OCD (Obsessive Compulsive Disorder) is a psychological condition that hijacks the brain, forcing us to think unwanted, “obsessive” thoughts and perform behaviors to reduce anxiety associated with these thoughts called “compulsions.” The obsessive thoughts are unpredictable and provoke extreme anxiety that leads us to believe we’ll never have control of our thoughts. To cope with these obsessive thoughts, an individual performs compulsions or repetitive behaviors that we feel must be completed to regain control of our thoughts.
There are many types of obsessive thoughts that people experience during OCD. A common obsessive thought is that a person’s hands are covered in germs that will make them sick. To cope with this obsessive thought, OCD sufferers resort to excessive hand-washing and sanitization to the point of chapped, red, blistered, or bloody hands – all resulting from the perpetual hand-washing compulsion.
A lesser discussed form of OCD is known as “HOCD” or homosexual obsessive-compulsive disorder. With this specific type of OCD, a heterosexual (straight) individual experiences obsessive homosexual thoughts. These thoughts become a significant source of distress, leading a sufferer to believe that their brain chemistry has changed and/or that they may be transitioning from heterosexual orientation (straight) to homosexual orientation (gay).
What is HOCD (Homosexual Obsessive Compulsive Disorder)?
HOCD can be defined as obsessive compulsive disorder specifically entailing obsessive thoughts related to members of the same sex. A person may feel as if their brain chemistry has changed and they cannot help the fact that they’re experiencing thoughts of homosexuality. Those experiencing HOCD are typically very fearful of the homosexual-related thoughts, to the point that they attempt to suppress them or do whatever they can to avoid thinking them.
When these thoughts occur, a person experiences a fight-or-flight response and panics, thinking that they are becoming gay. Deep down, they know they are not gay, but begin to question themselves, thinking that something is seriously wrong. The more they attempt to fight these thoughts and avoid them, the stronger they become.
Those experiencing HOCD are often completely straight (heterosexual orientation), but begin to develop a fear that they are becoming gay (homosexual). The OCD centers of the brain take this fear and use it to their advantage; circulating even more intrusive, yet inauthentic homosexual thoughts. This provoke even more distress, and without proper intervention, a person may put up with HOCD for years or turn to poor coping habits (e.g. alcohol or drugs) in attempt to minimize these thoughts.
Causes of HOCD: Potential Influential Factors
There are many potential causes of HOCD, making it difficult to pinpoint one specific cause. Certain factors such as genetics and environmental stressors may trigger symptoms, but the causal underpinnings are likely more complex than any one specific factor (e.g. serotonin). The major problem with HOCD is that it creates a self-sustaining feedback loop.
The more we resist the obsessive thoughts rather than accept them, and the more we act on compulsions in attempt to reduce these thoughts, the more severe the HOCD becomes. It’s almost like telling someone to imagine a pink elephant, and then telling the person to stop thinking about the pink elephant. The harder they try to stop thinking about it, the more difficult it becomes.
A good way to think about HOCD or any OCD is like a Chinese finger-trap of the brain; the harder you pull your finger (try to stop thinking the thoughts), the more they have a stranglehold on your finger (your consciousness). There are many complex factors that influence the manifestation of HOCD.
- Brain circuits: Research has suggested that there are likely neural correlates for HOCD. In other words, certain brain circuits are overactive, while others may be underactive. Researchers have discovered that in cases of OCD, distinct components of frontostriatothalamic circuits become dysfunctional. This leads to errors in both cognitive and emotional processing.
- Brain waves: Many individuals with HOCD have abnormal brain waves as recorded by a QEEG (quantitative EEG). It has been thought that OCD triggers abnormally high concentrations of beta waves and low levels of alpha waves. Alpha waves are associated with relaxation, whereas an abundance of beta activity is associated with fear, panic, and uncontrollable thoughts.
- Genetics / epigenetics: It is possible that some people are susceptible to HOCD based on their genetics and epigenetic influences. Due to the fact that most people do not have HOCD their entire lives, it should be speculated that epigenetic influences facilitate development of HOCD.
