Scary Thoughts as Costumes: The Illusion of Danger

Posted by Steven J. Seay, Ph.D. in Obsessive-compulsive disorder (OCD) It’s nearly Halloween, and kids around the country are digging through dusty closets and plundering the aisles of local Halloween shops in search of the perfect costume. Halloween is the one night of the year when we give ourselves permission to be silly, scary, or fantastical. We can act a little weird, and nobody will disapprove. On Halloween, it’s normal to see the ghastly holding hands with the divine; fairy princesses walk amongst zombies, lions, and super heroes. There is something thrilling about handing over the reins to your imagination…even if it’s only for a single night. But what would happen if the masks got stuck? What if every goblin remained a goblin and every ghost remained a ghost? The children underneath the make-up would still be our children, but their appearance would remain altered. How would we feel then? At first, it would be scary to inhabit a world populated by monsters. We would be angry. We would be confused. However, eventually we would learn to distrust our senses in the knowledge that beneath every scary facade is simply a child. Despite appearances, there is no danger here. We might wish that things could go back to the way they used to be, but eventually we would accept this new world as our reality. Sometimes our thoughts like to play dress-up, too. Scary, unwanted thoughts can masquerade as truths. Possibilities can take on the form of probabilities. Although these thoughts may have the appearance of danger, their form is intended to deceive. The semblance of danger is not danger. In the real world on Halloween night, beneath every sheet, mask, or painted face is a smile. Beneath every scary thought is simply a person. *     *     *Read more about OCD and unwanted thoughts,be it in the context of sexual thoughts, violent thoughts, or religious...
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Postpartum OCD – Fear of Harming Your Baby

Posted by Steven J. Seay, Ph.D. in Obsessive-compulsive disorder (OCD) Parents brace themselves for many changes when a new baby comes home. As new routines replace old, life quickly becomes a confusing jumble of cherished memories, bottles, and dirty diapers. Parenting can be joyful, but it can also be terrifying. Parenting comes with many important responsibilities, and it can be intimidating–if not downright frightening–to be responsible for protecting and caring for a vulnerable new life. What is Postpartum OCD (ppOCD)? For some parents (mothers and fathers alike), new parenthood may spark postpartum obsessive-compulsive disorder (OCD), a surprisingly common anxiety disorder that is associated with violent and disturbing thoughts, images, or urges (Fairbrother & Abramowitz, 2007). Symptoms may begin suddenly after the new baby arrives home, or pre-existing OCD symptoms may be exacerbated by new parental responsibilities. Postpartum OCD symptoms can involve virtually any type of OCD symptom, but harm obsessions and sexual obsessions are especially common. Harm obsessions may include fears of accidental harm or intentional harm coming to the infant. Postpartum OCD – Unwanted Violent Thoughts Consider the mother of a colicky young infant who, frustrated by her baby’s crying, has a mental image of herself throwing her baby down the stairs. This thought occurs unexpectedly and feels dangerous, and the woman becomes extremely upset by this thought. This mother might think: “Why am I having this thought? Does this mean I might harm my baby? What if I lose control and throw my baby down the stairs? Mothers shouldn’t have thoughts like this.” In response to these thoughts, the mother may avoid going near staircases while holding her infant or may hold her baby extra tightly whenever she is near the stairs. She may become especially fearful of caring for her baby whenever it is crying, for fear that she might do something impulsive or dangerous. If certain parenting activities feel especially risky, these responsibilities may be delegated to other caregivers. Postpartum OCD – Unwanted Thoughts About Danger or Accidents Another common type of postpartum OCD symptom is the recurrent, intrusive fear that something bad has happened to the baby. For example, a parent might experience recurrent thoughts or intrusive images of their baby choking or suffocating in their crib. This parent might think: “It’s my responsibility to prevent any harm from coming to my child. If I have a dangerous thought, it’s important that I check every time just to make sure my baby’s okay. After all,...
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HOCD: Homosexual OCD & Sexual Orientation OCD

