Archive for Obsessions
Orthorexia: Where Eating Disorders Meet OCD – Part 2
Effective Strategies and Predictable Complications in the Treatment of Orthorexia
In our previous article about Orthorexia, we described this relatively unknown and misunderstood condition. In this, the second and final installment in this series, we discuss strategies and pitfalls in the treatment of Orthorexia.
Orthorexia can be effectively treated with Cognitive Behavioral Therapy (CBT) and Mindfulness
Orthorexia, being a somewhat new conceptualization of a psychological disorder, is under-researched and often misunderstood within the mental health and medical communities. Many mental health professionals have found success treating individuals with Orthorexia using evidence-based treatment methods that are used to treat other Eating Disorders, OCD, and related OC Spectrum Disorders.
Cognitive-Behavioral Therapy (CBT) and Mindfulness are two highly effective treatment methods used to treat Orthorexia. Using CBT, individuals with Orthorexia learn to challenge and change their distorted thoughts (cognitions) related to their body and the foods they eat. Education about nutrition and what is considered “healthy” should also be integrated into CBT when treating Orthorexia, using logical, evidence-based strategies. › Continue reading
Casey Anthony, Reasonable Doubt, and OCD
The concept "reasonable doubt" may help some better understand OCD
When most people think of Obsessive Compulsive Disorder (OCD), they think of people excessively washing their hands or repeatedly checking their doors and windows to see if they are locked. But there are many variations of OCD, including a subtype in which people have intrusive, unwanted thoughts about harming spouses, friends, co-workers, strangers, or even their own children. Sometimes called “Harm OCD”, this condition falls under the category of what is commonly called Pure Obsessional OCD, or “Pure O”, because both the obsessions and the compulsions are primarily mental.
People with Harm OCD often perform mental checking rituals just as others with OCD might physically check their stove over and over again in an effort to feel sure that they haven’t accidentally left a burner on. They might repeatedly monitor and analyze their mental processes in an effort to convince themselves that they will not act on their unwanted thoughts, and that their intrinsic character or their love for the other person is strong enough to prevent them from doing some sort of harmful action. They may also repeatedly seek to determine whether they are a bad person for even dreaming up such a thought. And it is quite common for those with harming obsessions to repeatedly ask others for reassurance that they have not harmed someone or that they are not going to do so. But as anyone with Harm OCD knows, these efforts to gain certainty almost never provide the desired reassurance for the OCD sufferer, and the unwanted thoughts almost always increase in frequency and intensity. › Continue reading
Sexual Orientation OCD – Part 4: Challenges to Treatment of HOCD
Jon Hershfield, MA, of the OCD Center of Los Angeles discusses common challenges seen in the treatment of Sexual Orientation OCD, also known as HOCD or Gay OCD. Part four of a four-part series.
Sexual Orientation OCD - also known as HOCD or Gay OCD - is best treated with Cognitive Behavioral Therapy
In my previous blog on Sexual Orientation OCD (aka HOCD), I 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 I 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. › Continue reading
OCD and 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. › Continue reading
Sexual Orientation OCD: HOCD Sub-Types and Their Treatment
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 themselves being gay. This causes a lot of confusion and a lot of resistance to seeking treatment. › Continue reading
Body Dysmorphic Disorder (BDD) Research – Year in Review
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
Sexual Orientation OCD, aka HOCD / Gay OCD – Part 2
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
Treatment of OCD and OC Spectrum Disorders in Children
“If I knew then what I know now.”
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
Memory Hoarding in Obsessive Compulsive Disorder (OCD)
I was surprised to discover that Webster’s dictionary defines “hoard” as a kind of temporary fence put up around a structure being built, presumably with the intention of protecting it in a fragile state. Dictionary.com had a more familiar definition: “to accumulate for preservation, future use, etc., in a hidden or carefully guarded place.” Both definitions refer to the behavior of creating certainty around an uncertain state.
Squirrels hoard acorns to make sure they don’t starve during the winter. Armies hoard weapons to ensure they never run out. And some people with Obsessive Compulsive Disorder (OCD) hoard objects of uncertain value, usually with the belief that the object’s value may be revealed at an important point in the future. › Continue reading
I Have Bizarre Thoughts – Do I Have OCD?
I was leaving my house today to go on my morning walk and noticed that the front gate was open. As I passed through the gate, I had a thought that if I closed it, I would not return safely to my home. If I left the gate open, I would return safely. Prior to taking an important exam, it occurred to me that if I left the test registration in the car and folded it a certain way, it would mean that I would pass the test I was about to take. › Continue reading
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