What is HOCD?
Lately I have being talking to quite a few clients who have questions about an informal diagnosis called, HOCD or Homosexual Obsessive Compulsive Disorder. While HOCD is not a formal diagnosis, meaning it is not defined in a Psychiatric Manual known as the DSM IV, the term has been created to describe a type of OCD that is primarily related to fears of being homosexual. The clients that I speak with may or may not have a history of depression and/or anxiety; they are relatively young (teens to mid twenties, thirties) and many are in heterosexual relationships that they highly value. What all these clients have in common is the overwhelming fear that they may be homosexual. This fear often starts with a specific trigger or moment (such as transient thought, image or incident) that brings up a feeling of absolute insecurity, even panic. This intense emotion comes from the fear that in some way, some-how they may enjoy, want, or could possibly be aroused sexually by someone of the same sex. For clients with HOCD this thought is VERY scary and it creates an intense insecurity. Events or thoughts that bring up such intense anxiety are hard to forget because they can create intrusive obsessions and compulsions to control them Many studies link OCD to a chemical imbalance in the brain that makes it very difficult to control the thoughts we are having. Comparisons have been made to a sticky-gear shift in a car with manual transmission, in which the brain simply gets stuck on a thought and has incredible difficulty switching gears, or being reassured.
With HOCD the brain has a sticky gear-shift and it becomes very difficult for a person to reassure themselves and comfort themselves when they feel the doubts creep up or the thoughts fire rapidly in the their heads. Most interesting is that none of these clients have ever felt truly aroused by the images or thoughts they have. Instead they are afraid that they could be aroused. None of these thoughts or images create a feeling of pleasure, longing or enjoyment. Instead, the fear is that they could or will cause pleasure, longing or enjoyment. Whereas someone who is truly gay is physiologically aroused by someone of the same sex and feels a sexual urge to be with that person. Clients with HOCD in contrast, obsessively fear that they actually are aroused or could be aroused often with no physical or emotional signs of arousal other than the adrenalin rush of anxiety. So pervasive is this obsessive nature of these fears (hence the OCD component) that no matter how much they try to reassure themselves with logic and reason the doubt continues or even grows. Often clients will find themselves logically agreeing that are not gay only to have the doubt create another road-block or question to keep them in the same un-relenting cycle of doubt and fear. The suffering is intense and painful and clients feel desperate for help.
The real question with HOCD is not 'am I gay' because the mind has a very hard time holding on to any reassurance for very long with this disorder. The real question is what can I do when my OCD is triggered. This is something that can and will get better with treatment. HOCD can be worked through and there are tools to do so. It helps to have a qualified counselor guiding you, if can not afford to do so then I have a book recommendation which I will source in this article that discusses general treatment tools for OCD.
Lastly, the hardest part for many people with HOCD is the shame associated with this disorder. It can keep those who suffer from getting support from people who care about them. If you suffer from HOCD you are not alone, in fact I see clients suffering from this disorder quite frequently. I would be happy to speak with you online if you are looking for a counselor to talk with. In addition you can post on Supportgroups.com or look into the book: Brain Lock: A Four-Step Self Treatment Method to Change Your Brain Chemistry, by Jeffery M Schwartz.
Kellie Montgomery, LMFT