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Doubt, Denial and OCD

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 asPure 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.

OCD and The Denial Obsession

When most people think of the compulsions experienced by those with OCD, they think of the stereotypical hand washing or door checking seen in Hollywood films like The Aviator or As Good As It Gets. And most people with OCD do in fact have some overt compulsions such as these. However, for many with OCD, especially those struggling with any of the Pure O variants, their response to their obsessions is more likely to be in the form of internal “mental compulsions” that are less readily recognized as OCD symptoms. For these individuals OCD is, quite literally, all in their heads.

There are numerous ways in which people with OCD do mental compulsions in an effort to reduce their anxiety, including:

  • Mental Checking – Purposely calling up a “bad” thought to see if it still causes distress.
  • Mental Review – Compulsively ruminating on a past event in order to prove to yourself that you didn’t do something “bad”.
  • Thought Neutralization – Focusing on a “good” thought or image in an effort to undo or prevent a “bad” thought or event.
  • Mental Reassurance Seeking – A type of thought neutralization in which one compulsively repeats reassuring or calming statements.

As a result of these and other mental compulsions being less obvious to the outside world, many of those struggling with these types of internal rituals are more prone to discount their diagnosis of OCD, and to battle what could be described as the ultimate obsession:

“What if I don’t have OCD at all, and I’m just in denial?”

Given that OCD is characterized by near-constant doubt, it is not at all surprising that those with the disorder frequently question the authenticity of their diagnosis. In fact, it is not uncommon for those struggling with OCD to at times obsess about the possibility that they are nothing short of a fraud, with an internal monologue that goes something like this:

“I am an imposter. I don’t really need or deserve treatment. My so-called symptoms are just an excuse that allows me to deny my true character.”

This issue is further complicated by the fact that many mental health treatment providers are so uninformed about OCD that they too think OCD only exists if an individual exhibits the more overt symptoms such as hand washing and door checking.

But compulsions are compulsions, whether they are obvious to the outside world, or quietly and endlessly festering away in the mind of the sufferer. Simply put, those struggling with OCD do compulsive behaviors, including mental compulsions, because the condition makes the empty promise that such compulsions will relieve the nagging doubt that accompanies their obsessive thoughts. However, the compulsions provide only temporarily relief of the doubt. After fighting off their obsessions with any number of compulsions, the sufferer often briefly believes that they do in fact have OCD. Then the insidious uncertainty begins to creep in anew, often in just seconds, and the cycle thus starts again. The internal questioning continues indefinitely, with the false hope of a definitive answer always seeming just slightly out of reach.

So What is Denial Anyway?

Many people think that denial involves being so profoundly disturbed by an idea that one’s mind somehow will not allow that idea into consciousness. In actuality, denial involves active knowledge of something, coupled with a desire to reject said knowledge.

The person who has been diagnosed with cancer and who is “in denial” knows that they have cancer, and is simply attempting to ignore it because acceptance of their mortality may seem too difficult to tolerate. Likewise, if an individual is “in denial” about their spouse’s alcoholism, they are not completely oblivious to the problem, but rather are purposefully choosing to ignore every indication that something is awry for fear of the impact on their marriage and family. And someone who is attracted to the same sex and “in denial” knows about their attraction, but refuses to acknowledge or accept their sexual orientation, likely because social and cultural mores may make open acceptance of their urges seem unbearable.

Denial and the “Meaning” of Thoughts

Many people are under the misguided belief that all thoughts have important underlying meanings. Those who struggle with the thought, “What if I am in denial and don’t really have OCD at all?” might believe that this thought represents some underlying truth trying to break through from their unconscious. But the truth is that the vast majority of our thoughts are not intrinsically important. The human brain generates an endless stream of thoughts, including some that are deeply bizarre and unnerving. Does it mean anything that I just considered sticking a banana up my nose? Some would have you believe that this represents some inner urge, or has some secret meaning that needs to be ferreted out. We would posit that this thought, like so many of its brethren, is merely an odd byproduct of being a human being with a functioning brain.

Some people with OCD worry that accepting their diagnosis is somehow a “cop out”. This is particularly noteworthy as, in order for this to be true, an individual would have to mimic an extensive set of OCD symptoms of which they were previously unaware. Similarly, many people with OCD fret, “What if ‘deep down’ I know that this is my reality and I’m refusing to accept it?” We wonder where this “deep down” place is located, and would argue that it does not exist. One either knows something or does not.

The Denial Obsession in Various OCD Sub-Types

Most people with OCD occasionally (or frequently) fear that accepting their diagnosis would be a form of denial. The specific denial obsession varies depending upon the individual’s sub-type of OCD. For example:

In HOCD, also known as Sexual Orientation OCD, or Gay OCD, individuals question the validity of their expressed sexual preference. Those struggling with this sub-type of OCD often fear that they are in deep denial about their true orientation. For those who are straight, they incessantly question if they might actually be gay. Conversely, those who are gay question if they are in actuality straight. When people with HOCD experience the denial obsession, the thoughts often sound something like, “What if I’m using OCD as an excuse so that I do not have to deal with the difficulties of coming out?” or “What if I’m acting like I have OCD because I am in such deep denial of the truth about my sexual orientation?”

Relationship OCD (ROCD) generally targets the legitimacy of an individual’s romantic relationship, frequently employing the question of whether or not one’s partner is “the one”. Many with ROCD wonder, “What if I don’t have OCD, and I actually don’t love my partner?”

Those with Harm OCD obsess that they may harm others or themselves. They often question, “What if I wrongly accept this OCD diagnosis, and then suddenly lose control and kill someone?” Harm OCD obsessions often focus on violent thoughts or images, and the anxiety is often secondary to the overwhelming fear that the presence of such thoughts indicates a sub-conscious desire to purposely engage in violent behaviors. People who doubt that they have Harm OCD might ask questions like, “What if, deep down, I actually want to act on my thoughts, and I’m just manipulating my therapist into thinking that I have OCD so that I can go on a killing spree?”

Hit and Run OCD is a variant of Harm OCD in which the sufferer obsesses that they have accidentally or purposely run someone over with their car. When doubting their OCD diagnosis, they may think, “What if I actually did run someone over and they are lying in the street dying, with no one to help them because I am not accepting the fact that I ran them over?”

Perinatal / Postpartum OCD (PPOCD) is experienced by expectant and new mothers, and generally manifests as a variant of Harm OCD in which the sufferer obsesses about purposely or accidentally hurting their newborn child. Women with PPOCD are susceptible to denial obsessions such as, “What if I foolishly accept the idea that I have OCD, let my guard down, and then injure or kill my baby?”

Religious Scrupulosity focuses on a person’s faith and their alleged failings in adhering to their religion’s standards. Someone who struggles with Religious Scrupulosity is likely to question whether they actually have OCD, and might struggle with questions like, “What if I’m really not practicing my faith correctly, and I spend eternity in hell because I accepted this false diagnosis of OCD?”

Similar to Religious Scrupulosity, Moral Scrupulosity leads individuals to question whether or not they are “good” people living life in accordance with their morals, ethics and values. Those struggling with the denial obsession in Moral Scrupulosity are likely to worry, “What if I’m saying that I have OCD as a cop-out so that I don’t have to do the hard work of being morally upright?” or “What if I’m being dramatic – what if I’m faking OCD for attention because I’m an innately bad person?”

Relapse OCD is essentially a sub-type of Moral Scrupulosity that targets those in recovery from substance use disorders. These individuals fear that they may relapse, and go to great lengths to avoid any contact with mind-altering substances. A person with Relapse OCD might wonder, “What if my concerns are legitimate and accepting the idea that I have OCD leads me to let down my guard and relapse?” Those with Relapse OCD might also question the validity of their diagnosis of OCD as it relates to a specific past event – for example “What if my concerns that I did relapse are valid and aren’t OCD at all?”

Blackout OCD usually surfaces in one of two ways. Some have obsessive thoughts that they may have committed an offensive act during a substance-induced black out. Others question the nature of their activities during periods of time in which they cannot account for the exact moment-to-moment specifics of their behaviors. These individuals are apt to question their diagnosis by wondering, “What if I really did act inappropriately during that time, and I’m using OCD as an excuse so that I can get away with my bad behavior?”

Those with Pedophile OCD (POCD) experience unwanted thoughts about committing inappropriate sexual acts with children. Those who have POCD might be consumed with thoughts such as, “What if I’m actually a pedophile pretending to have this disorder so that I have the opportunity to surreptitiously prey on children?”

Someone with Hyper-responsibility OCD might be concerned that reducing supposedly “disordered” behaviors will result in a tragedy. For example, “What if I don’t pick up that trash along the side of the road because I’ve decided this is OCD, and a driver drives over the trash, gets a flat tire, loses control of their car, gets in an accident, and kills an entire family, all because I foolishly bought into the idea that I have OCD?”

Superstitious OCD is not dissimilar from Hyper-responsibility OCD. In this variation, individuals experience magical thinking, which leads them to follow arbitrary rules and/or perform unnecessary rituals with the purpose of averting completely unrelated negative events. Those with this form of OCD might think, “What if my superstition is actually realistic, and by not performing my rituals, I cause terrible harm to myself or to those I love?”

With Mental Health OCD, the sufferer worries that they are on the verge of decompensating into a grave mental disorder. Some fear they are developing Schizophrenia (sometimes call Schiz OCD), while others may be overly concerned with the idea that they have Bipolar Disorder. Those with Mental Health OCD often fear that their diagnosis is inaccurate, wondering, “What if my therapist missed something and my symptoms truly represent another, more debilitating disorder, not OCD?”

For those with Existential OCD, obsessions focus on the nature of reality. Someone with this form of OCD might wonder, “What if my focus on this issue isn’t OCD, but is instead a legitimate inquiry into the nature of reality and the universe that I truly need to resolve?”

This list is by no means exhaustive. It is also worth noting that, while the denial obsession is most common in these Pure O variants of OCD, it can also be present for those with more stereotypical manifestations of the disorder such as compulsive checking and washing. If your particular type of OCD is not mentioned here, it is only because the manifestations of OCD are as vast and varied as the individuals who have the disorder. Virtually all incarnations of OCD include some variation of the fundamental question surrounding the authenticity of the diagnosis – “What if I am in denial?” But this fear of being in denial is merely another manifestation of the incessant doubt that defines the disorder, and one that exemplifies OCD’s tendency to target an individual’s most terrifying fears.

Denial and the Backdoor Spike

One of the most pernicious manifestations of the denial obsession occurs with what is known as a “backdoor spike”. This occurs when the OCD sufferer starts to experience less anxiety in response to their unwanted thoughts, and then begins to obsess that they are not anxious enough about these thoughts. When this occurs, the person with OCD often sees this as further evidence that they have been in denial all along. “After all”, goes their reasoning, “if I am not upset about these horrible unwanted thoughts, they must be valid indicators of my true character and intent.” We have treated many people over the years who have found the backdoor spike to be the most difficult challenge they face in the course of treatment. Of course, the truth is that the backdoor spike is just one more way in which OCD injects doubt into the mind of the sufferer.

Treatment of The Denial Obsession

Research has repeatedly and consistently found that Cognitive-Behavioral Therapy (CBT) is the most effective treatment for OCD. CBT focuses on both the individual’s distorted obsessive thoughts (i.e. their cognitions) and the compulsive behaviors they employ in an effort to reduce or eliminate these thoughts.

When viewed from a cognitive therapy perspective, the goal of treatment for the denial obsession is to recognize that many distorted thoughts are present in all variants of OCD, and that the non-acceptance of an OCD diagnosis is the real “denial”. Using a technique called “Cognitive Restructuring”, individuals learn to challenge the content of their obsessions. For example, the obsession, ”What if I don’t really have OCD, and I am in denial that I am a murderer?” highlights a cognitive distortion called “selective abstraction” in which an individual over-attends to one negative detail instead of seeing the whole picture. In this example, those with OCD over-attend to this one unwanted thought, while ignoring four facts that frame the bigger picture:

First, that thoughts are just thoughts, and are not the same as actions. Second, that they have had millions of thoughts in their life, and this is just one of them. Third, that they have had this particular unwanted thought many times, and have never acted on it. And fourth, that they have lived many years, and have never even come close to killing anybody. By methodically and systematically questioning their anxiety-provoking thoughts, OCD sufferers can begin to see their obsessions for what they are – irrational and unrealistic thoughts that have been twisted into lies that they unfortunately have come to believe.

Mindfulness training is a valuable compliment to the cognitive component of treatment for both obsessions and compulsions. From a mindfulness perspective, treatment is focused on accepting of the presence of whatever thoughts pop into one’s mind, including thoughts of doubt and denial. The ultimate goal of mindfulness for someone with OCD is to develop the capacity to sit with the discomfort and uncertainty that their mind presents to them, making no effort to eliminate their unwanted thoughts or the anxiety they produce. A mindful response to the denial obsession in OCD might go something like this:

“Maybe it’s OCD, and maybe it isn’t. Oh well, I guess I’ll have to live with the uncertainty.”

The most important part of CBT for OCD is the behavioral component, which focuses on Exposure and Response Prevention (ERP). This is a technique in which the individual with OCD is purposely and repeatedly exposed to situations and things that trigger their anxiety. The primary goal of ERP is to tolerate exposure to one’s obsessions without responding with compulsions (hence, the name Exposure and Response Prevention). By repeatedly facing their fears without responding with compulsive behaviors, OCD sufferers “habituate” and become “desensitized” to the triggers that provoke their anxiety. In other words, they become bored by what previously caused extreme distress.

When tackling the denial obsession with ERP, the sufferer may be asked to do, or not do, certain behaviors, such as:

  • Purposely go to places that trigger the fear of being in denial. For example, if you are struggling with whether you have HOCD or are in denial, purposely and repeatedly go to a gay bar.
  • Don’t avoid things you would normally do just because you are obsessing about being in denial. For example, if you are struggling with whether you have ROCD or are simply in denial about not loving your partner, continue to spend time with them despite your fears.
  • Don’t ask for reassurance from friends or family about OCD symptoms. For example, don’t ask people whether they think you have Harm OCD or are really a murderer.
  • Don’t do online research about the nature of your thoughts, feelings, or urges. Compulsive research never provides long-term certainty about OCD.
  • If you struggle with Religious Scrupulosity, don’t compulsively read religious texts in an attempt to find scriptural evidence to prove or disprove that you are a sinner.
  • Post the word “denial” on numerous post-it notes throughout your home so that, over time and through repeated exposure, the word itself no longer evokes the same fear response.
  • Read articles about denial until words like “denial” and “subconscious” no longer hold the same triggering potential.
  • Resist the urge to analyze thoughts, feelings, or events in an effort to determine with certainty that you are not in denial.

