A Look at Obsessive-Compulsive Personality Disorder

Obsessive-compulsive PD’s are truly awful people, I am sorry. They just are. I knew my father for over 50 years of my life. They’re not ok.
The problem is because of their extreme conformity, workaholism, and morality, a lot of people who know them they are “fine upstanding people.” Only the people who live with them know what monsters they really are. That’s why no one believed my siblings and I when we talked about what a lousy father my Dad was. All the other adults of his generation thought he was the star of the neighborhood – a classic, fine, upstanding, good, hard-working, moral family man. That’s the face they put on to everyone else. They know exactly what they are doing, and they can control themselves most of the time. They just choose not to control themselves around their loved ones because they can get away with treating loved ones like crap.
OCPD often takes the form of hostility, constant criticism, and rages.
They project all the time and go around pointing out everybody else’s faults. Everyone else is lazy, messy, immoral, and incompetent.
They’re prigs. They’re always calling you evil in some way or another because you are probably inherently immoral.
You’re always a slob, no matter what. They love to go through other people’s stuff and clean it up. They often go through other people’s stuff and throw a lot of the other person’s possessions away.
They work constantly and they never have fun. They try to force everyone around them to do this too and if you don’t, you’re evil or sinful.
Having fun is evil or sinful and you need to be ashamed of yourself. They hate parties. You go on vacations with them, and they spend the whole time working, being uptight, and yelling at people. They are like martyr-saints who believe that life is crap, and life is nothing but suffering. Hence, suffering and constant deliberate deprivation are noble things.
They are frustrated all the time.
They are tightwads. They hate spending money except on necessities and paying off debt. Spending money for fun is literally sinful, and you should be ashamed of yourself. They’re stingy with money. If you need money as a college student, they might grudgingly give you five bucks.
They have no insight whatsoever and they have a defensive structure that is so elaborate that it is like an Escher + Goya painting combined with a Rube Goldberg device. The defenses literally have layers upon layers, trap doors, fake entrances, and the craziest fortifications you have ever seen. If you try to point out their OCPD nonsense, they fly into wild rages because it really hits home.
They can’t delegate any responsibility for any job because everyone else is incompetent, so they have to fix everything themselves. Except they don’t know how to fix anything. They try to get you to help them and then scream at everything you do because everything you do is wrong because you are inherently incompetent.
They are masochistic and are always taking on thankless tasks that other “incompetent” people won’t do. They stay late at work fixing the work of the “incompetents.”
They’re never wrong and they’re always right. Everyone else is always wrong and never right. They’re perfect and everyone else isn’t and needs to be constantly criticized for being such screw-ups.
They are always making long lists of things to do, but then they hardly do any of them. They get lost in the endless planning of the project such that the project itself never really gets going. They can’t see the forest for the trees. They can’t see the big picture.
They put everything off to the last minute, and then they run around frantically, hollering in frustration all the time, doing all the tasks that they put off to the end because now they are in a terrible time bind.
They’re control freaks in a covert way that is not obvious.
They hate change. They are some of the most rigid people you will ever meet. They hate anything new.
They are perfectionists and a lot of their own work is never good enough and needs endless revisions.
They’re always tense and uptight and rarely relax.

Alt Left: The Real Reasons for Many Murders of Transwomen and Gay Bashings of Gay Men

