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Dr John B
Dr John B, Psychologist
Category: Mental Health
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Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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My son who is 26 yrs old has being diagnosed with OCD and psychosis.

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My son who is 26 yrs old has being diagnosed with OCD and psychosis. When he has a crisis it usually envolves homosexual thoughts that bother him greatly.....he fears that he may be gay. Is there any truth to this, or does this stem from a experiemental episode that occurred when he was a adolescent 8-12yrs old?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr John B replied 1 year ago.

Hi,

Sorry to hear of the situation. OCD involving obsessive thoughts around sexual orientation is actually a reasonably common form of the disorder. I would imagine that an early experience may increase the likelihood of these kinds of obsessions forming (just as actually exposure to bacterial infection can increase the likelihood of contamination obsessions). It is very common for the obsessions & rituals associated with OCD to vary/change over time and so it does sound very much like you are describing the ongoing development of OCD. Obviously none of this excludes the possibility of actual sexual identity crisis but from what you describe it is entirely possible that this is all OCD related.

I will pause here and wait for any response you might have to what I have written so far.

Customer: replied 1 year ago.
Relist: Incomplete answer. He needs reassurance that he is not gay. What other signs or symtoms might we look for that would assure us and him that he is not gay, other then the obvious behavior. He get furious when we even suggest that it's ok to be gay. Accordding to him the thoughts are really graphic but unrealistic and won't go away, even with reassurance that thought never really happen.
Expert:  Dr John B replied 1 year ago.

Hi,

Just to clarify, my previous post was not meant as a full answer I was pausing to wait for your to read what I had written so far and then respond with further questions, etc. This can be an ongoing conversation and I won't attempt finalize my answer until your are happy that I have answered any & all questions you have.

So, the dilemma faced in this situation is that obsessions within the context of OCD is very much focused around uncertainty - questions or possibilities that it is very hard to ever be sure about. This is the nature of the disorder and makes the provision of reassurance nearly always futile. Individuals suffering from OCD become obsessed about the possibility of something and feel driven to seek certainty - which is usually possible to obtain.

For example, ritualistic checking is a very common OCD symptom. In this situation people repetitively check things like door locks, light switches, etc because they become obsessed with the possibility that the item may be unlocked/switched off etc. The only way they can seek assurance is to keep checking but this immediately fails as soon as they walk away (and need to check again).

In similar fashion individuals who become obsessed about sexual identify become obsessed with the possibility that they are (for example) gay and become disturbed by any thought, image, situation or behavior that could possibly suggest they are gay. Reassurance usually provides some relief for a brief period if at all) before the anxiety around the uncertainty becomes intense and they need to seek further reassurance.

The botXXXXX XXXXXne for all of this is that even if he is desperately seeking reassurance providing it won't help as it just feeds into the cycle of obsession and ritual. There are well know and effective treatments for OCD and I would be happy to discuss these with you if you would like.

I will pause again here and wait for your response to what I have written. Please remember that I am not intending this as my full answer yet, I am just giving you the opportunity to respond at this point in time. You don't need to request a re list due to incomplete information, just reply to this thread.

Customer: replied 1 year ago.

My self and my family have been educated on this since this surface when he was 13 yrs.old and it was terrible then. I know that there is no easy answer to his problem and there is good prognosis if he continues with his medication and some support from us and groups. Right now he is going through some rough times and we feel helpless. He might just need his medication adjusted (Prozac) and return to his comfort zone. Our biggest concern is whether he will be able to hold a regular job. He does have a 4 yr degree in Finance and Economics, but no motivation to seriously seek employment, it's been 3yrs.since he graduated. Thank you for your time and answers.

Expert:  Dr John B replied 1 year ago.

This must have been really tough for the whole family. There are many people who maintain a stable career while manging OCD and so the OCD is not necessarily an obstacle to stable employment. Cognitive Behavioral Therapy (CBT) is widely regarded as the gold standard therapy for obsessions and compulsions and the National Institute for Clinical Excellence recommends CBT as an effective treatment for OCD, see here. If he hasn't tried CBT then I would recommend that this be incorporated into his current treatment approach. I can direct you to a referral service if you'd like assistance seeking CBT or I can also suggest some CBT self-help material if you'd like. If you'd like me to continue or have any other questions please let me know. If not...I wish you and your son the best of luck.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
Dr John B and 2 other Mental Health Specialists are ready to help you
Expert:  Dr John B replied 1 year ago.
Hi Rito,

I hope you're son is having some succes with the current episode of obsessive thinking. If I can be of further assistance, or if you you ever have further questions please don't hesitate to contact me directly.

Regards,

John

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