Types of Obsessions
Expert Help for Obsessive-Compulsive Disorder
Louisville OCD Clinic
Monnica Williams, Ph.D.
Offering expert treatment for all types of OCD, including sexual obsesions. Our OCD treatment program is typically 20 sessions. We offer twice-weekly sessions and intensive programs. Intensive program can be in person or combined with Skype. State of the art medication management is also an option. Low cost options. [More.]
Sexual Thoughts in OCD
Sexuality Concerns in Obsessive-Compulsive Disorder (OCD)
Many people with obsessive-compulsive disorder (OCD) have sexual obsessions, or unwanted sexual thoughts. This may include sexual orientation fears, which is sometimes referred to as sexual orientation OCD (SO-OCD) or HOCD. Theses are not the same as fantasies or being homophobic.
Sexual thoughts in OCD may include the following:
- the obsessive fear of being or becoming LGBTQ
- intrusive, unwanted mental images of upsetting sexual behaviors
- the fear that one may become a pedophile
- the fear of becoming sexually aggressive
If you have unwanted sexual thoughts, please contact us to participate in a study so that we can learn more about this issue.
The Worst Kind of OCD
Although people with OCD may obsess over any number of concerns, one of the most upsetting types of OCD involves worries about causing sexual harm to a child, sometimes called pedophile OCD or POCD. Although this type of OCD typically receives little attention from the media, the Power to Change recently aired the story of a man whose POCD was so severe he contemplated suicide before he was treated by Dr. Monnica Williams. Hear his story online and learn about OCD treatments from Dr. L. Kevin Chapman. Read his story or watch it now.
OCD Therapy Going Nowhere?
Although any medical doctor can take your blood pressure, only a few can do heart surgery. Likewise, any therapist can help someone who is feeling a bit blue, but only a few can effectively treat OCD. OCD treatment is a type of therapy that requires a specialized protocol called Exposure and Ritual Prevention (ERP or EX/RP). Learn about the Top Mistakes Made by OCD Therapists.
Top Seven Myths About OCD
One stereotype is that people with OCD are neat and tidy to a fault. Actually, nothing could be further from the truth. Although many people with OCD wash because they are concerned about dirt and germs, being tidy is actually not a typical symptom of the disorder. Almost two-thirds of people with OCD are also hoarders... Learn more about the Top Myths about OCD.
Take The OCD Self Test
The OCI-R is a short, reliable, scientific test of common obsessive-compulsive symptoms. This measure was developed by OCD experts. Take our OCD Self Test.
About Hoarding Disorder
What is Hoarding?
Clinical hoarding is the excessive collection and retention of any materials to the point that it interferes with day-to-day functioning and creates a hazard or potential hazard for the individual or others. Hoarding frequently develops into a vicious cycle whereby individuals almost literally become trapped in their own homes due to the sheer amount of clutter that typically amasses. This excess clutter often results in both decreased mobility within the home as well as decreased utility of the home itself. Characteristics of hoarding are:
- Difficulty discarding
- Excessive acquisition
Hoarding behaviors are chronic, begin very early in life. and tend to worsen over the years. It is estimated that 2%-5% of the population are hoarders.
Fears of hoarders:
Fears reported by hoarders include worries about losing items that may be needed later and exaggerated beliefs about the importance of material possessions. Hallmarks of people who hoard may include an excessive emotional attachment to possessions; difficulties with decision-making, categorization, and organization; a desire for an almost pathological perfectionism; and a tendency to engage in both procrastination and behavioral avoidance. Compulsions may include excessive shopping or collecting as well as other forms of acquisition (e.g., saving of postal mail, e-mail, and phone messages).
Impact of hoarding:
Hoarding hinders one's occupation and social life. Family and friends have little desire to come to the home of a hoarder because of the excessive clutter and horrible living conditions. Or, more typically, hoarders will not allow others to visit and may create excuses to prevent people from visiting. Romantic relationships are not possible as most people do not want to do date someone who lives in clutter, filth, and chaos.
Examples of hoarding behaviors:
Not being able to throw away old items that are obviously trash. One the other hand hoarders also clutter their living spaces with non-trash items. It is common to find new, never worn clothing. Some homes are full of new things that have never been removed from original packaging or still have attached price tags. Hoarders have piles mixed with trash and new things so their saving is not restricted to trash items. Showers and ovens may be sacrificed for extra storage space, or the passenger and backseats of a car may be unusable due to clutter Hoarders feel guilt associated with discarding items. Many will report that they do not want to "waste" something that still has useful life. Thus, they may have "moral" reasons for keeping things.
Why do People Hoard?
People with hoarding disorder give the same reasons for saving items that non-hoarders do. The huge difference between hoarders and non hoarders is the volume and variety of saving.
Emotional attachment to an object associated with a significant person, place, event or time.
- Items are seen as a part of themselves, so losing an item would be the same as losing a piece of ones self or ones history; items are part of person identity. Feelings of grief and loss can accompany, similar to losing a person.
- There is also a tendency to assign human like qualities to possessions. For example, one study reported a case where a woman bought a dozen puppets from a TV shopping station because no one bid on them and she felt afraid the puppets feelings were being hurt.
- Comfort and security provided by items
- Hoarders are in a state of perpetual "just in case I need this," so they may carry lots of items with them.
Hoarders may feel a sense of security and comfort when surrounded by their possessions. For example, researchers reported a case where a woman who had had a very stressful day remarked that she wanted to go home and gather her treasures around her.
Items are saved for their usefulness.
