Jon Hershfield of the OCD Center of Los Angeles discusses treatment of Sexual Orientation OCD, also known as HOCD or Gay OCD,using Cognitive Behavioral Therapy (CBT) and Mindfulness. Part three of an ongoing series.
There are many variations and sub-types of Sexual Orientation OCD (HOCD)
When I initially wrote the part one and part two of my article on Sexual Orientation OCD (aka “Homosexual OCD”, aka “HOCD”, aka “Gay OCD”), it was intended solely to reflect this rather common form of the disorder as I saw it presented in several of my clients. I had not anticipated such a significant online response, with so many additional questions and angles on the subject.
Sexual obsessions in general are under-reported because of shameful feelings associated with them. And yet there is probably a somewhat higher prevalence of sexual obsessions in OCD than any other obsession for this same reason – the thoughts are unwanted! This seems so very evident in Sexual Orientation OCD because the feared consequence appears so tangible. In other common OCD obsessions, such as “Harm OCD”, the idea that someone might be in denial of violent impulses is plenty terrifying. However, there is an understanding that being violent is unacceptable in and of itself. With Sexual Orientation OCD, the sufferer generally does not see anything wrong with being gay per se, as long as it is not themselvesbeing gay. This causes a lot of confusion and a lot of resistance to seeking treatment. › Continue reading
In part one of this two-part series, we discussed the experience of the Social Anxiety sufferer. In part two, we examine how to treat this condition with Cognitive Behavioral Therapy (CBT), and how Social Anxiety relates to other Obsessive Compulsive Spectrum Disorders.
Treatment of Social Anxiety
Social Anxiety can be successfully treated with Cognitive Behavioral Therapy (CBT)
The most effective form of treatment for Social Anxiety is the same as in other Obsessive Compulsive Spectrum Disorders – Cognitive Behavioral Therapy (CBT). This is because, like the other disorders in the spectrum, Social Anxiety involves an obsession and a series of compulsions which form a cycle.
The fundamental obsession in Social Anxiety is the fear of being evaluated negatively. This generally includes fears of being rejected, as well as the fear of being singled out for humiliation and traumatized by emotional abuse from others. The primary compulsion in Social Anxiety is the phobic avoidance of social situations in which one fears rejection and/or humiliation (thus its synonym, Social Phobia).
It is tempting to look at avoidance as the absence of engaging in social behavior. However, avoidance is an overt physical and mental behavior, the primary goal of which is to reduce or eliminate anxiety. For the individual with Social Anxiety, the act of choosing not to go to the party thus serves the same function as the act of choosing to wash one’s hands serves for the individual with OCD. Further, those with Social Anxiety who are able to commit to a social interaction may find themselves escaping mentally in the process by spending their energy focusing on things other than the present situation. › Continue reading
Many people mistakenly think of Social Anxiety as nothing more than shyness. In this two-part series, Jon Hershfield of the OCD Center of Los Angeles discusses Social Anxiety, its treatment with Cognitive Behavioral Therapy (CBT), and its relationship to other OC Spectrum Disorders.
Social Anxiety, also known as Social Phobia, is more than just shyness.
When I first began treating people with Social Anxiety Disorder (also known as Social Phobia), it seemed to me that this condition was primarily a problem of interesting people not realizing that they are interesting. While this is a significant element of the disorder, there is more going on than one might initially expect.
In reality, Social Anxiety and Social Phobia are terms used to describe a cluster of symptoms that center around the fear of being negatively evaluated by others. This is often confused with being shy or introverted, or even schizoid. An introvert may genuinely prefer the quiet solitude of turning inwards to the self rather than outwards to other people, while someone with schizoid personality disorder may simply not find the presence of other people to be pleasing. In either of these cases, the experience of isolation from others is essentially rooted in ego-syntonic thoughts, which simply means that the thoughts are consistent with the individual’s true beliefs and values. In other words, those who are truly introverted or schizoid genuinely prefer to be alone.
Conversely, a person suffering from Social Anxiety is burdened by unwanted intrusive thoughts about being judged, rejected, and/or and humiliated by others. › Continue reading
Body Dysmorphic Disorder (BDD) is a condition in which one has an obsessive preoccupation with his or her physical appearance.We recently posted two articles about the condition, one on BDD in the media, and the other on BDD in teenagers. In the final installment of our three part series, we look at recent research related to this condition.
Body Dysmorphic Disorder and How We See Ourselves
Researchers are learning more about Body Dysmorphic Disorder (BDD)
This past year saw a number of interesting research studies on the topic of body image and Body Dysmorphic Disorder (BDD). One study surveyed over 2200 men and women of various body types regarding their self-perceptions related to weight and body image. Those who completed the survey were evaluated for their body-mass index (BMI), a ratio of height to weight that provides a range of numerical values for what could be described as a “healthy weight”. Participants were also instructed to describe how they perceived their bodies, using a range of terms such as “slim” and “fat”.