Posted by Steven J. Seay, Ph.D. in Obsessive-compulsive disorder (OCD) Fear of Being Gay (Homosexual OCD / HOCD) Emerging sexuality can be confusing for any teen or young adult, and gay teens face a variety of unique challenges over the course of adolescence. In addition to learning to understand their own sexuality, gay teens must navigate complex situations and pressures that may not be relevant for straight teens. They must also deal with opinionated parents, friends, and others who sometimes hold differing views about sexuality. Anxiety, distress, and confusion are often part of this process. This post is not about the anxiety associated with being gay or with “coming out” but instead discusses homosexual OCD (“HOCD”), an anxiety disorder that affects a small number of individuals. HOCD is not unique to teens but can occur at any age. What is HOCD? Homosexual OCD (“HOCD”) is a specific subtype of obsessive-compulsive disorder (OCD) that involves recurrent sexual obsessions and intrusive doubts about one’s sexual orientation. Straight individuals with homosexual OCD experience obsessive fears about the possibility of being gay. Their HOCD obsessions often consist of unwanted thoughts, impulses, or images that uncontrollably pop into consciousness. To reduce the anxiety brought on by their obsessions, individuals with HOCD engage in a variety of rituals that focus on “proving their true sexuality” or reducing their perceived “vulnerability” to becoming gay. Sexual obsessions can also affect gay men, lesbians, or bisexual individuals with OCD, who may become fearful about the possibility of becoming straight (“Straight OCD”). The common element that unites these seemingly opposite sexual obsessions is the fear of being attracted to something unwanted, taboo, or “unacceptable” based on one’s particular worldview. For the sake of simplicity, I’ll be using HOCD-centric language in this post. However, the same basic elements are directly applicable to all people with obsessive doubts about their sexual orientation. People with HOCD worry that they might secretly be gay or might become gay, despite not questioning their sexuality in the past. Prior to the onset of HOCD, they might have had few doubts about their sexual orientation. Many people with homosexual OCD also have a history of having enjoyed heterosexual relationships in the past.  It was only after the first unwanted thought “popped” that they became overly concerned about the prospect of being gay. The occurrence of this unwanted thought then causes them to question their sexual identity and reanalyze previous experiences, in light of the possibility that...
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Sexual Obsessions in OCD (Obsessive-Compulsive Disorder)

Posted by Steven J. Seay, Ph.D. in Obsessive-compulsive disorder (OCD) Sexual obsessions in OCD are recurrent unwanted sexual thoughts, such as the fear of being attracted to something unwanted, taboo, or morally “unacceptable” based on one’s particular worldview.  Although all forms of OCD can be debilitating, sexual obsessions can be especially confusing and disabling for sufferers because sexual obsessions target one’s fundamental identity as a social being. In addition to anxiety, which characterizes most obsessions, individuals with sexual obsessions often experience extreme guilt, shame, hopelessness, and depression.  Individuals with OCD with sexual symptoms often mistakenly consider themselves deviant, disgusting, or evil. Moreover, incorrect assumptions about the true causes of their unwanted sexual thoughts make them less likely to seek treatment or to share their symptoms with others.  In my Palm Beach County, South Florida psychological practice, I treat many individuals who have lived with sexual obsessions for many years before seeking treatment. Sexual obsessions often leave one feeling isolated and alone.  Moreover, in efforts to avoid symptom triggers, people with unwanted sexual thoughts often drop out of school, quit their jobs, end relationships, or make other life-altering decisions that paradoxically make their symptoms worse. What are Sexual Obsessions? Sexual obsessions in OCD can take many forms. Most sexual obsessions involve unwanted thoughts, ideas, impulses, or images focusing on sexual content.  Some individuals with sexual obsessions are bombarded by unwanted urges to act in a sexual way toward children, animals, or other populations.  They might experience intrusive images of sexual organs, envision themselves performing unwanted sexual acts, or have persistent doubts about their own sexual identity. They experience repetitive thoughts like: What if I’m attracted to that person? What if I lose control and act out sexually? What if I expose my genitals to that person? What if I secretly want to have sex with that person? Sexual obsessions often involve the fear of secretly being gay (if one is actually straight), being sexually attracted to children (fear of pedophilia), being sexually attracted to animals (fear of bestiality), or being sexually attracted to dead things (fear of necrophilia).  In fact, the variety and forms that unwanted sexual thoughts can take are limited only by the breadth of the human imagination. Societal and personal beliefs about these topics often lead to extreme distress whenever these obsessions occur.   Here are some common sexual obsessions / thoughts. Types of OCD Sexual Obsessions / Thoughts Fear of being a pedophile or becoming a pedophile. (parents often...
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