Did my childhood interest in rugby/dance as a kid mean I’ve always been gay and missed the signs? the Manhattan Center for Cognitive-Behavioral Therapy & Paul B. Greene, Ph.D. except where otherwise noted. However, they are not intended to convince you that you’re straight. Or Is It My Anxiety? Understandably, the most common impulse of someone with HOCD is to try to get rid of the obsessive thoughts. This is ideally used in the context of exposure and response prevention therapy, with the assistance of a trained therapist, but is presented here in the hopes that it might be useful to others. Read more on how thoughts become intrusive . OCD is a common disorder that involves obsessive thoughts and compulsive behaviors. For simplicity’s sake, this article describes the experience of a straight person with obsessions about being gay. These can lead to any of the following: Compulsions in HOCD run the gamut from the unnoticeable and subtle all the way to the life-altering. They usually stick around for a lot longer than you hope, leading to increased distress and fear. We will explain what these mean in subsequent newsletters, but for now, here is all you need to know. In their case, it’s a sensation and not a desire, but the situations are similar.) We are discontinuing future Intrusive Thoughts Newsletters. More and more psychotherapy (cognitive-behavioral and otherwise) in recent years has included an emphasis on mindfulness. Can you recommend someone? If you have HOCD and see a random therapist, you are not likely to find someone who recognizes and understands HOCD. Overcoming scary, Intrusive and Racing Thoughts with anxiety. What makes a thought feel real is the attention we bring to it. Martin N. Seif, Ph.D., ABPP. Manhattan Center forCognitive-Behavioral Therapy In many ways, this is the root of the problem. If you have questions this page did not address, please mention them and we will try to address them as the page is updated over the years. This maximizes the three elements essential to all intrusive thoughts: entanglement, sticky mind, and paradoxical effort. Why does this feel so real? The traditions of meditation and mindfulness offer a valuable perspective for those struggling with upsetting thoughts about one’s sexual orientation. It may feel pointless, painful, and unproductive. Note: HOCD can affect people of any sexual orientation. Similarly, if someone with HOCD has never tried anxiety tolerance as a means of coping, it will be difficult at first. The first thing to understand is that these kinds of negative thoughts, to a certain degree, are normal and everyone gets them. We often think things that we would never say or do in real life. When you are relaxed, thoughts and behaviors seem totally separate. This is a difficult problem to address, but two strategies can be helpful: mindfulness and creating uncertainty. Here is what I mean. i have obsessive and intrusive thoughts deep down i know there nonsense but why do they feel so real? By doing certain practices we can cultivate this awareness so that it becomes easier to access. You have created them, and all … In these exercises, you purposefully “expose” yourself to something that will evoke a little bit of HOCD anxiety. I was in a shop today and there was a little boy and I got an intrusive thought about him but it felt so, so real. That temptation makes the HOCD thought hard to tolerate. It is when we start to believe these thoughts that it can become a problem. One helpful step in combatting HOCD anxiety is to ask yourself: how certain am I that I’m gay vs. straight? It’s important not to use this technique for too long. As Son puts it, so personally and perfectly: [3] “If someone close to you experiences these intrusive thoughts, just love and support them. People with HOCD are often thrown by their obsessions, and explain that the thoughts “feel so real.” Why is that? The more someone with HOCD seeks certainty, the more they weaken their innate ability to tolerate uncertainty. I do not, however, believe in demons, the devil, etc, they do not cause intrusive thoughts or any other mental health problems because they don’t exist. that trigger the anxiety that comes with HOCD thoughts. And then there are the thoughts about what you fear you might do in the future. But as you get more anxious, your thoughts feel more and more like call to actions. Please contact us if we can help you in your efforts to find anxiety therapy here in New York. They’re upsetting because they feel so foreign… Follow - 3. This is sometimes referred to as overvalued ideation. They don’t make you a bad person. The primary recommended treatment is a form of therapy called exposure and response prevention. Intrusive thoughts feeling “real” (coming from outside you as sensation) as I know them are “stray thoughts” as hallucinations and nobody really knows why yet. How to Deal With the Torment of Relationship Obsessions, Coronavirus: Tips for Parents During Social Distancing, “Will I Get Sick Too?” — Talking