The study found that only 13% of the women participants who were evaluated as having a “healthy” weight for their height (BMI) were satisfied with their overall appearance. More disturbing was the finding that only 6% of these women saw themselves as being “slim”. Conversely, only 6% of the male participants who were evaluated as having a healthy BMI saw themselves as “fat”. Furthermore, of the study participants who were actually overweight, twice as many women as men described themselves as being “ashamed” of their bodies. The most obvious conclusion we can draw from these data is that men and women see themselves in startlingly different ways, and have very different emotional reactions to their weight. › Continue reading
Binge Eating / Compulsive Overeating is a real problem that can be successfully treated
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. Individuals with Binge Eating Disorder have a strong motivational drive for food and experience great difficulty in their attempts to restrain their eating. They frequently continue eating well beyond their satiation level, with many reporting that their behavior feels “unconscious”, and that they have little control over it. It appears that compulsive overeating is often done in response to emotional difficulties or psychosocial stressors. Unfortunately, during and after a binge, one is often left feeling more depressed, anxious and helpless than they did before they overate.
In addition to the psychological issues noted above, some researchers and theoreticians believe that compulsive overeating has played a significant role in the dramatic increase in obesity levels in the Untied States over the past 30 years. Obesity is commonly identified as having a body-mass index (BMI) over 30. Using this guideline, approximately 34% of Americans are currently classified as obese, compared to 15% in 1980. During this same 30 year period, this increase in obesity has led to a concomitant surge in diabetes and hypertension, both of which are risk-factors for heart disease, the number one cause of death in the US. › Continue reading
Jon Hershfield of the OCD Center of Los Angeles discusses treatment of Sexual Orientation OCD, also known as HOCD or Gay OCD,using Cognitive Behavioral Therapy (CBT) and Mindfulness. Part two of an ongoing series.
Treatment of Sexual Orientation OCD
Sexual Orientation OCD can be successfully treated with Cognitive Behavioral Therapy and Mindfulness
As noted in our previous post, Sexual Orientation OCD is a condition in which an individual, straight or gay, obsessively doubts their sexual orientation. Research has consistently found that the most effective treatment for this and all types of Obsessive Compulsive Disorder (OCD) is Cognitive Behavioral Therapy (CBT), with a focus on Exposure and Response Prevention (ERP).
Over the past ten years, many OCD specialists have also begun to integrate concepts from Mindfulness-Based Cognitive Behavioral Therapy (MBCBT) into their treatment of OCD. In MBCBT, the goal is to change one’s perspective toward one’s thoughts, as well as the behavioral responses these thoughts lead to. Using mindfulness, it is possible to circumvent much of the OCD process and ultimately reverse it into remission.
Mindfulness is particularly helpful when treating the more obsessional variants of OCD, including Sexual Orientation OCD. When combining MBCBT with the traditional tools of Cognitive Behavioral Therapy, the following treatment techniques are used to address the unwanted thoughts and behaviors seen in Sexual Orientation OCD. › Continue reading
Many people mistakenly think of Obsessive Compulsive Disorder (OCD) solely as a condition in which people wash their hands excessively or check door locks repeatedly. There are actually many sub-types of OCD. In this ongoing series, Jon Hershfield of the OCD Center of Los Angeles discusses Sexual Orientation OCD, also known as HOCD or Gay OCD.
So, Am I Gay or What?
I sat down to write this blog on Sexual Orientation OCD while my wife and I had started to watch a movie (It’s been suggested I work too much). It’s either irony or personalization, but the opening scene of the movie involves a man kissing his lover… another man. This is the second film in two weeks that I’ve rented which involve men and their male lovers, something I was not aware of when I selected the films.
Or was I?
Sexual orientation OCD is sometimes referred to as HOCD (an abbreviation for Homosexual Obsessive Compulsive Disorder) or Gay OCD. › Continue reading
Increasing numbers of teens are having elective cosmetic surgeries to address body image issues, without fully considering the physical and psychological risks involved. Part two of our three-part series on Body Dysmorphic Disorder (BDD).
Recently there have been a number of stories in the media that have touched upon the topic of Body Dysmorphic Disorder (BDD). These stories suggest the unfortunate extent to which women (and a growing number of men) appear to be internalizing extremely distorted ideas of beauty.
Will BDD become known as Heidi Montag Syndrome?
Perhaps the most public illustration of this growing problem is the case of Heidi Montag. Until a year ago, I had never heard of Heidi Montag, and I still have no idea why she is famous. Apparently, she is on a reality TV show called “The Hills”, which Stylite blogger Linda Ripoll describes as an “amazing exploration into self-hatred, body dysmorphic disorder, and addiction to plastic surgery”. › Continue reading
Chances are, if you’re reading this, you’ve found yourself saying the same thing at some point in your adult life. Nowhere is this more relevant than from the perspective of someone looking back on a childhood with Obsessive Compulsive Disorder (OCD) or an Obsessive Compulsive Spectrum Disorder. When I meet a new client under 18, there is a powerful sense of traveling through time. I think, “If only I had someone like me to go back and talk to me when I was someone like this.” How much time might I have saved being able to resist repetitive, unnecessary rituals? How many more events, relationships, and simple moments of peace might I have been able to enjoy if only I had known what was really happening to me? › Continue reading