Much has been written about how many transwomen are murdered. Many transwomen are indeed murdered. Whether these are the true transsexuals (homosexuals) or the transtrenders (transvestites, crossdressers, and autogynephiles) is not known. Many transwomen (men who think they are women) work as prostitutes. Many are not able to work in ordinary jobs, they often have very poor mental health that prevents them from working at regular jobs.
Transwomen have the highest rates of mental disorder of any group seen clinically. 90% of transwomen are significantly mentally ill, and they have everything under the book, from mood disorders such as depression and bipolar disorder to anxiety disorders of different kinds to personality disorders. They also have very high rates of paraphilias and sexual disorders and have rates of being convicted for sex crimes (these are the transtrenders). The transwomen working on the street are often homeless and many have drug and alcohol problems. Very high HIV rates have been found for transwomen prostitutes – up to 42%.
Although the murders of transwomen are tragic, it is helpful to note the circumstances under which these are occurring.
A lot of these murders occur when they are prostituting themselves, and their label doesn’t always say what’s in the bottle. In other words, they are out on the streets advertising themselves as female prostitutes. They get picked up by male clients thinking they are picking up a woman.
At some point, they are shocked to find that it is actually a man as many transwomen are pre-ops, that is, they take the hormones but they have not taken the surgery, so they look like women, have women’s breasts, and yet they still have penises. When the client finds out that this is a “woman with a penis” sometimes they fly into a rage and kill the transwoman in a blind rage murder of the type that men are susceptible.
A friend of mine picked up a “woman” in a cab and went home with “her” only find out halfway through the blowjob that it wasn’t a woman at all. He didn’t get violent but he was pretty freaked out and upset.
It’s pretty abusive for TIM’s to tell us other men that they are women, and we men get into dating/sexual stuff with them and suddenly find out they’re a guy. They’re men pretending to be women and worse they are not even telling everyone!
No one wants to hear this, but a lot of gay bashing is actually done to gay men who are openly propositioning straight men (like, say, grabbing their cocks?). I am not supporting bashing of course, and I have been gay-bashed three times myself, once with a baseball bat! So I’m not wild about gay men, but homophobes are 100X worse. Also, how come no one talks about straight men getting gay-bashed? It’s epidemic.
But it is actually true. Many gay bashings occur not just when gay men hit on straight men, which they do constantly, but when they won’t take no for an answer, which is all the time. You women think straight men are bad about not taking no for answer, well, gay men are 50X worse.
And no one talks about this either, but gay men are far worse than straight men as sexual harassers, in fact they wrote the book on sexual harassment. Sexual harassment is the unspoken norm in gay male society.
I do dislike gay men but I support them politically and even work on their campaigns. I dislike them because they have been hitting on me for decades, and they won’t take no for an answer. My reaction is similar to that of women mad at men over sexual harassment.
Yes, gay men sexually harass straight men. You cannot talk about this either because it is “homophobic.” When I lived in LA, I lived in a gay community for a while. Supposedly I was good-looking back and then had some male modeling offers. I had a couple of friends who were straight models who started out pro-gay but became almost violently homophobic over time due to constant harassment by gay men. Male models are not all gay. Actually 2/3 are straight.
Anyway, the place was swarming with gay men, and I would walk down the street, and all of them would be rubbernecking me in their cars driving by. I had one who waited outside my workplace every night right before work. I would go to the window and look out, and there he would be, staring right up at my window. I almost had a panic attack every time. And he would watch me like a hawk as I walked to my car.
When I would go to parties, etc. they would creepily stare at me for long periods of time.
I related this on my site and got called homophobe of course, but some of my female readers commented and said, “Ok, now you know what it feels like to be a woman!” And she was right. I didn’t like those gay men treating me like a piece of meat. Now if women want to, ok, maybe.
The generally feeling would best be described as unnerving, which may be how women feel with constant male sexual attention?
I also disagree that sexual harassment is driven by misogyny. As you can see, men harass other gay men worse than they harass women and gay men harass straight men like crazy.
Men sexually harass women because they are men, and that is what men, do – they sexually harass other humans?
It’s a more science-based theory.

Voyeurism, Exhibitionism, and Escalation to More Serious Crimes

It is a common myth, especially among feminists, that some people with paraphilias such as voyeurs and exhibitionists (peepers and flashers) commonly escalate to more serious offenses such as burglary, sexual assault, rape or homicide.
As with so many things in life, this is a half-truth.
Some or a certain number of flashers, peepers, etc. do escalate more or less as described above, yes. I am not sure I would call it shifting of boundaries, although that’s what is going on. Instead of shifting it is more like an escalation of boundary violations to more extreme violations. I also don’t know if it’s about respecting boundaries. I’ve read a lot about these paraphilias because I do work in this area as part of one of my jobs, and I’ve never heard people describe paraphilic escalation as a shifting of boundaries, even if that’s what it is.
To the flasher or peeper, their problem is more of a compulsion or an addiction than anything else. They feel a build-up of pressure in the period before the act which builds to a very uncomfortable level, and they feel that the only way to reduce the pressure is to do the act. They commit the act in a rush of fear and excitement, and the act is very sexually stimulating to them. After they do the act, there is a catharsis, and the pressure is relieved. Sometimes they feel guilty afterwards.
In therapy with these people, many of them are actually decent men with good jobs,  good fathers and husbands. They simply have a paraphilia – a sexual disorder – that takes the form of an addictive-like behavior or a compulsion. It is common in therapy for these men for them to break down and cry, saying that they can’t control themselves. The behavior can go on for decades if it is not checked. The paraphilia is apparently learned. I believe it is hard to treat.
But yes, some voyeurs and exhibitionists do escalate, and these are the boundary pushers. You get away with flashing or peeping, and now you realize that you can get away with serious violations of people’s boundaries.
Although I believe Ted Bundy killed first at age 14 (a 9 year old girl neighbor), he would never confess to that crime, and they could never formally pin it on him. I also think he killed some women back East
when he stayed at a family home there over the summer. The record says he started killing in college. Anyway, the record is clear that in his teens, Ted used to roam neighborhoods at night, peeping on women. He also started breaking into homes around this time, often the homes of the women he was peeping on. Later on he went on some serious murder sprees.

