In a post entitled, “The Architecture of Anxiety and Intrusive Thoughts“, I wrote:

Many of my clients suffer from the hell-realm of intrusive or unwanted thoughts. Thoughts like, “What if I’m a pedophile?” or “What if I’m a mass murderer?” or “What if I contract a deadly disease?” or “What if I don’t love my partner enough (or at all)?” parade through their minds day and night without reprieve creating a state of perpetual misery. The irony about people who are prone to intrusive thoughts such as these is that they’re among the most gentle, loving, sensitive, kind, creative, and thoughtful people you’ll ever meet. The thought is so far from reality that it’s almost laughable, except that it’s not funny at all because my clients believe the lie which, of course, creates massive amount of anxiety.

I neglected to include one of the most pervasive thoughts that plagues the anxious mind: “What if I’m gay?” When a client first shared this thought with me several years ago, I thought she was an anomaly. I worked with her the same way that I work with all intrusive thoughts – understanding that it’s a flare sent from the inner self designed to get your attention and then unpacking the feelings and beliefs that the thought is covering up – but it was only when I started hearing the same thought from other clients and courageous forum members that I understood how many people perseverate on this question.

What separates this thought from the other common intrusive thoughts is that there is, in fact, an element of truth to it. If you’ve studied human sexuality or examined your own with an observing and non-judgmental eye, you know that sexual orientation exists on a spectrum with most people having some bisexual tendencies. In our ego’s desire to delineate life into nice, neat, manageable packages, we like to say that people are either this or that: either black or white; either Democrat or Republican, either gay or straight. We don’t like shades of gray. We’re uncomfortable with ambiguity. So when it comes to sexuality, most people cringe to think that their own orientation cannot be folded inside a tightly locked box.

But sexuality is just that: it’s an orientation. Most people are oriented toward preferring one sex over the other. But many heterosexual people – more than you would ever guess – have experimented sexually with the same sex or fantasize about the same sex. And if there’s shame about this, if you don’t know that experimenting with or fantasizing about the same sex doesn’t mean that you’re secretly gay but is a normal part of healthy sexuality, the natural impulses are pushed underground where they mingle with shame and emerge, sometimes years later, as anxiety.

Love is a Choice and There Are No Guarantees

The “Am I gay?” question points to two of the most challenging concepts for the anxious mind to accept: that love is a choice and that there are no guarantees or certainties regarding the outcome of this choice.

Our culture certainly doesn’t help us accept the reality that love is choice. As I’ve written about extensively, we live in a romance-addicted culture and we’ve all, from the time we’re old enough to absorb information, been steeped in the fantasy that love is a feeling and when you meet The One, you’ll know it and be swept off into the landscape of happily ever after. (Buzzwords in italics.) So it’s often a long, hard road to recondition the mind toward the truth, and when the anxious thought of “What if I’m gay?” infiltrates into consciousness, it preys on an already faulty foundation and quickly develops into a mental earthquake of seismic proportions.

This leads to the second challenging concept to accept: in order to make the choice to be with one partner, those prone to anxiety believe that they need 100% certainty that they’re straight (or gay if the person is committing to a same-sex partnership). The anxious mind says, “How can I commit to my partner if I’m questioning my sexuality? That’s not fair to him (or her). What if, years down the road, I discover that I really am gay? Don’t I need to figure this out now so that I avoid the possibility of divorce?” And herein lies the underlying root that instigates the need for certainty: if you’re certain about your sexual orientation, then you can divorce-proof your marriage before it begins. So the fear of being gay is connected to the need for certainty, which is connected to the fear of loss and failure.

To address this second prong of the gay spike requires two parts: 1. Addressing the need for certainty and 2. Addressing the fear of loss or failure. Let’s take one at a time:

1. The Need For Certainty:

Dr. Steven Phillipson, Ph.D., the leading expert on R-OCD and H-OCD, writes clearly about treating the need for certainty in his article, “I Think It Moved: The understanding and treatment of the obsessional doubt related to sexual orientation and relationship substantiation“:

“Choices are encouraged which enable the “gay spiker” to allow for the constant reminder that they just do not have an answer to one of life’s most important questions. For those clients who are successfully treated with behavioral techniques related to this question, the best therapeutic answer that comes at the end of treatment is the ultimate acceptance of the uncertainty related to the genuineness of their sexual orientation. “I may be gay” is then the best response to the question.

“The concept of embracing a spike is paramount within this spike theme, as it is the case with all spike themes. Embracing a spike entails making an active choice to accept the uncertainty of the risk and tolerate the level of discomfort associated with the risk.”

