FearCast Podcast
Episode #229 – How Can I Fight the Daily Fight Against SO-OCD?
Host: Kevin Foss, MFT
Date: May 19, 2025
Overview
This episode focuses on managing and recovering from Sexual Orientation OCD (SO-OCD), featuring an in-depth listener question about daily struggles with intrusive and distressing thoughts related to sexual orientation. Host and OCD/anxiety specialist Kevin Foss provides thoughtful analysis, validation, and practical guidance, exploring both the emotional impact and evidence-based treatment strategies to tackle SO-OCD. While the question is specific, the discussion offers valuable insights applicable to anyone dealing with taboo obsessions, anxiety, or compulsive rumination.
Key Discussion Points & Insights
1. Listener Question: Phil’s SO-OCD Struggle
- Phil's Background: Lifelong relationships with women, sudden onset of panic attacks in 2020, evolving intrusive thoughts (suicide → harm to others → sexual orientation doubts)
- Symptoms Described:
- Daily intrusive thoughts connecting innocuous words/events to homosexuality (e.g., “coming out” at a party, making vegetables)
- High anxiety, depression, and occasional suicidality from relentless mental associations and inner accusations
- Discomfort around gay men and attempts to do exposure by being around gay people
Quote:
“It's a daily fight against the inner voice. And I have daily anxiety that makes me feel... very low on life.” — Phil [16:55]
2. Taboo and Amplified Obsessions
- SO-OCD is classified as a "taboo obsession," meaning the subject matter feels unacceptable or uniquely dangerous (e.g., sexuality, harm, religious themes).
- Cultural, religious, and personal factors can amplify the taboo, making thoughts feel more threatening and thus more frequent.
Quote:
“Taboo obsessions are certainly amplified or motivated by cultural, social, religious, or just kind of personally dangerous messaging…these topics are somehow bad.” — Kevin Foss [24:25]
3. Therapeutic Limits: The Therapist’s Role
- Kevin emphasizes the therapist’s job is not to determine someone's true sexual orientation, but to address the obsession and its impact on life.
- Importance of assessment and in-person therapy for individualized care.
Quote:
“I do know you have an obsession about your sexuality. That is what I know… My job in this isn’t to decide whether or not you are straight, gay, bisexual, or otherwise. Just to say: here’s an obsession that is overwhelming.” — Kevin Foss [30:25]
4. Living With Uncertainty
- Recovery involves making space for uncertainty rather than pursuing certainty, because compulsive reassurance never resolves the doubt.
- Kevin draws parallels to health/harm obsessions to show the necessity of accepting some “what ifs” in life.
Quote:
“We are working on naming the obsession and pulling back from it and spending less time on an obsession that you’ve ruminated and checked and… have not gotten any closer to an answer.” — Kevin Foss [33:50]
5. Common Maladaptive Associations & Magical Thinking
- Many people feel discomfort due to learned societal messages, false associations, or “magical thinking” (e.g., fear that being near gay men may cause you to become gay).
- Stigmatized content loses its threatening quality through direct experience and contact.
Quote:
“That’s like me saying, if I hang around a bunch of basketball players, like, I could be a pro basketball player. It doesn’t work that way, but it somehow works for this, right?” — Kevin Foss [38:25]
6. Commending Value-Driven Exposures
- Phil’s attempts to spend time around gay people is highlighted as healthy exposure—“getting to know people… stigma reduces when you approach the person or item…”
- Not to use people as “props,” but genuinely engage and learn to normalize presence and reduce stigma.
Quote:
“When we get to know people who are in the gay community, we start to learn that… they’re just people. They’re just like everybody else.” — Kevin Foss [41:40]
7. Acceptance and Commitment Therapy (ACT) Principles
- Accepting the presence of unwanted thoughts, images, or feelings as a part of life, without judgment or attempts at suppression.
- Behavioral “commitment” means continuing to live as you choose and value, despite the intrusive thoughts.
- Trust who you know yourself to be, while making space for doubt without acting on the urge to check or ruminate.
Quote:
“Instead of judging it or fighting it or suppressing it… we’re going to say, yeah, that is there. Now what?” — Kevin Foss [44:30]
8. Pattern Recognition and the “Tetris Effect”
- Human brains are wired to make associations and see patterns; OCD often exploits this.
