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What is Sexual-Orientation OCD?
First, Obsessive Compulsive Disorder (OCD) has two essential characteristics – obsessions and compulsions. The first involves intrusive thoughts, impulses and images that repeatedly plague the conscious mind of the person who has OCD; the second merges with the first to complete the disorder – these are the repetitive and ritualised behaviours that serve to counteract or neutralise the unwanted thoughts, impulses and images. So for people who have sexual-orientation OCD they will suffer from pure-obsessions in which intrusive thoughts enter their consciousness involuntarily, convincing them that they could be gay. One corresponding compulsion might be to check for signs that they are not gay. The compulsion is self-reinforcing and feeds the obsession.
What are Paedophile Obsessions?
Some people experience another form of purely obsessional disorder in which their symptoms include intense intrusive thoughts, impulses or images that include sexually harming or molesting children. The person in this situation becomes so horrified and overwhelmed by their intrusions that they feel driven to avoid or escape any situation in which particular thoughts seem likely to intrude, e.g. walking through a park, bathing their baby or babysitting a friend's child.
What are Harm Obsessions?
This is where people who suffer from harm obsessions will have thoughts, images or impulses about harming themselves or someone else. The person, who sees their intrusions as real and terrifying, suffers intense fear and dread, and will often hide sharp objects; or will avoid certain people and places that trigger their obsessions.
Purely Obsessional Disorder is also referred to as 'pure-o' and one estimate shows that 50 percent to 60 percent of OCD cases suffer from this subtype.
What happens when there is a depression overlap?
There is a clear relationship between OCD and depression in terms of either people developing obsessions during a depressive episode, where symptoms can reduce dramatically when the depression lifts; or becoming depressed following the onset of OCD, which is noted as secondary depression. Although a distinction can be made between depression and OCD, there is however a continuum where a person can experience on the one end depression without obsessions and on the other end experience OCD without depression, while at the same time swinging in the middle of the continuum where they tend to suffer a combination of both.
More about this is explained throughout the programme.
OCDonline follows the NICE guidelines at: www.nice.org.uk
What is CBT?
The best way to think about CBT is to consider how thoughts, feelings and behaviours interact with each other. For example, if we show a certain behaviour, such as anger, then our thoughts and feelings will be affected. What CBT does is change the behaviour. This is because behaviour is something we can control; thoughts and feelings we can't. So by altering an angry response for a healthier one, healthier thoughts and feelings naturally follow.
What is ERP?
First, when a person is faced with an obsessional fear and experiences increased anxiety about that fear, they usually respond by either avoiding whatever it might be (e.g. a children's play park); performing a mental counter (e.g. swapping a good image for the bad one); or they will give into an open compulsion (e.g. hiding knives).
The person feels they have to give into these corresponding behaviours to gain anxiety relief momentarily, and to ward off perceived danger or threat.
What ERP does is have the person agree to deliberately face their obsessional fear (exposure), and instead of giving into the compulsion (response), they are encouraged to resist giving into it (prevention).
Giving into a compulsion keeps OCD cyclic in which case the person remains sensitised to their obsessional fear and therefore anxiety goes up and down continuously; yet, not giving into the compulsion while at first increases anxiety does eventually decrease overall because the person begins to habituate to their fear.
Usually, the person has a hierarchy of fears that are listed from the least anxiety provoking item (bottom of list) to the highest provoking item (top of list). Once the list has been established, the person starts from the bottom of the list and works their way up until each item on the hierarchy has been carried out using ERP.
Behavioural experiments are based on gathering information about a person's prediction of what might happen with the purpose of proving the hypothesis wrong. So let's say a person holds the belief that if they pass through the park on their way into town then people will get the impression that he or she has the appearance of a paedophile eager to enter the area and observe and molest a child. In this instance, the experiment will be for the person to walk through the park (rather than continuing to go the long way round to avoid it) and to gather information to disprove their fear. For example, noting down how they are observed by others. The results following the experiment are then discussed with the therapist in which the person starts to realise that their perceived belief is associated with OCD, and not their true values. Moreover, they grasp that thoughts themselves do not link to feared actions and as such cannot make them happen. Behavioural experiments work well when integrated into the CBT model; or for people who are not suited to traditional exposure response prevention methods.
OCDonline offers you the opportunity to chat with professional CBT Therapist, Carol Edwards, who will be delighted to help you work through her structured programme via instant chat and e-mail.
As soon as you enrol on the course you will receive an easy-to-follow psycho-educational package in which you are guided step by step towards becoming efficient in understanding how CBT/ERP works as a complementary treatment for sexual and harm related obsessions and their corresponding compulsions.
Breaking barriers and building trust
Personal feelings often prevent some people from engaging in therapy; for example, you may have had a bad therapy experience that has put you off going back for more sessions. 'CBT Therapy at OCDonline' can help break down those personal barriers and help restore lost confidence in the therapy process, leading the way to personal recovery without engaging in the usual face-to-face sessions.