- Hoarders feel guilt for not using up or wasting an item when it could be used later. This is the strongest predictor of hoarding severity. Hoarding sometimes insist they can get rid of items if they want but progress in getting rid of items is slow and usually new items are still being acquired.
- Fear of losing important information: this is closely associated with lack or memory, which can really be a lack of confidence in memory. Hoarders will say that items help them remember things, i.e. "saving items means I do not need a good memory"
- People hoard because of the exaggerated desire to have control over their possessions. Very resistant to having people touch or share their items. Unauthorized touches can result in strong reactions (because items are seen as an extension of self, unauthorized touching may be seen as a violation).
Genetics may play a role.
- Hoarding tends to run in families.
Safety & Social issues
Hoarders excessively save items and refuse to discard them. This causes significant distress not only for the hoarder but also for family and members of their community. Hoarding causes major interference with work and social life. The home of a hoarder can be so severely cluttered that normal everyday activities become impossible. Hoarding prevents living spaces to be used in the way they were supposed to be used. For example, living rooms would be so cluttered that visitors would not be able to come sit down, bathrooms may be so cluttered and unsanitary that outsiders would not feel safe using or even entering it.
Hoarding can cause fatal falls, especially in older adults, poor sanitation, and in ability to eat in the home, and serious health risks from infestation. Hoarders suffer from strained relationships with family and friends because of the hoarding. Romantic relationships and daily life activities are significantly impaired because of the hoarding.
Hoarders also may experience threats from authorities (police, health department officials) who will demand the hoarding behaviors stop because of health risks. Hoarding can be so severe that adults can lose custody of children. They can also be faced with eviction by landlords.
Hoarders may not have working appliance or bathroom facilities. In severe cases appliances are not functional and water and electricity may be shut off.
Hoarding can increase the risk of death from house fires. Stacked and cluttered possessions can block exits and doorways used to flee a fire. A 10-year review of residential fires in Victoria, Australia revealed that hoarding residences accounted for 24% of all fire related fatalities.
Information about gender differences in hoarding has not been consistent. Some studies have found hoarding to be more common in men than in women while some studies have found the opposite. At this time there appear to be no differences between the genders on measures of clutter or difficulty with getting rid of clutter, but some research has shown that women are more likely to go out and acquire more possessions more often than men. This finding may be connected to the fact that women are more likely to buy compulsively. Men have been found to be more likely to acquire more free things than women (70% men; 57% women) and to be more likely to steal items (16% men; 8% women) .
Hoarding behaviors exist all over the world but few studies examine hoarding criteria across cultures. A study was done on hoarding behaviors on the Japanese. The hoarding characteristics of the Japanese OCD hoarding patients were similar to patients from Western cultures as far as what types of items were saved and the extent of the clutter.
In a study of OCD in African Americans, it was found that African American hoarders were more likely to suffer from substance use disorder. It is believed that the effects of alcohol use contributed to people to neglect organizing and uncluttering their living space. This study also found that African American hoarders had difficulty with indecisiveness.
Animal hoarding is not listed in the criteria for hoarding disorder because the types of things hoarded are not of particular interest to establish a diagnosis. However, animal hoarding poses safety and health risks for the hoarders and the animals they accumulate. Animal hoarding involves the accumulation of a large number of animals that the hoarder is not adequately caring for. Animal hoarders may have dozens of pets in one home all caring various diseases. Animal hoarders sometimes will even have the bodies of dead animals lay around among themselves and the other animals. This poses a threat to the health and functioning of the hoarder, the other animals and those living in the surrounding community. There are about 700 to 2,000 new cases per year in the US. Hoarders who collect animals usually live in filthy and unsanitary conditions. Sixty percent of animal hoarder homes have animal feces and urine covering floors and over half of the cases have dead animals on the floor. In many cases, the home of an animal hoarder becomes so saturated with urine and feces, that it cannot be cleaned up or fixed; the home must be torn down.
Treatment for Hoarding
What doesn't work:
- Forced clean outs
- Traditional "talk" therapy
What does work:
- Medications: Studies have shown that hoarders who try selective serotonin reuptake inhibitor antidepressants (SSRI's) such as Paroxetine show improvement in hoarding symptoms (with or without psychotherapy). One study showed that 28% of study participants were classified as responders to treatment and another 22% were partial responders. Overall, 50% of compulsive hoarders had at least a partial response to medication treatment.
- Cognitive behavioral therapies: Research has shown that hoarding does respond to cognitive behavioral therapy (CBT). Treatment for hoarding can be intense and very hands-on, but with patience and perseverance, it can be very effective.
How do you know if someone is a hoarder?
You may be able to identify a hoarder by observing their environment. For example, someone who has lots of pets in one home could be a hoarder. Usually responsible animal owners will have one or two pets, but someone who has an outrageous amount of animals could be displaying hoarding behaviors. Too many pets, as well as mountains of clutter and waste can cause horrible smells coming from home which can be detected even before entering the home.
Another possible sign of hoarding behaviors is a lack of visitors or friends. People who are compulsive hoards can become isolated as they will not invite people inside their living space because of the embarrassing clutter. Their windows may be covered to prevent people from seeing inside or simply due to piles of clutter that cover the windows. You may notice clutter even outside of the home. One a hoarders home is full, you may observe clutter in the yard or on the side of the house. Anything from clothes, to furniture, appliance could begin to pile up outside.
Compulsive hoarders may also have mold growing and infestations in and around their homes. They may have rodents. Kitchen counters may be full of bacteria from old food and dirty dishes. Foods in the refrigerator will be spoiled and one would be unlikely to find something edible inside.