← Get to know OCD
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Foreign.
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Are you tired of the endless cycle of your obsessions and compulsions? And do you feel like OCD is ruling your life? Well, listen, you don't have to go on like this forever. As a licensed clinical psychologist with 25 years of OCD treatment experience, I know firsthand how debilitating the condition can be. But I also know that it can be managed with the right treatment. This is why I lead a team of top tier clinical experts at nocd. NOCD is an online platform offering specialized, accessible and convenient OCD treatment. To get started with effective treatment for obsessive compulsive disorder, head to nocd.com and book a free call with our team to start your treatment journey today. It's time to live the life you deserve and not the life that OCD wants you to live. And don't forget, subscribe. Subscribe to our NOCD YouTube channel so you can stay up to date with our latest podcasts and webinars. Now, on to today's episode. Hi, everyone. Welcome to another episode of the get to Know OCD podcast. If you like the get to Know OCD podcast, you can subscribe on the NOCD YouTube channel or get it wherever you watch your favorite podcast at. And if you're looking for help for OCD related conditions, check us out@nocd.com that's nd.com now, normally I have amazingly fun people, but today I have Tracy. Sorry, Tracy.
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That's okay. I was feeling similarly. I was like, God, like, why?
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Talking Taboo.
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You know, we are featured together frequently on Tracy's wonderful support groups that are taboo in nature. Tracy has a nickname, Taboo Tracy, which I gave her, by the way. I am proud of the fact that I am the origin of that. That was wonderful. But Tracy, introduce yourself to everybody. Not that they don't know you, but go ahead anyway. What the hell.
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Yes. I'm like, worldwide. People are like, Taboo Tracy. Everybody knows it's like Mickey Mouse.
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They're like Mickey Mouse. Taboo Tracy. Donald Duck. It's fine. Know. I'm Tracy Ibrahim. I am indeed a therapist at no cd and I have ocd and I happen to also be a sex therapist. So it's just the situation. So we're going to talk about taboo things. Oh, I almost forgot. I'm also the chief compliance officer.
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Oh, yeah, yeah, there's that.
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There's a couple things. And I run a couple of Taboo taboo groups, as Dr. Mark McGrath said. Because at NOCD, we have support groups unlimited, about 30 a week for all of our NOCD members. So two of those, mine happen to be on taboo topics, so people cannot feel alone or weird when talking about it.
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B
Well, you did a talk with a panel at the International OCD foundation conference this summer about OCD and sex. And so we thought, what a great chat you and I could have. And of course, since OCD attacks things that people love or find important or don't want it to attack, sex is going to be in that realm. Then that OCD is going to be like, oh, you don't want me to show up while you're being intimate with someone. Guess what? I'm popping in your head while you're, you know, doing the thing. So OCD just loves to rain on a parade, shall we say? That's the nicest way I could say it. So let's talk about the relationship between sex and OCD and what your panel was really focused on.
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Sure. We kind of will chop it up into sections because it's so, so can touch so many different areas. There's no one, you know, theme of OCD where you're like, no, there it is. That's the one where you avoid sex, or that's the one where OCD comes in. Because OCD lives in our brain. So it goes everywhere you go. And whether you're having intimacy with yourself or others, there's no reason that it can't pop up. Just like it does when you're asleep, just like it does when you poop. It just can come up. But people put things together because that's what OCD does. It takes something and it puts it together with a different puzzle piece and says, this is real. So why is this happening while you're being sexual? Is it, you know, what is the reason behind that? And then you get all fascinated and freaked out. So really we started our panel talk off talking about the avoidance of sex. Avoidance being a compulsion and what types of ways that shows up for people with ocd, whether it's contamination of some sort of, you know, the list goes on. Fears of catching a disease, maybe bodily fluids are yucky to you. Disgust based obsessions. It could be about physical touch, it could be about your genitalia. You could just be embarrassed or have an interpersonal problem even on then OCD attacks that as well. So.
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I'm sure you've had some people I know I had had a handful of people who had to go through a decontamination ritual before and after they would have sex, or even sometimes in the middle of all of that, or have their partner have to go through Something excessive.
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And it can. It can even be masturbation. Right. It doesn't have to be that you're with a partner. It could even be having a solo experience and. And OCD can pop into your head. Or maybe you have to do it a certain way, and if you don't, you have to do it over or start over or something until you've done it absolutely just right.
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Yeah, exactly. And sometimes when you have something like contamination, you end up taking away from it because you're spending so long kind of freaking out, thinking, I have to do this. I have to. You know, I can't touch any fluids, so, you know, I have to make sure there's this. I. I have worked with somebody who, if their bodily fluids, like semen, would get on any part of their clothes or sheets, they would throw them away.