Carol Edward's focuses on personal recovery and so without any pressure whatsoever you have the opportunity to talk to her about your own experiences as you work your way through the programme, opening the way to building trust in a therapeutic relationship. Question and answer sections are included for you to discuss relevant points either out of interest and/or to talk about the skills needed to recognise and correct maladaptive behaviours associated with your obsessive compulsive problems.
Parents, carers and therapists can enrol too!
OCDonline's CBT Therapy programme is also suitable for parents and carers who look after a young person who suffers from sexual or harm obsessions; therapists unfamiliar with treating this type of OCD; or family members/friends who would benefit from learning how this process works and to assist their relative or friend throughout the course.
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How to start therapy at OCDonline
If you like the sound of 'CBT Therapy at OCDonline' please go to the contact page and leave your details in the message box; alternatively you can e-mail the author of the programme, Carol Edward's at: firstname.lastname@example.org
If you prefer not to enrol on the course but would like to chat with Carol Edwards, you can use the low-cost online chat feature which you can link to from the menu bar above.
Carol Edward's, author of 'CBT Therapy at OCDonline', has a professional qualification in cognitive behavioural therapy with continuing professional development in obsessive compulsive disorder and Asperger syndrome. She is a member of OCD-UK and is registered with the CMA. She blogs on mental health at ocdasd.wordpress.com and also writes a column for special-ism.com. She runs a Facebook Page that provides information for families living with OCD and related problems and is an admin to an online OCD group. She is also the author of ocdkidsweb.com - this is a FREE programme for kids aged 7-12, and their parents. She has lived experience of OCD, is a volunteer for an online parents group in partnership with OCDAction, and works freelance for families who are affected by primarily OCD, anxiety and depression.
- Professional Diploma in Cognitive Behavioural Therapy with Core Counselling Skills and Developmental Psychology (D)
- Diploma in OCD Studies (D)
- APT accredited for CBT with OCD - follows the NICE guidelines
- ADHD Awareness Cert.
- Teaching Assistant Cert.
- UFA in the Behavioural Characteristics of Autism in Children plus a CPD Certificate in Asperger Syndrome: Insights and Interventions for Support - awarded by the National Autistic Society and ICEP Europe
- Presently studying Drug, Solvent and Alcohol Abuse Counselling; and Developmental, Learning & Behavioural Disorders in Children & Adolescents
- Ongoing research into OCD and Asperger's with up-to-date study on complementary interventions
- Enhanced CRB check.
- Registered with the Complementary Medical Association (CMA)
ETHICS, CODES, AND LEGAL ISSUES
Due to certain restrictions in some countries for providing therapy access across state boundaries (e.g. HIPPA compliance) means communication is done through e-mail and online chat only. Also due to DPA 1998, Skype or call phone for TeleTherapy treatment in the UK is unavailable. However, e-mail/online chat is open to UK users only in which case all reasonable measures will be taken to ensure information is kept safe and secure. Please see the 'disclaimer' at the bottom of this page for more details. Thank you.
To the best of the author's (Carol Edward's) knowledge, the information provided for 'CBT Therapy at OCDonline' is accurate at the time of writing. Up-dates are included if and where necessary. It is meant to offer evidence-based information about OCD and related conditions and describes CBT/ERP (cognitive behavioural therapy/exposure response prevention) tools that can help to minimise a person's obsessions and compulsions. The material is provided for one person only and is therefore prohibited from being shared with any other person for their use. It is not intended to be a replacement for clinical treatment nor is it meant to offer advice on how to deal with specific clinical problems for any person. OCDonline strongly advises that consulting with a medical practitioner is the most appropriate course of action for clinical problems for any person. While the author has taken every care possible with planning and delivering CBT Therapy at OCDonline, it is advised that any person over the age of 18 enrolling on the course asks a doctor's advice before engaging in personal therapy (parents and carers of a teen under 18 are advised to do the same for their young person; or if the person is aged 18 or over and the parent/carer is responsible for them). Also, since the course material is information-based only, the author cannot accept responsibility for any misunderstandings or misuse that relates to suggested techniques having adverse effects on any person. It is asked that the parent or carer of a person under the age of 18, or a person they are responsible for over the age 18, takes on the responsibility for enrolling their young person on the course, and also before using CBT and ERP, where the intention is that each is in agreement to using the information as an adjunct for managing obsessive and compulsive behaviours and related conditions. All information will be passed to the person doing the course, and if under 18 or a dependent over the age of 18, only with the permission of the adult responsible for the young person. OCDonline is not in a position to train/treat mental health issues other than OCD and overlapping issues, e.g. anxiety/phobias/depression, in which case referrals may be made if a person's problems appear to fit the symptoms seen in, for example, schizophrenia or personality disorders. All information disclosed will remain confidential and will not be shared or passed to any other person/party.
Copyright © Carol Edwards 2012. Updated 2014-2015. Recent update 2016. All rights reserved.