to Your Children and Teens about Coronavirus, How to Overcome the Vicious Cycle of Depression and Avoidance. There are no known instances of HOCD or anxiety changing anyone’s sexual orientation. I know how to show you exactly what to do to reclaim your life. This is the “response prevention” step. How to cope with HOCD thoughts when they arise: Acknowledge to yourself the possibility that you may be gay. You might even come to enjoy it! (Lloyd Christmas was the name of the character played by Jim Carrey in the film “Dumb and Dumber” who succeeded in creating doubt where there had been none — see video below.) People with HOCD focus excessively on their reaction to men vs. women. You therefore fight against these thoughts, and they begin to feel like impulses. Intrusive thoughts are so-called for a reason: they stick with a person, and the harder a person fights them, the stronger they get. Maybe not enough! Why do my HOCD thoughts feel real? ERP therapy helps you develop both of these skills. Worrying, obsessive, intrusive or racing thoughts are some of the symptoms of anxiety that can bother people the most. The same intrusive thoughts that feel so real, all powerful and self-defining when swirling around in your head will disintegrate when said out loud. There is no comparable temptation to “figure out” where we’ll be in a year because we know we can’t. The key with the Lloyd Christmas technique is to only use it as long as needed to create some doubt, and then to stop. Obsessions, in relation to obsessive-compulsive disorder, are defined on the International OCD Foundation website as "thoughts, images or impulses that occur over and over again and feel … You can work with a professional or try to make changes on your own. past sexual relationships as possible evidence you might be straight, hobbies or interests you have that are stereotypically heterosexual, perhaps your friends think you’re straight, past aversive reactions to same-sex flirting, touching, or erotic material, past serious and long-lasting romantic relationships with someone of the opposite sex. Living With Intrusive Thoughts. Delusional thoughts. Why did I slow my pace a little when I walked by the LGBT community center the other day? If you have HOCD, The good news is that there are a lot of things you can do to help yourself. Unwanted intrusive thoughts are stuck thoughts that cause great distress. And if you thinking about slicing up your wife with a carving knife, how can you be sure that you won’t do that? Intrusive Bizarre Thoughts When Anxious People who are chronically anxious are in a highly sensitive state. Sometimes people with HOCD go from being anxious because they’re unsure if they’re gay to being convinced that they’re gay. You also refrain from ruminating about the possibility that you might be gay. In the next newsletter, we’ll address intrusive thoughts that center on things you worry you might have done in the past. Remember, it is possible to feel 100% certain of something and to be wrong about it. https://manhattancbt.com. Unable to feel like their thoughts are just thoughts, people with OCD develop a strong distress response– their mind and body go on high alert. There is an excellent chance that I can help you as well. You can try this on your own by briefly contemplating any of the following: Granted, none of the above factors prove that someone is straight or gay. Read 21 Responses. They are all temporary experiences without any inherent substance or profound meaning. When your thinking changes that way, your relationship between thoughts and actions also changes. Selective serotonin reuptake inhibitors (SSRIs) are often prescribed in high doses to address symptoms of OCD. You get a small stress response the first time it happens. So why are obsessive thoughts so hard to tolerate? We know that the more we try not to think about something specific, the more it tends to crop up in our minds. There are two options for those who would like to improve their HOCD symptoms. Click here to see all 15 previous newsletters. It helps us remember that even beliefs we take for granted — e.g., that I’m reading an article on HOCD right now — are not reality. She doesn’t buy it’s all OCD because the thoughts seem too real. The lesson is clear: abandon efforts to get rid of the thoughts. It’s based on the components of exposure and response prevention therapy, which is described below. So why do they feel so real and convincing? New York, NY 10001 (map) While it is true that obsessions are biologically generated intrusive thoughts, compulsions are simply very bad solutions you, yourself, have invented as a way of dealing with the anxiety resulting from your obsessive thoughts. So what does this do? This shift in thinking reduces the questioning of one’s sexual orientation; the belief that one has been masquerading as straight becomes strong and solid. This way of understanding your symptoms is a critical framework for what comes next. This is a major problem in access to effective