of Los Angeles.

  • Doubt, Denial and OCD

    A discussion of “The Denial Obsession” in OCD, in which sufferers obsess that they don’t really have OCD, but are merely “in denial”. By Lauren McMeikan, MA, and Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • Dermatillomania: A Skin Picker’s Guide to the Dermatologist

    How one woman with Dermatillomania finally opened up to her dermatologist about her longtime struggle with skin picking.

  • Imaginal Exposure for OCD and Anxiety

    Imaginal exposure for the treatment of OCD and anxiety is discussed by Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • ROCD: Relationship OCD and The Myth of “The One”

    ROCD (Relationship OCD) is an often misunderstood variant of OCD. By Sheva Rajaee, MMFT and Tom Corboy, MFT of the OCD Center of Los Angeles.

  • Moral Scrupulosity in OCD: Cognitive Distortions

    Cognitive distortions are common in the Moral Scrupulosity subtype of OCD. Part three of a multi-part series.

  • OCD in the Family

    One mom’s story of her son’s battle with OCD and its profound impact on their family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity in OCD: Cognitive Distortions

    A discussion of cognitive distortions in the religious Scrupulosity subtype of OCD. Part two of a multi-part series.

  • OCD and Eating Disorders

    Diagnostic similarities and differences between OCD and eating disorders are discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Harm OCD Treatment With ERP

    Harm OCD treatment using Exposure and Response Prevention (ERP) is discussed by Tom Corboy, MFT, Executive Director of the OCD Center of Los Angeles .

  • My Life with OCD

    The impact of OCD and related anxiety based disorders on the family is often overlooked. In this multi-part series, we present first-hand accounts of the ongoing impact of OCD, BDD, and Bipolar Disorder on one man and his family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity: Where OCD Meets Religion, Faith, and Belief

    The Scrupulosity sub-type of OCD is discussed by Kevin Foss, MFT, of the OCD Center of Los Angeles. Part one of a four part series.

  • Mindfulness for OCD and Anxiety

    Using mindfulness to enhance traditional CBT for OCD and anxiety is discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Hoarding, Cluttering, and Compulsive Shopping: My Childhood Story

    One woman’s story of her life as the child of multiple generations of hoarders.

  • OCD and Thought-Action Fusion

    Thought-Action Fusion is a frequent problem for those with OCD. This issue is discussed by Laura Yocum, MFT, of the OCD Center of Los Angeles.

  • OCD, Anxiety, and Resistance

    Resistance and acceptance in OCD and related disorders is discussed by the OCD Center of Los Angeles.

  • Harm OCD Treatment: Cognitive Restructuring

    Harm OCD is often misunderstood, but it can be effectively treated using an integrated treatment plan that includes Cognitive Restructuring. Part three of our ongoing series that explores “Harm OCD” and its treatment .

  • OCD & Anxiety: Five Common Roadblocks to Treatment

    Learn the five common mistakes that interfere with successful treatment of OCD and anxiety. By Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Harm OCD Treatment: Mindfulness Based CBT

    Harm OCD is an often misunderstood condition that can be effectively treated using Mindfulness integrated with CBT. Part two of a multi-part series from the OCD Center of Los Angeles.

 

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