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That gets very expensive.
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I worked with someone who thought that if anyone touched anything that. That his semen had touched, that he could cause them to become his sexual orientation.
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Interesting. I always find it sad and terrible for the person suffering, but interesting. Right. I worked with somebody recently who was at his grandmother's house, and it was a tight squeeze to get by her couch. So the crotch of his jeans brushed the couch of his grandmother, and he started worrying he might get her pregnant.
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And I was like, say how that makes sense. In fact.
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Yeah, there's.
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I.
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And I mean this. Seriously. This is not a joke. There's the super sperm concept that can travel through underwear and jeans, hang out on a surface for several days or years, and then someone else happens by it and suddenly finds a way inside of them, finds the egg, and boom, they're pregnant. And there was no consensual sex that occurred in that situation. But now I'm a dad, right?
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Right. Now, I've heard. I can't tell you how many times I've heard. I'm worried about masturbating in the shower or the bath, because when it goes down the pipes, it's going to come up into someone else's bath and impregnate a woman. Yep. I've gotten that one as well. I'm like, whoa. Now, if I love a new one.
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That'S a new one. I love a new one. Yeah.
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Something coming from out of a drain into your tub, I would just. I would jump out.
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Yeah.
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Can you imagine what that'd be like? I'm like, oh, no, it's just semen. Fine.
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The most fascinating thing I saw come out of a drain was during a heavy rainstorm at my dad's warehouse. I heard a noise and I went over to this drain and it just kept getting louder and louder and louder and. And suddenly like a blurp of water came out. I don't know if blurps a word, but I just made it up. And a crawfish shot out of the drain.
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What the heck?
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Yeah, it was fascinating. So I took it over to the river and I released it because I felt it deserved to live.
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Crazy. I was braced for like a really disgusting poop. Like I'm like out of 10. And then it was like, crawfish. I was like, oh, did you eat it?
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Now, this is a drain that had no cover on it or anything like that, you know, and was in. Not in a residential area, not a place that you wanted to hang too much. But, you know, it was just.
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It was like, wow, that's so weird.
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Well, anyway, back to sex instead of crawfish. But, you know, we. We'll do a crawfish episode later.
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We will. How they come out of your drain as well as semen?
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Yes, yes. That. That could. Or it was just a large semen is what it actually was.
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It could have. Maybe it was a semen that mixed with a crawfish.
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Maybe one. One never knows. Now, subtypes of OCD can come into play here, and you can have all sorts of subtypes of OCD that have to do with this. I know you were talking about this idea of contamination, that if it gets on something, you have to throw it away. Right. We could talk about pedophilic OCD and this idea that vaginal fluids, semen, somehow are on me, and then if a child hugs me, that it gets on them. And is that a way that I molest children in some way or contaminate them in another way? Right. And. And just let us all say here, first, contamination tonight isn't going to have the negative connotation like I've got a horrible viral issue or disease or germ or something like that. Contamination in the OCD world means something is on me or in me that I don't want because it's an ego dystonic belief. Something that we find to be against something that we want for ourselves or believe in. Right. But it. It doesn't. In. It doesn't mean this idea of germ or something of that nature. But you could still have all sorts of reactions to it. You could have a discussed reaction toward it, even though there's nothing actually there. But you think, what if there is? And that's enough for someone. So Just wanted to put that out there to make sure that if people hear us talking about contamination in sex, it. It doesn't mean a germ and STD or something like that necessary.
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A
Yeah, it means so many things. There's emotional contamination. There certainly is physical contamination. There's, you know, just feeling yucky in general. Sometimes people fear getting something. Sometimes people fear giving something. I. I've certainly worked with plenty of people thinking I'm going to give something to someone. But I. I say one of the most common questions that I get is, what about these subtypes? Right across all the subtypes, what about if something intrusive, either an image or something like that pops up in my head during sex or masturbation or something, and then that creates a problem like, oh, what if I think of my dad or a child or my own child or, you know, know, a baby or whatever. A bat. It's Halloween.
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And this will not shock you, Tracy, but may surprise others. The more you hope that thought doesn't pop into your head, the more guaranteed that that thought will be popping into your head when you don't want it to pop into your head.