- Fears of homosexuality: Those experiencing HOCD may know deep down that one of their biggest fears is becoming homosexual. For a person’s entire life, they’ve been straight, but what if by some chance they became gay? The OCD uses homosexual fears to its advantage, hijacking a person’s thought process and strengthening fear-based circuitry to promote the obsessive-compulsive disorder feedback loop.
- Neural pathways: When you develop HOCD, distinct neural pathways in the brain are created involving fear associated with becoming gay. Each time you resist or fight these thoughts, the fear-based circuitry keeps churning out more intense, intrusive homosexual-related thoughts. The HOCD continues to gain power as a result of neuroplasticity or your brain’s ability to change itself. These neural pathways become more active than necessary and a person may come to believe that they’ll never escape from the torture.
- Neurotransmitter imbalances: Many have speculated that low serotonin levels is a root cause of obsessive-compulsive disorder, including HOCD. This theory is derived from the fact that when individuals with OCD are administered an SSRI antidepressant, their symptoms improve or diminish. Others have speculated that insufficient levels of GABA may play a role in perpetuating OCD and fear-based circuitry. There are likely many neurotransmitters that become imbalanced and perpetuate HOCD.
- Sympathetic overactivation: When your sympathetic nervous system is overactive and your parasympathetic nervous system is underactive, you experience the fight-or-flight response. This fight-or-flight activation results in production of stimulating hormones like cortisol and epinephrine. These stimulating hormones can trigger obsessive thoughts and make it more difficult to escape the trap of HOCD.
Note: For some individuals there may be one cause influencing symptoms of HOCD more than others. For most people, a combination of varying degrees of the aforementioned factors will lead to the manifestation of HOCD.
HOCD Symptoms: List of Possibilities
Depending on the specific case of HOCD, a variety of symptoms may be present. The most common symptoms include: uncontrollable homosexual thoughts and a fear of “becoming gay” despite having been attracted to the opposite sex prior to OCD onset. Those with the condition often research their symptoms online and may question their sexuality for reassurance that it is merely their OCD and that they are heterosexual (straight).
- Anxiety: Most sufferers of HOCD have significant anxiety. This anxiety may be generalized, somatic, or take a number of forms. They often have underlying anxiety that needs to be addressed in order to reduce symptoms of HOCD. While anxiety may be provoked by the HOCD itself, there is often more anxiety than solely that associated with the HOCD.
- Fear of “becoming gay”: Perhaps the most prominent symptom of HOCD is a fear of becoming gay. A person will have been straight throughout childhood, but start to fear that their brain wiring has changed and they are now becoming gay. They begin to fear that their old, straight self is now turning completely gay.
- Distress: Individuals attempting to cope with HOCD may believe that they’ve sinned or done something bad to deserve their intrusive thoughts. The thoughts alone often result in significant distress unless a person has learned how to properly cope via psychotherapy. Until a sufferer consistently visits a psychotherapist, they may have a difficult time minimizing distress.
- Emotional dysfunction: Those dealing with HOCD often have strong emotions associated with the potential that they’re experiencing homosexual thoughts. This may cause significant depression, hopelessness, and maybe even suicidal thoughts. A person is often emotionally imbalanced and has a difficult time coping with how they feel.
- Homosexual thoughts (uncontrollable): Rampant homosexual thoughts circulate throughout a person’s consciousness. It may seem as if over 90% of a person’s daily thoughts are related to members of the same sex. These thoughts aren’t controllable, yet the more a person tries to control them, the more potent they become. A significant portion of an HOCD sufferer’s daily thoughts are unwanted homosexual ones.
- Lack of genuine homosexual attraction: Those with HOCD have no history of homosexual attraction or attraction to members of the same sex. Even if their brain is spewing incessant homosexual thoughts, biologically they aren’t attracted to the same sex. The thoughts are scary and meddling, but do not change a person’s sexual orientation.
- Rapid thoughts: People experiencing HOCD often experience other rapid uncontrollable thoughts on a variety of topics. It just so happens that since those related to HOCD induce the most fear and pronounced reaction, they continue to circulate. You may find that you have other obsessions and compulsions that aren’t related to homosexuality.
