About a year ago, a man named Steve from Pittsburgh, PA, started responding to comments on my blog, especially on the topic of intrusive thoughts and sexuality spikes: What if I’m not the sexual orientation that I think I am? How do I know? What if this means I have to leave my partner? This is now known as SO-OCD – sexual orientation OCD – in the mainstream psychology community. His comments were so full of wisdom and support that I felt inspired to reach out and ask if he would be willing to share his journey of recovery from this most debilitating intrusive thought with my community. Gratefully, he agreed. As you’ll read, he poignantly describes the mental torture of being caught in this spike, and also shares what helped him find his way through. There is so much gold in this essay. If you struggle with SO-OCD – or any intrusive thoughts – please read this slowly and carefully. And Steve: thank you for bravely sharing your story. I have no doubt that it will serve as a lifeline for anyone who struggles with this theme.
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Obsessive Thinking around Sexual Themes
It was early December 2019. My wife and I were on the roof of our house, hanging Christmas lights as we started decorating for the holiday season – a season which we both thoroughly enjoy. As I moved from the front of our house to the back, where the roof is much higher from the ground, I thought to myself: “If I fell off the roof onto my head, maybe my memory would erase, and I could start over and forget about all the fear I now have about HOCD and ROCD and everything in between”. The logical side of my brain tried to chime in – “well you’d lose all the good memories you have and would need to learn everything all over again”. The reply – “yeah but it would be worth it to stop all this noise and 24×7 buzzing”.
At this point, at 41 years old, I was one year into my journey with OCD. The main “theme” that “introduced” me to the world of OCD, was SO-OCD – or sexual orientation OCD, otherwise referred to as HOCD (homosexual OCD – i.e. fear that you have turned gay or were gay and never knew). Throughout this year, I had bounced between SO-OCD, ROCD and Harm OCD. The irony is that while experiencing each “theme”, I would wish for the prior theme to return, because the “new” one felt worse at the time. The truth is that the themes never mattered; it was the fear I was associating with the thoughts and feelings that caused so much distress. The fear of what consequences would prevail should this noise my brain was throwing up have any actual relevance.
The “buzzing”, as I refer to it, is like a constant state of anxious energy. It feels like your mind and body are basically in a constant state of alertness, a constant state of vibration, which prevented me from the huge spikes of panic. My theory here is that I was in such a state of de-realization and de-personalization, and apathy, that there was no room for flight or fight. It was just constant compulsive protection from my mind. While that may sound nice, it also prevented the parasympathetic, or “rest and digest” response – meaning my mind and body were never “spiking” because they were never relaxed. They were in a constant state of anxious awareness. Constant state of monitoring. Constant fear. Why was this? Why did intrusive thoughts regarding sexuality cause so much distress? Why couldn’t I let this go and trust myself?
OCD with sexual themes is much different than experiencing a shift in your desire or orientation. It typically will strike “out of nowhere”, and suddenly you begin doubting something about yourself you had never given second thought to. It doesn’t just come in as “what if I’m gay” (although it may start with that). It comes in with statements – “oh look at him, he’s attractive, yep you’re gay”. It comes in with memory challenges – “did something happen to me as a kid, did I miss something?” It comes with dreams and images, scenarios, word-associations. Anything and everything you can imagine AND all the feelings that come with it are not pleasant – fear, shame, terror, guilt.
When this happens, and why it’s so powerful, is that it doesn’t just stop at the sexual stuff; you start to wonder who you truly are. You question your entire identity, your likes and dislikes, your personality, your humor and character. You start to fear yourself, your mind, your body. Confidence all but disappears, and the doubt grows and perpetuates into your entire life. Even if you are functioning, which I was, I was not fully living. I have this visual to describe this year of my life: I picture my body on the surface of the earth, above ground. I’m walking, you can see me, I can see the physical presence of people, trees and buildings. I can speak, and hear, I can smell and taste. But I am not fully there. My mind and soul are buried, beneath the surface, under the dirt, branches and rocks of intrusive thoughts and feared emotions that feel too sharp to climb onto and above. The buried me is screaming: “I’m down here, can anyone hear me, see me?” But they cannot, as I cannot even see myself. I’m only presenting the world the shell of my body that is barely hanging together.
While I never really felt an actual urge to leap off my roof that December, I was fortunate enough to find a percentage of space in my mind to gain some awareness through the weeds of hopelessness and apathy. I realized that despite thoughts of escaping my tortured mind, I wanted to live. I wanted to move ahead, and I decided then to commit to working on my mental health. I had started true OCD treatment in November, but it wasn’t until that December that I truly committed to working to understand OCD and how to navigate it, and my mental health. I dropped the resistance, dropped the need for a quick fix, and allowed myself to absorb therapy and perspectives. In a sense, I gave myself permission to move forward, and this permission was a huge turning point.
My therapy followed a traditional OCD approach: CBT tactics to work with intrusive thoughts and learning about thought patterns, thinking, and how OCD works, mixed with ERP. Now I could list out all the exercises I did with ERP, but I’m going to refrain from doing that. Why? Because even during my therapy, I chased ERP. And chasing anything, sadly, is a compulsion. It’s a way of trying to institute control, to achieve a feeling. I not only was doing the ERP with the therapist and the homework assigned, but I was also researching other exercises I could do. I became obsessed with OCD itself and how to beat it.