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Exactly. And so that's why I always tell people, listen, it's going to pop up at any time. And so if it does and you're in the middle of doing something, the best thing you can do that I always recommend is sort of imagine it. It's sort of like a blurry situation, and it's behind you. So it's like the blurry people in your backseat, but you can't really. You hear it. You know it's there. But then if you really focus on what you're doing, like, what senses are you using? Are you thinking about the thought or the image or. And why did I have it? And, oh, my gosh, that's kind of. Nothing's hot about that. So if you're trying to have a hot, sexy moment, but you're having thoughts that you know, and you're asking why? What does it mean? And am I a pedophile? Am I this? Am I committing incest? Am I a bad person? Should I be doing this? Or, oh, no, I orgasm. Dwell. Thinking about recently. I had not even that recently, but I had somebody tell me they orgasmed while an intrusive image of a little newborn baby being stabbed with a sword. And I was like, congratulations. They're like, no, it's terrible. I was like, oh, sorry. What way terrible? Like, what happened when I orgasmed? I was like, well, anything can happen when you orgasm, you could be thinking about Kraft Macaroni and cheese. It could be any. Just happen to be a baby getting stabbed with a sword. Like, don't connect it. You were doing something and that showed up. So.
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Yeah, you know, that throws people off. But how. How could I get off if that's. That means I love that.
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Right? There's this notion almost that if it pops into my head, I want it. Which is just not true by any means whatsoever.
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But OCD sure loves to throw that one at us. You wouldn't have thought that if you didn't want it. Well, how about this? The reason you thought it is because you didn't want to think it.
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That's exactly right. That's exactly right.
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Okay, so we talked about potential for pedophilic OCD contamination. Ocd? What other ways does OCD interfere in sexual experiences or intimacy?
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Certainly comes up in a relationship. Ocd.
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Oh, well, yes. Tell us more about that.
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Oh, my goodness. Right. It could be wanting to do a confession, compulsion to your partner because of something you thought that popped in your head while you were being intimate. Or avoidance because the last couple times you tried to be together, you got intrusive thoughts about a different person or a different thing or a dog or whatever it is can make you question, oh, no, but do you know? I don't know. I got. I got a gral response while looking at somebody at work or something. Then it's like, oh, my gosh, now what do I do now? This mean I'm not in the right relationship?
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Can we talk about the gral for a moment? Just so everyone truly understands the gral.
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These are things that happen basically in your genitalia.
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And it can be anything from a tingle, a feeling, a reaction. Some people go, yeah, I know, but this came up recently. Somebody was like, yeah, but I get erections. And I was like, yep, that can be part of a gral. That's someone else.
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Definitely in the gral realm.
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It did happen in your crotch, so it makes sense. And the other one, which really throws people off, I've had a couple of people who said, I know, but I get. Not only do I get an erection, but I get some discharge, so there's moisture down there as well. And I'm like, oh, well, congratulations that your penis works.
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And that could be vaginal discharge, too.
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There could be vaginal discharge. It can be.
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Yeah.
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It can be whatever you have. Having any reaction you could imagine in.
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Your crotch that you, again, hope you don't have. But because you're hoping you don't have it. There we go.
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Exactly. Somebody was asking recently, they were like, yeah, but. But what if I like it? Okay, I know, but what if I like it? But what if I don't like it? But how do I know if I like it? If I don't like it, how do I know if it's OCD or if I just like it?
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The answer is, stop trying to figure it out. And, you know, usually things we like don't distress us. I like to point that out. Yeah, because it makes sense.
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Exactly. So now we have this feeling in our middle region of our body that we're hoping not to feel or that we're looking out to see if we feel something. And, you know, a slight breeze could lead you to feel something potentially. And then you'll be like, oh, damn it, there it is. I.
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Why?
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Why did I have to have that? And you'll use that as a quote unquote proof of something. You know, the only reason I felt something there must be. Enter worst case scenario ever. And that's why I felt the thing that I felt there.
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Right. It comes up with sexual orientation, ocd. Sometimes people will do some checking. They'll maybe watch porn that normally they wouldn't watch, but they're like, I'm checking to see if I can become aroused while watching the thing. I don't like to test to see if I am or am not whatever it is you think you are or not.
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Not even just aroused. People will masturbate to it, hoping they don't orgasm to it. And then when they do, they'll be like, oh, it must mean that that's. That's it then. Because why would I have orgasm? Well, because you were masturbating. Maybe. I'm just throwing that out there.