- Researching homosexuality: Individuals with this condition often spend hours of their time researching homosexuality online. They may dig around in forums and on blogs in attempt to find reassurance that they are really straight. They may believe that HOCD can turn them gay or that if they have HOCD, there’s a chance they may become gay or bisexual. In reality, they will never become gay and as long as they’re able to treat their OCD properly, the thoughts will subside.
- Questioning sexuality: Most people with HOCD question their sexuality as a result of their thoughts. In reality, a person cannot choose their sexuality – it is something they’re born with. However, sufferers of HOCD start to question their own sexual orientation, believing it’s possible that their brain is turning them completely gay.
- Sympathetic activation: Another symptom associated with HOCD is an overactive sympathetic nervous system. This may have been triggered by a traumatic experience, drug withdrawal, psychiatric treatment, etc. Their sympathetic nervous system is in overdrive, whereas their parasympathetic needs more activation for stress reduction. The problem is that the sympathetic nervous system continues to fuel the fear-inducing HOCD.
HOCD or gay? Determining HOCD from Homosexuality
Below is a chart that you can use to help you distinguish whether you’re experiencing HOCD or are legitimately homosexual. Understand that this chart may not apply to every case of HOCD or to every individual that considers themselves to be homosexual orientation. However, the chart denotes some relatively obvious differences between those suffering from HOCD and those legitimately attracted to the same sex.
|Sexually aroused by people of the opposite sex.||Sexually aroused by people of the same sex.|
|You've been attracted to members of the opposite sex since childhood.||You've been attracted to members of the same sex since childhood.|
|Thoughts about engaging in homosexual relationships are unappealing.||Thoughts about engaging in homosexual relationships are arousing.|
|Feel anxious about romantic relationships with people of the same sex.||You embrace romantic relationships with people of the same sex.|
|You have enjoyed sexual acts with a person of the opposite sex.||You only enjoy sexual experiences with a person of the same sex.|
|Thoughts about homosexuality provoke fear and worry – you still want to be with people of the opposite sex.||Thoughts about homosexuality provoke fear only because of what others think or various religions.|
|You aren't able to stop thinking about homosexuality and the thoughts are disturbing or distracting. (You lack control over thoughts).||You think about homosexual relationships – but are able to stop thinking about them whenever necessary. (You have control over thoughts).|
|You feel emotionally intimate with a person of the opposite sex.||You feel emotionally intimate with someone of the same sex.|
|You become fearful that people of the same sex will find you attractive.||You enjoy when people of the same sex find you attractive.|
|You fantasize about being in physical relationships with people of the opposite sex.||You fantasize about being in physical relationships with people of the same sex.|
|You research sexual identity and attempt to reassure yourself that you are not homosexual.||You research sexual identity to get a better understanding of yourself.|
My Experience with HOCD: Fearful of Becoming Gay
During my sophomore year of high school, I was exposed to many psychiatric medications in attempt to correct a hypothesized “chemical imbalance.” The Paxil I had originally been taking had stopped working, and my psychiatrist was playing antidepressant roulette in hopes that a drug or combination would correct my neurotransmitter deficiencies and make me feel better. Unfortunately, none of the drugs helped and actually dug me into an even deeper hole of anxiety.
From my anxiety manifested OCD, obsessions of all types. As the OCD grew worse, I’d notice that sometimes the obsessive thoughts would change. Sometimes they would provoke me to check all the locks on the doors and other times they would provoke me to perform cleaning rituals. One day, out of seemingly nowhere I began to have sexual thoughts related to members of my same sex.
When these thoughts occurred, I was only a teenager and thought that it was possible that my sexuality had not fully developed. I thought that my brain may have been changing and that abnormal development may make me transition from being straight (heterosexual) to gay (homosexual). I considered it plausible that psychiatric medications may have severely damaged my neurochemistry to the point that my sexuality had changed.
I feared that at the very least I would become bisexual, and at the very worst I would become fully homosexual. These thoughts began to take over my entire brain. I knew physically that I wasn’t attracted to members of the same sex, but the graphic, sexual thoughts cycled through my brain and I kept resisting. The more I resisted the thoughts, the more intense they became.