ERP also often includes what is called Imaginal Exposure in which the sufferer, with the assistance of their therapist, writes fictional short stories outlining their worst fears. When addressing the denial obsession, this might include writing a short story about your anxiety-provoking thoughts turning out to be true, and the realization that you have been in deep denial. A variant of this is to email your therapist on a daily basis about how you do not have OCD and are actually in denial.

As with all variants of OCD, the goal for those struggling with the denial obsession is to expose themselves to the unwanted thought repeatedly, without doing compulsions, until they habituate to it. Through this process, they learn first-hand that, when they do not respond to the obsessions by performing compulsions, the anxiety sparked by the idea of being in denial greatly diminishes over time.

For those with the fear that their OCD diagnosis is a charade – that they are OCD imposters – the ultimate fear can be summed up as follows:

“What if I’m in denial, and this isn’t OCD, and I never recover from whatever this actually is?”

If you have OCD and are struggling with this question, we would ask one alternative question in return:

“For someone who doesn’t have OCD, and is merely in denial about their “true self”, aren’t you spending an awful lot of time compulsively seeking out the alleged truth?”

After all, people without OCD spend no time whatsoever trying to determine whether or not their thoughts are evidence of OCD.

• Lauren McMeikan, MFT, and Tom Corboy, MFT, are psychotherapists at the OCD Center of Los Angeles, a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related anxiety based conditions.  In addition to individual therapy, the center offers five weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment.  To contact the OCD Center of Los Angeles, click here.



  • Thank you for this article, it is very thorough and informative. I especially like the suggestions provided to help start moving toward the solution.

    One question I have that wasn’t mentioned was if an OCD characteristic could be defined as the “What if…” scenario loop appears in the form of paralysis with regards to decision making. “What if I’m making the wrong decision?” Thus locking the person in a loop of obsessional thoughts and mental loops and replays from which there is seemingly a no win escape. Even external reassurance or outside opinions don’t seem to quell the internal dissonance.

    Any thoughts? Thank you!

    • Hi AJ,

      Glad to hear that you found our article helpful.

      While all OCD is focused on “what if…” thinking, not all “what if…” thinking is related to denial. In fact, not all “what if…” thinking is emblematic of OCD. I can think of plenty of situations in which the possibility of making the wrong decision has nothing to do with denial or OCD. For example, “What if I make the wrong decision when I order chicken instead of beef for dinner?” or “What if I make the wrong decision about which movie to see this weekend?”

      The denial obsession focuses on more weighty matters and generally reflects a concern that one is fooling themselves about something they deem to be “important”. Even within the context of OCD, there are many situations in which “what if…” thinking is present and wreaking havoc on a person’s life, but the denial obsession is not an issue.

  • This was a great read and I appreciate the posting. I know I suffer with OCD and as such it did serve as a source of reassurance. Now the task will become not to obsess over that. I can’t thank you enough for all you’re doing to bring the light of OCD into mainstream consciousness.
    Best Wishes

    • Thanks for your kind words Kevin. It’s great to hear that our article resonated so strongly with you.

  • My problem is a disgusting sexual fantasy I had when I was about 13. I didn’t really acknowledge it until recently when it has pouredbinto my mind causing awful anxiety. I have some the norm and researched extensively about fantasies, asked for reassurance that they are normal. My mind still argues over the fact it was morally bad and out tricks me. It seems to not be able to understand that all teens have weird fantasies. I am trying to stop the mental reassurance and exposing myself to the fantasies using scripts. It feels bloody awful…

    • Hi Amanda,

      A few thoughts….

      1) Everyone has sexual fantasies.

      2) As you note, “all teens have weird fantasies”.

      3) One person’s “disgusting” is another person’s “turn on”, or at the very least, “not disgusting”.

      4) Behaviors, can be “morally bad”, but fantasies can not, as they are just thoughts, not actions.

      5) Your goal is to accept the presence of these fantasies, without doing any compulsions in an effort to reduce the anxiety and disgust you experience related to them. They are just thoughts.

      • So you have any advice on how to treat these thoughts and images? They make me feel incredibly distressed although I can rationally see at times that freaking out about something I thought of 25 years ago is excessive. My ocd is morphing them into something larger. It’s very hard to focus on work and chatting when I get these images in my mind and I feel the urge to escape and think them through to reassure myself that I am not an awful person. Any advice would be helpful, I’m currently taking mirtazapine which isn’t helping a great deal.

        • Amanda,

          My advice is four-fold:

          1) Stop trying to “escape” from your thoughts. That is impossible.

          2) Stop trying to “think them through”. This is a compulsion that makes OCD worse.

          3) Stop trying to reassure yourself.

          4) Seek treatment with a therapist who specializes in treating OCD.

          • I was really interested in #2, where you said to stop trying to “think them through” – that this is a compulsion that makes OCD worse.

            I do this all the time. I didn’t realize it was a compulsion, but it is very helpful to me to know that.

            I especially obsess when someone makes a negative comment about me or my loved ones. I can’t get it out of my mind for maybe weeks. I keep going over and over it to try to “disprove” the comment in my own mind.

            As silly as it may sound, I used to talk it out with my mother. I had to be reassured by her that these negative comments were of no importance. Then I could let them go until the next situation arose. But she passed away seven years ago, and I’ve had a hard time being reassured without her support. This is so embarrassing to admit, because I am a middle-aged women.

            Have you ever run into a person with this symptom of OCD?

            Thank you!

          • Jessica,

            A few thoughts…

            1) Yes, trying to control your thoughts is a compulsion. Better to let your thoughts do whatever they want without trying to control them and without taking them so seriously.

            2) Spending weeks trying to disprove something other people say sure sounds compulsive to me.

            3) Getting reassurance from your mom is classic OCD. I encourage you to read our article Reassurance Seeking in OCD and Anxiety.

    • I am dealing with a real event that I cannot get out of my mind. I was in a car accident in which traffic suddenly stopped so I stopped behind it, obviously. However, the guy who rear ended me falsely claimed that traffic did not stop and was no where near us anyway. Having a learning disability I did a crappy job explaining the accident (had a concussion too) and he came out as more credible even though he changed his story, they didn’t care. I was falsely accused by his insurance of “braking without due warrant” which equaled “inattentive driving” they said I put others lives in danger. I am horrified by the false accusation almost every minute of every day. I feel sick being accused of driving dangerously as they said. I remind myself that it was only a lie but that makes my compulsion to prove my innocence worse, I tried to but video footage is too late to get as it tapes over itself after 48 hours and I requested too late, and nothing I said would work to change the insurance’s mind, despite pointing out several errors in their logic to their conclusions about the crash. It’s to the point I don’t even want to live anymore. this crash happened 15 months ago.

      • Sara,

        Car accidents happen. And they are generally expensive. And whenever money is involved, just about everybody tends to get very focused on their self-interest, even if that means lying to one’s insurance company. So it is not surprising that the other party is spinning the story to make this your fault. There is nothing you can do about that.

        However, you do have the power to do the following:

        1) Have your insurance company fight for you against his insurance. This is the most likely response of your insurance company anyway, as they are not interested in paying out unless they have to. Be very clear with your insurance company that the other party is lying. Stick to your guns.

        2) Accept that you feel uncomfortable about being accused of “inattentive driving”. Nobody likes being charged with anything, so I am not surprised that you don’t like this. But like it or not, you are being charged with this. Accept it, and the discomfort that it causes in you. Then fight back. As I said above, be very clear with your insurance company that the other party is lying, and stick to your guns.

        3) If this case has already been settled, and the other party has prevailed, your best course of action is to accept the loss and move on. You say you “don’t even want to live anymore”, which is an over-reaction to losing (or potentially losing) an auto accident case. As I said above, car accidents happen.

        4) If you are genuinely suicidal, please take yourself to your local emergency room immediately.

  • Well written article. As an OCD sufferer with “Pure O” myself, I have greatly benefited by the research and work put into these articles. They expose my illness and help me face my OCD thoughts as being only thoughts, and not indications of true realities. Thank you

    • Thanks Leah. I’s always nice to hear that our articles are helpful. And as you note, it is important to remember that thoughts are just thoughts. They are not the same as action, and they frequently have absolutely nothing to do with one’s true intent or character. Take care.

  • This is an incredible article. I am not in denial of having an OCD. I am actually happy that what I have can be defined because for so long I thought I was a terrible person having terrible thoughts. I actually laughed when I read about drumming up a terrible thought to see if ithey scared me. Oh boy is that me! I can’t tell you the amount of comfort your website and blog has given me. Over 20 years of fear and suffering slowly started to disappear because I learned that I had an OCD. The worst part? No one knew this about me. I could never talk about it.! I was too terrified of what they would think of me Now I feel like I have a voice and I am not alone. Thank you thank you thank you.

    • Hi Kay,

      Thank you for your very kind words. It is extremely gratifying to know that our work has helped you so much.

      Trust me when I say that you are not alone. So many people with OCD suffer quietly for fear that others will judge them. Fortunately, the stigma is fading as people like yourself more openly discuss their struggles. Take care.

  • This article definitely pertains to me and is very well written, thank you!

    I often struggle with denial OCD and while I was reading your article I particularly noticed how you said, “One either knows something or does not.” But doesn’t this line of reasoning directly contradict the idea that we can’t be truly certain of anything? My perceptions constantly change and obsessions come and go accordingly. Not only this, but often my compulsions are logical ruminations, and just when I think I have a definition for something, my certainty changes when I learn a new piece of information. If I run across new information, my original “certainty” becomes doubt once more. I’ve learned not to trust my logic or feelings because there’s always more to the story/another perspective.

    • Brigham,

      We see no benefit in getting into an epistemological debate about what constitutes “knowledge”. We agree that nobody can “know” something 100%. I cannot even know with 100% certainty that I exist! Nor do I need to know.

      When we say “One either knows something or does not”, we mean that, with “reasonable probability”, and based on the evidence at hand, one knows what they have experienced, what they think, what they feel, etc. We propose that there are no secret thoughts hiding in your subconscious waiting to spring out with new “knowledge” about who you are that contradicts everything you “know” about yourself.

      The thoughts you describe as “logical ruminations” are by your own description “compulsions”, and compulsions always make OCD worse, not better. Furthermore, while they may be “logical”, they are not even remotely helpful – they never provide you the certainty you are seeking. Besides, as you have noted “certainty” (i.e., absolute “knowledge”) does not exist.

      We encourage you to accept uncertainty, and to stop to analyzing your thoughts in an attempt to get certainty. That is a strategy that will never work. You may also want to read our article on reasonable doubt and OCD.

  • Thank you so much for your articles, these are some of the most thorough, well written articles I have ever read on OCD. I am in my mid twenties and after a stressful period four years ago in college I started to have really intrusive scary thoughts, and was diagnosed with anxiety and OCD. However all of the internet research made me fear I was misdiagnosed and really had schizophrenia, bipolar, or psychosis etc.. At times I have done better (usually when I stay really busy), and have still been very successful, however the scary intrusive thoughts are still there, which then makes me doubt. The hard part is since I have researched so much I know the thoughts those people with the much more serious mental illness have, and then those thoughts automatically come to my head because I fear them so much, but then the OCD makes me fear that those are actually my thoughts because I have those things, not because I am so scared of those things.

    So I am in a constant battle with myself everyday. No matter what I do, those thoughts about those illnesses keep coming up in my mind, and it makes me fear that I actually have been misdiagnosed. What do you feel I should do get over this for good?

    • Logan,

      These thoughts about having Schizophrenia, Bipolar Disorder, etc, are quite common in OCD, and as you notes, your compulsive research has not resulted in the cure you seek. That is quite predictable, as compulsions always make OCD worse in the long run. I suggest you do four things:

      1) Stop researching anything related to mental illness.

      2) Start accepting the existence of these thoughts without taking them so seriously. They are just stupid thoughts.

      3) Let go of the idea of getting over OCD for good. OCD is just thoughts that people pay too much attention to, and to which they then over-respond by doing compulsions. Nobody gets to control what thoughts pop into their head, and there is no cure for thinking other than non-existence.

      4) Find a therapist who specializes in OCD treatment using Cognitive Behavioral Therapy (CBT).

  • I really enjoyed this article but I’m wondering about the opposite: Is there such a thing as worrying that your thoughts do come from OCD when they don’t? What I mean is this: I have come to accept that I am not straight, but when I go to gay events or chat groups I start thinking “What if I really just have HOCD and I don’t belong here,” and I get really scared and want to leave. But my fear isn’t of being bisexual or gay, it’s of having HOCD. I know it sounds weird. I do have OCD. I just don’t think that’s where these thoughts that I am not straight come from because the thoughts themselves don’t bother me at this point and in fact I like them. But since I’ve never been in a relationship with someone of the same sex it’s easy for me to doubt everything and let these thoughts prey on me.

    • Hannah,

      One can obsess about just about anything. And it is not unusual for people with OCD who are gay to obsess that they are straight, and “in denial”.

  • Thank you very much for this article. (My english is not correct but I understand almost everything, I hope you cab understand my writing).
    I actually struggling with the idea that i want to suicide,only because one day I read something about it in a newspaper. My fear is that if I consciously do something,not loosing control,but at the same time I want to live and enjoy. Before this I had horrible thoughts about harming my child for a long time, but I really love my daughter,I suffer o lot when she is ill or sad, and this idea return every time I bored with another idea . A few months ago I was really good and I believed that ocd is disappeared but during the summer vacation I had some panic attacks and everythings turn back and worst than before It was awful,altough at this moment I am a bit better,because I finally understand that is the same that before, but now it cost me more effort to overcome. My question is how can I cope with this new idea, my thoughts changes every few days, some of them returns? Is this normal that I had a good year and I felt down again? I feel that I can recover but sometimes I don’t know how.
    Thank you very much for everything.

    • Maria,

      Having obsessions about suicide is quite common in Harm OCD. And it is not unusual for someone to have their harm obsessions morph from harming others to harming themselves. It is also quite common for the severity of symptoms to change over time.

      The best way to cope with OCD is by seeking treatment with a therapist who specializes in Cognitive Behavioral Therapy for OCD. This treatment approach has consistently been found to be the most effective therapy for OCD.

  • I would love to personally thank the writers of this article. As a person who has suffered from confirmed OCD since a child, I know all too well the little ‘games’ OCD can play with the mind. I could only wish to wash my hands or not step on sidewalk cracks. I think I could handle that. My OCD is the ‘harm’ type that has made a good portion of my life a living hell. And even when I am in ‘remission’ or have a period where it eases up, it always is there just waiting…Oh, on the outside I am sure I appear as normal as the next person…busy with everyday activities, work as a medical secretary, elderly parents to take care of, a husband who has been ill and a daughter and grandchildren. What they DON’T know is how their daughter, wife, mother, grandmother, worries about whether I had done murders that were in our hometown. Even though I KNOW it wasnt geographically possible, my mind will find a way that I ‘could have’. I have turned around more than once to see if I ‘may’ have run someone over. That’s a classic. I have thrown countless items away thinking they may have been ‘tampered with.’ I wish I had more space as I have only touched the surface.