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Yeah, yeah, it's weird. That's how it works. So, yeah, this is a good time to. To kind of walk through arousal non concordance, which is. Which is exactly what describes this thing that people freak out about. Why would I have, you know, what appears to be maybe a positive genital reaction to something that if I'm so grossed out by it or if it's something I don't like or I don't want. So arousal non concordance. We will discuss it in two directions. The first direction, wow, I really want to go be sexual with this whoever right now, myself or somebody. And then your body doesn't do what you want it to do. You're like, no, please, I just want to do this. And they're like, sorry, not Cooperating, genitals not cooperating. So this is your mind wanting to do something and your body saying, no, my I am not working. Right.
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Which could come just from anxiety about the. The more you hope it works, the potentially then the less likely it works because all you're doing is thinking about it. I liken this to if you want to ruin your golf game, think about your golf swing. Right. And if you want to really get in the way of sex, think about your performance of outside. Right?
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Yeah, exactly. And then. And then this is where people with OCD get messed up. Is arousal. Non concordance also flips around and goes the other direction, which is maybe your brain is saying, no thanks, I would hate that. And your genitals go wrong. Love it, love it. Doing the stuff that's also rousing on concordance. And what does it mean? It means you don't like it, you don't want it, but you're body is having a reaction. That's it. Not connected. Don't care.
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It's like, doesn't have to mean a damn thing.
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Nope. You can wake up having had a dream about something. What does it mean? It means you were asleep and now you're awake. Oh, okay. You know, it doesn't matter if you've ever woken up upset, you know? Well, were you upset? I don't know. Maybe in your dream you're upset, it doesn't mean the rest.
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Good point. Even to bring up the dreams too. Because we'll do weird things in our dreams, even around sex. And then we wonder, now does that mean that I wanted that because I dreamt it. Right?
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Exactly. One day I actually, I did so much pedophilic ocd, so many sessions in a particular day of pedophilic ocd, that that night I had a dream where I had a crush on a kid at a high school and the dream was just me going through, Wow, I have a crush on that kid. He's hot. And the kid was like, I want to be with you. And then I was like, well, this just doesn't seem like I really want to do that though. And so that was the whole dream. And I woke up going like, oh, why would you think a high schooler was hot? And I was like, you know what? I'm just going to get up and have coffee because I don't need to figure out a dream. I was asleep. That's the answer. Asleep. Then I woke up and then I remembered that I was like, that's it.
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That's the answer. That's all you need.
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That was it. I'm like, all right, I'll call whoever this. Well, I don't even know this person. It wasn't even a real person. My brain made up a person. I was like, shoot. Not even a neighbor.
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What are you going to do? So that's arousal. Non concordance. Like, to explain it, because that's one of the things people freak out a lot about. And I'll also say another big fear people have around sex when people have ocd. Like, we had talked about.
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You know, pregnancy, right? Fear of somebody getting pregnant in a variety of different ways that can. You know.
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And also being afraid of things like.
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I mean, just like, anything. Like, what if. What if I'm sleeping on this bed and somebody. Somebody came by earlier that was a plumber. This happened recently. I'm recanting a session. Somebody was like, well, a plumber came by earlier. They had to walk through my room to get to the bathroom to fix the toilet. And I was like, okay. They're like, my bed. I'm like, what. What's going on with your bed? Like, oh, all the contaminants came from this person to my bed. And they were like, I don't think that I want this blanket anymore. And I was like, wait, like, what are you saying? And she was actually saying, well, but, like, what if he just had something on him? And, like, he. I somehow get pregnant when I go to bed tonight? And I was like, that's. I don't know. I'm gonna go with that doesn't sound likely. And we tried it, and she slept with that blanket and did not get pregnant. And I'll have you know.
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Well, again, the super sperm. Right. Just jumping off of the plumber onto the blanket there. Yeah.
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I was like, that's kind of. I was like. I was like, walk me through it. I don't think I have this theme of ocd, but I do want to point out that, erp, that is how we solve all of these problems. Now you can get some real issues that can get in the way of sex when you have ocd. Maybe you're on medications.
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Sure.
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And sometimes medications will cause side effects. Not always. Everyone's like, oh, my God, I have side effects. Don't read the side effects. Can I just. Can I just sidebar for. Please don't read the side effects.
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You know, that is. What. What of my. One of my ways to describe OCD is you could tell someone has OCD because they've taken that little pamphlet out of the medication, unfolded it into the nine by nine thing that it is and read it word for word and then come to the next session going, can we review all of this? No, but, yeah, exactly.
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Yeah. It's the thing I rip off and throw out.
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B
But.
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But in real life, people can have side effects. You can have a decreased libido. You can be fatigued. Sometimes it can cause erectile functioning issues. Sometimes people can't orgasm maybe, you know, can cause weight fluctuations that could make people feel not. Not attractive. So there's also having to balance medications with wanting to have a healthy sex life. Life when you have OCD and working with somebody who knows what they're doing as far as prescribing is important.