HOCD treatment in the United States. For a small proportion of the population, however, they are followed by a strong urge to address the way they make us feel. Their unusual nature can cause distress and anxiety. Intrusive thoughts can become a serious issue, and are not limited to the examples above. The content of unwanted intrusive thoughts often focuses on sexual or violent or socially unacceptable images. I’m Doctor Marty Seif, and I know how you feel, because I’ve been there myself. How much am I *really* enjoying this stereotypically straight man/woman activity? At first, I saw no connection between these harm “urges.” The only similarity between them was that they both felt incredibly real and disturbing. That’s dishonest! Psychologists call this thought-action fusion, and it can scare the heck out of you. This sets up a situation in which you are struggling not to think something. A person with experience of intrusive thoughts and obsessive-compulsive disorder (OCD), and a leading OCD psychiatrist, explain how to deal with unwanted thoughts. Every highly anxious person has to cope with intrusive thoughts. So far I only gave you an example of self-harm, but I also had obsessive thoughts of violent character directed towards others. Itstheeyes. Several strategies are listed below that have been helpful for many suffering from HOCD. When this inability to discern real sexual preferences repeatedly meets with fear and pessimism, there are consequences. Be relentlessly patient in your battle against OCD; be willing to use these techniques forever if necessary. Answer Save. For example, you might feel like the FBI is watching everything you do, or that someone is trying to poison you. Our CBT therapists are doctoral-level psychologists. We can tolerate not knowing what we’ll wear tomorrow, we can tolerate not knowing exactly where we’ll be in a year. Remember that HOCD is not distinct from OCD. HOCD has been around for a long time and, to those in the know, is an established and well-understood sub-type of OCD. Your email address will not be published. Mindfulness is an awareness that we all have at times — an awareness that is relaxed, focused on the present, and not caught up in distracting thoughts. If you’ve spent most of the past few days feeling certain that you are gay, then use the Lloyd Christmas technique described above. Therapists who specialize in OCD are typically familiar with HOCD, but most other therapists are not. You will learn about OCD and about how obsessions and compulsions work. 276 Fifth Avenue, Suite #905 They are over sensitive to comments made by others, their own thoughts and equally to their own fearful reactions. (If you don’t know about the amygdala, go back to my website and read about it.) Generally speaking, it’s always helpful in battling HOCD to keep the following points in mind: The treatment of choice for sexual orientation obsessions is a form of cognitive-behavioral therapy called exposure and response prevention (ERP). Sincerely, This has some parallels to Claire Weekes‘ metaphor of swimming rather than floating; you want the anxiety to go away, and assume that hard work is needed to make that happen. Everything written here can be applied to a gay person with obsessions about being straight; just swap the words “gay” and “straight.”. There is an excellent chance that I can help you as well. Mindfulness derives from ancient traditions of meditation. For people with HOCD, tolerating anxiety around their sexual orientation is analogous to acquiring a taste for healthier foods if you’re used to eating junk food. 1 June 2013 - 21:33. moosie. People with HOCD are tempted by the prospect of “figuring out” if they’re gay or straight, either by checking in some fashion or by mental exercise. Did my noticing that man/woman just now mean I’m gay? Another way is to reevaluate the meaning you attribute to HOCD thoughts, images and impulses. This feeling of anxiety in combination with the thought, might be enough for your brain to mark this as a threat. For those with panic disorder, these thoughts can be so problematic that they increase the risk of having another panic attack. The core symptoms of HOCD are intrusive thoughts about being gay. When symptoms are severe, some straight people with HOCD describe feeling 100% sure that they are gay. For these reasons, as well as the lack of emphasis on concrete strategies to navigate the symptoms, traditional therapy is typically unhelpful for HOCD. Your therapist will teach you different ways of understanding the thoughts and feelings you’ve been having. Instead of feeling horrified that they might have been wrong about being straight, they start to feel horrified that they are certainly wrong about being straight. Others worry about a specific symptom, like whether or not they can get a full breath. And How Often? An intrusive thought is an unwelcome, involuntary thought, image, or unpleasant idea that may become an obsession, is upsetting or distressing, and can feel