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Sexual Obsessions in OCD (Obsessive-Compulsive Disorder)

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Sexual obsessions in OCD are recurrent unwanted sexual thoughts, such as the fear of being attracted to something unwanted, taboo, or morally “unacceptable” based on one’s particular worldview.  Although all forms of OCD can be debilitating, sexual obsessions can be especially confusing and disabling for sufferers because sexual obsessions target one’s fundamental identity as a social being. In addition to anxiety, which characterizes most obsessions, individuals with sexual obsessions often experience extreme guilt, shame, hopelessness, and depression.  Individuals with OCD with sexual symptoms often mistakenly consider themselves deviant, disgusting, or evil. Moreover, incorrect assumptions about the true causes of their unwanted sexual thoughts make them less likely to seek treatment or to share their symptoms with others.  In my Palm Beach County, South Florida psychological practice, I treat many individuals who have lived with sexual obsessions for many years...

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Scrupulosity

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What is Scrupulosity? Scrupulosity is a form of obsessive-compulsive disorder (OCD) characterized by religious and/or moral obsessions. Scrupulosity can sometimes be difficult to recognize because even within a single faith community, religious beliefs and practices vary widely. There is no singular belief or behavior that is diagnostic for scrupulosity. Instead, scrupulosity is best regarded as a pattern of beliefs and behaviors associated with excessive worry about having committed a sin or engaging in immoral acts. Concern may focus either on thoughts or actions already taken or the possibility of committing sins in the future. This results in significant emotional distress, guilt, and despair. Scrupulous individuals also worry about the sinfulness of having bad thoughts. This experience is very similar to individuals with OCD who experience harm-related obsessions (e.g., the fear of harming a child or loved one). People with...

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Scrupulosity & OCD: Religious/Moral Symptoms

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Question: I have scrupulosity (religious/moral obsessive-compulsive disorder), and I am triggered by religious posts on Facebook. When I see a religious post, I feel like I have to repost it or God will be mad at me. I also worry about what other people think about these reposts, which then leads me to fear that God will judge me for worrying. Any suggestions for treating scrupulosity (religious OCD)? Religious Scrupulosity/OCD For many people with OCD/scrupulosity, treatment can be especially confusing at first. Every action or inaction can feel potentially dangerous, which is why scrupulosity often goes untreated for so long. The very fact that you recognize that this is related to obsessive-compulsive disorder is excellent. It also sounds like you have insight about your OCD symptoms and the OCD positive feedback loop. Many people with religious obsessions don’t realize...

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Treatment of Unwanted Thoughts & Sensations in OCD

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In my post about the treatment of sensorimotor OCD, a reader asked about the ultimate goal of treatment. Should the goal of treatment be to never notice an unwanted thought or symptom? Suppressing Unwanted Thoughts & Sensations in Pure-O & Sensorimotor OCD Let’s explore this idea in detail. Suppose I adopt the goal of being 100% symptom free. After all, this is the endpoint of treatment that most people are seeking. What are the implications of this goal? You will likely slow down your progress. Why? Because every day you will encounter something that violates your expectations. Unwanted thoughts are a normal part of the human experience. Everyone has thoughts that are unwanted, aggressive, selfish, perverse, or deviant at times. For people without OCD, these thoughts tend to be fleeting because the thoughts themselves aren’t treated as significant. They...

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Thought Control & OCD (Obsessive-Compulsive Disorder)

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OCD & Thought Control Can I learn to eliminate my OCD thoughts? I hear this question all the time from new patients who are searching for ways to suppress their unwanted thoughts. When I answer this question with a resounding “no”, there is often much surprise and grief. After all, this is why they’re coming to see me. Many people with Pure-O OCD imagine thought control to be the only way to improve the quality of their lives. Unfortunately, thought control conceptualized in this way is not an attainable goal in OCD treatment. Our brains just don’t work like that. I explain it like this, “A penguin obsessed with flying is an unhappy penguin.” Expecting thought control to work is a little bit like a penguin flapping its wings and expecting to fly. It may work for the other...

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Reassurance Seeking in OCD

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Although contamination OCD and washing rituals often go hand-in-hand, many rituals in this domain do not actually involve cleaning or disinfecting. These more subtle rituals are often based around reassurance seeking behaviors that become ingrained in everyday habit. In the context of exposure and response prevention (ERP), reassurance seeking OCD rituals are just as important to address as washing rituals. If you resist washing rituals but continue to engage in reassurance seeking rituals, your recovery will eventually stall (or perhaps never get started at all). Do you believe that knowledge is power? Do you aspire to optimum health? Do you believe that an ounce of prevention is worth a pound of cure? If so, you may be vulnerable to reassurance seeking rituals. Information-Seeking vs. Reassurance Seeking Reassurance seeking rituals involve mentally preparing for potential threats. These compulsions are often...

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