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Because there are certainly things that are less affecting than others that a doctor could tell you all about that specializes in that.
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But also sometimes they'll tell you, like, oh, well, if you normally have sex at night and you normally take your medication at night, maybe you should take your medication in the morning. Or, you know, maybe you should have sex and then take your medication. You know, so there's things that a doctor can do that can help so that you can be on your medication and hopefully still be able to have, you know, your sex life and whatnot. Because a lot of people freak out and, like, I don't want to take meds because of that. But, you know, Right. Sometimes you need meds to help at least a little bit. So what about scrupulosity? How the fears and sexuality.
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B
Oh, welcome to one of my favorite topics. Imagine being in church and hoping, okay, can I at least while in church, not have a groinal response or, you know, look at some statue or icon and not think about them nude or something of that nature? And OCD says no, no, you, you. You will be thinking of them nude and you will be having a groinal in church. Right. Because you don't want to, and therefore you are going to. So nothing is off the table. There are no limits. There's no place. And again, this is where people will say to me and Tracy, but why does it have to happen there? And we have one similar response, which is, because you don't want it to. That's why it happens there. Yeah, but I just want a place where it's not going to occur. And we say, how about working on accepting that it'll occur at any place? And when you do that, the likelihood is it's probably not going to occur once you accept the fact that it could occur anywhere.
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A
Absolutely. And. And we can't shame ourselves, people, with OCD are some of the worst shamers of themselves. And I always ask, like, when I'm running group or when I'm in a session with somebody, and they're like, I'm just, like, such a bad person. You know, I'm a sinner, or I'm morally, you know, just a bad person. I don't have any ethics, you know, something like that. And I'm like, oh, okay. I'm like, do you think that about me? Oh, no, not you. Do you think about other people with mental illnesses? No, no, no. It's like, oh, you just hate yourself. Well, that's terrible. You deserve the same kindness and gentleness and patience with yourself. We. I cannot say it enough. I feel like I should just get a forehead tattoo that says this. You do not con. You do not create your content. OCD comes up with it. We don't. It's not us in our. In our morals and all going, oh, let me create this. You know, terrible. Worst case. And it just happens. It happens. And it's like, okay. And I've heard sometimes people call it, like, synthetic thoughts. They are made. And then what? And then you just have to move on.
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B
You know what surprises people with OCD sometimes is that those of us without ocd, you know, we're the yin and yang of each other here. You've got it. I don't. But those of us without OCD also have all of these thoughts and images and urges, too.
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And that hopefully goes to prove to people that the problem isn't the thought or the image or the urge. It's the way you react to it. Can you just go, well, that was weird, and move on? Or can you be caught up in doing compulsion after compulsion after compulsion?
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A
That's right. And I think that's where people get really thrown off. Like, people will say, how are you supposed to go on with your day? I remember suffering. I remember being a college student and just sitting in a big, you know, lecture hall with just every possible thought, like, you're going to climb over. You know, you're going to do this, you're going to do that, you're going to do. And it's like, okay, I can't even pay attention to what's happening here because I don't know what's going on. And I'm like, why are you thinking like this? And then I have a bunch of anxiety, and then I'd be like, I need to get out of this room. And then, you know, now I get those same exact thoughts, those same images. Same urges. And the difference, because I've been through ERP therapy, is I, I, I'm just, like, just used to it. It's like somebody offering me a glass of water that I don't want. Like, that's about as. It's pretty neutral. Like, it's like, oh, you know, like, I shared the other day. You were there when I shared this, but I was at a o. An OCD game changers event. And I shared a very realistic. What does it look like to live with ocd? So whether it's sexual or anything else, and I always have either sexual or harm things going on at any given time.
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And so I was, I had the spotlight on me and I'm sharing about my story of OCD lived experience. And the entire time, just like, screaming in the back of my head was. And this image was like, you are just going to jump on top of the microphone stand and it's going to go up your vagina and come out your mouth. And it was like that entire, like, sentence as well as the image as well as the urge, because I'm standing right next to it. And I was like, just sharing my story and just talking. And I waited till the end and I was like, by the way, this entire time, this is what thought I've been having in the image. They're like, what? Like, you wouldn't have known. And it's like, yeah, this is what living with well, controlled OCD looks like. You're going to keep having intrusive thoughts. They're just not distressing. I wasn't thinking, oh, gosh, what if I do? Because that's ridiculous. It's very ridiculous, obviously. And I was so excited because afterward somebody came up to me and was like, hey, I have ocd. Super weird. I had the exact same intrusive image and thought as you about the microphone phone. I was gonna, she was gonna run up and do that. And I was like, oh. I was like, my OCD's so boring. Like, apparently you can't even come up with, like, a unique, like, situation just for me.
