What is HOCD and Why is it Never Talked About?
“Can I private message you.” Is normally how it starts. “My child has an issue that I am nervous to discuss in front of others.” More often than not, they want to talk about HOCD, also known as Homosexual OCD. I prefer the newer term, Sexual Orientation OCD, as it is more encompassing and much more accurate.
HOCD is just another sub-type of OCD. Another flavor in the array of flavors OCD likes to wrap itself in. Most people have at least a couple of OCD themes and they can morph and shift over time. Some will argue that themes aren’t important for that very reason, but I disagree.
When people don’t know about HOCD they quietly suffer for years if not for a lifetime. That’s why we need to teach parents, mental health professionals and the public at large all the many ways OCD can show up.
So What is HOCD?
OCD starts with an intrusive thought, feeling image or song, that gets stuck in your head. In this particular case, the intrusive thought has to do with sexuality and sexual orientation.
Am I gay? Do I like girls? Do I like boys? Was I attracted to her, to him? It can also extend out to other themes. Am I transgender? Am I straight? Am I a girl? Am I a boy? Do I find my pet attractive?
I have seen every rendition of this theme – and I’ve seen it even in young kids.
People with HOCD are Not Homophobic
There is a misconception about this theme. If you are so distraught about being gay, doesn’t that mean you are homophobic? Not even close. There is a reason OCD is called the doubting disease. It makes you doubt.
Did I lock the back door?
Did I say a mean word?
Did I wash my hands well enough?
Did I find that girl attractive?
Did I walk like a boy?
Doubt, doubt, doubt. It’s the same issue dressed up in different clothes. I have also seen quite a few kids who were openly gay with HOCD. Their intrusive thoughts made them worry they may actually be straight. It doesn’t matter what your orientation is – it just makes you doubt it.
In fact, one of the biggest compulsions that go hand in hand with HOCD is checking. People mentally check to weigh the evidence for and against each preference. They check their attraction responses. They check where they stare, where their eyes are drawn.
The more they check, the more the OCD grows. The more the OCD grows, the more they check. It’s a vicious cycle that never seems to end.
HOCD is Not About Gender Dysphoria or Genuine Confusion
Often HOCD gets mislabeled as Gender Dysphoria or as genuine confusion over the person’s orientation. Parents bring their kids to therapists who have never heard of HOCD and they wind up spending each session, unwittingly engaging in checking compulsions until the hour is up. This does more harm than good.
A person with HOCD is acutely distressed by the notion that they may be the opposite of who they think they are. They do compulsions to keep the discomfort and distress at bay, but it is never enough. The more the person tries to process these issues with others, the deeper the issue becomes.
Help for HOCD
Just like all the other flavors in the OCD rainbow, HOCD is approached in the very same way, with Exposure Response Prevention (ERP). ERP is the gold standard approach for all OCD themes and HOCD is no different. It is important to find a therapist qualified to treat OCD and do ERP. A great place to start is with the International OCD Foundation’s resource directory: www.iocdf.org/find-help.
HOCD is just one theme in a sea of themes. Themes will come and go, but OCD will be the constant. It is important that people learn the various ways in which OCD can disguise itself so they can call it out and not let it fester and grow.
Learn How to Help Your Child Crush OCD:
Parents cannot get rid of their child’s OCD, but they do have a crucial role to play in the whole process. In my therapy practice the kids who do the best are the ones whose parents take an active role in educating themselves in the many ways OCD can show up. If you miss OCD , you can’t tackle OCD.
In my on demand, online class, How to Crush Your Child’s OCD, I walk parents step-by-step on the many faces of OCD and I teach parents how to empower their children and teens to help themselves through ERP.
Explaining HOCD to Kids:
One of the best ways to help a child with HOCD is to let them know what it is. This is a very isolating and embarrassing theme. Parents can help reduce the shame HOCD can cause by having an open discussion about it.
To help you in this endeavor, I have created a Youtube video for kids and teens explaining how HOCD works.
You can click below to watch it. If you don’t have time, click here and hit subscribe to watch it later. I have new videos for kids and teens with anxiety/OCD every Thursday, so subscribe and keep updated.
Other Resources on HOCD:
Living with Sexual Orientation OCD | Made of Millions Foundation
How Do I Know I’m Not Really Gay? | International OCD Foundation