HOCD Update

Hi, Dr. Lane.

I'm sorry to be posting here again- I really wish I was getting better but I've fallen into a rut again. I wish I didn't feel the need for reassurance.

Lately I've gotten over reviewing the past but HOCD has latched on to groinal responses and urges/impulses. I have tested myself many a time in terms of thinking of women sexually, and I think I've become neutralized to these thoughts. I feel like I WANT to touch breasts, etc. and it brings me an extraordinary amount of pain and sadness. I feel like I'll never get over this.

Tomorrow I start working with a new therapist who does CBT. I am hoping for the best with this. I'm tired, Dr. Lane. I'm tired of the responses, the anxiety, all of it. I feel defeated and down right sad. I hate feeling like I want to do these things; I just want to be with my boyfriend and be happy again.

Please pass on any advice you have for me. I definitely feel as though I'm suffering.


Hi Brit, It's good to hear

Hi Brit,

It's good to hear from you, although I'm sorry to hear you are struggling. However, PLEASE know that nothing you describe is abnormal or unusual with OCD.

OCD (including HOCD) often manifests in disturbing and distressing impulses and urges. You "feel" like you "want" to touch breasts, etc., but you know you really don't - there is no genuine desire. It's another "trick" your mind is playing on you. I hope that makes sense.

For what it's worth, people with OCD very rarely ever actually act on their OCD-related impulses. However, that doesn't make them any less distressing because: 1) they fear that they will at some point and 2) they misinterpret the impulse as a genuine desire.

Remember, OCD is a challenging and complex disorder. It's not so much about "getting over it" (although some people do), but rather, it's usually about learning to manage it effectively.

You've had a few disruptions in your treatment that have very likely hindered your progress, so I encourage you to not beat yourself up or think you'll never get to a much better place with this.

If I recall, you were using the Mindfulness workbook and found the helpful - I hope you will continue to practice mindfuless and hopefully your new therapist can help you with that as part of your treatment.

Something that might be helpful is to remind yourself, when you have a groinal response or urge, to take a deep breath and just let it be there. They cause anxiety (e.g. just like a photo of a dog would cause anxiety for someone who had a phobic fear of dogs) but the reality is, they can't hurt you (just like a photo of a dog is harmless), right? That's not a great analogy but the best one off the top of my head at this late hour! In other words, there isn't something to be truly afraid of.

What IS scaring you is what you tell yourself (deep down) that they mean (i.e. the groinal response or urge to touch someone's breasts means you must be a lesbian). I think working with your therapist to change what you tell yourself with regards to these things will be very helpful.

The only meaning these urges and responses actually have are the meaning YOU assign to them (btw, that's not a criticism). This is a key issue with every anxiety disorder - people become very anxious due to what they're telling themselves about the anxiety-provoking trigger (sorry if that sounds like psychobabble!).

I hope something I've said is helpful. I'm so glad you'll be working with a new therapist this week!

This is a process, and often a much slower one than most people would like. I wish there was some magical way to speed it up, but therapy takes time. Be patient and gentle with yourself, okay? (I know that's MUCH easier said than done!)

Dr. Lane

Hi, Dr. Lane! Thanks so much

Hi, Dr. Lane!

Thanks so much for your support. I so appreciate it in between actual therapy!

For some reason I feel like even though you've told me this is entirely normal for someone with ocd, my brain says, "no, this is not ocd. this is you" and it's terrifying.

In terms of urges/impulses- I felt reassurance in terms of the fact that you said most people don't actually DO these things; however, when I get the impulse, specifically to touch breasts, I feel as though I need to grab hold of something (almost like a stress ball) and to me it feels like I'm doing that so that I don't act out and actually touch someone! It's terrifying and takes up a lot of time. It makes me feel like I don't really have ocd. I never had these thoughts/feelings before ocd. Sure I noticed womens' breasts because they were there! But NEVER like this. Is this still ocd?! I'm thinking maybe this is a compulsion for me, although it feels like I like it. I'm just so lost, confused, anxious and quite frankly fed up!

I do continue working in my mindfulness workbook, but I'm noticing I use it to reassure myself...so I'm trying to set aside time to do it even when I'm not stuck in an extreme obsession. I'm so afraid this type of ocd isn't real and I'm so afraid that my therapist doesn't believe in it.

Thanks again! Time for a deep breath for me :)

Hi Brit, I encourage you to

Hi Brit,

I encourage you to discuss all of this with your therapist next time you see him or her.