    • Hi Terri,

      Thank you for sharing your struggle. You highlight some of the insidious ways that OCD lies in order to get people to live in fear. Keep on challenging your obsessions and you will see results.

  • Thank you for your wonderful article! I suffer from pure o and magical thinking that often surrounds religious themes. If during prayer or while having an intrusive thought I match up these fears with something that happens in the external world (i.e., someone calling my name or my sons etc.), then these coincidences seem to validate my fears. What is the best way to deal with this type of ocd?
    Thank you!

    • Hi Reuben,

      Keep in mind that “Pure O” is just a slang term for OCD in which the compulsions are mostly internal mental compulsions, and that religious themed obsessions are very common for those with a variant of OCD that is commonly called Scrupulosity.

      The most effective treatment for Scrupulosity is the same as for other variants of OCD, namely Cognitive Behavioral Therapy (CBT) with an emphasis on Exposure and Response Prevention (ERP).

  • In relation to black out OCD when you have drank . What is the best approach to take ? My brain keeps telling me this one is different because I actually did something that would cloud my judgement and would make me not remember . I remember most of the night and I have had this similar obsession before . I keep getting repetitive thoughts that i don’t deserve to go on as normal because I’ll only get caught and be punished . I just wish I could move on and go on with my life the way normal people do after a night out . With persistent practice of allowing thoughts will I begin to have that ability ?

    • Jesse,

      Many people think their OCD is “different” or “special”, but I assure you that the symptoms you describe are not unusual. The problem is not that you did something that would impair your judgement (i.e., alcohol). The problem is that your OCD has you believing that you need to remember every moment of the night. While you have evidence that you drank, you have no evidence whatsoever to support the thesis that if you can’t remember a period of time when you were drinking, then you must have (or may have) done something horrible when you drank.

      The best approach for Blackout OCD is the same as for any other variant of OCD, namely Cognitive Behavioral Therapy (CBT) with an emphasis on Exposure and Response Prevention (ERP).

  • Hi I am seeing a cbt therapist who has said they believe I have ocd. Reading your article brought to light exactly what was happening in our sessions, I had the belief that I was a fraud and sometimes still do but I guess that what ocd does. My question is about rituals, I suffer really bad with intrusive thoughts and in a constant battle with myself. The problem I have is most of my compulsions are just mental and don’t really have rituals. Can you still have exposure response therapy without rituals?

    • Hi Tina,

      Mental compulsions are still compulsions, and they are treated most effectively with Cognitive Behavioral Therapy (CBT), with an emphasis on Exposure and Response Prevention (ERP). The key is finding a therapist who truly understands OCD and has significant experience treating it with CBT.

  • Brilliant article, written in a clear and down to earth way which makes it both reassuring and motivating. 🙂

  • Thank you so much for this article. I personally questioned the fact that I am suffering from OCD despite more than one therapist’s diagnosis and my intake of medications… After months of treatment I started to stop experiencing many of the doubtful thoughts but I still have the urge to analyze past troubling thoughts and images. I cannot say i am fully back to myself but reading your article, for the first time I find a thorough analysis of how I feel and this makes me more comfortable about accepting the illness and not fearing it. Thank you again

    • Hi Lina,

      Thank you for your comment. It is extremely gratifying to hear that our article has helped you to better understand your struggles.

  • Thank you for your article!
    I am in a difficult situation: I’ve been struggling with homosexual thoughts for a few weeks now and it’s deteriorated by the fact that since my tough breakup few months ago I can’t imagine me connecting emotionally with a woman and finding men easier and more pleasurable to communicate and spend time with.
    I was having a conversation with my friend whom I didn’t see for a long time over drinks, I felt relaxed and connected to someone, I knew his vulnerability and he mine, then I imagined kissing him and thought that I’d like it. And then the realization of this somewhat arousemend led me to another spike of fear that I’m bi. Now I feel that I should kiss him to figure out but afraid I’ll like it
    I know that some bisexual people realized that they are bi in 20-30s and they were also dreaded by that realization at first. What make me different? Why it’s an obsessive and groundless fear, not the incapability of accepting of who I am? I really think that’s possible and I believe that the reason of why those thoughts cause anxiety is that they lead me to be not who I thought/planned to be. So I nay actually be bi, just can’t accept such a…

    • Alexander,

      Just because you find it easy to talk to men does not mean you are gay or bi. I suspect many men find it easier to communicate with other men than with women

      It is quite common that, after a break-up, many men find it difficult to “imagine connecting emotionally with a woman and finding men easier and more pleasurable to communicate and spend time with”.

      If you attempt to kiss your friend to see if you like it, you will be doing a compulsion, to which the following are likely to occur:
      ~ you won’t like it.
      ~ you will then doubt that you didn’t like it.
      ~ you will feel even more confused.
      ~ you will want to do other compulsions.
      ~ your friend will no longer feel comfortable spending time with you.

      A better solution is to accept that your brain creates lots of different thoughts, including some that are weird and unexpected, and to stop analyzing your thoughts in an attempt to find meaning.

  • This website has helped me tremendously in the past year. Here where I live it’s really hard to find an OCD specialist and, after studying enough about the theme to make my own self-program (with your book and Grayson’s one), I think I’m finally making some progress listening to exposure scripts that remind me about not getting into OCD thoughts all the time and accepting whatever they could mean. It works like mindfulness to me in a sense. My biggest compulsion is checking out guys and the denial doubt itself (“how can you know your rituals, like checking out, are not actual gay desires you are pretending not to have??”) and this helps me a lot because I keep remembering that I should NOT review or analyze these thoughts, feelings and events related to my sexuality. As I keep learning to let go of the certainty about my sexuality (which is REALLY hard sometimes), I’m realizing that the thoughts are not bothering me as much. I’m going to my fourth week now on treatment – listening to the script – and I can only thank you for letting me KNOW what was happening to me. My only question now is when do I know I’m done with therapy. But, finally, now I have hope! Thanks!

    • LF,

      As you are doing “self-therapy”, I see no reason that you need to know when therapy is “done”. So long as you continue to see benefit from exposures, keep doing them.

  • In this article you wrote, “Denial involves active knowledge of something, coupled with a desire to reject said knowledge.”

    As you know, many of us have had a thought, feeling, or perhaps even a moment of knowledge (a troubling epiphany? … I may not love her like I think should, I may be gay, etc.) that didn’t sit very well at all, and triggered our OCD cycle.

    I am left wondering how we are to differentiate between this triggering thought and the rejected active knowledge that sits at the heart of a denial? How are we to know which one is real? Or is the pursuit of this question just another grab at certainty?

    Thanks for your help!

    • Hi Eric,

      I think you’re spot on by suggesting that “the pursuit of this question [is] just another grab at certainty.” It sounds like you’re looking for certainty about what differentiates a triggering/intrusive thought from an “important” thought. But analyzing your thoughts in the pursuit of certainty about your thoughts will never work.

      From a cognitive perspective, we make decisions about what is an intrusive thought vs. a more accurate and helpful thought based on what is logical, evidence or experience-based, and probable. Then the goal is to sit with the remaining uncertainty and the discomfort that accompanies it.

      Intrusive thoughts are by definition unwanted. If a thought is unwanted, then it is not an “epiphany”, it is just an intrusive thought. By calling intrusive thoughts a “moment of knowledge” or “epiphany” you are overvaluing them. That said, you will not get absolute certainty that the thought it intrusive. OCD will bait you with the promise of relief, but 100% percent certainty doesn’t exist.

      Our brains create weird thoughts. Your problem here is: a) the belief that thoughts are important; and b) your effort to figure them out.

  • My obsessions shift from Harm to POCD towards my daughters. I want to know if this is a compulsion – I get near them to kiss them and hug them. Then I say to myself “see you didn’t do anything”. I purposely go on walks with them to make sure I will protect them from cars or something like that. Then I realize ok I did protect them. I accidentally stepped on my daughter and felt terrible. Ok you felt bad, you wont hurt them.

    When I wake up I go to them and lay with them for a while to see if I have any reactions. I do notice that I will feel better for a while after doing this, but then my fears come back right away. If this is compulsions, then how should I face my fears.?

    • Hi Cecy,

      These actions that you are taking are, in fact, compulsions. Some are considered mental compulsions, like the mental review you do when you analyze your intentions. Others fall into the category of checking compulsions, like spending time with your children to see if you have any reactions. The “feeling better” you describe is the temporary relief that compulsions do provide. The problem, of course, is that the relief is temporary, and by performing compulsions, you’re teaching yourself that you need relief from anxiety that is secondary to an empty threat.

      As for how you should face your fears, my first suggestion is to find a local CBT therapist to work with. As described in the article, Exposure and Response Prevention is ultimately what will help you to face your fears in a gradual manner. Based on the compulsions you’ve described, one such exposure would be to spend time with your children without checking to see if you are having any “reactions.”

  • A very interesting article thank you.
    My type of OCD isn’t mentioned, but I rarely see it mentioned. It is real event ocd. The denial part of the ocd is difficult because how can you be in denial about something that really happened? Can it be ocd if it is something that actually happened?
    The event that I obsess about happened over 10 years ago. It was a mistake that I made at work. I have ended up feeling responsible for someone’s death despite reassurance (that I have constantly sought) that I probably wasn’t. I will never get 100 per cent certainty and that is so hard to live with.
    A therapist told me it is ocd but I can’t help thinking this is a cop out. After all its easier to tell myself that I have ocd than actually accept that I did something bad.
    I have tried writing down a kind of exposure script but it hasn’t really been helping me.
    Any advice would be greatfully received.

    • Carrie,

      Denial as discussed in this article does not focus on whether or not something did or could happen. It focuses on an individual doubting whether or not they actually have OCD. In fact your fear that a diagnosis is a “cop out” is extremely common for people with the denial obsession. The “what if” in this scenario is not “what if I did something wrong” (which you apparently did), but rather “what if I don’t have OCD, and am merely in denial”.

      My advice is to seek treatment with a therapist who specializes in treating OCD. Trying to treat one’s self is not generally a good idea, and utilizing imaginal exposure scripts is more difficult that it seems.

  • Hey I have been diagnosed with OCD.

    My main themes are worrying I am a transsexual and worrying that I am a paedophile but I have had all kinds of crazy thoughts and images.

    This was an interesting article as I often worry that my OCD is just a cover-up for my transsexualism.

    Anyway, I have a couple of symptoms that make me think that I am actually a transsexual.

    Firstly I have felt a discomfort at the base of my penis. As far as I can make out, this is genital dysphoria which means I am a transsexual but I really don’t want to be. What are you thoughts on this?

    I have often seen the groinal response mentioned in terms of attraction but this isn’t an attraction, this is a discomfort.

    Also, in the last 2 days I have thought that my feet are too big to be a transsexual and this has made me anxious. Why would someone with OCD be anxious that their feet are too big to be a woman? Surely that is a sign of transsexualism.

    Please let me know what you think.

    Best wishes,


    • Tom,

      You are paying way too much attention to your penis. I encourage you to entirely stop paying attention to your penis, and stop analyzing whether the sensation you feel is “discomfort” or “attraction” or whatever. The bottom line is that your penis and whatever sensation you are experiencing there does not require nor deserve analysis. No amount of attention and analysis will provide you with evidence that you are or are not a transsexual.

      Further, I do not know where you got the idea that a man with big feet could not be a transsexual. Foot size has absolutely nothing to to do with sexuality.

      I encourage you to seek treatment with a therapist who specializes in treating OCD.

  • Thank you for these articles. You seem to understand.

    I struggle with depression, Tourette’s, and OCD. My upbringing was traumatic spiritually (and in other ways). My mom thought Satan sent me to torment her, identified me as the wicked in Proverbs, gave me messages from Jesus, and threatened me with hell. My father wouldn’t let me take art classes because of my test scores. He said he would love me if I was valedictorian – so I was. After a suicide attempt in high school followed by a psychotic break and forced hospitalization, I left home and studied art in college and graduate school.

    I’m now 37 and still struggle. I try to distract my mind with detailed paintings and self-set goals (ie. finish the list of Time’s top 100 novels). Yet, I have religious dreams that feel like visions. I question reality and my perception thereof. I fear that I will someday lose my sanity. I have urges to “tell”. I am in a game with eternal stakes where I don’t know the rules. I bargained away my soul to stop the tics. I spend hours researching the Bible/ theology. I email my priest too frequently. He has tired of reassuring me of God’s love.

    • Hi Jennifer,

      Thank you for your response. Based on your description, it would seem that by researching the Bible and Theology and emailing your priest you are performing compulsions in an attempt to gain certainty about God’s love. The emailing falls into the category of what we would call reassurance seeking, and the research is both an overt behavioral compulsion and reassurance seeking as well.

      The trouble with compulsions is that, while they temporarily relieve anxiety, their performance leads you into an endless loop of obsessions and compulsions. If you are confronted with an intrusive thought about not being loved by God you can note that this is just a thought instead of taking it as a serious threat and make a choice not to perform compulsions. Instead you could make a choice to sit with the anxiety that arose initially with the thought until it dissipates.

      Ultimately the thoughts that you have are not the problem, it is the importance that you give them that is the problem. If you can begin to recognize your thoughts as unimportant byproducts of having a brain, you will stop being so bothered by the thoughts.

      All my best,


  • I am really struggling and could use some advice. I was diagnosed with anxiety about 15 years ago and have been in medication for it but it has morphed into harm OCD I think started with self harm then moved to harming strangers, my pet and now my husband. Just recently I have started having the thought that I have to kill my husband and it is very scary because I have never had an “I have to” thought, it was usually just “I’m going to” or “I want to”. I am terrified that I will think I have to kill him and then do it. My psychologist is on vacation this week and my mom who I go to for reassurance and has always been my safe person is also on vacation out of state. Does having these I have to kill my husband mean I will act in them or is it just another morph of the OCD to scare me?

    • Jenna,

      There is no significant difference between “I have to” thoughts as compared to “I want to” or “I’m going to” thoughts.

  • After reading many articles, I am realizing that my past behaviors could probably be explained by OCD, although I’ve never been officially diagnosed. I believe that I am suffering from HOCD and have been for over 3 months now. I am a female that has always been attracted to guys growing up and am very strong in my Christianity. I have always wanted to find a husband and share that faith with him. After almost an entire year on a college rugby team, I became best friends with a girl who happens to be lesbian and then people started assuming we were dating and saying I “act super Christian to convince myself I’m not gay.” I was able to laugh it off for several months, but one day I was struck with unbelievable panic and anxiety that has not stopped since.

