Question abut HOCD and exposure therapy

[Guest jqm1445]

am a recovering porn addict. I have been 65 days clean of porn. I did NOT escalate into gay porn so I have never watched it before. Do you think I can use exposure therapy, meaning watching gay porn, looking at pictures of men, gay men, reading coming out stories, listening to voice recordings of me admitting to myself I am gay, etc. to overcome HOCD. I have been to a ocd specialist and this is what we did but I was never consistent with the homework and wound up not being able to afford the sessions anymore so I left. My feeling is is that watching gay porn every day while RESISTING mental compulsions (reassuring myself I am not gay) will help me to become bored with this fear and it will no longer cause anxiety and lessen the amount of thoughts. That's how exposure therapy is suppose to work. Lastly, has anybody done exposure therapy and seen results or improvement?

[Sodovka]

Hi jqm1445, that sounds reasonable enough to me. I've struggled with designing my own exposures (for harm thoughts) but if you can increase your anxiety without doing any compulsions, you are doing the exposure correctly and should eventually become bored by (i.e. habituated to) your obsession. Sometimes just imagining the feared thing (telling yourself that you are gay without any reassurance, for example) might even work better. But if you can't see a therapist, then experimenting with different exposures is wise. Good luck!

[PolarBear]

Jqm, you have a complex problem. On one hand you are having sexually intrusive thoughts related to orientation and on the other you have an addiction to pornography. I'm not sure if mixing the two would be the right thing to do. We're not therapists and your problem is more complex than just OCD.

What is the nature of your OCD? How do the obsessions manifest with you? What types of obsessions do you get?

Edited August 30, 2015 by PolarBear

[Guest jqm1445]

Well my addiction to porn really started to show when I turned 19. As a young boy I started watching porn at 12 years old. Always straight porn. From the age of 12-19 when I started to meet girls I must have made out with over 50 girls and have had sex with 14. I went to an all guys high school from 14-18 and never once experienced a question doubting my sexusl orientation. Never onced thought twice about another classmate. I even showered with them and never once had a gay thought. I am 21 now. At 19 I started noticing I was experiencing weaker and weaker erections when watching porn and even with girls. I didn't know what was going on with me. At that age I was watching porn and I started noticing the guy more and a thought in my head popped up, "how would it feel to be the girl"? Ever since that moment I have started having gay intrusive thoughts. My self esteem took a plummet. I stopped wanting to go out and socialize.

I then got a girlfriend a few months after this happened, wound up falling in love with this beautiful girl and we were with each other for what years. Throughout our relationship I consistently struggled with erections, although at times better then others. The thing was I had to remember porn scenes or watch porn earlier in the day before we had sex to get in the mood. I never linked the fact that I had wired my arousal to be more turned on by porn than real life women. Throughout this relationship I still had HOCD and struggled everyday. Still ifound my self in love with this girl and she loved me. We recently broke up about 4 months ago and she has moved on very fast into another relationship. We were each other first loves and it has been very hard on me to see her with someone else. She dumped me because of my addiction to porn. She felt as if it was cheating.

Fast forward to today. I still suffer from hocd. My obsessions include

Constant images of me being penetrated by another man

Constant images of a penis and me performing oral sex on another man

Fear that I will eventually have to come out of the closet and admit to people I'm gay

Constant paranoia that people perceive me as gay

Constant paranoia that I have a "gay faces and feminine facial features and that my hands are small (men are suppose to have big hands)

The fact that the more older brothers a man has the more likely he is gay (I have two older brothers)

The fact that I am more emotional and cry more easily then other men

The idea that I don't meet the stereotypical masculine strong man that society expects men to be

I went to a therapist that specialized in ocd about a year ago. We went through exposure therapy but unfortunately I wasn't good with keeping up with homework and refused medication because I had a girlfriend at the time and didn't want it to impact my sex drive and erections. A lot of his exposure assignments I still remember but I don't know if I should use gay porn to expose myself the gay imagery that intrudes my mind every day. HOCD has held me back from so much in life. It has made every day a living hell. I have had a hard time looking men in the face. I don't want to go out and socialize anymore. I have no sex drive towards women. The fact that my ex dumped me and has moved on and I am still stuck on her and have no motivation to move on with my life really sucks too. I don't want to put myself back on the dating field because I have these thoughts. And also because I fear I won't be able to get an erection like I use too with women

[Sodovka]

I'm so sorry for what you've been going through. I think PolarBear is right that the porn addiction complicates things but perhaps you don't have to push things in that direction. You laid out a good hierarchy of obsessions in your previous post. Could you start to work up that from easiest to hardest? The key will be repeatedly exposing yourself to your feared situations without engaging in any compulsions. I would recommend imaginal exposures for most of them. Playing out feared scenes in my head has worked well for me at times. Good luck.