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B
Like, twins OCD there or something.
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A
Yeah, Yeah. I was like, look at that. And as somebody who, before I got treated, I would have been like, I'm, like, the craziest person ever. I'm not. Okay. I should leave this room before I actually do that. And then that would hurt. So just want to say, like, there is hope. We're not trying to get rid of the thoughts or the images or the urges. We're just trying to learn how to Live with them. We're not figuring them out. I've never asked myself in the last bazillion years since I did erp. But what if I do? But what does this mean? I'm just. I don't dabble in trying to find certainty, because maybe someday I will do that. Maybe. I don't know. But not today. Not today. So, anyway, I just wanted to share that.
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Let's talk about another way, though, that OCD and sex come up, which is then.
- [31:29]
Did I have consent? Have you had sessions with people? I've had a lot of, oh, gosh. But what if there wasn't consent?
- [31:35]
B
You know, when the MeToo movement came around, I got so many calls from people who worried, what if I did something and there wasn't consent, and now I'm going to get sued for it.
- [31:50]
A
Yep, exactly. I remember that. Yep. A lot of people will say, and then. Then they do compulsions, like calling for reassurance. Hey, remember when we did this? Remember when we dated? Remember how we were married? Is that consensual? You know, asking over and over and over.
- [32:10]
But, yeah, I wanted to point that out. A lot of people will say, but nobody talks about this, so my thing is different. So it means it's not ocd. So I'm trying to think of all the different things and ways that. That, you know, it can come up.
- [32:25]
B
That is one thing. Tracy and I get a lot where we'll do talks like this, and then someone will say, but you said the word two, and mine is a three. So it's very different. We're like, no, it's the same. It just, you know, there's nuances to each one of these things. But just because there's a nuance doesn't mean that suddenly yours is the worst or different than everybody else's, and no one's ever heard it before. And therefore, it's something brand new and we should start a new field of science around it or something like that.
- [32:57]
A
That's right. And. And also just to point out to people, because people will say, I have a worse OCD than you. And it's like, well, I hate to say this, but OCD is one thing. Nobody has ever been diagnosed with a type of ocd. Your OCD is type sexual orientation. Yours, but yours is different. That's. That's not how it works. We only diagnose OCD because. Because the content or the theme. The only reason we even have themes is because OCD is so boring that it comes up a lot of times under Sort of like a handful of umbrellas. And so we just use that. We're like, okay, this is what it is. And so if you're ever like, I know, but mine's different. I haven't heard people talk about cannibalism of people while having sex. You know, twist it around all you want, it's still ocd. Still. Especially if you've been diagnosed with ocd. So I think that's important. Have we covered all of the different areas that we could possibly cover for this? I'm trying to think if there's any other. Have we left a stone unturned? I mean, there's. I. I mean, throwing beastiality. That's very common, right? I'm going to sexually assault my cat or I'm going to have sex with my dog, or maybe I touched my dog inappropriately. That comes up a lot.
- [34:21]
B
We didn't talk about sexual orientation, ocd.
- [34:23]
A
We did not deeply talk about sexual orientation, ocd. That is true.
- [34:27]
B
Or gender identity, which. And gender identity, which is not a dislike of any particular orientation. It is a what if I'm not the orientation that I am? And so you could find someone attractive that is not of your orientation and then worry about what if that means that I'm only attracted to that orientation now. And then, now I have to leave my spouse and my. If I have a family, my children, because now I have to go be with this other person. And then that goes back to the what if that pops into your head while you're being intimate with your current spouse and just all of these types of things. So OCD will even attack to your origins of who you are and get you to doubt that as well.
- [35:10]
A
That is so true. And, and there's no trying to, like, people will say, but how? If I was only certain.
- [35:18]
And OCD is not a fact disorder. Because I've tried saying, well, okay, let's just go with the facts, right? It was like, what about the day before this hit? Where were you then? There it is. Okay, so whatever it was before, it is now sounds good, or maybe you're getting flexible. I don't know. But if it feels distressing, right? Has anyone ever been like, oh, gosh, but what if, you know, what if, like, you, you're trying to date a particular. Let's just say I'm looking for a guy that I want to date. You know, am I even like, oh, my God, what if I date a guy? What if I go on a date with a guy? Oh, no. A date with a guy like no, not if I'm looking for a guy. But what if I really want a girl? Oh, that doesn't sound good. Oh, okay. Well, I know, but what if you do? Then should you look for a guy? I don't know. Maybe she'll look for a girl. Now I'm just confused. And now I'm just going in circles with myself.
