Monthly Archives: June 2009

Answer to Nina about “Compulsive Staring” at Privates

Nina’s OCD behavior, feeling compelled to stare at the private parts of others is not unusual and is an OCD behavior that we have seen before.  Nina, you mention your fear that you will be caught by others and be humiliated.  I am guessing you also have fears/concerns about what this may mean about you and are concerned is this really OCD or is there some other problem you have.  This is OCD.  The targets of OCD are often focused on what might be most threatening to us.  With the trauma you suffered, your mind creatively has figured out what would be terrible for you — further humiliation and, again, what does this mean about you.  Again, I am guessing that you spend an equal amount of time obsessing about being caught, how to control yourself and what does this mean about you.  Because I don’t know you, I can only discuss in general terms what exposure and response prevention would look like.  Because it is impossible to have the concentration to control where you are staring 24/7, initial treatment would have you staring at private parts on purpose, but trying to do so in a sneaky way so as to not get caught.  This gets you out of the control bind.  Scripts to accompany the exposure depend upon whether my guesses about your feared consequences are correct or not and your personal history.  In general, they would focus on how you would try to cope with being caught in a positive way and not having definite answers to questions about yourself.  You’ve mentioned a traumatic experience, this also requires treatment combined with the OCD treatment.  I don’t know if you have seen an OCD specialist.  You can check with the OC Foundation (www.ocfoundation.org) and their find a therapist part of the website.  If you find names that are close to you, you can call the Foundation to find out if they can tell you more about the therapist.  I’m sorry I can’t be more specific, but you should know this is a treatable form of OCD.  If you have a therapist who is willing , I would provide them with some supervision.

Answer to Aaron’s Fears about Exposure to Violent Thoughts

Jonathan Grayson

It is true that many who don’t understand OCD have some difficulty with the idea of treatment. Part of the answer is to check out my blog about normal people don’t know what they are doing. The standards of what they actually think and do are not the same as the standards they claim to have.
The literature on violence/sex in the media as a cause of violence is a broad literature with pros, cons and qualifiers as to when this may or may not happen. There isn’t anything in that literature that alters our treatment.
In reading my book, your statement that exposure will reduce anxiety is not the entire story. The primary goal of exposure in the treatment of OCD is to learn to live with uncertainty. Thus, you are accidentally undermining your treatment, because you want to be sure that you will not engage in any violent or improper sexual behavior. That is, you want to be reassured. Treatment and life are a risk. How do I know that I won’t slice and dice my wife tonight? I don’t have a plan to do so, but one doesn’t plan on going crazy. There is no way I can be sure she is safe. I could stay away from her, but then what is the point of human contact? Or I can do what everyone does without realizing it. I can go to bed, hope it won’t happen and if it does, I will be stuck coping with it. My life will be ruined, I will feel guilty, book sales will go down and even with this I will have to find a way to go on. No one has any other choice, but for most people, they are willing to take the risk. You are trying to avoid the risk and have correctly assumed that even treatment could make you worse. It isn’t where I would bet my money, but it is possible. The reason to do treatment is because of all the options you have to make life better this one is the best bet. No guarantees other than it is wiser to bet on the higher probabilities.