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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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Sexual Outrage

Customer Question

What might be the cause and feasibility of "cure" of this behavior? Thank you for your attention. "Sexual outrage and associated rituals : Sexual obsessions in OCD are unwanted thoughts, images or impulses which make you anxious or distressed every time they come into your mind. The are completely inconsistent with a person's true values and desires, and as a result they are often associated with high levels of shame and embarrassment in addition to anxiety or fear. Common examples include thoughts of molesting children, unwanted homosexual images, and impulses to inappropriately touch or stare at breasts or genital areas. Most people with this type of OCD respond to their thoughts by reminding themselves that they would never do such a thing, and by trying to avoid situations where the thoughts are likely to occur." Source: http://www.crufad.org/index.php/learn-about/compulsions
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi,

As a form of OCD it is generally accepted that there isn't a specific cause for the illness but rather that it develops due to a diathesis-stress process. The diathesis-stress model explains psychological illness as a result of biological/genetic vulnerability and stress from life experiences. The assumption is that the onset of a certain disorder may result from a combination of one's biological disposition towards the given disorder and stressful events that bring about the onset to such disorder. The term "diathesis" is used to refer to a genetic predisposition toward an abnormal or diseased condition. According to the model, this predisposition, in combination with certain kinds of environmental stress, results in disordered behavior.

Whether there is a 'cure' depends on how you define cure. There are certainly many people with OCD who experience a cessation of symptoms but there also many people who experience relapse or experience significant but not complete reduction of symptoms. If the diathesis-stress model is correct then OCD like other anxiety disorders is a condition that could always potentially come and go as the diathesis (vulnerability) would remain.

While CBT is one of the recommended treatments for OCD there is also some evidence that SSRI anti-depressants can reduce symptoms and if you haven't tried this then a combination of CBT and an SSRI may be good option to consider.

I will pause here and await any further questions you might have.

Customer: replied 2 years ago.

I took Anafranil and diazapam for six years with some success. In 1986, I changed to prozac and clonazapam (2.5 mg ) for enhancement in difficult social situations which is very helpful but leaves me with a hangover. (What option do I have?)
Mostly,I isolate but sometimes I must interact with my married children's parents. This "staring" is extremely
difficult in those situations. Should I take them into my confidence since at this point I believe the poor bastards think I'm hitting on them? Many people react as if I'm a deviant or homosexual and shun me.
My daughter and daughter in law are pregnant so the future looks bleak. Should I show the literature from my first question to my children at this time?
Expert:  Dr John B replied 2 years ago.
If you believe that the behavior is impacting on your relationships then I would certainly encourage you to explain the situation to your family. If you chose to do this I would also encourage you to provide them with supporting literature as people often have very, very limited understanding of mental health issues and require some education so that they can understand. Do you have any family member that is aware of the situation and could help you with this?
Customer: replied 2 years ago.
I appreciate you comments.

Two More Questions.
My children (35 and 37) have a lay understanding but I have not been as specific as described in my initial question above. My daughter is a teacher in Manhattan but is pregnant and due next month. So I don't want to upset her with this issue. I will speak to her tonight via web cam. Should I mention it?

This issue is more difficult with my son's in laws. The father is a typical "comfortable" lawyer and the wife is a retired teacher and in my view both would be quite uncomfortable with this type of question.

Also, how could I establish a support system as described below without going into the poorhouse?
Wiki: "More importantly, it has stimulated research and treatment on how to mitigate this stress, and therefore reduce the expression of the diathesis, by developing protective factors, which include rigorous and nuanced psychopharmacology, skill building (especially problem solving and basic communication skills), and the development of support systems for individuals with these illnesses."

Ideas?
Customer: replied 2 years ago.
"skill building (especially problem solving and basic communication skills}"

Are you aware of any literature or source that deals with this?
Expert:  Dr John B replied 2 years ago.
Without personally knowing the people you are considering informing it is impossible for me to advise you on whether you should actually tell them or not. However, if you believe that the behaviors are already having a detrimental impact upon your relationship with these people then it may simply be a case of weighing the damage the behaviors are currently causing against the potential damage disclosure may impart (if it imparts damage at all - it may improve the situation.

In regards XXXXX XXXXX the support structures it may not be as difficult as you think.

"rigorous and nuanced psychopharmacology" - connecting with a skilled and interested Psychiatrist will take care of this. Do you have access to Psychiatry?

"skill building (especially problem solving and basic communication skills)" - a good Clinical Psychologist will take care of this. Do you have access to Psychology?

"the development of support systems for individuals with these illnesses." - a good Clinical Psychologist should also be able to assist you with this.

What is your situation in relation to accessing specialist mental health services?
Customer: replied 2 years ago.
McGill University Health Center has many experts but the problem is access and payment. Psychiatrists are free to dispense drugs and discuss for 1/2 hour every six months. How could I persuade the Dept. of Psychology at MUHC to organize a group that would address "sexual outrage" or staring? I feel I could take an organizational/facilitator role. I have 35 years of experience as a teacher. By the way, the Paterno news item frightens the shit out of me.
Customer: replied 2 years ago.

Is it worth sending our thread with the precision of your answers to my son and daughter for analysis and comment?
Expert:  Dr John B replied 2 years ago.
I'd go with trying to make contact with someone at McGill. Academic departments regularly conduct treatment research and offer low cost services as part of their teaching programs. As an initial target I would do a little research and identify an expert in the area - they will be able to recommend how you gain assistance.

I'm not familiar with the Paterno item you refer to.

You are more than welcome to forward this conversation to family members if you feel they would benefit from it.
Customer: replied 2 years ago.

Your answers cannot be copied from to gmail chrome with my MacBookPro. Are you aware of this?
The usual and paste does not function with your response? Solutions?
Could you copy the tread and send to my email? XXX@XXXXXX.XXX

Paterno? http://news.google.ca/nwshp?hl=en&tab=wn

This is why I many who think it through will not consider working with minors?

Thanks.
Expert:  Dr John B replied 2 years ago.
I think you are able save the thread and come back to it later. Could you open it when they are present? I have no knowledge of using Just Answer from the customer end and it is probably best if you contact Administration and check if/how you can retain a permanent copy of the conversation. Email addresses are blocked through this site so even if you type yours out for me I cannot see it (it comes up XXXXX@XXXXXX.XXX)

The link you pasted does not go to a specific news article and I can't see any article on the page with Paterno in the title.
Expert:  Dr John B replied 2 years ago.

Hi,

Was my answer helpful? If so, please select Accept! If not, let me know and I will opt out and open the question up to the other experts to answer.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and 3 other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
Yes, insofar as my problem is, after 35 years , for the most part insoluble, I thank you for your input. I have made an appointment to meet with my son to show him this thread and I will contact the McGill University Health Centre to investigate if group support /therapy is possible as you suggest.
Expert:  Dr John B replied 2 years ago.
You are welcome. Good luck!

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