    I know I need to do ERP, but I’m afraid that I’ll find out I was in denial the whole time and will never be able to fall in love with a man. How do I deal with doing ERP without the fear that I am going to have to start a life outside of my Christian values? How do I accept uncertainty about something that goes against the most important thing in my life?

    • Grace,

      If you happen to be gay (which I doubt based on your comments) then avoiding ERP is not going to protect you from that reality. And if you are not gay, ERP is not going to make you gay. The main issue with HOCD is not sexual orientation, but doubt, and ERP will address your doubt by addressing your obsessions and compulsions.

      As for accepting uncertainty, we all have to accept uncertainty every day of our lives. For example, I am uncertain I will live through the night. I probably will, but I am not 100% certain. ERP does not require that you accept something about your self that is “against the most important thing in (your) life”. It does however require you to accept the presence of irrational thoughts without trying control them. They are just thoughts, and have nothing to do with your actual sexual orientation. And thoughts and feelings of uncertainty are at the very core of OCD.

  • Thank you so much for the articles, they are of so much help, and they are some of the very best, I have ever read. I have such bad intrusive thoughts and my biggest fear is getting a very serious mental illness, and because I have researched a lot (trying to prove to myself that I don’t or won’t have worse), I now know a lot of the thoughts they have, and my OCD just plays on those and makes me feel like I actually believe them. It is so hard as the thoughts are just very non-stop and makes me doubt even the most basic things that I know, such as my name, who I like, what I like to do, etc… It is just very maddening as my mind never accepts the fact that I only have OCD and nothing else. I have been diagnosed by a psychologist and says I have pure O, but the thoughts are so bad that it makes me doubt constantly about what I really do have, and the constant fear that I am about ready to lose my mind and end up in a hospital. I want to get over this so badly, but I am obviously doing something wrong that keeps me in this vicious cycle. Thank you so much for the help!

    • Hi Logan,

      Fear of having a severe mental illness is actually quite common in OCD. I encourage you to click here to listen to a podcast interview I recently gave about this very topic.

      It sounds like you have very good insight about your symptoms, and that you just need effective treatment. Your psychologist should be using Cognitive Behavioral Therapy (CBT) with an emphasis on a specific CBT technique called Exposure and Response Prevention (ERP). If he is not focusing on CBT/ERP, I encourage you to seek treatment with a therapist who is more specialized in this area.

  • Thanks for this article!

    I have never received a formal diagnosis of OCD, but looking at some of my long-term anxieties and my response to them I think that it seems likely that I have some form of it. One of my biggest problems is what seems to be moral scrupulosity; what makes it particularly unpleasant is that is mostly affects me after I have done something…I have never done anything which has intentionally harmed someone and I don’t think that there’s anyone out there who thinks that they have been wronged by me…but I sometimes worry that I have done something wrong that has negatively impacted on someone without them being aware of it.

    I have a few instances in which I I believe I made a reasonable/legitimate decision, but which afterwards I realise may not have been the right choice and it makes me analyse my thoughts when I made it and try to figure out the extent to which it was influenced by good intentions or selfish ideas. The people ‘affected’ by it are not aware of the decisions, let alone the influences on it.

    The trouble is that I can’t properly remember what was in my head at the time.

    • C.,

      Your primary obsession appears to be “what if I accidentally harm someone because I selfishly did not think through my actions”. The solution is to accept this thought, and to accept the possibility that you have inadvertently caused harm. Everybody on the planet at some time or another causes harm by accident, and analyzing your actions in an attempt to prove to yourself that have not caused harm is a compulsion that is making your OCD worse, not better. Trying to remember what was in your head is likewise a counterproductive compulsion.

  • Hi there,

    I’ve been diagnosed with OCD and intrusive thoughts but after a discussion with a friend I wonder if I am just in denial?

    When I was 13 I remember the thought popped into my head “what if youre a lesbian?” as I was watching an episode of Jerry Springer at the time involving lesbians and it interested me.

    Since then it’s always been in the back of my mind even when I’ve had relationships with men.

    If I ever masturabte it’s to gay porn or lesbian porn/sex scenes from movies.

    I am in relationship with a man and have been for six years – he knows everything but now I worry that I don’t love him anymore and in fact im gay deepdown and have known all along – especially since I had this thought at 13 and have continued to be aroused by lesbian porn etc. I also do not feel sexual at all right now. I cannot recall being sexually attracted to another woman. I know i’ve found other women beautiful.

    Im seeing a therapist but I feel like nothing is helping. She simply tells me to imagine the anxiety lifting away and that I am pansexual. But now im concerned im in denial and it’s all I can think about – I even have just given in to this thought.

    • Lori,

      The fear of being in denial about having OCD is common. Based on your response, it seems that you are uncomfortable sitting with the uncertainty inherent in matters regarding sexuality and would like definitive proof that you are one hundred percent straight. But the search for one hundred percent certainty is not only compulsive, but ultimately fruitless.

      Trying to figure out if you have ever been sexually attracted to a woman is a checking compulsion, no different from checking that the stove is off. While you want certainty regarding your sexuality, the person checking the stove wants certainty that their house will not burn down. But we only ever get relative certainty about anything and the checking process will ultimately result in continued urges to perform other compulsions in an effort to get relief.

      Also, some straight individuals watch gay porn. This is part of the normal spectrum of human sexuality and does not necessarily indicate one’s sexual preference. The problem isn’t that you have thoughts about your sexuality, however, it is the fact that you are not able to tolerate the discomfort associated with not having certainty. I encourage you to explore sitting with discomfort.

  • Hi, I’ve had what I think is transgender OCD for a while now. I’m in therapy and my anxiety has gone down quite a lot and is quite manageable. What I’m still having trouble with is (1) still not being certain I’m not transgender even when I’m not anxious and (2) convinced if I stop thinking being transgender is the worst thing, I’ll accept the fact that I am one or I’d want to be one. I know on the surface this sounds like an attempt to control it, but I really do feel like it’s true, and what gives more proof to this is that sometimes I feel like the thought of being transgender makes me happy and that I really am one. This confuses me greatly, because it doesn’t sound like the “backdoor spike” – everywhere I’ve read about that it just said worrying about not being as anxious, not being apparently happy with the thought.

    I also am afraid I knew I was transgender ever since the obsession started and that the ocd-like symptoms were really just me being scared to accept that I’m transgender because of the social repercussions that would have on me. So I think what I want to ask is, is it possible to have ocd about something but also have that thing be true?

    • Damian,

      In response to your questions:

      1. You don’t need to be certain that you are not transgender. In fact, such certainty doesn’t exist for anyone. Wondering if one could be transgender does not mean that one is transgender. You are reacting to your thoughts as though they are a direct reflection of reality, but I imagine that you’ve had lots of thoughts that don’t reflect reality. Ever thought about winning the lottery? Ever won?

      2. Many worry that if they stop obsessing then their obsessions will come true. But have you ever obsessed about becoming psychotic? I imagine that you haven’t given that much thought, though you have, likely, never become psychotic. Similarly, plenty of cisgender people, myself included, don’t think being transgender is the worst thing. So accepting something doesn’t translate to becoming that thing. I encourage you to learn more about cognitive restructuring as these thoughts are illogical.

      Lastly, I have worked with many individuals with OCD and have yet to meet one who, at the completion of treatment, found their obsessions indicated their reality. Is it possible? Sure. But not likely.

  • Thank you so much for this. I now have a better understanding of myself. I have terribe harm ocd that started about two years ago when I got engaged now I’m 33 weeks pregnant and a few months ago the awful thoughts popped up again (it’s really awful like what if I lose my mind and kill my family). The thoughts terrify me and I try to brush them off but then I think maybe that’s what I would really like to do since I keep thinking about it….its a awful feeling, it gives me like a hot flash (and then with the hot flash I think, see it make me excited). I find myself trying to convince myself I’m not crazy all the time, then when I do, I try to convince myself the awful stuff s how I really’s mentally exhausting. But thank you so much for this information. It eases my mind-for the moment.

    • Jes,

      A few thoughts…

      1) Unfortunately, OCD often spikes during pregnancy, likely due to hormonal changes, combined with increased stress related to pregnancy.

      2) That hot flash is likely anxiety, not evidence that you are excited by the idea of killing your family.

      3) Assuming you have never killed anyone before, I see no evidence to support the idea that you are likely to kill your family. A thought about something does not mean that an individual wants or is planning to do that thing.

      4) I encourage you to seek treatment with a therapist who specializes in treating OCD.

  • Thanks, this article and site helped me understand a lot more about my OCD, specifically recently the Existential OCD and the doubt associated.

    I read something distressing on the internet recently which triggered intense new existential OCD and I was in the midst of panic attacks and agoraphobia even a bit of derealization by then so it had a worse effect than it may normally would and it took a while for me to regain my composure and start to actually question the nature of what I read and then look for articles and evidence that dispproved it entirely and were critical of it and I myself in my ruminations came up with several key pieces of evidence why the hypothesis is flat out wrong and irrational but despite that there is still that hint of doubt in “the back of my mind” and I recognized it from before as a type of lingering doubt and I started to wonder if it was a part of the OCD and sure enough in my searches I found this article and recognized my own doubting dilemma right here.

    Existential OCD, doubt and backdoor spikes, they describe my situation perfectly, thank you for shedding light on these awful experiences and facets of OCD.

    • Hi Planets09,

      I’m glad that you’ve found the article and website to be helpful. It’s great that you were able to recognize that the “hint of doubt in ‘the back of [your] mind’” is what makes OCD what it is. Many are aware that their intrusive thoughts most likely don’t define them, but they have trouble living with that gnawing doubt that these thoughts might be true representations of reality. Congratulations on recognizing this. It’s a huge step toward recovery.

      All my best,


  • Hi. I am scared of this not being sexual ocd because I have don’t have a full erection but a very small not that much erection when the thought of men pop in my head and I don’t like the feeling I get. I feel uncomfortable, I feel weird, if I am in a room with guys and I have a reaction, it makes me feel like I need to leave the room as soon as possible. I’m scared I am not going to like women anymore, I don’t feel like myself anymore, I feel worry every day. I never used to feel like this before, I am all for gay people and anyone from the LGBTQ community but I don’t want to become or be gay/bisexual because I don’t like it, it doesn’t feel like me. Please help me.

    • Daniel,

      So let me get this straight – you’re concerned that you might not have HOCD, and that you may actually be gay, and as evidence supporting this view you note that your erection when thinking of men is not that strong? Does that mean that if you had a stronger erection that you would then have evidence that you are not gay, and that instead you have HOCD? Sorry, but this makes no sense at all.

      The bottom line is that you are paying way too much attention to your penis. Let it do whatever it wants and stop evaluating it.

  • You mention in the article that the goal of mindfulness for someone with OCD is to develop the capacity to sit with the discomfort and uncertainty that their mind presents to them, making no effort to eliminate their unwanted thoughts or the anxiety they produce. A mindful response to the denial obsession in OCD might go something like this:
    “Maybe it’s OCD, and maybe it isn’t. Oh well, I guess I’ll have to live with the uncertainty.”

    I am struggling to understand this concept ? Saying to yourself that it may be ocd or it may not ….. ?? But if the thought is clearly OCD then why would you think oh it may not be ?

    I have an example of my own .. I have rOCD and sometimes wonder oh what if I am losing interest in my partner, what if I don’t love him enough etc … so are you saying that I should say to myself “oh it may be OCD, it may not … oh well I’ll just live with the uncertainty’ …. I love my boyfriend and know in my heart that it’s ocd, sometimes i think oh what if it isn’t ocd though … but I just think saying what you have suggested would put more doubt and fear into my mind ….

    • Fleur,

      The goal is to accept uncertainty. People with OCD desperately want certainty about things that do not require certainty. You do not need to “know” if you love your boyfriend without any doubts whatsoever. Doubt is normal, and accepting it is the best solution. Seeking certainty is only going to make your OCD worse. So saying to yourself, “Oh it may be OCD, it may not … oh well I’ll just live with the uncertainty” is meant to help you become more open to the uncertainty.

  • Hi, this article is wonderful. It helps shed a lot of light on the different facets of OCD, especially the Pure O side. I’ve had Harm OCD since I was 17 and I’m 23 now. I’ve been seeing a psychologist for six years now and only recently started doing ERP. I’m worried that when I have thoughts of killing my family, I don’t respond with real fear, anxiety and repulsion. I’m also worried that my real personality is that of a violent murderer, if that makes sense. Is it common? And what can I do about it?

    • J.,

      The thoughts you mention are extremely common in Harm OCD, which is a common type of Pure O. What you can do about it is to continue with treatment using Exposure and Response Prevention (ERP).

      That said, I am wondering why it took your psychologist six years to get around to doing ERP with you. Perhaps you meant that you had recently switched to a new psychologist who specializes in ERP. On the other hand, if you have been with the same psychologist for all of this time, and he/she is just now starting ERP, they are likely not very well versed in OCD and ERP.

  • I’ve recently been diagnosed with OCD, and have only gone to one therapy session, which was just the initial session where I got my diagnosis. My current obsession, or worry, is that I don’t have OCD and that worries me, because for the last two days I’ve felt good. Little to no anxiety or intrusive thoughts. I’m worried that I’m a fraud and that I don’t need treatment and that this was just me trying to seek attention. It’s almost like I want the OCD and am upset that I’m feeling better. If that makes sense. I’ve dealt with intrusive thoughts for a long time without knowing that’s what they were. My anxiety has been flared these past few months and the thoughts were getting worse. I did research and everything seemed to point to OCD but I was hesitant to fully accept that because I didn’t want it to seem like I was wanting to belong to a community or something. Now that I have been diagnosed I feel like it’s not true. I’ve been reading a lot about it and some of my symptoms don’t seem that extreme when it comes to anxiety and such. I know this post doesn’t make sense. Basically Im worried that I don’t really have OCD and that I’m spending money on unnecessary therapy.

    • KE,

      Actually, your comment makes perfect sense. As our article points out, doubt that one has OCD is a common obsession in OCD. I encourage you to discuss these matters with your new therapist.

      That said, I sincerely hope that your therapist specializes in CBT for OCD. If he/she is a traditional talk therapist without special training in OCD, you are likely to spend lots of time and money trying to figure out why you are having such thoughts, and that would be pointless and counterproductive.

  • Hi, I was diagnosed for OCD. I want to share my experience and need your help.
    My OCD was under control, but recently it is getting triggered. In-fact i was going through all the comments and your responses. Last time, i had thoughts of HOCD (for the first time) and i could relate that what ever i read in the comments, those thoughts were started coming the moment i close my eyes. I couldn’t even sleep properly. Is this normal with OCD? what do i do?
    Please help.

    • Goutham,

      If I understand you correctly, you have recently been binge reading our articles on HOCD, along with all of the hundreds of comments and replies these articles have engendered, and that you have then been anxious to the point of impaired sleep. That sounds like a classic OCD pattern.