Every client I’ve ever worked with has struggled with needing certainty before making the commitment of marriage. They ask questions like, “What if we get divorced? What if I cheat on him? What if she cheats on me?” These are unanswerable questions, and when the mind becomes stuck in the spin-cycle of trying to answer them, anxiety kicks in. If you’re stuck on, “What if I’m gay?”, the anxious mind truly believes that if you could answer this question with 100% certainty, you would be able to hedge your bets and offer yourself and your partner that you are, without a doubt, making a good choice is marrying him or her. But since the presenting question is unanswerable and the underlying questions are also unanswerable, you’re left with the highly uncomfortable challenge of learning to accept the uncertainty of taking the biggest risk of your life: namely, committing your heart and soul to one person for the rest of your life without any guarantee that it will work out. Which leads to the second strand of the second part:

2. The Fear of Loss or Failure

Another element in healing from this thought is to recognize that perseverating on this question is one of the wounded self’s best tactics for trying to convince you to run from your loving, stable, and terrifying relationship (terrifying because real love requires that you risk revealing your vulnerability and, thus, take the risk that you might lose yourself for your partner). Because if you’re gay and you’re planning to marry someone of the opposite sex, then clearly you’re making a mistake. (This line of thinking also applies to my gay clients who struggle with the converse thought, “What if I’m straight?”) So embedded in the the risk of uncertainty is the fear of loss or failure.

In my work with clients and ecourse members over the past 14 years, it’s become increasingly clear that the fear of loss lives in the very center of the intrusive thoughts. At  some point, when people remain committed to peeling away the surface layers of anxiety – the “what if” questions – they arrive at the raw, vulnerable core issues, and at the very center of these core issues lives the fear of loss. It’s not easy to get there and most people would rather remain stuck in the anxious mental loops than drop into that vulnerable heart-space where the awareness of the possibility of loss sits like a tender child, but it’s only when someone allows themselves to touch this place that the real healing can begin.

Treatment: Pulling the Thought Out By The Root

The traditional treatment of OCD-type thoughts follows two routes: Cognitive-Behavioral Therapy (CBT) and/or medication. While the success rate is high with CBT, I have also found that, unless the root cause of the thought is addressed, one healed thought will often give way to a new intrusive thought. It’s much like banging the gopher back into the hole only to find it pop out from another hole.

Our culture is passionate about addressing issues from the top layer and removing the symptom. We believe that if the symptom – i.e.. intrusive thoughts in this situation – is removed, then the problem is solved. It’s for this reason that many people opt to take medication as a way to “solve” the problem. While medication can certainly take the edge off the anxiety, it doesn’t address the root cause and, when it loses efficacy over time, it opens the doorway for another intrusive thought to enter.

I work a bit differently from the traditional treatment of ROCD or HOCD. I dig deeper into the roots of the intrusive thoughts and recognize them as a cover-up for deep wells of pain and false beliefs that need attention. They’re like flares that your inner self are sending up as a way to get your attention, but they’re not the truth. Working with the thoughts on the surface level may offer short-term relief but it doesn’t address them at the core, which requires pulling them out by the roots. This is challenging, painful work. It requires reversing the false beliefs that say, “I can’t handle my pain. If I feel my pain, I’ll never stop crying. If I feel my fear, I’ll go crazy.” While these beliefs may have been true as a young child when you didn’t have the support of a solid, loving parent to hold you as you cried, they’re no longer true as an adult. Feeling your pain is a necessary part of healing yourself from the inside out.

Addressing the root cause of OCD-type thoughts also requires developing a tolerance and acceptance of uncertainty. The wounded self is the part of us that believes it can control the outcome, which usually means trying to convince you to leave. Of course, no one can control the future, so while you have no guarantees about whether or not your relationship will last a lifetime, you can control if you stay or leave the relationship right now. Many people would rather leave a loving relationship than take the risk of uncertainty because leaving is a known variable, whereas staying pushes you into the realm of the unknown.

If you find yourself plagued with the thought, “What if I’m gay?” the first course of action is to develop a tolerance for the possibility that you may have gay or bisexual tendencies but that you’re choosing to be with the opposite sex. The next step is to recognize that attaching on to the thought is your fear/pain/uncertainty trying to protect you from the risk of opening your heart to love. You likely have an old belief that plays silently in your subconscious that says, “Love isn’t safe,” because perhaps what you knew of love as a child only felt like pain, betrayal, heartache, despair, and loneliness. The intrusive thoughts are designed to keep you safe, in a box, and protected from the risk of love. The work is about unearthing the old stories, bringing compassion to your scared self, allowing yourself to feel the old pain and sit with the current fear, developing a practice of letting go as an antidote to the wounded self that tirelessly tries to control, and finding the faith and courage to take the risk of opening your heart with your loving, present, available partner. Sound easy? It’s the work of a lifetime.

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