Initially I didn’t even know there was a condition called “HOCD” and even when I found it, I wasn’t convinced that I had it. I thought that I was completely different from other suffers in that I was more likely to become gay or bisexual. It felt as if my brain had undergone a metamorphosis from one that was completely straight (heterosexual) to one that was now programmed with a homosexual orientation (gay).
It took a lot of courage to talk about this with my therapist because I thought she may just assume that I may be “in the closet” gay. I explained my situation and how much I was suffering with gay thoughts that I couldn’t control. She asked me some questions about my past such as: “Were you attracted to members of the opposite sex throughout childhood?” and “Have you ever been attracted to members of the same sex?”
The truth is I had never been attracted to members of the same sex before my HOCD onset and was always attracted to members of the opposite sex in the past. She helped me realize that this was a subtype of OCD that many people experienced and helped me learn how to cope with this condition. It wasn’t easy to cope with, and actually took awhile to develop new neural pathways and overcome HOCD.
Eventually I would learn how to overcome OCD, but it wasn’t a quick and easy overnight fix. It took consistent effort and an intelligent psychotherapist. In total, I suffered from HOCD for less than a year, and recovery took months. These days I haven’t experienced a homosexual-related thought or any unwanted thought related to sexuality. My OCD is completely under control to the extent that I view my coping with OCD as a stint lasting several years; I haven’t had any symptoms now for approximately 7 years.
HOCD Treatment: How To Overcome HOCD (Homosexual Obsessive Compulsive Disorder)
HOCD is a tricky beast to overcome, it makes you think that you are really gay, when in reality you’re completely straight. If you were to think of your brain as a mirror and the reflection showing you your authentic self, a brain with HOCD is like a mirror covered in dust. The dust doesn’t reflect your actual nature, rather it artificially covers it up, leading you to second-guess your true identity.
1. Find a quality psychotherapist
If you want to overcome your HOCD, I would highly recommend finding a quality psychotherapist. It may not be easy to find someone that you connect with, but it will be immensely helpful just to share that you are dealing with intrusive homosexual thoughts. When the HOCD hits, you don’t want to tell friends or family as they may think you’re just now “coming out of the closet” and were really gay the entire time.
When I was dealing with HOCD, it was excruciatingly difficult to even tell my therapist. I thought that she maybe hadn’t heard of this condition and would think I’ve really been gay the entire time. Fortunately she had heard of “HOCD” and helped me address these homosexual thoughts that weren’t a true reflection of my identity.
My psychotherapist also helped alleviate my anxiety by suggesting that I’m probably not gay or becoming gay, rather I’m experiencing HOCD. Just her telling me that it was a byproduct of OCD gave me a sense of comfort and reduced some of the HOCD-induced panic. We discussed my lifelong attraction to women and she helped point out the unlikelihood of my newly-acquired fear-inducing thoughts related to members of the same sex.
The most painful aspect of dealing with HOCD is learning to accept the homosexual thoughts. When a person first experiences homosexual thoughts triggered by anxiety, the initial urge is to panic and attempt to suppress them. In other words, when these thoughts arise, most people attempt to “fight” them and try hard to regain control over their brain.
The irony is that the harder you try to control them, the more they will actually control you. Attempting to drown them out of your head or focus on other thoughts without accepting the HOCD thoughts will only strengthen their intensity and give them more power. My therapist helped me realize that in order to rid myself of these thoughts, I would need to accept them.
I understood that they weren’t related to my nature or authentic self – they were thoughts being generated by faulty brain wiring. I had never experienced them before, and my therapist helped me realize that they are something that I will need to put up with. Conjuring up tactics to “fight” these thoughts only intensified them.
3. Embrace the thoughts
Oddly enough, the next step given by my therapist was to embrace the thoughts and accept that (while totally unlikely), there’s a chance I could be gay. She pointed out the fact that there’s nothing wrong with being gay and that there’s no reason to be ashamed if I’m having these thoughts. Her homework given to me was to actually look up and watch “gay porn” or embrace the HOCD related thoughts.