      You ask what to do, so here goes…

      I encourage you to immediately stop reading these articles and the comments, as you have clearly been doing this as a compulsion. Any benefit you got from the articles was experienced early on, and now you are seeing what happens when one does compulsions (i.e., the symptoms get worse, not better).

      My other suggestion is that you seek treatment with an OCD specialist.

  • I think i have HOCD. for the past two years i have been suffering from intrusive thoughts about being gay. It consumes my life and i spend HUGE amount of time researching/thinking/trying to make sense of my thoughts. I have never had any same sex experiences, nor have i have ever desired one. When ever i see men i always try and determine if they are gay or not. I actively search and look for men on the street to see if they are gay, if i see someone who seems or looks gay I get really anxious and feel sick. I know doing this is utterly ridiculous.. I have had a course of CBT (what i think was CBT) and i dont feel any better, which makes me think i must be gay because it hasnt worked. I have no problems with gay people what so ever, i just know same sex relationships fill me with dread. It consumes my life its the first thing i think of before i sleep and as soon as im awake i think im gay. I constantly think back to my past to try and see if i fancied any blokes. I remember when i was younger thinking some blokes were cool and good looking fellas, now im thinking was that my true gay self.
    What do you think?

    • Nickk,

      You ask what I think, so here goes…

      1) This all sounds like classic HOCD.

      2) Researching in an attempt to make sense of your thoughts is a compulsion that will things worse not better.

      3) Ditto for analyzing guys you see on the street in an attempt to determine their sexual orientation.

      4) Ditto for analyzing your past to see if you ever found men attractive.

      5) Some blokes are “cool and good looking fellas”. Others are not. Either way, this has nothing to do with your sexual orientation.

  • Hi
    This article helped me understand a lot more about my OCD.Thank you.
    My mom always doubts my father where ever he goes.This was continuously happening from the past 6 years.But my father is really a good person.Mom quarells with every women and dad saying that “why did you look at that women?” and creates a big scene where ever she goes with dad.Mom speaks all non-sense for three to four hours when she quarells.Mom doubted my dad with all my relatives.She quarells with every women who comes home.Is the suspicion of my mom is OCD? If this is OCD, what should be done for her treatment?Kindly, reply.Please,suggest a solution.

    • Somi,

      This does not even remotely sound like OCD. It sounds like your mom is a possessive and jealous woman with more than a hint of paranoia. The best suggestion I can make is that she seek psychotherapy with a local mental health counselor.

  • Hi,
    I want to clarify whether this is a form of reassurance:I am a hetrosexual guy and do not want to be a gay.So,one day when my friend was there i put my hand over his shoulders which i used to do before getting HOCD.But after I did that I started to worry whether that is a form of gay relationship or something.But what is confusing is that if it was a gay relation then why didn’t I feel the same when doing it before.Basically whatever i used to do before or found it normal to do before is now making me think before doing a lot of times until i get tired and withdraw my hands.


    • H,

      Having a gay relationship involves having some sort of sex with a member of the same gender. Putting your arms on your friend’s shoulder is not sex. The reason you are experiencing some confusion about whether your gesture indicates that you are gay is likely because you have HOCD. There is no legitimate reason to assume that expressing your friendship by putting your arms on your friend’s shoulder is an indicator of being gay.

  • For 5 months I have been struggling with exstistential thoughts, mainly based on nihilism. I am so obsessed with the scary thought that everything I do is pointless. It happens especially when I’m doing a task that I enjoy a lot, I get intrusive thoughts such as ‘there’s no point in what you’re doing right now’ and ‘what’s the point if I’m going to die and be forgotten.’ Although I’m atheist and believe this to some extent, I still think I find great meaning and I am generally a positive person so this deeply distresses me because I’m worried that I really do believe that there’s no point to anything. I just want to be happy and enjoy things without worrying about the point of it all, I spend hours searching forums and websistes for answers sometimes. I also sometimes mentally check to see if I’m happy and I’m finding meaning in certain tasks. It’s exhausting. Do you think it’s ocd or are these thoughts what I really think and believe? Please help!

    • Lucy,

      Obsessions about the meaning of life are quite common in what is commonly called “Existential OCD”. That said, based on what you have written here, it seems at least reasonable to assume that you do in fact believe that life is not innately meaningful.

      But what you believe is not the problem. The real problem is that, despite your core belief that life is not in and of itself “meaningful” (whatever the hell that is), you persist in trying to prove to yourself that life actually does have innate meaning.

      I think you would benefit by choosing to truly accept what you appear to believe. I fail to see why a lack of innate meaning is a problem. If life is not innately meaningful, you still have the option of choosing to live a good life and to create meaning in the relationships you have and the work you do. In other words, believing that life has no innate meaning doesn’t have to make one despondent. You can choose to say “so what”, and get on with the business of living.

      • Thanks for the reply!

        Sometimes when I think nihilistic thoughts about nothing really mattering and then I try to defuse that by thinking ‘I can make my own meaning’ my mind then thinks ‘well if there’s no point in anything why am I trying to get better’ does that make sense? It’s like I can’t win. Because My mind can apply these thoughts to any positive thought which I use to make me feel better. It’s very distressing. My worst fear is falling into depression and not seeing a point in life – which is not how I truly feel (I think). Should I label these thoughts as ocd?

        • Lucy,

          The short answer is that, yes, you should label these thoughts as OCD.

          The slightly longer answer is this: Your mind is always going to counter your reasonable, rational thoughts with more BS. That’s what OCD does – it just keeps bombarding us with nonsense. Don’t engage with your OCD, as that is a compulsive effort to win the argument. Instead, accept that your OCD is like an annoying guy at a party who just won’t shut up about something that you don’t find particularly interesting or important. I encourage you to read our article “OCD is Fake News”, which may help you to more effectively reframe these unimportant thoughts about existence.

  • I’m afraid to swallow foreign objects. But I doubt myself: maybe I’ll swallow foreign objects? But I never swallowed any. I just have a huge irrational worry that I might swallow foreign object.
    Sometimes when things are far away from me, I get the thought pops up in my mind that they are very close to me and maybe my mouth touched it. And I worry things got into my mouth. I think it’s just a thought that the objects are close to me. I have thought action fusion: because the thought is so strong and real, I sometimes wonder maybe it’s true it’s not just a thought.

    What should I do? And how do you treat thought action fusion? How can you differentiate between what’s actually happening vs just a thought?

    • Nicole,

      Thought-Action Fusion is a cognitive process in which one comes to believe that just because they have a thought about an event, that the event will occur. You acknowledge that you have for some time had what you describe as a “huge irrational worry” about swallowing a foreign object. You also acknowledge that you have never actually swallowed a foreign object.

      Based on your report, it seems pretty clear that it is unlikely that you will swallow a foreign object. That said, neither I nor anyone else can provide you with 100% evidence that you will never swallow a foreign object. Maybe you will. Maybe I will too. That ‘s life. I fail to see why swallowing a foreign object would be catastrophic. When I was a kid I swallowed a dime. Guess what happened. Nothing? For all I know it is still lodged somewhere inside my colon.

      The real issue here is that you are assuming that it would be horrible if you swallowed a foreign object. This is called catastrophizing, and the best solution is to accept that your brain comes up with these thoughts about swallowing foreign objects, without taking the thoughts so seriously. Don’t spend time analyzing whether the swallowing thought is realistic – that would be a compulsion. Instead, identify the thought as just another ridiculous swallowing thought, and get on with doing whatever it was you were doing when the thought appeared.

      I encourage you to read our article “OCD and Thought-Action Fusion”.

      We humans have a tendency to jump to the conclusion that our thoughts are meaningful, when in fact, many of them are ridiculous, or at the very least unworthy of attention.

  • I was diagnosed with Post Partum Anxiety/OCD that has now moved on to other mental areas. Is it possible that PPOCD gets worse or moves from one obsession to another? This has been the worst thing I have ever dealt with. Didn’t even know what it was when I first had the intrusive thought and it completely destroyed my life. Once I was diagnosed with PP/Anxiety OCD my OCD got so much WORSE! I also think it caused me to have PP depression. I found this website very helpful.

    • Maca,

      Postpartum OCD is not some special form of OCD that is separate from other forms of OCD. It is just OCD that happens to get triggered or exacerbated by the stress and the huge hormonal shifts that accompany pregnancy and giving birth. It is not at all unusual for women with PPOCD to have their symptoms of OCD remain long after the postpartum period, and to experience their symptoms morphing over time. It is also not unusual for women with PPOCD to also experience Postpartum depression.

      I encourage you to read the section of our website on Perinatal and Postpartum OCD.

  • My ocd isn’t denying I have ocd. I know I have ocd but worry that because it got so severe that it might have driven me crazy.If I hear of a murder or see an ambulance I think what If my ocd drove me crazy and i don’t remember killing someone. The guilt from that uncertainty is hard to live with.

    • Tim,

      A few thoughts…

      1) Not everybody with OCD struggles with the denial obsession (i.e., “What if I don’t really have OCD, and I’m just in denial that I am a (fill-in-the-blank)”.

      2) That said, you sound very much like someone who is struggling with Harm OCD. You suggest that you are asking yourself “What If my ocd drove me crazy and i don’t remember killing someone”. That is a classic Harm OCD thought.

      3) You may also benefit from reading our article “OCD is Fake News”.

      3) I find it extraordinarily unlikely that you would somehow forget that you murdered someone.

  • How would I respond to intrusive thoughts that form as questions I feel I must answer, even simple things I don’t know I feel I need to know otherwise I’m scared the thought will never go away until I get an answer or seek reassurance either by googling or asking my partner. It feels like I need an answer to everything that pops up in my mind.

    • Donna,

      A few thoughts…

      1) You almost certainly do not need an answer to most of the questions that are appearing in your mind. They are just questions. Let them sit unanswered.

      2) Of course the thoughts will go away in time, just not according to your timetable. Thoughts arise and disappear on their own.

      3) That said, if a thought were to somehow remain forever, my suggestion is that you pay it no mind. The great majority of our thoughts are not even remotely important

      4) Googling and asking for reassurance will do nothing other than to worsen your OCD.

  • Hi,

    Thank you for this article. I believe I’m in the throes of an OCD / Denial attack at the moment.
    I have never been officially diagnosed with OCD or Pure-O but looking back I believe I can pinpoint moments in my life when I’ve been consumed with mental obsessions and mental checking.
    Around this time last year, I got the intrusive thought “What if you’re trans” while I was reading a transgender person’s post online. I had only recently come out as a gay woman to myself and my immediate family, and the post in question said something along the lines of “I didn’t know I was trans most of my life, I thought I was a gay woman”. My brain went into meltdown and I was consumed for three weeks with the fear and terror that I was in denial about being transgender, looking to my past to see if they held any truth. The thoughts petrified me into inaction, I couldn’t sleep, eat or concentrate. When it passed, I felt normal and myself again, and it didn’t trouble me for the rest of the year.

    Over the last few weeks I started thinking about it again, but now am obsessed with the idea that I’m in denial even though I have never wanted to be a man in my life.

    • Hellen,

      This all sounds like classic HOCD, which is better defined as “Sexual Orientation OCD”, as evidenced by the fact that a gay woman like yourself can experience obsessions about her sexuality that have nothing to do with the fear of being gay. I encourage you to read our article Gay OCD / HOCD / Sexual Orientation OCD, which addresses this issue head on.

      I encourage you to accept these thoughts for what they are – mental noise that doesn’t deserve much attention.

  • I know the denial game with OCD is common and well documented, but (this is going to sound stupid and egotistic) I wonder if I really don’t have OCD and there is something else wrong with me? See, I have had violent intrusive thoughts dating back at least to high school (I’m in my 30’s), but they never really bothered me, they were just there. After the birth of my second son I developed postpartum depression, and as it got worse, the thoughts and images began focusing on my children. They became so frequent and intense and began to scare me so badly that I became desperate to make them stop, and I began to wonder if acting on them might make them stop? A plan popped into my head and refused to leave. One night I finally couldn’t take it anymore, and I got to the point where I stood over my sleeping husband with a weapon in my hand, just thinking I want the images to stop, but I really don’t want to do this. I didn’t, and the next day I told someone and I was hospitalized. That was 2 1/2 years ago. I haven’t had intrusive thoughts in many months, and now I am doubting if it was really OCD like the doctors claim.

    • Jen,

      You present your story essentially like this:

      “I understand that OCD often includes obsessions that one is in denial about having OCD…but I think my denial is different”. Well, your denial sounds EXACTLY like the denial of everyone else with OCD who obsesses that they don’t really have OCD, and that they’re just secretly in denial. If you were secretly a killer, you wouldn’t obsess about having these thoughts. You would just kill people. The fact that the thoughts upset you so much is a pretty clear sign that you are not a killer, but that your obsessions are a function of OCD.

  • Your article is excellent. One of the most accurate articles that tells to the world in a manner PRACTICALLY PERFECT how us OCD people suffer this disease.
    It’s a relief that professionals like you knows about our daily fight, and i’m impress about the exactness of your speech, even without you have the disease.
    Congratulations and thanks in advance.
    PD: Sorry for my bad english

    • Christian,

      Thank you for your kind words. We really appreciate hearing that our articles are helpful. Take care.

  • This was a really good article that gave me a lot of information. I’ve been dealing with ocd for a very long time, grew up in a religious household, and dealt with obsessions in my mind. They varied throughout the days/weeks/months/years, and my ocd progressively got more. I was always diagnosed by my GP of G.A.D. Anyway, i would obsess about anything, my health, working out, if I did something wrong, am I guilty of this sin etc. I had my first panic attack a couple months back.I have these thoughts that God or other religious figures are telling me that I’m going to (can’t write it,but it’s about doom). And I tell myself it’s not God talking to me or sending me messages in my mind, but it makes me scared and anxious. Then I get stuck on it and argue with those thoughts. Like I get a visual picture of the religious figure telling me. I tried to research but all that I would find is ocd and being afraid of sinning, not the side of thinking I’m receiving messages. If you could please respond I will greatly appreciate it. Thank you.

    • Joey,

      A few thoughts…

      1) Avoiding writing the word is a compulsion that makes your OCD worse, not better.

      2) If God exists, I assume he/she has more important things to do than to send you messages in your mind.

      3) Arguing with your OCD thoughts is a compulsion and a waste of time.

      4) Your job is to accept these thoughts as being being present in your mind, without taking the them seriously. They are just unimportant, irrational thoughts.

