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HOCD: 30 Things You Need To Know

OCD Center of Los Angeles March 28, 2017 9:13 am 516 Comments

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. (more…)

Doubt, Denial and OCD

OCD Center of Los Angeles September 12, 2016 1:42 pm 166 Comments

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, MFT, 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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Dermatillomania: A Skin Picker’s Guide to the Dermatologist

OCD Center of Los Angeles June 17, 2016 1:22 pm 44 Comments

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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

OCD Center of Los Angeles April 25, 2016 2:19 pm 234 Comments

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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. (more…)

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

OCD Center of Los Angeles May 13, 2015 12:01 pm 696 Comments

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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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Moral Scrupulosity in OCD: Cognitive Distortions

OCD Center of Los Angeles June 17, 2014 10:45 am 68 Comments

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 in OCD: Cognitive Distortions — 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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OCD in the Family

OCD Center of Los Angeles April 21, 2014 7:40 am 5 Comments

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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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Scrupulosity in OCD: Cognitive Distortions

OCD Center of Los Angeles February 10, 2014 6:36 pm 40 Comments

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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.

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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OCD and Eating Disorders

OCD Center of Los Angeles September 24, 2013 5:09 am 6 Comments

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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.

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.

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Harm OCD Treatment With ERP

OCD Center of Los Angeles July 23, 2013 5:56 am 186 Comments

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A discussion of Harm OCD and its treatment using Exposure and Response Prevention (ERP). Part four of a series.

Harm OCD treatment — Exposure and Response Prevention (ERP) is the key component to effective treatment for Harm OCD.

In our three previous articles in this series, we discussed the primary symptoms of Harm OCD, along with how one can use mindfulness and cognitive therapy to address unwanted harming thoughts. In this installment, we focus on directly challenging the behaviors associated with Harm OCD by using Exposure and Response Prevention (ERP).

What is Exposure and Response Prevention

The primary behavioral therapy tool used when dealing with Harm OCD is called Exposure and Response Prevention (ERP). While cognitive therapy challenges the content of our intrusive thoughts, and mindfulness addresses our perspective towards those thoughts, ERP directly confronts the behaviors done in response to those thoughts. While mindfulness and cognitive therapy set the table, ERP is the main course. This is where the real work gets done.

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Serving the community since 1999

HOCD: 30 Things You Need To Know

Doubt, Denial and OCD

Dermatillomania: A Skin Picker’s Guide to the Dermatologist

Imaginal Exposure for OCD and Anxiety

What is Imaginal Exposure

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

Moral Scrupulosity in OCD: Cognitive Distortions

OCD in the Family

Scrupulosity in OCD: Cognitive Distortions

OCD and Eating Disorders

Harm OCD Treatment With ERP

What is Exposure and Response Prevention

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Contact the OCD Center

OCD Center of Los Angeles