I felt fairly uncomfortable doing this, but as I embraced the possibility of being gay, I began to realize that the HOCD began to lessen. Rather than fighting these thoughts, I was accepting them and fully embracing them. I understood that if I was truly born straight, I wasn’t going to somehow morph into someone that was gay.
I also realized that there was a chance I could be bisexual and didn’t fight that possibility. The more I embraced these thoughts, the less scared I became of them. The irony is that the combination of acceptance and embracing the thoughts diminished them significantly.
4. Relaxation techniques
In my case, the HOCD I was experiencing was caused by overactive fear-based brain circuitry. To create new neural pathways and essentially help my brain recover, I was instructed to engage in relaxation exercises daily. I had experienced PTSD and severe anxiety – all of which lead to a state of hyperarousal and fear-based thinking.
This state of hyperarousal was partially responsible for inducing HOCD. I used various techniques such as brainwave entrainment with the hypothesis that reducing high beta waves and increasing alpha waves would help induce relaxation. In addition to brainwave entrainment, I engaged in self-hypnosis, the emWave2, and even used essential oils for anxiety.
This helped reduce activity in the sympathetic nervous system and fear-centers of the brain. Reducing both sympathetic nervous system activity and activation of fear circuitry lead to increased relaxation. This meant that my thought-speed slowed and my body was less aroused, both of which helped decrease HOCD severity.
While acceptance and embracing the HOCD thoughts are the single most effective intervention for coping, engaging in relaxation can help rewire your brain and nervous system. By giving your sympathetic nervous system more power and strengthening activity in your prefrontal cortex, it becomes much easier to deal with any OCD-related thoughts.
5. Let time pass
Once you’ve mastered the first four steps, then you can simply “let time pass.” With consistent psychotherapy (CBT), you will have addressed faulty thinking and learned to correct it. Your therapist will provide you with support and keep you on the right track to recovery. With acceptance and embracing the HOCD, you will become less bothered by the thoughts when you experience them.
For some people, simply accepting and embracing them will serve as a “cure” due to the fact that you are no longer fighting against these thoughts (which give them fuel). HOCD is almost like a Chinese finger trap in that the harder you attempt to pull (fight the thoughts), the more they’ve got a stranglehold on your consciousness – whereas the less you fight and more you relax, the easier it is to escape from the trap (the HOCD thoughts subside).
When you add various relaxation techniques to the equation of recovery, you are literally rewiring your neural pathways. When you relax, you’re activating the parasympathetic nervous system, which perpetuates physical and mental relaxation. This leads to creation of different hormones and neurochemicals that also reduce likelihood of HOCD in the future.
Assuming you’re consistently implementing Steps 1-4, you simply need to let time pass. Don’t become attached to when the HOCD is going to fully subside. If you’re doing Steps 1-4, you probably won’t care when the thoughts subside and won’t be concerned with time. Keep letting time pass, and assuming you’re consistent with recovery efforts – you’ll eventually fully recover.
HOCD can be overcome with just the 5 aforementioned steps, or arguably just a couple of them. However, if you’re in dire straits and want to utilize some alternative methods to recover, you have other options. These include: using supplements, medications, neuroplasticity, and/or neurofeedback.
Chemical alterations: Most people with HOCD will panic and immediately jump on the medication bandwagon. For immediate relief, medications can be helpful. However, over the long-term, medication will not teach you how to cope with HOCD when it strikes. There’s a chance that in the future, your antidepressant will stop working and you’ll experience even worse HOCD than before you took a medication.
Altering chemicals in your brain is helpful, but in my opinion not usually necessary. In my experience, altering your brain chemicals is best achieved via supplements to help reduce some anxiety and improve your sleep quality. For example, if your circadian rhythm has been thrown off-kilter by your HOCD, you may want to consider taking melatonin to improve your sleep quality.
There are a variety of supplements you can consider to help take the edge off and facilitate your recovery. Assuming you want to take a pharmaceutical drug, you may want to consider something safe like Clonidine for anxiety; this is one of the safest psychiatric drugs and my provide some benefit among those with HOCD. Work with a psychiatrist if you believe it’s necessary to take a pharmaceutical.