      5) I encourage you to read our series of articles on Scrupulosity, starting at

      • Thank you so much for responding Mr. Corboy. I will continue to work on it. I am currently reading the articles you informed me of. It’s just hard when these thoughts produce feelings or emotions, and that makes it so much more confusing. I spend my days trying to fight these emotions, whether they make me feel anxious or make feel almost peaceful. I saw my psychologist two days ago and he said maybe these thoughts in my head are from the devil, which made matters worse for me, because I would prefer to not think anything is putting things into my mind but it’s hard to not believe that, whether it be God or the devil… I got in contact with a cbt therapist in hopes they provide unbiased help and not religious opinions. Sorry to bother you with this, I can go in circles all day long, and it starts from when I wake up to when I go to sleep at night. I’m going to continue reading the articles you sent me. Once again I really appreciate your help. -Joey.

        • Joey,

          Glad my reply has been helpful. That said, note the following:

          1) Yes, thoughts inform our feelings/emotions.

          2) Trying to “fight” these feelings/emotions is not gonna work. You would be better served by accepting the presence of unwanted feelings/emotions.

          3) If your psychologist suggested with sincerity that your thoughts are from the devil, he is a religious nut and I suggest you find a new therapist asap.

          4) Unmitigated acceptance is the key.

  • Hello,

    I’ve had OCD for seven years now, since I was seventeen. My OCD is usually cantered around harming my family. Now though, it has shifted to my morals. I’m very passionate about the LGBT community and I consider myself a very open-minded, loving, accepting person in that regard. Plus, I have family and friends who identify as LGBT, people whom I love dearly.

    I’m really worried that I’m homophobic because I’ve had thoughts and feelings, while hanging out with my best friend, that are negative. For instance, we could be swimming and I’d think ‘I don’t want to hang out with you anymore because you’re gay’ and I’d get a feeling of disgust, which I would take as ‘confirmation’ of how horrible I am as a person. I feel awful, guilty and driven over the edge with anxiety. I feel as if I’ve betrayed myself and everything I ever believed in by having these thoughts. It feels like I agree with/want these thoughts and I’m terrified.

    • Jude,

      Nobody (and I mean NOBODY) can control thoughts that pop unbidden into their mind, and you are not violating or betraying your personal values because some unwanted thoughts popped into your mind.

      Accept the presence of unwanted thoughts without taking them seriously. They are just thoughts.

  • .I am guessing I have been fighting with real event OCD for years. I lost my mom in May 2014 to a cardiac arrest. I was 28 years old and married at this time. Two months later I had gotten up from my nap at my friend’s place and out of the blue a thought about something which happened in August 2012 popped in my head and it made me really guilty. This is what happened in August 2012- I had a confrontation with one of my friend’s GF on Facebook. Things got really heated,lot of words were exchanged where I said ” Bitch please” to something she said for which she replied calling me something along the lines of pimp and what followed was me arguing with my friend and eventually my friend, his GF and her brother( these two were good friends) blocking me on FB till date. They have not tried to amend things since then.I simply let go off this when it happened in 2012 August but in July 2014 when the thought popped into my head, I was a nervous wreck and had a great sense of shame anger and guilt. I asked myself how horrible I must be if three ppl I have known for years decided to end everything with me. Since that day, I have been fighting with thoughts about them every single day.

    • A.,

      The interesting thing about so-called “real life OCD” is that, unlike other variants of OCD, “real life OCD” often (but not always) relates to things that have actually occurred, and generally (but not always) focuses on things for which the sufferer rightly feels bad. In other words, people with other variants of OCD generally have nothing “real” to actually feel bad about, but those with “real life OCD” often feel anxious about something that really did occur, and often times, a certain amount of their discomfort is justified.

      Now, some will take exception to that comment, but I believe that “real life OCD” is often anxiety about unwanted feelings of guilt, and that people SHOULD feel guilty about certain things. If you do something “wrong” or “bad”, feeling guilty about it is a healthy response. It becomes “real life OCD” when the person can’t move on from the event and becomes consumed by it. Additionally, those with “real life OCD” often are more focused on the anxiety they experience related to the guilt, rather than the guilt itself. In other words, they are focused on getting relief from their anxiety about having the thoughts over and over, and are not so focused on addressing the actual guilt itself.

      So what is one to do? I would argue that the best thing to do is to acknowledge what you have done that you think is “wrong” or “bad”. That means contacting the people that you clearly feel you have wronged, and apologizing. In other words, accept and admit what you have done.

      It is important to note here that the goal is to do this exactly ONCE. Repeated confessing or apologizing is a compulsion that is more about anxiety relief than guilt.

      It is also important to note that accepting and acknowledging what you have done does not automatically mean that you will feel relief from your guilt. Again, guilt is normal and healthy in certain circumstances. So you may continue to feel bad for having acted badly. That’s called having a conscience, and it is the very thing that helps to keep us from acting badly in the same way in the future.

      Finally, keep in mind that your accepting and acknowledging of your past mistake does not mean that the others involved in this story will forgive you. So your admission of wrongdoing may not be accepted.

      The bottom line is that we all make mistakes in life – lots of mistakes – and the best approach is to own up to our failures (in a non-compulsive way of course).

  • Hi Tom- I have a 3 questions but first a bit of background:
    I was diagnosed with OCD when I was 16. I am in my 30’s now. Major OCD thoughts is HOCD but I have experienced ROCD and others including Existential OCD. I am pregnant now and when I first learned about it I was very confused and immersed in a surreal feeling. It was totally unexpected. I started producing existential thoughts again after the news I believe due to this new life growing inside me, the wonders of nature, purpose of life now that I will have a baby, etc. OCD thoughts were like “what if this is not real” “what if all I see (the world, the people) is not true”, etc. Fast-forwarding, as of this week, my pregnancy is under threat and my brain despite the anguish and the fear of loosing the baby, continues to produce these existential thoughts. Here the 3 questions:
    1. How can I challenge these existential OCD thoughts?
    2. Am I going psychotic and will break from reality?
    2. Why is my brain producing existential OCD thoughts when it should be focusing 100% in overcoming such a serious situation? How is it possible that it still finds room to be OCD when I (my brain) should only focusing on my…

    • Marsi,

      While I cannot provide a diagnosis via this blog, I can say that everything you write is consistent with Existential OCD. And there is no evidence in anything you say to support the notion that you are becoming psychotic.

      Your brain is producing these thoughts for one simple reason – you have OCD.

      The best way to challenge these thoughts is by seeking treatment with a therapist that specializes in treating OCD. You are not trained or experienced in treating OCD, and there is are no secret words I can say here to provide you with a shortcut to relief..

  • I have this real event ocd. When I was younger I would at times voluntarily have masturbatory fantasies that were abnormal and abhorrent in nature. I then may have(it was long ago so I cannot remember exactly) promised to God that I would not perform such masurbatory acts/fantasies ever again and that if I did perform them again I could and/or would receive punishment from God for going back on my promises. I am now in a constant state of panic due to the possible breaking of my promises from back then.

    I’ve been in therapy for religious ocd for years now but I’m petrified of possible punishment against me or my mother for the possible breaking of my promises in regards to this real life event. Can you offer me any help or advice here?

    • Ryan,

      My advice is to accept the presence of unwanted thoughts, without assuming that they are accurate or meaningful. I also suggest that you accept masturbation as normal, and stop trying to absolve your self of the allegedly horrible thing you have done. Masturbating does not require nor deserve punishment.

  • How do I know if i’m in denial or have HOCD? I’m very doubtful about my sexual orientation, because ever since i was a kid I remember being attracted to girls and wanted to go out with them.. but i remember that in high school i saw one attractive guy and i began to question myself all of the time about wether i was secretly gay or what and ever since i try to ignore my thoughts but it’s like i feel it’s just a symptom of denial. Every time I see an attractive guy i question myself and start putting fantasies in my head to see how I react and it’s horrible.. i feel that maybe if i let go and didn’t worry about social sturctures i would be gay… i’m scared because i really wanna be straight.

    • Bob,

      The obsessive desire to know one’s sexual orientation is a typical HOCD obsession. There is absolutely no reason that anyone needs to “know” their sexual orientation.

      Uncertainty is not your enemy.

  • Is it normal for someone with hocd to focus on certain individuals. For example someone from work.

    • Ernie,

      Yes, it is extremely common for HOCD obsessions to focus on certain individuals.

  • This was a good read. However I have a few questions. My therapist, who treats OCD, told me I had obsessive compulsive tendencies. For which he later clarified as “mild OCD”. He told me your obsession of guilt/GuiltOCD will eventually pass because my obsessions in the past all have passed. To clarify, Thoughts that used to cause me great anxiety in the past do not bother me anymore. I can even talk about it and I’ll never stress about it, ruminate nor will it drive me nuts. Strange I know LOL. After reading too much about OCD, my questions are

    1) Since I have a mild case of it, does Mild OCD ever progress to moderate and then severe? Or is it fair to believe wherever you fall not he spectrum of OCD is where you land and you use the tools of therapy to manage it?
    2) I find myself during good days saying in my head “wow i haven’t thought about “X” and then I think about “X” for days on end LOL is that part of the disorder?

    However lately when I have thoughts that cause me anxiety now they don’t. However i still think about them. The thoughts don’t cause me anxiety, its the idea of having OCD i find upsetting. Any advice?

    • Joe,

      1) Yes, OCD can become more or less severe over time.

      2) This is quite common in OCD.

  • At age 21 a girl whom I’d attended high school with came out of the closet. She had many previous relationships with males (which got me thinking). The question pondered my mind can someone just suddenly or over time become gay? It immediately overwhelmed me spiked instant fear and anxiety. I questioned everything in my past. Started thinking back to high school hockey and past experiences. Constant checking for reassurance seeing if I was areoused at any point. I drove myself insane. Stopped watching tv and movies because I was afraid to see handsome men. When I would go out I constantly analyzed members of the opposite sex. I have read about HOCD in the past and found many stories similar to my own it brought me some comfort. After research and weeks/months of compulsion and checking and reassurance my OCD slowly faded away. Then you hear and see stories on social media About denial and everything came right back.. and makes me question things x10 why would someone be in denial? Am I in denial? Can your sexuality change over time? Once again here I am analyzing same sex members when I go out to the bar and scrolling through forums and scrolling through social media to “check”

    • Chris,

      You are doing an awful lot of analyzing, all of which appears to be based on the premise that, just because someone else came out as gay, you might be gay. That is a flimsy foundation on which to build your theory that you might be gay.

      This ALL sounds like HOCD to me. All of the analyzing, all of the reading of online forums about the topic of sexual orientation, all of the various compulsions you are doing in an effort to prove to yourself that you are straight.

      As for the possibility that you are “in denial”, I think you would be well served by re-reading the article above, as it directly addresses this extremely common HOCD obsession.

  • I was diagnosed with OCD in my 20s after wanting to end my life due to intrusive sexual thoughts. This from a young age.I haveperiods of relief and huge flare ups where i am consumed by unwanted thoughts and fear. I can’t eat or sleep, feel dread, guilt, the need to confess, get reassurance from mum, google etc. I check thoughts repeatedly and myself for arousal and disgust. At times feel I am kidding myself it’s ocd.
    2 months ago I began to have intrusive thoughts again towards family + others. I thought i was past this + was devastated. It got so bad that I was afraid of who to look at next in case i had the thoughts about them. My most beloved thing in life is my pet and i thought at my lowest ‘at least will never have thoughts about you’ which would be ABSURD. Laughable.
    Next day-boom! Thoughts about pet. Couldn’t believe it. Horrifyingly, a memory from childhood that i actually rubbed my privates against a family pet blasted into my mind. NO IDEA WHY. This was never an obsession i had. I NEVER acted on any other thoughts but i actually DID this once so my fear can’t be OCD. Never touched this pet or many other pets. I am terrified, ashamed + scared.

    • Jane,

      A few thoughts…

      1) Kids do all sorts of things that are inappropriate, and focusing on things you did as a child will get you no relief.

      2) Trying to figure out why you have specific intrusive thoughts is a compulsion and a waste of time.

      3) Trying to figure out why you have any thought of any kind is also pretty pointless and will not help.

      4) Your goal is straightforward – accept that your brain churns out intrusive thoughts, without taking those thoughts seriously, without analyzing them, without trying to figure them out, and without doing any other behaviors (including mental behaviors) in an attempt to control or eliminate the thoughts.

      5) Thoughts are just thoughts.

  • I need help. I have been suffering from HOCD I believe for a number of years. All started when i was in Australia and a few gay guys assumed i was gay. Since then, I have had many instances where people have said they think I am gay. It has made me question myself as a person and subsequently has made me extremely anxious around guys. I have always been with woman. Only ever fantasized about woman, but something in my head continuously tells me I would be better just coming out and that is what is making me anxious. I read articles about HOCD daily. save them, read them again. Get reassurance and then come back again when i have a spike which has been consistent. It is destroying me. I am with someone who I love, and I am very lucky. But my brain tells me I am living a false life and that actually, I am in denial and everyone knows my secret that I know nothing about? How do they know and I don’t? Do I want to be with a man? No. Would I ever want to be with a men? No. But my brain tells me to fantasize about it suddenly and i try my best to force it but can’t. It is making me so ill. I do so many rituals and nothing helps. it just perpetuates my anxiety levels.

    • Mikey,

      A few thoughts…

      1) Other people thinking you are gay does not mean you are gay.

      2) If you have only ever been with women, I see no evidence to support that you are gay, and hence nothing to “come out” about.

      3) Reading articles about OCD daily is a compulsion and will make your OCD worse.

      4) Ditto for saving such articles and reading them repeatedly.

      5) Stop analyzing your thoughts. Instead, accept that they exist but are not particularly important. Thoughts are just thoughts.

      6) Stop posting comments under different names on various of our blog articles. That is also compulsive…and annoying as well.

      • Apologies about writing comments on different blogs. I just didn’t think any of them were ever being posted or read.

        I know. But when others say it, I feel like I am an imposter. And it suddenly starts to feel funny when I say I have a girlfriend. Like I am lying to myself and have been for years. I have had this OCD for over 10 years on and off I think. It has been there a while without me recognizing and that makes me think I am just in denial and an a closeted gay who is anti gay. I begin to question whether I am homophobic and don’t have HOCD at all. But, I don’t have a problem with peoples sexual orientation. You are who you are, but it doesn’t stop me from feeling anxious around homosexual people or even straight guys for that matter.
        I read so many posts about four things……….Childhood memories, homophobia, Home culture, and who you look at on the beach to show whether you have homosexual tendencies. And that spikes fear in me and then I start telling myself to just accept it and come out already.
        I just feel I look gay now.

        • Mikey,

          None of this sounds like homophobia. None of this sounds like you are gay. All of this sounds like HOCD.

  • Hi
    I found this article very helpful
    I would like to say I get weird homosexual thoughts sometimes a get a thought whether I’m gay or not because I don’t like to be like that please help!!

    • Rakshith,

      Having unwanted thoughts about possibly being gay is the core issue in HOCD. I encourage you to seek treatment with a therapist who specializes in treating OCD with Cognitive Behavioral Therapy (CBT).