[PolarBear]

Well your idea that the more older brothers one has the higher the likelihood you're gay sounds like Internet hogwash, much like the gay finger ratio I've heard about.

You do have a complex situation. It's possible that your porn addiction caused you problems in the libido department. Although it is fairly normal for people with sexual orientation obsessions to feel aroused by the same sex (or the different sex if you identify as gay.)

Your feelimgs that you are not as masculine as other men is a red herring because there are some awfully masculine gay men out there.

So, what do you do? Given your addiction I think watching gay porn may be the wrong move at this time. Ideally you'd talk to a therapist, who is well versed in OCD, about this.

I would meet the thoughts half way. When you get an image of you having gay sex I'd say, yup I might be gay. If the thought pops up that someone thinks you're gay I'd say, yup he might think I'm gay.

I would urge you not to Google about being gay or searching about feminine looking men or anything like that. That would be a compulsion and you don't want to go there. In fact do no searching at all about being gay or the difference between gay and straight men.

[Guest doris]

Hi Jqm.

Yes I think I would stay away from using porn in your exposure theapy, given your history with addiction there. I think there would be lots of exposures you could do without using porn. You seem to have a good handle on how exposure works--have you ever tried imaginal exposure? This is where you describe scenes you fear in detail either in writing or on tape and read and/or listen to these scenes over and over during your session. if the exposure works you should be seeing your anxiety going up initially as you confront your fears and then your anxiety should decline by the end of the session.

I also think the examples for exposures you listed in your first post all sound good except for using porn:

'looking at pictures of men, gay men, reading coming out stories, listening to voice recordings of me admitting to myself I am gay, etc. to overcome HOCD'

regarding your other question--yes I've used exposure therapy along with other cbt techniques and it worked well. my obsession are contamination and fear of causing harm.

[Guest jqm1445]

Thank you all that responded. What's crazy is since quitting porn I have had strings of days where my HOCD seems almost to be non existent. I have almost no gay thoughts and when I do they don't bother me or cause an anxiety response. And my attraction and sex drive comes roaring back. But these days come only 3 or 4 at a time and then I find myself obsessing and having an anxiety response to them again. But when I am free from them or the anxiety response is non existent I feel like my old self again and I feel so much happier to be alive. If I can only feel like this more of the time. I know in order to conquer my fear I must face it and not care about any anxiety response my body gives me. Does anybody have any other good exposure suggestions for HOCD? And how long should I do each exposure exercise for each day ?

[snowbear]

Hi jqm,

I agree with Polar Bear that you probably have two separate conditions: an addiction to porn, and intrusive thoughts related to sexual orientation. Although there is a common theme (sex) they are very different things and trying to use one in an attempt to treat the other is unlikely to be helpful.

Looking at porn pictures - whether gay or straight - isn't 'exposure' for you, it's feeding your sex addiction. The only difference between looking at gay pictures and watching filmed straight porn is you're telling yourself it's therapy and it's acceptable because it's 'not your thing'. Perhaps because you're less excited in response to gay porn than straight porn there's less guilt about doing it, but it's still keeping your brain thinking 'sex' and that's not good for a sex addict.You can't overcome an addiction by being exposed to a side-kick of the thing you're addicted to. That's like suggesting we can cure heroin addiction by hooking the addict on cocaine instead.

I'm confused about repeated exposure of voice recordings 'admitting' your gay. Perhaps I've misunderstood, but it seems to me you're saying you're basically straight with obsessive fears about being gay. Transient bisexual feelings or thoughts are normal for any straight person and it's quite different to being gay (which is determined by your genes), so how does telling yourself you are something you're not help? If you are gay and are trying to come to terms with it, then such recordings could indeed be useful, but repeating a lie to trick your brain into not worrying about something you fear might be true but isn't strikes me as a convoluted way of confusing your subconscious further. Perhaps you would find it useful to talk to a therapist about your sexual ideas generally. What's so bad about being gay? What are the consequences being gay would have on your life that it generates fear in you? In other words, don't try to reduce the fear by guiltily 'admitting' it, face it head on and ask where it comes from. Challenge the thought processes that generate the fear in the first place.

The reduced erections during your relationship were most likely related to general anxiety and nothing to do with your sexual orientation. Libido reduces markedly when under stress, and the stress of worrying about how gay-ness and previous use of porn might impact on your relationship would easily account for such physical symptoms. We tend to look for causes and seek out links between what's happening to us and our thoughts or fears, but it can be misleading.