difficult to manage or eliminate. If so, are they right? So if you are thinking “F*** God” in the church or synagogue, how can you be sure that you won’t yell out the blasphemous thought? Answer Question. We all have the ability to tolerate uncertainty. Partially, they’re hard to tolerate because they run counter to our well-rehearsed habits of eliminating that uncertainty. And it would be terrible if you actually did what you think about, and how can you know for certain that you won’t do them? Similarly, acknowledge that it’s also absolutely possible that you may be straight. The thoughts that run through our heads all day every day are our biased view of things. If you’re able to refrain from doing these things for a long enough time, you will weaken your HOCD. Intrusive thoughts are a type of OCD. Importantly for those with intrusive thoughts, mindfulness helps us relate to our thoughts as they actually are: insubstantial and much less important than they feel in the moment. OCD, the broader category in which HOCD falls, affects 1.2% of Americans — approximately 3.95 million people. With the “Lloyd Christmas” technique, the person with HOCD strives to manufacture uncertainty. The answer involves fear, repetition, and the power of mental habits. Despite how they feel, unwanted intrusive thoughts can’t be … 1-646-863-4225 You make yourself do compulsions. Many readers ask why their intrusive thoughts feel so much like impulses? Avoidance Coping – The Reason Why Harm OCD Urges Feel Real. Resolve to yourself that for the next few minutes, you will refrain from efforts to determine whether you’re gay or straight. Your email address will not be published. He wants to talk with someone who can help him look at the things in his life that have possibly steered him in this direction, not someone just telling him to embrace or explore what he’s feeling. Your therapist will then teach you how to do exercises called exposures. Overcoming obsessive worry and unwanted intrusive thoughts. The same intrusive thoughts that feel so real, all powerful and self-defining when swirling around in your head will disintegrate when said out loud. They do not understand how they can have these thoughts that seem so scary and come with such impact and frequency. They are all temporary experiences without any inherent substance or profound meaning. The emotion behind these thoughts can be so strong that they feel like facts, rather than intrusive thoughts. This informs our experience of anxiety and other emotions, and in some cases, even how we live our lives. The effect of the phenomenon is clear for those suffering from intrusive thoughts about sexual orientation or any other common obsessive topic. PeMarie April 2nd, 2016 at 11:44 AM Mindfulness of Emotions: How Can It Help You? It’s also known as SO-OCD (sexual orientation) or “gay OCD.” It is a variant of OCD, and can have a profound impact on the lives of those living with it. HOCD is the abbreviation for homosexual obsessive-compulsive disorder. How Long Should You Meditate For? Even if you don’t feel this way but would like to discuss how intrusive thoughts are affecting you, speak with a psychologist or psychiatrist. After all, nobody knows for 100% sure, and neither do you. Sometimes i wish i could just sleep forever because that is the only time i don't really think so much. Required fields are marked *. Then, you fall for the Myth about thoughts that says, “If I am thinking about something a lot, it must mean that I have some deep desire to do it.” Or, “If I am thinking about something repeatedly, it is then more likely to happen.” Both statements are just plain false, but they add to the mistaken belief that these are impulses that need to be held in. The safer they feel to open up about intrusive thoughts and share their struggles, the better. DBT vs. CBT: How to Know Which Is the Best One for You. HOCD affects less than 1% of the population. For some people, intrusive thoughts are part and parcel of panic or intense anxiety. HOCD is poorly understood outside of the OCD community. Under the therapist’s guidance, the more you do the exposure exercises, the more you will improve. If you’re looking for CBT therapy in another part of the country or world, please contact us — we are happy to help! This might be helpful for obsessive thinking: OCD thrives on resistance. Writings on Unwanted Intrusive Thoughts are now included in the Psychology Today Blog post, Living With a Sticky Mind, Copyright © 2020 :: Dr. Martin Seif :: Web design by dmpdesigns.com. This second category of thoughts are the ones we are going to speak about in this newsletter. And that really scares you, because you say to yourself something like, “I really don’t want to hurt my wife, but what if I have impulse to hurt her and it gets the better of me?”