HOCD - 30 Things You Need To Know - 300

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

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

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

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

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

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

Doubt, Denial and OCD

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

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

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

You might notice something that ties all of these phrases together – the struggle to answer the question “what if …?” This phrase strikes terror into the hearts of those grappling with OCD. These two short words introduce enough doubt and anxiety into the minds of sufferers that they feel compelled to repeatedly perform compulsive behaviors in a seemingly endless attempt to reduce or eliminate their distress.
Read More »

    

Imaginal Exposure for OCD and Anxiety

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

What is Imaginal Exposure

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

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

    

ROCD (Relationship OCD)

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

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

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

Read More »

    

The OCD Center of Los Angeles discusses treatment of Harm OCD using Mindfulness Based Cognitive Behavioral Therapy.   Part two of an ongoing series.

Mindfulness for Harm OCD

Mindfulness Based CBT is a key component of
successful treatment for Harm OCD.

In our previous installment of this series, we defined the symptoms of a sub-type of Obsessive Compulsive Disorder (OCD) known as Harm OCD. The defining characteristics of Harm OCD are intrusive thoughts of a harming/violent nature (obsessions), and the behavioral response of engaging in physical and mental strategies (compulsions) in an effort to relieve the inherent discomfort one experiences when having these thoughts. In upcoming articles in this series, we will discuss each of the main elements of Cognitive Behavioral Therapy (CBT) used to treat this form of OCD.

Psychoeducation and the Treatment of Harm OCD

The first step in treating Harm OCD is psychoeducation. Unfortunately, sufferers who are not already well-versed in OCD are likely to approach treatment with extreme apprehension and doubt. This is because the pain of being burdened with unwanted thoughts of causing harm has worn them down to a point that they may genuinely believe it’s possible that a therapist will take one look at them, smile, and call the men in white coats. So before any discussion of treatment can begin, a Harm OCD sufferer has to have a better understanding of the nature of the condition, and why some people are hyper-aware of these types of thoughts, while others appear not to be. Read More »

    

Harm OCD

Harm OCD is a common variant of OCD, and is very
treatable with Cognitive Behavioral Therapy (CBT).

Harm OCD is a manifestation of Obsessive Compulsive Disorder (OCD) in which an individual experiences intrusive, unwanted, distressing thoughts of causing harm. These harming thoughts are perceived as being ego-dystonic, which simply means that the thoughts are inconsistent with the individual’s values, beliefs and sense of self. Harming obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act.

It is not fair to say that one form of OCD causes more pain than another. In our experience of treating individuals with OCD, those with compulsive hand washing appear to be in no less pain than those who live in fear of being sexual deviants or psychopaths. What sets Harm OCD apart is the way in which it attacks the things we love the most, and does so with such brutality and lack of mercy as to astound even the most creative minds. The moments that we most want to be highlighted by memories of peace and contentment suddenly become contaminated by mental imagery of horrific violence and feelings of relentless guilt. Read More »

    

The OCD Center of Los Angeles discusses common challenges seen in the treatment of HOCD, also known as Gay OCD or Sexual Orientation OCD.  Part four of a four-part series.

Gay OCD / HOCD / Sexual Orientation OCD and CBT

HOCD, also known as Gay OCD or Sexual Orientation OCD,
is best treated with Cognitive Behavioral Therapy (CBT)

In our previous article on HOCD, we looked at some of the potential sub-types that appear in this condition.  While they are all treated with various Cognitive Behavioral Therapy (CBT) strategies, crippling fear can lead people toward beliefs that impede therapy.  Here are some thoughts about treatment issues we commonly hear from HOCD clients.

My Big Gay Secret Self

Many HOCD sufferers, regardless of sub-type, become preoccupied with the idea that other people might think that they somehow “appear” gay.  As a result, some men with HOCD may over-attend to the way they dress, opting for baggy, neutral choices rather than fitting, stylish choices that they might associate with homosexuality.  They may pay special attention to the way they speak or even the way they hold a drink, trying to eradicate any possibility that a person may mistake them for being gay.  Women with HOCD may over-attend to the length of their hair, or whether their clothes are “feminine” enough.  Both men and women with HOCD are likely to obsess about their body type and whether there is something inherently “gay” about it. Read More »

    

OCD Thought Suppression

Thought suppression is a common feature of OCD,
especially for those with Pure Obsessional OCD
(sometimes called “Pure O”).

Over the last few weeks, I have had a secret. For most people, this secret would not have been seen as important, but to me it was. Every time I had these thoughts I became overwhelmed with anxiety, fear and an almost palpable sense of terror. As soon as the thought of this secret flashed through my mind, I would have visions that would take me to its worst-case outcome.  As I played these thoughts out in my head, I physically experienced extreme anxiety, as if the discovery of my secret was actually happening.

Just a few days ago, I was on the treadmill and the thought flashed through my mind again. I was immediately plagued with heightened anxiety. Even the lady on the treadmill next to me noticed and commented that my face had a strange look on it. In response to the thought, I did what most people would do. I tried not to think about it.

At that point, I started a conversation with the lady next to me…and the thought popped up in my head. After the conversation was over, I read a trashy magazine… and the thought popped up in my head again. I then began running as fast as I could, dripping with sweat and breathing deeply, and the thought still managed to surface. Actually, not only did it surface, but it continued to inflate in my head, as if it was going to soon explode. Read More »

    

If you are faced with the challenge of Pure Obsessional OCD (Pure O), then chances are you’ve completed your first round of obsessions and compulsions before you’ve even gotten out of bed each day.  Before you open your eyes, the wheels in your OCD machine start turning, and a sort of science fiction scan of your brain begins searching for evidence of “it”.  Whatever “it” is, “it” is sure to be in there somewhere. Read More »

  • HOCD: 30 Things You Need To Know

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

  • Doubt, Denial and OCD

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

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

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

  • Imaginal Exposure for OCD and Anxiety

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

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

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

  • Moral Scrupulosity in OCD: Cognitive Distortions

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

  • OCD in the Family

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

  • Scrupulosity in OCD: Cognitive Distortions

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

  • OCD and Eating Disorders

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

  • Harm OCD Treatment With ERP

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

  • My Life with OCD

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

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

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

  • Mindfulness for OCD and Anxiety

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

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

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

  • OCD and Thought-Action Fusion

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

  • OCD, Anxiety, and Resistance

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

  • Harm OCD Treatment: Cognitive Restructuring

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

  • OCD & Anxiety: Five Common Roadblocks to Treatment

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

  • Harm OCD Treatment: Mindfulness Based CBT

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

  • Dermatillomania / Skin Picking Disorder Treatment

    Treatment of Dermatillomania (Skin Picking Disorder) with CBT. Part two of a series from the OCD Center of Los Angeles.

 

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