I'm not an expert on HOCD so I won't even attempt to suggest alternative exposures, but please do seek professional advice. Treating yourself in this way may be sending you round in circles rather than helping.

Edited August 30, 2015 by snowbear

[Guest jqm1445]

The thing i I would have no problem with being gay if it caused me feelings of well being and was something I enjoyed. I see nothing wrong with gay people or being of a homosexual orientation. It's not that that I fear, it's more of unwanted intrusive gay sexual images that play over and over in my mind. Images such as another man's penis penetrating me or me giving a man a blow job constantly aytvk my mind. If these thoughts aroused me and I enjoyed them I wouldn't have a problem but they don't. All they do is cause me anxiety. But then the thing is the anxiety almost feels like arousal sometimes especially when I try to fight the image or thought off. I then experience increased blood flow to my penis and almost like a half erection. From what I have read is that anxiety and arousal can feel the same and both cause an increase in blood flow. I then take notice of this blood flow to my penis and then panic even more because it feels like arousal and the cycle continues. I just don't know exactly how to deal with these thoughts. Do I let them just be there and try not to focus on them? I fear this leads to suppression which only feeds and gives fuel to the thoughts even more.

[Guest jqm1445]

I know I am not gay because I have no innate desire to do anything with a man. I would never go out and look for a guy to hook up with. It just doesn't appeal to me. I also can't imagine having an emotional connection with another man. Like calling him baby or cuddling with a guy. It just doesn't feel "right". With a girl like my previous girlfriend all those things felt "right". I felt comfortable and loved sleeping next to her. I have also had sex with a dozen girls and enjoyed it. Like I said I have nothing against being gay and I am all for gay rights. I just have uncontrollable intrusive thoughts of gay sexual acts and male body parts.

[snowbear]

jcm,

If you're not gay, don't 'expose' yourself to tapes telling you that you are. All that does is keep your brain focused on sex which, for someone addicted to porn, isn't helpful. Doesn't matter if it's gay sex, straight sex or a mix of the two. It's all sex-related. Gay images may not arouse you directly, but your brain will be activated in the region that enjoys sex when you look at any sexual images or hear sex related words.

As for the gay images that intrude on your mind, you need to learn how to let such images come and go without giving them significance. Worrying about the content automatically gives them a significance they don't deserve.

At risk of getting too scientific, let me explain. When exposed to any topic, the subconscious mind routinely explores all possibilities and suggests them to the conscious mind. The conscious mind instantly dismisses any possibilities it doesn't like. In a normal person this happens so quickly they'd find it difficult to recall the unwanted images as ever being present as the unlikely scenarios barely register with the conscious mind at all. But an OCD brain focuses in specifically on the possibilities it doesn't like and stays with them, continually checking for threats or reassurance. It focuses on the images until they feel like real possibilities, instead of momentary fragments of explorative mental creativity which are of no importance.

We can learn to ignore them. I get equally horrid sexual images in my thoughts from time to time. But now I understand the mechanism behind how anything I find so disgusting could be in my brain in the first place, I shrug them off and don't waste time thinking about them. So what if my mind created something horrid for an instant? It was only throwing random ideas together in an effort to be creative, to be an efficient problem solver - the subconscious mind doing exactly what it was designed to do by evolution. The days of worrying for hours that such sexual images in my thoughts made me a disgusting person are gone. I still get the images from time to time (often when I'm stressing about something completely unrelated to sex), but because I know they aren't significant I can ignore them (exactly like a normal person does) and they vanish within moments and are forgotten. The fact they are about penis choking me etc is irrelevant. Could as easily be a fork poking me in the eye. It's just the subconscious mind saying it's being prodded by way of a metaphor.

Edited August 30, 2015 by snowbear

[Guest jqm1445]

So are you saying this is OCD or not? I don't know if I should use exposure therapy or work on just letting the thoughts be there without trying to mentally reassure myself I am not gay. So you would not recommend exposure therapy?

[snowbear]

Yes, it's OCD.

Letting the thoughts be there without reassuring yourself about them is a form of exposure, and retraining your mind not to respond the way it has in the past is good therapy whatever terms you use to describe or define it.

[BeardGuy]

Here are some articles on the topic from a recent forum post that are worth reading:

http://www.ocdforums.org/index.php?showtopic=48263&p=410217

One of those articles (I can't remember which) reccomended the tape thing jqm is talking about. So that is where he is getting the idea, snowbear. I'm sot sure what the best general advice is currently, my therapist didn't suggest the tapes, and he told me to stop looking at porn because I do it obsessively (I am sort of failing here). Really, the best thing to do is try and get back to therapy. I am taking sertraline and it does do something, it is worth trying if you are having troubles.