  • Hi,

    I am a gay woman, and about 2 months ago I had the sudden thought “am I trans?”. This seemingly came out of nowhere as I have never questioned my gender before. I am a tomboy, but I don’t remember ever wanting to be a boy? I was immediately overcome with intense anxiety that lasted about 4 days. I looked back at memories from my childhood trying to figure out if maybe there were warning signs. I could not figure out what was wrong with me, or why I was suddenly questioning. I googled excessively and came across an article about transgender themed OCD, and I believed that I had it, and I felt better for a while but about 3 weeks ago it returned even stronger and it’s the only thing I think about, and even though I think I have OCD, i’m nervous to talk about it because what if I’m trans and just in denial? Even though I know denial is part of OCD what if I’m actually in denial? Even posting this makes me feel like I’m lying to myself and that I am trans, and that I’m just adopting other peoples symptoms that I’ve read about because I keep googling to try prove to myself that I’m OCD and not trans. What’s your opinion on this?

    • C.,

      You asked for my opinion, so here it is…

      Everything you write sounds like you have Trans OCD. I encourage you to re-read the article above which directly addresses the notion of denial as it pertains to OCD.

  • I have been dealing with the concern of pedophilia, and being a pedophile. I Google pedophilia and POCD to try and find out which one I am. Part of me says I should feel proud of being a pedophile, but I feel like my heart knows that not me. I wish I could go back to when I didn’t have those thoughts. It all started as I was taking a sexuality course in fall of 2018 and the topic of pedophilia came up. Ever since then I question who I am, my true self, and my intentions. I want to get help but what if it is pedophilia. I’m scared.

    • Yessica,

      While I cannot provide you a a diagnosis via a blog comment, I can say that your symptoms sound very much like POCD. I encourage you to seek an assessment with a therapist who specializes in treating OCD.

  • I really enjoyed the article. I’ve been struggling with OCD for a bit though it wasn’t diagnosed until recently. About a week ago while thinking about what I want in life the thought that I may be trans crossed my mind. I am a gay male so naturally I know we often like more feminine things that straight men do (well openly anyway). The thought crossed my mind in a minute and I haven’t been able to shake it. Even my therapist and partner have told me this is just my OCD, but i think I may just be in denial. I had a hard time accepting I was gay and spent a lot of time wishing I weren’t. But I always knew I was. I never seriously thought I was trans before but now my mind is reaching back across the years to all the time I thought the dress was pretty or wanted to walk in the heals. It’s completely taken over my life. I’m miserable. I’m losing weight constantly and I’m not sleeping. I’m having several panic attacks a day and crying all the time. I’m starting to think I’m trans and just don’t want to accept it, despite never thinking this before a week or so ago. These thoughts are ruining my life. I just started Luvox for it but I’m only a couple days in. I need relief.

    • Luke,

      Obsessions about being trans are fairly common in OCD. Nothing in your comment even remotely suggests that you are truly trans, and it sounds to me like your partner and your therapist are correct – i.e., that this is just one more iteration of your OCD. I encourage you to re-read the article above which addresses this issue of fearing that one is in denial.

  • Hi, I have been anxious for about 4 months due to an obsession with my health. When I went to the doctors and they looked at me and saw that I had nothing, I calmed down. The fact is that one day they gave me good news and I told my parents happy and then that afternoon I started thinking about what bad things could mean, I thought paranoid things and that the world was not real and I ended up thinking that I was going crazy and if I went crazy I could hurt someone (I had symptoms of anxiety attack) and there I had the first intrusive image of hurting. From that day until now I still have the problem, and more than the intrusive images themselves, my mind does not stop generating situations and thoughts related to the subject and I become a criminal. The problem is the doubt that I have about whether it is something hidden in me, if it is what I want and if I really want it. During these months has derived to moments where my fear was to go crazy and have psychosis or schizophrenia.. I’m super confused. I go to the psychiatrist and the psychologist and both of them have super sure that I have OCD, but I can not stop doubting if they are wrong and that I am the exception.

    • Jonah,

      A few thoughts,

      1) OCD has often been called the doubting disease, and your doubts about whether you have OCD are quite common. I encourage you to re-read the article above, as that is one of the key points of the article.

      2) It is quite common for people with OCD to obsess that they actually have Schizophrenia.

      3) Nothing you write suggests that your treatment providers are wrong, and that you have a secret self inside of you that is looking to hurt people.

      • Thanks for the answer.
        Sometimes it gets better, and im 90% sure that if i can choose between keeping the thoughts or erase them, I would choose to erase them and live like always did after the anxiety. But sometimes I think that this is hypotetical and that the thoughts will last forever and im becoming evil or a potential murderer. I struggle with sadness and anger because I feel that can impulse my thoughts to become real, but never acted on them or tried, though. I feel detached from people and sometimes I want to disappear because Im suffering and I dont like the idea of me being dangerous for others…
        I’ve never been violent or sadistic, I never liked cruelty towards animals or people.
        My life seems weird and strange, like im not living the same after the anxiety due to health issues.
        I dont know what to believe or what I am. My mind can create all kinds of thoughts, sometimes I can think that I dont want the thoughts and then doubt it, I cry more than usual and i feel im being punished.

        • Jonah,

          Yes, your mind (just like everyone else’s mind) “can create all kinds of thoughts”. That is what our minds do – 24/7 conjuring up thoughts, most of which are remarkable only in that they are so consistently unimportant.

          You are not being punished. You are simply misinterpreting your unimportant thoughts as being “important”.

          I encourage you to seek treatment with a therapist who specializes in treating OCD.

  • Hi, I have all sorts of constant intrusive thoughts including Harm and POCD, what troubles me the most is that when I was about 10 (I’m 22 now) I squeezed a baby’s hand to see if it would cry( I didn’t do it too hard) and I also remember sexual play when I was around this age too. So I’m worried that my thoughts have evidence and I really am bad

    • L.,

      Everybody on the planet Earth has done things that they later regret. In fact, your regret is actually evidence that you are not a cruel sociopath, but a decent person with a conscience.

      Further, lots of kids do sexual play when they are young. This is normal.

  • I had largely been untroubled until 2015 then a gay guy recently started at my work and it spiked my OCD or at least I hope it’s OCD. I am completely in love with my wife and the last few years we’ve had marriage counselling to repair certain aspects of our relationship and we were happier than ever until this latest spike where I can’t get out of my head a vision of me kissing this guy which is terribly distressing, I’ve been wondering how can I go for years without ever having this urge after countless sex with women and being extremely gratified to getting to my age and now all the doubt creeps in, was it all an act? I’m terrified please offer me some wisdom?!

    • Don,

      You ask for my “wisdom”, so I’ll do my best. Here goes…

      This all sounds like textbook HOCD. Accept the presence of these unwanted thoughts (or any unwanted thoughts). They are just thoughts, and trying to figure them out will only make your OCD worse.

  • Hi,

    I have recently been told by my therapist that I might have HOCD but I have not been convinced. I have been straight my whole life and have never had to question what I liked. I even went as far as trying to reassure myself by kissing someone of the same sex. I did not find the experience enjoyable and ever since then have only been further confused. I don’t know how to tell if I am in denial even after reading this article or if this is truly who I am becoming. I feel like I don’t even know what I know. Sometimes I feel like I am still me and other times I feel permanenetly changed and everything I ever wanted for my future has gone out the window. Sometimes I look in the mirror and don’t feel like myself anymore. I cant listen to the same music, watch the movies I once enjoyed or hang out with anyone of the same sex.

    My question is: can OCD can ever manifest itself as more than just thoughts but “feelings”. I have thought that I was feeling things for members of the same sex but it never “lasts” and it can be a different target on any given day. It’s to the point where my thoguths suggest I should just date a member of the same sex because it’s constant.

    • N,

      Three things:

      1) This all sounds like HOCD to me.

      2) People don’t suddenly “turn gay” out of the blue.

      3) Attempting to discern the difference between thoughts and feelings is almost certainly a compulsion that you are doing in an effort to get certainty that you are not “feeling” gay.

  • Thank you so much. This was immensely helpful. It’s so bizarre to think, “oh, this time it isn’t really OCD, I don’t actually have it”, and then see your exact modes of thinking outlined in a post like this. It’s happened to me too many times. This was immensely healing and I will be using the self-help advice offered since my current therapist hasn’t been offering me much. Thank you so much.

    • Lulu,

      Thank you so much for your comment It is incredibly gratifying to know that our article has been helpful for you. Take care.

  • Hi,

    Thank you so much for the article. I’m a bit stuck with my thoughts, as they relate to the past, but I haven’t actually done anything. The problem is, I feel like I was ‘about to do something wrong’. E.g I have memories of going into the kitchen and I ‘must’ve gone in there and been about to harm someone but I stopped myself. I see how illogical it is, because I haven’t done anything. But the thoughts come at me like ‘you intended to’, and your tried to but something stopped you’. Typing this out I know how silly it sounds, but I constantly find my self arguing that I haven’t done anything wrong, but maybe I have about to? I’ve used mindfulness as ERP to get over memories I now know never happened, but I can’t seem to let this one go because I don’t know if I was about to or tired to do something wrong.
    Any advice?

    • Ben,

      You ask for my advice, so here it is…

      This is all just OCD. You don’t need to “get over” anything. You just need to accept that the human brain comes up with all sorts of unwanted thoughts. It never shuts up, but much of what it comes up with is nonsense that doesn’t deserve even 5 seconds of you time and analysis.

  • I’ve been struggling with pocd for the past almost 2 months now. It first started off with a sexual thought about a friends little brother which scared the f*ck out of me and brought lots of shame and guilt. And also I’ve started to have thoughts of my niece, at first I knew I would never do anything of the sort, but now I’m just terrified, I don’t know if I would or wouldn’t, or if I have a sexual attraction to children or not. I know I’ve NEVER gotten aroused by a child at all, but still, I’m just so unsure about anything anymore. Please help, the guilt has been eating me alive whenever I start or try to feel happy.

    • Jordiano,

      The fact that these thoughts are terrifying to you is a pretty good indicator that you have POCD, and not that you are a pedophile. I encourage you to seek out treatment with a therapist who specializes in treating OCD with Cognitive Behavioral Therapy (CBT).

  • hi, my name is Davi, I am from Brazil. I have suffered from this for 2 and a half years and I see no way out. What I just wrote is the reality. My girlfriend can’t stand this situation anymore. I look at guys, and I feel like I really want to be with them, it’s desperate, then I think: “You want to know? This is real? I need to have a face to end this doubt soon. ”.

    Please, help me

    • Davi,

      From your email, it sounds like you may be struggling with HOCD. There is little we can do to help you via a comment thread on a blog. If you would like to discuss online therapy with one of our OCD specialists, please contact us via the contact page of our website at

  • Anal sensatio ,mouth an groinal responses ?
    Are they symptoms of HOCD ?

    • Filip,

      You have already asked this same question on another of our blog articles, and received an answer. The fact that you are asking this question again suggests that you are compulsively seeking reassurance that your sensations are evidence of HOCD, and not evidence that you are gay. I encourage you to read our article about the pitfalls of seeking reassurance.

  • Hi Tom & team,

    I don’t have a question, but rather I would like to take the time to thank you for the amazing work you do. I have not yet been formally diagnosed with ocd, but I am 99.9% sure it is the case.

    I have been hesitant to pursue therapy for a bit now, but I’m sick of living my life In fear over something that is highly unlikely. Your website has encouraged me to build up the strength to finally seek help and work towards improving. I don’t want to let intrusive thoughts and catastrophic thinking dictate the terms of my life.

    • Rio Grande,

      Thank you so much for your kind words. It is extremely gratifying to know that our work has helped you choose to seek treatment. This is the first step in a process that will lead you to moving past your symptoms.

  • I have OCD, my obsession is a memory 1.5 years ago. I was new to my relationship with my current boyfriend. I went to hang out with friends and we were heavily drinking, I blacked out with fragments of memory. I woke up at home the next morning and realized my friend dropped me off. I texted him to thank him for making sure I got home safe, he said no problem. Now I’m thinking that I was alone with a guy in a car and could’ve had sexual contact, even sex or tape, although I don’t remember that. There’s no evidence of any of what I’m fearing, but gaps in my memory make me feel like I cheated and have to confess. I’ve never thought about it until now, I feel like contacting my friend that dropped me off to go over the event as well.

    • Adriana,

      Let’s simplify this…

      You report that you have no evidence to back up what you fear may have happened. Based on that alone, I would argue that all of the rest of what you report is unworthy of even one second of your time. There is nothing to confess, and reviewing the issue with the friend who dropped you off would be a compulsive effort to get certainty. Your best bet is to accept that you will never have certainty about this situation.

      On a separate note, I encourage you to consider your drinking to the point of blacking out. I am not moralizing here – I am simply suggesting that drinking to the point of blacking out is a pretty good indicator that you drank too much that night.

  • Three years ago is the time when my OCD became very serious. My OCD made me doubt I may commit a crime. Rationally I knew the worry was unreasonable and it was not compatible with my personality at all, but I still felt very anxious. I tried to find evidence and review my memory to ensure I did not do anything, and analyzed the thought was unreasonable. These measures did not work. I felt less certain. I decided to go to see a doctor.
    Being diagnosed with OCD is a relief. However, my new obsession is that maybe I do not have OCD and just deny I did something bad. The good thing is that now I know how to deal with my OCD. I would like to thank you because your website and posts give me knowledge to understand more about OCD.

    • Hi Tom,

      Glad to hear that our website and articles have been helpful for you. Reviewing one’s memory in an attempt to gain evidence is a very common OCD compulsion. And as you note, your efforts did not succeed in resolving your doubts. Likewise, the thought “what if I don’t have OCD and I am just in denial” is extremely common in OCD.

  • Dear Tom is it normal for OCD to have same persistant obsessive toughts for 5 years? They give me a great deal of anxiety and are so scary for me that i cant shake them off no matter what. Now I am scared of being in denial. I dont know anymore whats true or not probably because my brain is constantly obsessed over same tought and it gets worse as time passes. The fact i am a person who is too empthic and emotional doesnt help…. Is it possible because of so long time being exposed to same tought that i made an elephent out of a fly? Sometimes i can ruminate whole day everyday and at the end of the day just burst into tears. Now i am scared of being in denial because this thought is persisstant for so long.

    • Jane,

      Some people with OCD focus on the same unwanted thought for years, while others have obsessions that change many times. There is no single “normal” way to experience OCD.

      And yes, it is quite common for people with OCD to make “an elephant out of fly” by over-attending to a thought.

      Finally, just because a thought sticks around for a long time doesn’t mean that you are “in denial”. A more likely answer is that you have OCD.