- [36:12]
B
Let's get the porn out and see what we're attracted to.
- [36:14]
A
Let's get it out and see. Oh, now I'm aroused. Now I'm help now. Oh.
- [36:18]
B
Oh, my. Oh, jeez.
- [36:20]
A
And that's a thing in the life of sexual orientation, is it? It goes all the ways. It could be whatever. People who are gay think they are not. People who are not gay think they are something else. You can be bi, but maybe it's there a certain percentage. Is there trans? But it doesn't you sexual, like, yeah, there's. There's gender identity. Am I trans? Am I not trans? Am I fluid? Am I not fluid? Am I experimenting? I'm not. It's like.
- [36:50]
The endless search for certainty. OCD will never let you have it. So that's a fun fact. Doesn't matter what your theme is. And there's no such thing as a worse theme. There might be a theme that bothers you more than other themes. And people will also get confused because they'll say, but what if there's an element of truth? Which, okay, there could be. Maybe I'm going to wake up one day and maybe I'm going to feel differently about something and I'll worry about it on that day. I'm not going to worry about it today because it's not happening today. Maybe today I'm uncertain. And if I become certain, I'll know, just like I know other things. Just like if I said, what is your favorite food? You would know. And if I said, what is your least favorite food you would. Would know. He wouldn't be like, I don't know. Maybe it's pickles. I. I think I like pickles. I don't love pickles. Are they pickles? Sour pickles? I don't know if I love. It wouldn't make any sense. But now, because it's about your sexuality, now you're confused, right? Not a logic disorder. That's why straight CBT doesn't work. That's why you have to go to erp because all so many of us have tried the wrong therapy. That's. This is what happened to me, right? Of like, oh, yeah. Like, well, what if. Does it make sense? I'm like, no, okay, well, if it doesn't make sense, then you won't do it or think it. And it's like, okay, thanks. Bye. See you later. Sounds cool. That sounded really easy. You know, I would just. Right. Solve it in one minute.
- [38:17]
B
Right. Let's talk about that treatment for a little bit. Because as you stated, Tracy, there may be many subtypes, but we are only diagnosed with ocd. And there's only one treatment. There's. There's not like a subtype treatment. And we do this for that sub. No, we do ERP across the board.
- [38:33]
A
For all of it.
- [38:34]
B
Whereas. And it's really two parts. We're exposing people to whatever those thoughts, images, and urges are. And. And the. And is the most important part. We're doing response prevention, which is helping people to eliminate whatever those safety behaviors are that they're doing when they're exposed to those thoughts, images, and urges. Be wary of someone who says they're an exposure therapist instead of an exposure and response prevention therapist, because people with. With OCD are constant exposed to things all the time. If just pure exposure worked, people with OCD would not need therapy because they're always being exposed to things that are their thoughts and urges. You'd be, yes, instantaneous cure. That's not the issue. The issue is if you aren't doing response prevention. And my mentor, Alec Pollard, came up with an equation, E minus RP equals 0. If you aren't doing response prevention, you aren't going to see change. And this is the hardest part of therapy, because we're asking people to just be with whatever their thoughts, images, and urges are and not attempt to neutralize them in any way whatsoever.
- [39:38]
A
That's right. And I think this is the hardest part, and this is the difference between you and I and other people with OCD and not ocd. When we get triggered. When you have ocd, you get triggered. You get the chemical shower of the adrenaline and all the things coming down to make you react. So I always tell people, I will tell them sometimes on their second or third session, listen, I really just need you to do two things, and you'll be all set. One, learn that it's gonna feel real, but you need to react like it's not even there.
- [40:12]
B
Right.
- [40:12]
A
They're like, what? Yep. I need you to feel like it's okay. I acknowledge it feels real. It feels urgent. Feels like I must solve it. It feels dangerous. It feels disgusting. Disgusting. Whatever the feel is that you're going to feel it, but you're still going to need to not compulse about it. And that. That's going with ERP therapy. Over time, it's going to trigger you to be less triggering. It's not going to be like, you know, I get triggered most. I don't even have to get triggered. I just have intrusive thoughts all the time. And that's fine. Right. Back in the day, I was like, hiding in my closet, curled up small, crying, thinking. I was like, you know, all these terrible things were going to happen. Now I have the same thing probably times a thousand in terms of how interesting it is. I'm just like, okay, that's fine. Like, I just. It's nothing. I'm just like. But. But I feel the feels. I still get something. I'm like, you know, I feel a little anxious or whatever. Not a big deal, because I don't try and figure it out.