My thoughts (which may or may not be helpful). IF you were a lesbian (or bisexual), do you really think you'd have the urge to randomly grab women's breasts? That's not a normal urge for anyone, regardless of their sexual orientation. But it is very typical of the type of urge that accompanies OCD. You also notice women's breasts more because you're "hyper-alert" to them right now - again, typical with OCD.

But your mind is misinterpreting the urges and hyper-alertness to mean something much more than it does (which, again, is typical with OCD).

So, even though all of this is reinforcing your deepest fear - that you're a lesbian - it's all very typical with HOCD. It feels real, but that's the OCD.

I know you are frustrated, confused, scared, and fed up. OCD is a really tough disorder. But you're working with a new therapist, and I encourage you to discuss this urge (and the best way to manage it) in your next session.

As for your fear that your therapist doesn't believe this is OCD - I can't speak for your therapist but I can say with a pretty high degree of confidence that that is HIGHLY unlikely - and that fear is another manifestation of your OCD. (And I strongly encourage you to tell your therapist about that fear as well!!)

I know logic is rarely helpful. If there was a guaranteed, 100% accurate sexual orientation test (e.g. like a blood test) that you could take, and it said "You're STRAIGHT", you'd still question it, because that's the nature of OCD.

That's why the focus of treatment isn't to prove whether or not you're gay or straight or bisexual or whatever. The focus, rather, is, at least in part, to help increase your tolerance for UNcertainty, so that when these doubts creep in, they don't overwhelm you and cause so much anxiety. It's also to help you learn to effectively manage the obsessive thoughts (which includes urges) and compulsive behaviors so they no longer consume your life or cause so much distress (and hopefully enable you to overcome them completely).

Hang in there! Take a deep breath. Work on your mindfulness (I'd recommend letting your therapist know you've been using that book, and perhaps that can be incorporated into your treatment).

I hope this helps!

Dr. Lane

Greetings, Dr. Lane. I have

Greetings, Dr. Lane.

I have an appointment tomorrow with my therapist and I will definitely mention these things to her. Right now we're working on why ocd came about; she seems to think that ocd always comes about for a reason, so we're searching for that. Maybe this is ineffective.

I still get the urges every day. Today I felt the urge to touch my own breasts, which horrified me but I guess also felt good? I didn't feel aroused, it just felt good to my hands I guess. But now I'm compulsively searching the Internet to see if this is normal or not. I'm just so afraid I'll never feel attracted to my boyfriend again because I'm so far in this.

I'm going to go work on my ocd workbooks now so I stop performing compulsions....then I think I'll hit the gym so I walk away from all of this!

Thank you,

Greetings, Dr.

Greetings, Dr. Lane.

Unfortunately I have found myself falling in to picking through the past again.

I feel embarrassed to say this, but I have always been excited to have kids and experience pregnancy. I think pregnancy is a beautiful thing, and I remember watching pregnancy shows from a young age. I think pregnant women are beautiful. I have always been excited for this stage of my own life. During sexual relations with my boyfriend, I have definitely thought about getting pregnant and feeling aroused by that.

My HOCD (if that's what I have) has turned this into a nightmare. I now wonder if that is the only reason I ever wanted to have sex with my boyfriend is to get pregnant, and even worse, maybe I have some type of lesbian-fetish with pregnancy. I have tried searching the internet for information but it has not come up helpful. I just don't know how to interpret this and need some clarification. Although maybe this is just a reassurance post into something that falls into ocd.

Thanks in advance for the advice,

Hi Brit, I encourage you to

Hi Brit,

I encourage you to discuss all this with your therapist. Remember, with HOCD, your mind is always going to find new things to make you doubt your sexual orientation. Hopefully your therapist will work with you to help you learn how to manage these new doubts each time they creep in, so that you can recognize them for what they are and not become so anxious.

Dr. Lane

Hi, Dr. Lane. Thanks for the

Hi, Dr. Lane.

Thanks for the continued support-much appreciated. You're so right about the new doubts always creeping in. I read an article about a therapist who treats this and he said 10% of people are actually gay! This stressed me out beyond belief. I don't know how to interpret it but I'm trying to stay calm and not worry.

Hi Brit, could you send me

Hi Brit, could you send me the link to that article?

While that's certainly possible in some cases, it doesn't mean that that's the case for YOU, okay?

A lot of people mistakenly assume that it's an either/or thing - "EITHER it's HOCD OR I am gay". Unfortunately, some people use the term HOCD too broadly - to refer to ANY doubt about one's sexual orientation, and that's not accurate.

People can have doubts about their sexual orientation and not meet the criteria for a diagnosis of OCD (remember, HOCD is a type of OCD and not everyone with doubts or anxiety automatically has OCD).

