H-OCD /“Sexual Orientation OCD”
The Common Misdiagnosis of HOCD
Society’s misunderstanding of Obsessive Compulsive Disorder is profound. This is primarily due to the way OCD is portrayed in popular culture as the person who is quirky and extremely organized or as the person who washes his hands a lot. Yet Obsessive Compulsive Disorder (OCD) presents with many symptoms and obsessions can take on many themes. Obsessions consist of unwanted, intrusive thoughts, images, impulses or sensations. Compulsions can be overt such as washing, checking, or counting and they can also be covert, which means they cannot easily be seen and consist of primarily mental processes. OCD is both genetic and learned. Because OCD is such a complex disorder, it is not only misunderstood by the general public, it is also often misdiagnosed by physicians and psychotherapists. This is particularly true when the individual with OCD suffers from primary mental obsessions and compulsions, also (incorrectly) known as “Pure-O”. A common theme of “Pure-O” is SO-OCD or H-OCD, which is misdiagnosed a great deal of the time.
Obsessive concerns about one’s sexual orientation was once called H-OCD (homosexual OCD) as it referred to heterosexual individuals who experienced intrusive thoughts, urges or images about being bisexual or homosexual. However, more current research suggests that obsessive sexual orientation distresses are also present in individuals who identify as a part of the LGBTQ community and the term H-OCD was revised to be more inclusive, and therefore this particular theme of OCD is now called sexual orientation OCD or SO-OCD. Obsessive fears in SO-OCD include experiencing an unwanted change in one’s sexual orientation, fear that others may think that one is gay (or straight if one is gay) or a fear that one has suppressed homosexual desires (or heterosexual desires if one is gay). These sexual orientation obsessions are very distressing to the individuals experiencing them.
It is estimated that 30% of individuals with OCD suffer from sexual and/or religious obsessions. A 2015 study of 237 individuals with a prior OCD diagnosis reported very high levels of distress relating to sexual orientation obsessions with 51% reporting extreme distress and 21% reporting a suicidal level of distress. Research indicates that men are more likely to suffer from sexual orientation OCD, but women tend to report a higher level of distress. Many individuals who suffer from H-OCD come from religious, conservative backgrounds.
SO-OCD or H-OCD is often misunderstood by sufferers and it is very commonly misdiagnosed by professionals as a “sexual identity crisis”. A 2015 research study found that 50.5% of doctors misdiagnosed OCD in general and 84.6% of the time sexual orientation OCD was misdiagnosed. Another study found that psychologists and psychotherapists misdiagnosed OCD in general 30.9% of the time and 77% misdiagnosed sexual orientation OCD. Thus, actual statistics of individuals who suffer from SO-OCD (H-OCD) is probably greatly underestimated.
At GroundWork Counseling in Orlando our OCD therapists are highly trained, well qualified and experienced in the treatment of OCD and they are committed to using therapeutic techniques that have been proven to be effective for the treatment of OCD in controlled research studies. Cognitive Behavioral Therapy (CBT) with an emphasis on Exposure and Response Prevention (ERP) is widely regarded as the gold standard of treatment for OCD and this is the only form of psychotherapy that has been found in multiple controlled trials to be effective in treating OCD. It is important to note that generic “talk therapy” is not effective treatment for OCD. Talking about your fears, getting reassurance and confessing one’s struggles is easy, but it is not effective. In many cases, this type of talk therapy makes OCD worse. Keep in mind that not every therapist who claims to treat OCD actually knows how to treat it. Use our list of suggested questions when seeking help for OCD.
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