HOCD over a single person

Hello everyone,

It's been three years on and off I've been living again with HOCD (after 8 years ocd-free), which however manifests itself in the form of obsessing over a specific person, usually a close friend or coworker. So the thought would go like "if you're gonna think about him you're not gonna be able to have sexual intercouse with your girlfriend" or "well, if you think about him now you won't be able to enjoy this nice night out" and so on.

I proud myself of always being able to play this thoughts down but now they've become intrusive all day long and it's not about believing them or not (I don't), but rather that it's starting to affect my quality of life as it's omnipresent, as I feel like I'm having a filter put on which prevents me from enjoying life and being in the moment. It's almost as a short circuit in my brain.

Now I have two questions:

1). Does anybody else here obsess over a single person?
2). I'm not seeking reassurance here, I'm more in search of recovery stories (possibly without SSRI); I read that exposure therapy works, but I'm wondering whether for a person with no compulsions whatsover and obsessing over a single person that would work too..? Any first hand experience with that?

Thanks in advance for your inputs.

I'm not sure if I understand what you are saying, so let me see if I am getting this right.

You are a man who is dating a woman. But you are having intrusive (unwanted) sexual thoughts about a particular man, such as a close friend or co-worker? The intrusive thoughts are causing depression which ruins your night out or intimacies with your girlfriend.

You know this is related to OCD, so you are not feeling what most people with HOCD do.

Obsessing over a single person? You say, co-worker or friend, which means to me that this single person occasionally changes. Is that correct?

I don't think I can answer the question without clarification of the above.

Hello Otter,

Yes, I developed an HOCD around 15 years ago. It then remitted after three years, replaced by SOCD for a while, followed by a relateively calm period of 8 years. This long hiatus made me understand that all of the content of my HOCD was nonsense, and that I'm very much heterosexual (with that 1% uncertainty that I have been advised to apply).

Now, shortly after meeting my now girlfried almost 4 years ago, the HOCD returned in full force, also because I knew since the very first weeks that she's the one (we're actually getting merried in a while), which made it all the more worse. The thing is, my HOCD manifests itself in the fear of obsessing over a single person of my same sex: for instance, I obsessed about one of my best friends for a while ("If I think about him I won't be able to have sex"), then a coworker, and now over another close friend of mine, except this time around it's much more powerful and omnipresent, i.e. the intrusive thoughts about him are there 24/7. The trigger could indeed be the marriage, so the higher the prize, the more intense is the obsession. For me it's really the worst thing ever because it means not giving to my girlfriend that space in my head that she deserves, and basically having an unwanted presence in my brain when I'm with her, which makes me hate everything. For the first time ever I'm also experiencing feelings of depression because of this, which I never had before (only anxiety). So in this sense my HOCD is different because it focusses only on one person and it's not even fear about wanting to have sexual intercourse with that, it's more the desperation to have this person inside my head 24/7 (an intruder, basically).

Now my question is: I really would like to avoid resorting to SSRI and use it only as a last resort. I've been reading everywhere that ERP should be the number 1 therapy in such cases, particularly the imaginative ERP. So my question to the public was:

1). Is anyone else here with HOCD obsess over a single person?
2). Does anyone here have positive feedback about imaginative ERP applied to this specific case? I know that it does work for HOCD in general, particularly the forms exhibiting a lot of compulsions, which I actually don't have at all.

Thanks for your input.

Otter wrote:I'm not sure if I understand what you are saying, so let me see if I am getting this right.

You are a man who is dating a woman. But you are having intrusive (unwanted) sexual thoughts about a particular man, such as a close friend or co-worker? The intrusive thoughts are causing depression which ruins your night out or intimacies with your girlfriend.

You know this is related to OCD, so you are not feeling what most people with HOCD do.

Obsessing over a single person? You say, co-worker or friend, which means to me that this single person occasionally changes. Is that correct?

I don't think I can answer the question without clarification of the above.

Thank you for that detailed response. First let me say, congratulations on your engagement. Second, it was very encouraging to hear that your anxiety/OCD seemed to abate for an extended period of time. I have had shorter periods of relief but not 8 years. However, as I get older my anxiety is less and less and I have many tools to fight things with.