Not only was I compulsively researching ERP, but I was also investigating any modality that claimed to have success. I read that ACT was super beneficial, so started compulsively watching you tube videos on ACT while still chasing exposures as well. I started finding all sorts of acronym-based techniques and was bouncing back and forth between all of them. I was questioning acceptance, after all, what was it I was trying to accept? Worst-case scenario: how the heck does someone accept that? While I was making some progress on the theme of SO-OCD, the progress was disguised by the fact that my obsessive mind found something else to become compulsive about. Some folks call it “meta-OCD”, or OCD about OCD. I like to refrain from labels here, as quite frankly that’s part of why I was in this mess to begin with. What was happening was that I was not paying enough attention to my behaviors, and I was just soaking in content from the shiny screen of my phone or laptop, thinking it was the key information I needed to magically get rid of this whole OCD thing once and for all.
Now, not all research is negative. The fact that we live in an era where information is abundant can be a good thing, and a helpful thing. But we must proceed with caution. Not everything we read on the internet is true, and while something may help someone, it doesn’t mean it applies to you. ERP should not be wrapped in a box and produced in mass quantities that you can then purchase at your local department store and just open and go. It needs to be effective. Just copying another individuals’ exposures is likely going to result in frustrations. For example, if you’re a heterosexual with SO-OCD, you may read that going to a gay bar is a “good exposure”. If the point of this exposure is to spike up your anxiety so that you can sit with it and habituate to it, what happens if the anxiety never spikes? What if going to that bar doesn’t really strike into a core fear? Further, say you do have anxiety going into this bar and you eventually habituate to it. Are you ever going back there? Was there value in habituating yourself to entering a gay bar?
I understand that’s not the point of exposure, but from my perspective, if exposure is not targeted at allowing you to return to activities that you are either avoiding or white-knuckling your way through, then what’s the purpose? What are you learning? For me, I learned that most targeted exposures didn’t really ramp up fear and emotions as much as my imagination and mind did. So, for me, the greatest exposure was my own thoughts, and learning how to create space between a thought that occurs to me, and compulsive thinking, was crucial to improving my overall mental health. Learning that I cannot control a thought, but I can control my thinking – that I have a choice in what I focus my attention on – allowed me to alter my entire perspective on what was happening. Slowly, I gained more confidence in my mindset, my confidence in my ability to notice what was happening up there, and more confidence to break the obsessive thinking that I feel is the deepest behavioral habit those with OCD of any theme need to work on.
Throughout my compulsive research, I really struggled with the concept of acceptance. I read so many stories that said, “just accept you could be gay”, or “just accept you could be a pedophile”, or “just accept your partner may not be right for you”, or “just accept that technically you could someday stab your child in the face with a knife”. It was pitched as pure gold – just do this and you will have peace of mind. You will be free from worry and the world will be sunshine and rainbows and unicorns. I kept trying to accept things. I was working through worst-case scenario’s saying, “Ok, I accept this, even if it happens, I will be ok”. Essentially, I was compulsively trying to reassure myself that certain horrible things wouldn’t be so bad. It was like a backwards way of trying to neutralize the thoughts and feelings. What I eventually had to learn was that acceptance is not an action. You cannot force yourself to just accept something. You cannot “work” on acceptance by ruminating about it.
To me, acceptance is no longer fighting with your thoughts and fears. It means when your mind is wanting you to make sure you’re attracted to that person you always have been, and continue to want to be attracted to, you can feel that pull to be compulsive, that urge, and say “I don’t have to prove this to myself anymore”. When you’re watching TV and you see a sexual scene or there’s an attractive person on there, and your OCD is urging you to check for arousal, you let that go. Let the arousal happen on its own. When you’re with your partner, and this can be excessively challenging, the same thing applies. Get out of your head. Focus on them. You will feel the pull to check, to think, to analyze. Bring the focus back to your partner, the TV show, the person you are speaking with. Practice the power of AND. I can have these thoughts AND be intimate with my partner. I can have these thoughts AND bathe my young child. I can have this anxiety, fear, shame and guilt AND go out to dinner for Valentine’s day with my spouse or partner. I have OCD, I’m struggling, AND it’s a beautiful day.
With it being 2024, I am now 5 years past the initial hurricane of intrusive thoughts, OCD and anxiety. I continue to have ups and downs. Is that because I am not “recovered”? Is that because I failed in my healing? No. It is because I am human and learning how to be human takes time and patience. It takes an openness to see where you might be practicing unhealthy mental habits, even in areas that do not cause you distress. I’ve been able to see how quickly my mind can go into rumination about any topic. How I aim to avoid discomfort at any costs, and how that cleverly overlaps with how my mind falls into compulsive activity around sexual thoughts as well. So, when I’m doing that obsessive thinking on any topic, I’m practicing it. Which makes it much easier to fall into when intrusive thoughts come knocking. I’m continuing to uncover fears that exist below the surface of the thoughts, and tie in things that I never “associated” with OCD to follow the same core fear. I’ve found that shame around masculinity has been a major topic for me. And changing my beliefs on what masculinity is NOT, and beliefs about my own perceptions of myself, has helped take the weight off that mental topic and provided more natural acceptance of my strengths and flaws.
If you find yourself in a spiral of obsessive thinking around sexuality, or other themes that can often coincide, take a breath and slow down. Work on not chasing answers. Identify what safety behaviors you are doing, especially up in your head. If possible, work with a therapist, but do not look for a set length of time you would spend there. Avoid putting a time frame on it (“oh we typically have people come to us for 6 months, or 12 visits”). If you cannot work with a therapist, be careful what you find online. Look for reputable places where certified specialists are contributing to the content. If someone is saying they alone have the “key” to OCD or anxiety, I suggest you disengage because there is no key. You must find your way. A good therapist will help, but ultimately you hold any “key” that could exist. Someone may show you the door, but you have to unlock it and walk through.