  • Hi, we all hear of intrusive toughts but how about feelings? Do feeling just like thoughts come and hold no meaning? I am not talking about physical feelings but emotinal like regret, disapponent et .For example you really feel something at some moment and you dont give that feeling much thought. But later you start ruminating and think it holds deeper meaning of who you are or what you want. Are feeling just like thougts? Do they just happen with no hidden agenda? I am scared that my feelings had deeper meanig. Should i just lable it as feeling that has no deeper meaning and is just that…a feeling?

    • Anna,

      Emotions happen. Full stop.

      That is not the same thing as “My emotions are incredibly important and worthy of my full attention and analysis”.

      Some emotions are important, just as some thoughts are important. But most emotions and thoughts do not deserve analysis. Instead just experience them as they arise, and do not assume that their existence is incredibly important. They are just a fact of life.

      Furthermore, analysis of your thoughts and emotions in an attempt to figure out if they “hold deeper meaning” sounds compulsive to me.

  • I struggle with OCD relating to my sexual orientation: I’m a lesbian with horrible fears that I am suddenly or deep-down attracted to men and hiding it. How do you know if it’s actual attraction or just a thought? I really don’t want to like men, but I’m so scared it’s suddenly true. My brain practically doesn’t ask what-if questions anymore, it just states that I am straight and/or bisexual and/or like men as a statement. My attraction to women is at an all-time low. I know I can never be certain and there is no certainty, but I’m so afraid that my sexuality has suddenly changed. I don’t want it to, I was so happy as a lesbian. How do I know I’m not attracted to men? This is impossible 🙁

    • Hi Scared Straight,

      Thank you for your thoughtful comment, and I’m sorry to hear about your struggle. This is a very common and difficult dilemma that we often see with sexual orientation OCD (SO-OCD). Attraction can get confusing, come and go, and can drain one’s confidence in who one finds attractive where it was never seriously questioned before. I recommend getting an assessment for OCD from an OCD specialist, and if diagnosed, pursue treatment to help navigate and move forward in your recovery, living the life you want to live.

      Thank you and best to you in your journey forward.


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  • Pure OPure O 101
    People with Pure Obsessional OCD ("Pure O") often feel overwhelmed by intrusive, distressing thoughts. Tom Corboy, MFT of the OCD Center of Los Angeles discusses Pure O and its many permutations. […]
  • Excoriation (Skin Picking) Disorder, aka DermatillomaniaExcoriation (Skin Picking) Disorder, aka Dermatillomania
    Excoriation (Skin Picking) Disorder is an obsessive-compulsive spectrum condition in which sufferers repeatedly pick at their skin. Crystal Quater, MMFT, of the OCD Center of Los Angeles discusses her personal experience with, and recovery from, Excoriation Disorder, and how she treats clients struggling with this condition. […]
  • OCD is Fake News: The brain is a machine for jumping to conclusionsOCD is Fake News
    OCD obsessions are 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 KnowHOCD: 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. […]
  • Dermatillomania: A Skin Picker's Guide to the DermatologistDermatillomania: 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 - OCD Center of Los AngelesImaginal 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 OCDROCD: Relationship OCD and The Myth of “The One”
    ROCD (Relationship OCD) is an often misunderstood variant of OCD. From the OCD Center of Los Angeles. […]
  • Moral Scrupulosity in OCDMoral Scrupulosity in OCD: Cognitive Distortions
    A review of cognitive distortions seen in Moral Scrupulosity OCD, and a discussion of how to effectively challenge them. From the OCD Center of Los Angeles. […]
  • 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 ERPHarm 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 OCDScrupulosity: 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. […]
  • Thought Action FusionOCD 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. […]
  • Skin Picking Disorder / Dermatillomania TreatmentDermatillomania / Skin Picking Disorder Treatment
    Treatment of Dermatillomania (Skin Picking Disorder) with CBT. Part two of a series from the OCD Center of Los Angeles. […]
  • Harm OCD: Symptoms and Treatment
    This is the first installment in a series of articles in which The OCD Center of Los Angeles demystifies both the symptoms and the treatment of Harm OCD. […]
  • Orthorexia: Where Eating Disorders Meet OCD – Part 2
    Kimberley Quinlan, MFT, of the OCD Center of Los Angeles discusses Cognitive Behavioral Therapy (CBT) and Mindfulness for the treatment of Orthorexia. Part two of a two-part series. […]
  • Casey Anthony, Reasonable Doubt, and OCD
    Harm OCD and 'reasonable doubt' are discussed in relation to the Casey Anthony murder trial. From the OCD Center of Los Angeles.unbearable. […]
  • ABCs of DermatillomaniaThe ABC’s of Dermatillomania / Skin Picking Disorder
    Symptoms and treatment of Skin Picking Disorder, also known as Dermatillomania. From The OCD Center of Los Angeles. […]
  • HOCD / Gay OCD: Challenges to Treatment
    Common challenges seen in the treatment of HOCD / Gay OCD are discussed by the OCD Center of Los Angeles. Part four of a four-part series. […]
  • Orthorexia: Where Eating Disorders Meet OCD
    Orthorexia is an eating disorder in which people obsess about eating only "pure" and "healthy" foods. By Kimberley Quinlan, MFT, of the OCD Center of Los Angeles. […]
  • Thought Suppression and OCD
    Thought suppression is a common feature of OCD, especially for those with Pure Obsessional OCD (sometimes called "Pure O"). […]
  • HOCD / Gay OCD: Common Subtypes
    Common subtypes of HOCD / Gay OCD are discussed. Part three of a four part series. From the OCD Center of Los Angeles. […]
  • Social Anxiety / Social Phobia: Alone With Witnesses – Part 2
    Treatment of Social Anxiety is discussed, along with its relationship with other OC spectrum disorders. From the OCD Center of Los Angeles. […]
  • Social Anxiety / Social Phobia: Alone With Witnesses – Part 1
    Many people mistakenly think of Social Anxiety as nothing more than shyness. In this two-part series, the OCD Center of Los Angeles discusses Social Anxiety and its treatment with CBT. […]
  • Body Dysmorphic Disorder (BDD) Research – Year in Review
    Tom Corboy, MFT, of the OCD Center of Los Angeles reviews research studies published in 2010 related to Body Dysmorphic Disorder (BDD). […]
  • Binge Eating Disorder / Compulsive Overeating and Its Treatment
    Binge Eating Disorder, also known as ‘”compulsive overeating”, can perhaps best be described as a condition in which one periodically consumes extremely large amounts of food. Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles, discusses Binge Eating Disorder and its treatment with Cognitive Behavioral Therapy (CBT). […]
  • Gay OCD / HOCD Treatment
    Treatment of Gay OCD / HOCD / Sexual Orientation OCD using CBT and Mindfulness is discussed by the OCD Center of Los Angeles. […]
  • Gay OCD / HOCD / Sexual Orientation OCD
    Symptoms & treatment of Gay OCD, also known as HOCD, or Sexual Orientation OCD. From The OCD Center of Los Angeles. […]
  • Body Dysmorphic Disorder (BDD) and Teens
    Increasing numbers of teens are having elective cosmetic surgeries to address body image issues, without fully considering the physical and psychological risks involved. […]
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  • Body Dysmorphic Disorder (BDD) and Body Image in the News
    A discussion of BDD and recent news reports about the condition. From the OCD Center of Los Angeles. Serving clients in California and internationally. […]
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  • Treatment of OCD and OC Spectrum Disorders in Children
    The OCD Center of Los Angeles discusses Cognitive Behavioral Therapy (CBT) for the treatment of OCD and anxiety in children and adolescents. […]
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  • Trichotillomania, Skin Picking Disorder, and the Resistor’s High
    The OCD Center of Los Angeles discusses treatment of Trichotillomania (Hair Pulling Disorder) and Dermatillomania (Skin Picking Disorder). […]
  • Memory Hoarding in Obsessive Compulsive Disorder (OCD)
    Many people with OCD engage in 'memory hoarding', a mental compulsion to over-attend to the details of an event, person, or object. Memory hoarding is done with the belief that the event, person, or object carries a special significance, and may be important to recall exactly as-is at a later date. […]
  • OCD and the Law – Part 3
    An Australian pro boxer assaults a 70-year old man on a ferry boat and claims his OCD made him do it. Last of a three part series on OCD and the law. […]
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  • OCD and the Law – Part 2
    A Kentucky man murdered his wife and then tried to claim that his OCD led him to kill her. Part 2 of a 3 part series. From the OCD Center of Los Angeles. […]
  • OCD and the Law – Part 1
    A Scottish man claims his massive child pornography collection is due to OCD. Part 1 of a 3 part series from the OCD Center of Los Angeles. […]
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  • OCD Stockholm Syndrome
    Something akin to the Stockholm Syndrome occurs in some people who struggle with Obsessive Compulsive Disorder ( OCD ). […]
  • Athletes With Anxiety
    Mental health has long been shrouded in secrecy and shame. So when public figures like professional athletes actively seek help for anxiety, it is a sign of cultural progress. Here are some who have gone public with their struggles. […]
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  • Social Anxiety in Baseball Revisted
    This past week marked the arrival of the 2010 Major League baseball season. And as with last year, this season already has three developing stories of athletes dealing with Social Anxiety. […]
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  • Treatment of OCD and Anxiety: A Brief History
    A look at how the treatment of OCD and related anxiety disorders has changed over time, especially the development of CBT and mindfulness for OCD. […]
  • Tiger Woods, Sex Addiction, and OCD – Part 2
    Sex addiction is misconstrued by many to be a type of Obsessive Compulsive Disorder (OCD). This article reviews various factors relevant to determining what diagnosis might be more appropriate. Second of a two part series. […]
  • Tiger Woods, Sex Addiction, and OCD
    Many people, including professional psychotherapists, incorrectly think of sex addiction as a type of Obsessive Compulsive Disorder (OCD). This article reviews the essential differences between these two conditions and, how therapeutic strategies used for the treatment of OCD are unlikely to be successful when treating sex addiction. First of a two part series. […]
  • Latisse and Body Dysmorphic Disorder (BDD)
    The drug Latisse is prescribed to lengthen eyelashes, but it has significant, under-reported side effects. This raises two questions - is Latisse safe, and does its marketing exploit women's body image concerns? […]
  • Proposed DSM-5 Changes for OCD and Anxiety Disorders
    The American Psychiatric Association (APA) has proposed significant revisions to its "Diagnostic and Statistical Manual, Fourth Edition" (DSM-IV). Tom Corboy of the OCD Center of Los Angeles discusses changes planned for the new DSM-5, specifically those relevant to Obsessive Compulsive Disorder (OCD) and related anxiety-based conditions. […]
  • Reassurance Seeking in OCD and Anxiety
    Those with OCD and other anxiety based conditions often seek reassurance that their unwanted thoughts and feelings are not a threat. The OCD Center of Los Angeles discusses the problem of using reassurance seeking as an anxiety management strategy. […]
  • Phobia Treatment in Unconventional Settings
    Traditionally, phobias have been treated in a therapist's office. But effective help for phobias can now be found in some very unexpected places. […]
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  • Body Dysmorphic Disorder (BDD) and Cosmetic Surgery
    Many with Body Dysmorphic Disorder turn to cosmetic surgery in an attempt to alleviate their insecurities. Unfortunately, there are plenty of cosmetic surgeons who are more than willing to cash in on those with this serious psychiatric condition. […]
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  • OCD & Anxiety: The Year 2009 in Review
    OCD and anxiety were in the news throughout 2009. Here are our votes for the top stories of the year about OCD and related anxiety based conditions. […]
  • Bizarre, Disturbing, Weird, and Unwanted Thoughts in OCD
    Everybody has bizarre thoughts. But people with OCD respond differently to these thoughts. From the OCD Center of Los Angeles. […]
  • Emetophobia treatment at the OCD Center of Los Angeles with Cognitive Behavioral Therapy (CBT)Emetophobia and Cognitive Behavioral Therapy (CBT)
    Emetophobia is the fear of vomit and/or vomiting. Tom Corboy, MFT, Executive Director of the OCD Center of Los Angeles, discusses Emetophobia and its treatment. […]
  • OCD and Mental Checking
    People with OCD often struggle with 'mental compulsions'. The OCD Center of Los Angeles explores how to manage this sometimes baffling problem. […]
  • Cyberchondria: Health Anxiety in the 21st Century
    The twin explosions of television and the internet have spawned a sharp increase in Hypochondria, and spawned a new mental health issue - 'Cyberchondria'. […]
  • Is Compulsive Overeating OCD?
    A discussion of compulsive overeating (aka binge eating) and how it differs from OCD. From the OCD Center of Los Angeles. Serving clients internationally. […]
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  • Cy Young, Zack Greinke, and Social Anxiety
    Zack Greinke has overcome his Social Anxiety to become a superstar in major league baseball. […]
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  • Exposure Therapy for OCD and AnxietyExposure Therapy for OCD and Anxiety
    Exposure therapy for OCD and other anxiety conditions is discussed by Tom Corboy, MFT, of the OCD Center of Los Angeles. […]
  • Social Anxiety Research
    Recent Social Anxiety research is discussed by Tom Corboy, MFT, executive director of the CD Center of Los Angeles. […]
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  • OCD Awareness Week
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  • CBT and Evidence Based Psychotherapy
    Unfortunately, many psychotherapists dismiss evidence-based treatments such as CBT, instead choosing to do what feels comfortable for them. […]
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  • OCD, Mental Health, and the National Health Care Debate
    A look at the national health care debate, especially as it pertains to OCD and related anxiety based conditions. […]
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  • Childhood OCD, Strep Infections, and PANDAS
    There is a growing body of research that indicates strep infections are related to rapid-onset OCD in children. […]
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  • OCD and the Swine Flu – Part 2
    Panic about the Swine Flu continues, despite facts that suggest there is no cause for increased concern. […]
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  • 2009 Obsessive-Compulsive Foundation Conference
    A review of the 2009 Obsessive Compulsive Foundation conference. […]
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  • New Trichotillomania Research
    A look at recent research related to Trichotillomania. From the OCD Center of Los Angeles. […]
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  • Parenting a Child With OCD
    Parenting any child is a full-time job. But parenting a child with OCD can be particularly challenging. From the OCD Center of Los Angeles. […]
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  • Social Anxiety in Baseball
    A look at the recent rash of pro baseball players struggling with Social Anxiety Disorder. […]
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  • Michael Jackson and Body Dysmorphic Disorder (BDD)
    A look at the sad tale of Michael Jackson and his mental health issues. […]
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  • OCD and the Swine Flu
    The past few months have seen an avalanche of news stories on the Swine Flu, despite its relatively low impact in the US. […]
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  • Meet the OCD Center of Los Angeles Staff
    Meet the OCD Center of Los Angeles Staff […]
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  • Welcome to the OCD Center of Los Angeles Blog
    Welcome to the OCD Center of Los Angeles Blog […]
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