. Anxiety is not your fault, and it can be successfully treated. Then try to use the 4-step ERP technique. These can indeed be symptoms of OCD, but for some people, OCD can look completely different. Next, your therapist and you will develop a list of people, places, situations, images, etc. Why would the thoughts be there if … Your worry, of course, is that you might actually act on the thoughts in your head. The first stage of ERP is informational. Let us know about your experience in the comments below. If your thoughts are bizarre or paranoid, you might be experiencing signs of psychosis. 3 Answers. Feelings like this, or intrusive thoughts, are a normal part of life. A therapist using the Lloyd Christmas technique helps an HOCD patient who is quite convinced that he or she is gay to create some doubt about their sexual orientation. How can I continue in this relationship if I’m actually gay? This technique is appropriate for when you’re feeling completely convinced that you’re gay (or straight!). Intrusive thoughts are frightening thoughts about what might happen to you or someone you care about, or what you might do to yourself or another person. I have 35 years of success with the treatment methods I use. Allow the question to remain unanswered. Copyright © 2020 Manhattan Cognitive-Behavioral Therapy/Psychology, PLLC, d.b.a. Free PTSD evaluations for frontline medical workers. Typically in OCD treatment, the emphasis is on learning to tolerate uncertainty. However, it made me feel anxious and sad,, I almost started crying. Marty Our offices are in midtown Manhattan, but we offer teletherapy services to people elsewhere in New York State, New Jersey, and Florida. Contact me. So a reasonable estimate of the number of Americans suffering from sexual orientation-themed OCD would be 315,000. When an intrusive thought strikes, be ready. Intrusive thoughts are powerful because they “stick” in your mind. If, on the other hand, HOCD symptoms have not dominated the past few days, then try the 4-step ERP technique. Anxiety Phobia treatment help therapy, Greenwich, CT, Manhattan Martin Seif. People with HOCD feel a strong temptation to eliminate uncertainty about whether they are straight or gay. If one overindulges in it, it becomes simply a form of reassurance and can become compulsive. Anafranil (clomipramine) is also used in some cases. Mindfulness practice helps us maintain a healthy relationship with thoughts (and emotions). However, for people with obsessive thoughts, the origin of the problem is 1) usually impossible to find and 2) not helpful even if you do find it. This maximizes the three elements essential to all intrusive thoughts: entanglement, sticky mind, and paradoxical effort. One factor that perhaps makes HOCD more torturous than other types of OCD is its relative obscurity. People with PTSD can … I’m looking for a therapist for my teenage son. Tolerating this distress is extremely difficult, so people feel the need to do something about the thoughts. 1 decade ago. For this reason, many people misunderstand it to be “repressed” homosexuality. From the mindfulness perspective, no thoughts are real, regardless of how they feel. (Similar phenomena happen in other anxiety disorders – for example, people who suffer from panic disorder also become very focused on a feared internal experience. The more you are able to practice tolerating the thoughts without ascribing meaning to them, the sooner HOCD will subside. This is a useful perspective for someone with HOCD to have as they cope with thoughts and beliefs around their sexual orientation. However, in our experience, it is quite unusual for someone to make significant and lasting progress against HOCD without learning, to some extent, how to understand and cope with the intrusive thoughts. This type of therapy aims to — as the name suggests — produce insight. Take for example a woman who gets thoughts that she might have touched a child inappropriately in the past. Relevance. (Check out our post with examples of how HOCD presents and how treatment can help.) There is emotion attached to them, if you felt nothing you probably wouldn’t notice them in the first place. Following that, you practice responding differently than you have been; you refrain as best you can from efforts to seek reassurance about your sexual orientation. Manhattan Center for Cognitive Behavioral Therapy. Their intrusive nature makes them harder to dismiss, which leads the person to believe they must mean something. The culprit is what I like to call anxious thinking. Consider doing a consultation with an OCD specialist if at all possible. OCD and Intrusive Thoughts. Forum User. The following four-step technique will help you practice precisely the skills necessary to reduce your HOCD symptoms. Anxious thinking is the altered state of consciousness that occurs when your amygdala sounds the alarm bell in response to a non-dangerous trigger. The more we try to get rid of an undesirable thought, the more it will come up! Some folks incorrectly think of mindfulness as a fad — in reality, mindfulness is an innate capacity of mind that we all have to one degree or another. 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