Random events in life, such as unthinking comments by peers at vulnerable moments, can cause some people to start questioning their sexual orientation compulsively (HOCD).
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Abstain from the “rewarding” behavior for long enough, and (after a period of intense withdrawal discomfort) the brain eventually stops activating the related brain circuits with the same vengeance. The same principle operates in addiction recovery. Eventually the brain says, “Meh…no point in getting activated by that germy doorknob because I’m not going to get a neurochemical reward.” Why? They no longer lead to rewarding feelings. When the OCD sufferer consistently denies himself this neurochemical reward (“response prevention”), his triggers gradually lose their power. The OCD sufferer keeps performing his particular rituals because they trigger the neurochemicals associated with reward. Some experts conceptualize OCD as sharing important elements of behavioral addiction because of the role that reward plays. Yet the scientific reason that exposure therapy often helps with some forms of OCD is the very reason that it can backfire in the case of porn-related HOCD. For example: resisting the urge to wash one’s hands compulsively in certain situations.
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“Exposure” refers to willingly entering situations that are likely to trigger compulsions, and “response prevention” refers to purposefully inhibiting one’s coping rituals. Therapists who treat HOCD, such as Steve Seay PhD, often recommend a standard OCD treatment: Exposure & Response Prevention. More properly such worries would be called sexual orientation obsessive-compulsive disorder because they also strike gay people who suddenly wonder if they are straight. Intrusive worries that someone has become gay-although he (she) has been straight for years with no doubts-have gained the label HOCD, homosexual obsessive-compulsive disorder.
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Porn-related HOCD may call for its own treatment protocol