It seems like you have a grasp of how HOCD affects you but you are still being bombarded with imagery, constantly and especially at times when it can interfere with pleasure, causing depression - though probably not clinical. This happened to me a lot. But that is the nature of anxiety when it is at high levels - we are afraid something is going to intrude and since it's our brain it intrudes right on schedule. A self-fulling prophecy.

Let me try and answer some of your questions.

This idea of it being "one person" that our anxiety focuses on, yes, that has happened to me many times. But the "person" was really just a vessel for the negative thoughts. There was nothing in particular about them that made any difference. After a few days or a few years, it might leap to someone else. But the obsessive thoughts needed one person and so it picked one, usually someone who was in my life on a constant basis. So, not unusual.

No SSRI? Ok. I am glad you still have it on the table as a last resort. I take a low dosage of Paxil and it does a world of good for me. But I am also BiPolar and Paxil in specific seems to be really receptive to positive change. But you seem like you are going to try to work this without. It can be done, so good luck on that score.

I'm not sure how imaginative ERP would work here. It is not one of my tools. In the past, I had severe OCD and my Os were very complex, as were my Cs. I don't think "thinking" would have helped. Do you have a therapist? Have you discussed it with them? I would be interested to know how it worked for you if you'd like to share in the future.

Otter.

Yes, it's exactly how you say it, it's a "carrier", but it's still very painful not to be able to live in the moment with the person you most love. It's as if happiness was precluded.

I wanted to avoid SSRI mainly because of their side effects. I'm also quite hypochondriac so I worry that those side effects would impact me very negatively.

As for the imaginative ERP, let's say that my biggest fear right now is to live my whole life with this intruder in my head and merely be an observer of the most important things in my life like wedding, birth of kids etc. I think an imaginative ERP would unfold more or less like this: the last step of it would be to imagine that I'm 80 year old and writing a diary where I regret how poor my life has been because I had an outsider in my mind for the whole time. Then I'd have to record it and play it back to me for hundreds of times until I'm completely desentitized to this thought. Again, this would be the last of many intermediate steps to subside anxiety.

This is how I imagine it. I haven't been able to find a specialist who would properly do imaginative ERP though. I'm doind therapy but it's more about acceptance and it's not very effective I must admit. From what I've read online, ERP and its imaginative subform are the only effective therapies (pharmalogical approaches aside) for OCD.

Otter wrote:Thank you for that detailed response. First let me say, congratulations on your engagement. Second, it was very encouraging to hear that your anxiety/OCD seemed to abate for an extended period of time. I have had shorter periods of relief but not 8 years. However, as I get older my anxiety is less and less and I have many tools to fight things with.

It seems like you have a grasp of how HOCD affects you but you are still being bombarded with imagery, constantly and especially at times when it can interfere with pleasure, causing depression - though probably not clinical. This happened to me a lot. But that is the nature of anxiety when it is at high levels - we are afraid something is going to intrude and since it's our brain it intrudes right on schedule. A self-fulling prophecy.

Let me try and answer some of your questions.

This idea of it being "one person" that our anxiety focuses on, yes, that has happened to me many times. But the "person" was really just a vessel for the negative thoughts. There was nothing in particular about them that made any difference. After a few days or a few years, it might leap to someone else. But the obsessive thoughts needed one person and so it picked one, usually someone who was in my life on a constant basis. So, not unusual.

No SSRI? Ok. I am glad you still have it on the table as a last resort. I take a low dosage of Paxil and it does a world of good for me. But I am also BiPolar and Paxil in specific seems to be really receptive to positive change. But you seem like you are going to try to work this without. It can be done, so good luck on that score.

I'm not sure how imaginative ERP would work here. It is not one of my tools. In the past, I had severe OCD and my Os were very complex, as were my Cs. I don't think "thinking" would have helped. Do you have a therapist? Have you discussed it with them? I would be interested to know how it worked for you if you'd like to share in the future.

Otter.