- [41:18]
B
There you go.
- [41:19]
A
Right? It's like a permanent itchy mosquito bite. That's what I like to think about it. As if you're. If you had an itchy mosquito bite and it never healed, like, sometimes it's kind of like that. It's annoying. But, you know, you got other things to do, so it's well worth doing the work.
- [41:37]
And it's not scary like people say. It's really not. We start very small, very small things. Having you imagine something or write something down. It's not a big deal. But without doing, learning how to behave your way through ocd, if you don't change the way you react, if you don't stop compulsing, you're not going to feel any better. You're going to keep getting worse.
- [42:04]
So I think that we Trying to think, if there's anything else. Is there any. Are there any stuff. Stones unturned in terms of sexuality? We kind of covered the. Did. We covered scrupulosity. We really, I think, you know, maybe just like a little slice of. In there of sometimes it. It really can attack people's religions.
- [42:28]
B
Sure.
- [42:29]
A
And sometimes people will end up doing things like compulsions like compulsive praying and things of that nature.
- [42:39]
B
To not have these thoughts or images or urges or desires or wants or needs or whatever they're describing them as. And of course, those just become compulsions in that situation. Yeah.
- [42:50]
A
Yeah.
- [42:51]
B
I'll say a prayer is to commune with a higher power, and a compulsion is to alleviate an obsession. And so very often what people tell us, our prayers are not actually prayers anymore.
- [43:01]
A
There you go. Yeah. Because I was thinking about that Somebody that was getting intrusive religious thoughts during sex. And then they would pray during sex because they were having those thoughts and they were trying to neutralize it real time. And then they would have trouble with sex, obviously, because now you're just praying, trying to erase thoughts, which isn't possible.
- [43:22]
B
Some religions also can look at sex as being a very dirty thing. Right. And so if you. If you happen to enjoy it while you're having it, then maybe that's a sin and you're being bad or wrong in that situation. And, you know, sex was evolutionarily designed to feel good. And that's why. That's why it does. And so many, but not many, but there can be faith that will put a spin on that, that says you just. You should never enjoy that.
- [43:54]
A
That.
- [43:54]
B
That's. That's an evil act.
- [43:57]
A
That's true.
- [43:58]
B
One of only necessity to procreate. And everything else is. Is wrong in that situation.
- [44:02]
A
Right. Like masturbations wrong or something like that.
- [44:05]
B
That's true.
- [44:06]
A
And we should probably put a plug in here. But sometimes you have comorbid things going on or things happening more than one.
- [44:15]
B
Thing at a time. You don't have to be limited to one subtype of ocd.
- [44:18]
A
Yeah. Yeah. So maybe you have a bunch of different things going on and. And ERP will address all of the OCD going on, all of the themes the same way. Um, you learn tools and you use them across all your themes. So that's the handy thing. You just need one set of ERP tools. Then you apply it for the rest of your life, no matter what. Maybe you'll get a new theme. Maybe now you're afraid of whatever's. And you'll apply the same tools you learned to whatever it is that was bothering you when you went in for treatment.
- [44:52]
B
And here's the good thing. After people watch this, there may be questions. Write them, let us hear them. We can always come back and do a part two of this, which is great.
- [45:02]
A
That is true. Absolutely. And yeah. And just know if we didn't say something, that is exactly how it's happening to you. Well, we can't possibly say everything that's ever happened that we've ever heard of. We would.
- [45:15]
B
Yeah. There's 5 million people with OCD around here, so we can't give all 5 million examples, right?
- [45:23]
A
Absolutely not.
- [45:24]
B
We could try, but we're going to die before we finish. If that's okay.
- [45:28]
A
That's true. And that would be so sad because then we couldn't have any more of these where we talk about taboo topics.
- [45:36]
B
And I've got a few other things I'd like to do before death.
- [45:39]
A
So yeah, yeah, makes sense.
- [45:42]
B
Good. Well, Tracy, thank you for joining tonight. And again, we can come back for a part two, depending on what kind of questions or comments we get here. So we look forward to that and thank all of you for watching the get to Know OCD podcast. If you enjoy it, subscribe to the NOCD YouTube channel. If you're looking for help for OCD related conditions, check us out@nocd.com that's nocd.com until next time. Be better to yourself than your OCD ever has been to you. Thanks for watching.