Remember, the treatment goal for HOCD is NOT to prove to you that you're not gay. Rather, the goal is to help you learn to effectively manage the obsessive thoughts and compulsive behaviors, and to learn to TOLERATE the uncertainty when it creeps in.

(And I strongly encourage you to not be researching articles on HOCD (or sexual orientation, coming out, etc.), because more often than not, they'll just feed your anxiety - and that's not helpful).

Dr. Lane

Hello again, Dr. Lane! I

Hello again, Dr. Lane!

I think that is great advice- I will definitely try to be more comfortable with my thoughts and mention that in therapy.

Here is the article I mentioned: http://abcnews.go.com/Health/homosexual-ocd-straight-men-fear-gay/story?id=22589452

Thanks again!

Hi Brit, Thank you for

Hi Brit,

Thank you for sending the link. This article (which I thought was excellent, btw) provides a perfect example of how your OCD mind sets you up!

You read the article and COMPLETELY missed ALL the things in it that were great examples of why I believe that you have HOCD and aren't a lesbian. But YOU focused on one sentence in the entire article and missed everything else - all the things that could have been so AFFIRMING and reassuring for you!!

(Btw, I'm not lecturing you (even though my typed words may come across that way). :)

Did you miss this statement? "Someone who is gay, but in the closet, is not spending time researching and testing themselves," he said. "They know deep down that is a part of them. Gay people are not looking for any kind of external validation."

Or this one? "They know they're not attracted to the same sex and are to the opposite sex, but are consumed all day long with this battle," said Brodsky. "They can think of nothing else. A gay person doesn't go through this battle."

I'm not surprised that, "occasionally" (which is the
word he used) a client learns they are gay. Without knowing any details about those specific cases, it's easy to jump to conclusions. However, I suspect there were some salient differences in their stories (for lack of a better word) than the straight HOCD clients.

Another thing he mentioned that support what I've told just about every HOCD reader here is that some therapists miss the OCD diagnosis. And that's why I ALWAYS recommend seeing someone who specializes in treating OCD if at all possible, OR, who at LEAST has a lot of experience in treating it. An inexperienced therapist (in terms of treating OCD) can easily do more harm than good, which, IMO, really was the point of this article.

So, my point for you is this: your OCD makes you very vulnerable to distorting the bigger picture. I actually expected a very different article, and was glad to see that I was wrong.

I hope that this helps you see your vulnerability due to your OCD. So, when something like that "10%" issue jumps out at you, causes more anxiety and doubt, and you miss everything else, remember that that's your OCD "talking". And you have to take anything your OCD says with a HUGE grain of salt. (Does that make sense?)

I hope that helps!

Thank you for sending the article. I encourage you to read it again and look for ALL the things in the article that actually support that you AREN'T gay and ARE struggling with OCD (or, more specifically, HOCD). :)

Dr. Lane

Hi, Dr. Lane! Hope you're

Hi, Dr. Lane!

Hope you're doing well. Thanks again for everything.

I've been trying to stay offline for a while and it has been helping. I totally understand what you meant by your comments before...my ocd did attack the one thing it could doubt in that article! My mind continues to do this, but I'm better about labeling the thoughts as ocd thoughts. Like when I read your response and you said "I believe you have ocd and are not a lesbian" my mind panicked because there wasn't certainty in that statement! Funny how ocd works.

My problem now is...was I ever sure I wasnt a lesbian? Did I ever question my sexuality before? Am I sure I didn't question it before? Did I have lesbian thoughts before? Why? When was the first time I remember thinking a thought like this? Before or after my diagnosis? Do you think this is typical uncertainty is typical with hocd? Or maybe I did think these thoughts before? I'm realizing that this is me asking for reassurance. The funny part is before I had hocd I would obsess if I found any male but my boyfriend attractive. Now it's pretty much opposite!

I appreciate any advice or tips you have. I'm currently in therapy, but my therapist cancels frequently. She also seems to believe being gay is a "choice" and it's my choice of sexuality. I think I'm going to switch counsellors again soon because my mind is convinced she only doesn't think I'm a lesbian because she thinks they don't exist!

Thanks again for everything!

Hi Brit, Due to some changes

Hi Brit,

Due to some changes with BrainPhysics, I will no longer be answering readers' questions via this website. If you would like to temporarily post your email here (and then delete it once I get it, which I'll let you know), then I'm happy to respond via email as time allows.

Dr. Lane

Wow, thank you so much for

Wow, thank you so much for your dedication. You truly are helping to get my life back!

Thanks, Brit!

Thanks, Brit!

Dr. Lane

No, thank you!

No, thank you!

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