Assuming you haven’t had HOCD your entire life, it is possible to overcome the condition without drugs or supplements. The goal is to reset your body into physiological homeostasis rather than fear-mode of sympathetic overactivation and activation of the fear-circuitry.
Neurofeedback: Those with HOCD can use a technique called neurofeedback to expedite recovery and cope with the condition. Neurofeedback analyzes brain waves across your entire cortex and determines whether any regions are likely to be dysfunctional based on the norm. For example, if most people have slower brain waves in one region, yet your brain is showing excess fast-wave activity – this could result in symptoms of the HOCD.
A neurofeedback practitioner would then work with you to correct this (potentially) faulty brain wave rhythm in a specific region. The correction in theory should help promote healthy brain functioning and reduce the likelihood of obsessive thoughts. Many people with OCD (of all types including HOCD) will benefit from working with someone who conducts QEEG neurofeedback.
Self-directed neuroplasticity: Another concept that you can take advantage of is that of self-directed neuroplasticity. This concept is based off of the idea that you can literally control the way your brain works based on your focus. If you focus on being stressed and fearing the thoughts, you become more rattled and manifest more of what you don’t want.
Self-directed neuroplasticity involves a four step process and happens to work brilliantly for suffers of OCD. In fact, some believe it works better than medication – I happen to be one of those people. The four steps are as follows:
- Step 1: Relabel – This involves relabeling your thoughts for what they truly are, obsessions and compulsions. Each time you think a thought that you might become gay, you would immediately relabel it as an “obsession.” Recognize that these obsessions and compulsions are just false-alarms, not actually a reflection of who you are.
- Step 2: Reattribute – Next you reattribute the cause of the thoughts as being “faulty brain circuitry.” You don’t identify that you are creating the thoughts, rather you take a step back and view them with mindful awareness. In other words, you view them from a third-person perspective, realizing that they are a result of faulty brain chemistry, not your fault.
- Step 3: Refocus – After you’ve mastered the first 2 steps, you refocus each time you have an HOCD thought. You do this by having a list of alternative behaviors rather than the compulsions associated with the obsessions. Make a list of benign, enjoyable behaviors such as: gardening, reading, journaling, biking, etc. Each time HOCD strikes, you immediately perform an alternative behavior such as gardening for a minimum of 15 minutes; this helps activate a different neural pathway rather than the one associated with HOCD.
- Step 4: Revalue – Ultimately you come to realize that you need to give your own life more value than the OCD generated by abnormal brain chemistry. You place more value on doing something productive or living your life than giving the OCD power. You have now revalued your HOCD to the point that it has no power over you and cannot control your consciousness because you can work around it.
How long does it take to recover from HOCD?
It’s difficult to give an estimation regarding recovery time from HOCD. Assuming you seek help from an experienced therapist and follow some of the tips mentioned in this article, your recovery may be quicker than expected. Assuming your onset of HOCD was relatively insidious and long-term, it may be difficult to work around the ingrained neural pathways created by the obsessions and compulsions.
The early stages of treatment are the toughest, but as you gain momentum – things continue to get easier. Individuals with severe cases of HOCD who aren’t willing to do necessary psychotherapy and put forth coping efforts may not ever recover. Those who are willing to put forth effort will begin to notice gradual symptomatic relief over time; progress happens over the course of months, not usually days.
In my experience, it took a relatively long-term (at least 4 months) before my HOCD significantly diminished. Once it diminished, it would randomly pop up to keep me “in check” but eventually even the random “pop up” spam-like thoughts would subside. If you have successfully learned how to cope, you shouldn’t be too concerned with recovery time.
Time is going to pass anyways, regardless of whether you put in the work or not. If you want to recover, keep doing what works best for you and you’ll continue to make progress. For most cases it will take several months to notice significant improvement, yet for others, recovery may seem like a long, drawn-out affair.
Have you suffered from HOCD?
If you have dealt with HOCD, feel free to share your experience in the comments section below. Discuss how long you’ve been plagued with this specific subtype of OCD and whether you’ve also experienced other types of OCD. If you’ve managed to minimize these thoughts and/or are successfully coping with them, mention any coping techniques that you think could help others suffering from the same condition.