- Intrusive connections (e.g., noticing “bending” or “coming out”) are part of the brain's overattunement, not evidence of truth.
Quote:
“You have a very active imagination… What you’re noticing, though, is that you’re seeing these objects that have these maybe connections… your brain is making this immediate connection to it and telling you this story.” — Kevin Foss [54:55]
9. Active and Passive Acceptance Techniques
Passive Tools:
- “Maybe I will, maybe I won’t” responses to intrusive thoughts.
- Practicing “yes, and…” improvisational technique to defuse anxiety (e.g., elaborating playfully on the thought).
- Viewing unwanted thoughts as neutral mental events.
Quote:
“Maybe I do [want vegetables somewhere else], maybe I don’t… but it doesn’t matter. I’m going to keep making these vegetables.” — Kevin Foss [1:05:10]
Active Tools:
- Scripting: Writing anxiety-provoking stories (worst-case or even positive scenarios) and practicing noncompulsively sitting with discomfort.
- Exposure without compulsions; deliberately being in feared situations or thinking feared thoughts and letting go of the urge to “fix” or check.
10. The Importance of Acceptance Statements
- Example internal monologue:
“I will accept, without judgment or conclusion, the presence of the content of the thought, but I do not have to accept the truth of the thought. I will continue to live my life as desired, knowing that thoughts will come and go and that I am free to pursue my expressed desires, attractions, and goals despite the thoughts and anxiety.” — Kevin Foss [1:11:30]
11. Uncertainty as Exposure: Letting the Story Play Out
- Pulling away compulsions (safety behaviors) gives the brain the chance to learn that anxiety spikes are tolerable and worst-case fears don’t materialize.
- Living with “what if”—just as one lives with health and other life uncertainties.
Quote:
“We’re going to wait, we’re going to see how long it takes… and the exposure then is to the feeling of uncertainty about that future… But we don’t know when it’s going to happen, and we’re sitting with making space for that uncomfortable, uncertain, unsettled what-if feeling.” — Kevin Foss [1:17:15]
Notable Quotes & Memorable Moments
- “If you have these questions and these doubts, I’d encourage you to go see a therapist, have an assessment, talk about what’s going on…” [28:50]
- On noticing attractive men: “Guess what, there are some attractive dudes out there. Boy, there really are. And just because you notice an attractive man doesn’t mean anything.” [1:01:25]
- “If you can accept the reality that we’re allowed to have thoughts, whatever we want them to be, but they don’t have to be dangerous… then who cares, right?” [1:13:50]
- Improv/“Yes, and” technique: “Yep, I am Cookie Monster and be a ridiculous human as I sometimes am.” [1:09:05]
- “You can have your life and date and marry and do whatever you want and have that uncertainty, and we’re going to see what happens.” [1:18:30]
- Closing mantra: “Take a risk, challenge yourself, and don’t take your brain too seriously.” [1:21:24]
Section Timestamps
- Phil’s Story – [16:10]
- SO-OCD as Taboo Obsession – [24:25]
- Therapist’s Role & Uncertainty – [30:25]
- “Comparison Distortion” & False Associations – [51:15]
- Pattern-Spotting and the Tetris Effect – [54:55]
- Passive Acceptance (Maybe I will/maybe I won’t) – [1:05:10]
- ACT-Inspired Acceptance Statements – [1:11:30]
- Script Writing & Exposures – [1:15:00]
- Uncertainty as Exposure & Living With It – [1:17:15]
- Final Encouragement & Sign-Off – [1:21:24]
Takeaways
- SO-OCD can create distressing, taboo, and persistent doubt, but recovery is possible.
- Effective strategies include both exposure (active) and acceptance (passive) techniques.
- Stigma and magical thinking are best addressed through direct and genuine engagement, not avoidance.
- Living with uncertainty, rather than seeking compulsive reassurance, is at the heart of progress.
- Valuing yourself for who you are and acting according to your true intentions matters more than your thought content.
Memorable Sign-Off:
“Take a risk, challenge yourself, and don’t take your brain too seriously.” — Kevin Foss [1:21:24]
For more resources, episodes, or to submit your own question, visit fearcastpodcast.com.