How Criminal Escalation Works

In crime, when you get away with a crime for a while, there is tendency to think “If I got away with X, I can get away with X+1.” The people who think this way are not necessarily bad people per se. If they had never gotten away with X crime, they might have lived perfectly decent lives. But they got away with X crime, with caused them to escalate beyond X further and further, and at some point, they might commit homicide. And it is typically a male criminal who escalates like this.
 
 

Schiz OCD Versus Psychosis: Differences and Interactions

Hassan Herrera: By saying “Anxiety processes can at times escalate all the way to psychosis.” You mean, for example a OCD’er getting through the fear of going psychotic can start experiencing psychotic symptoms coming out of the anxiety process? I catch sight of a post of you setting apart core process and where the symptoms come from. I hope i got myself across.

Never seen a case of Schiz OCD going all the way to psychosis, although I know a woman with schizophrenia and Schiz OCD in which the two sort of go together but not completely. She still has delusions that she does not doubt. She also hides symptoms a lot, which is very hard to figure out, though I can sometimes do it.
I don’t think the Schiz OCD went into the Schizophrenia, but the Schizophrenia dx obviously played into the Schiz OCD. It’s an extremely complex case. Never seen a case of Schiz OCD going all the way to psychosis, although I know a woman with schizophrenia and Schiz OCD in which the two sort of went together but not completely. She still has delusions that she does not doubt. She also hides symptoms a lot, which is very hard to figure out, though I can sometimes do it. I don’t think the Schiz OCD went into the Schizophrenia, but the Schizophrenia dx obviously played into the Schiz OCD. It’s an extremely complex case.
There is a Psychotic OCD but I have never seen a single case of it, and I have seen more OCD’ers than 95% of clinicians will ever see. I have seen cases that I worried were Psychotic OCD, but when you got it all untangled, they still had reality testing intact more or less, at least in terms of overvalued ideas. There is a sub-diagnosis of OCD with Overvalued Ideas.
The OCD symptoms in this case were extremely bizarre, and phenomenologically, they looked a lot like the sort of thing you see in Psychotic OCD. His symptoms appeared so psychotic that when I mentioned them to a retired clinician, she insisted that this person was psychotic and would not accept that they were not. Unfortunately I am not allowed to share the very interesting symptoms on here.
Psychotic OCD has a sort of a “look” to it along with typical delusions that are present in a lot of cases – it is a syndrome, in other words.
A classic case of Psychotic OCD would be a case where the obsessions have escalated into delusions. The people are typically not dangerous, as fear is a freezing agent, and OCD’ers tend to be shy or very shy, passive, introverted, and remarkably nonviolent. A classic case is a man sitting in a chair all day shaking like a leaf and going on about his obsessions, which have now reached delusional intensity. The old view was that Psychotic OCD’ers never got too far gone psychosis-wise, and it was quite easy to pull them out of the psychosis. A typical case might last three weeks.
However, we now have recent cases of Psychotic OCD going on for years that did not respond to treatment. Some responded to ERP oddly enough. Some of these people are so ill that they have become the homeless mentally ill like a lot of schizophrenics, carting their belongings around in a suitcase.
The main thing to note is that Psychotic OCD is rarely seen. However, when OCD is very bad, they can appear psychotic. Hence, OCD’ers are often misdiagnosed with psychosis of one form or another and put on antipsychotic drugs, which generally do not help them. I get clients all the time coming to me with a diagnosis of some form of psychosis. Once I figure out they are not psychotic and are usually instead Schiz OCD’ers with what I call fake delusions and fake hallucinations, I tell them to fire their psychiatrist and go doctor shopping until you find an MD who understands that you have OCD and not psychosis.
A lot of psychiatrists continue to misdiagnose OCD’ers with psychosis. The phenomenology of OCD is not understood well by many clinicians, and the fact that OCD when severe looks like psychosis but is not results in  a lot of misdiagnosis.
I think a Schiz OCD’er would be the last person to go psychotic, as the condition is predicated on continuous worry and doubt that they are going psychotic. If you have spent any time around psychotic people, that’s clearly not what’s going on. In psychosis the person never worries whether they are psychotic, nor are they are aware they are psychotic.
If you are worried about or are aware of being psychotic, then you cannot possibly be psychotic. That’s a rule out for psychosis right there. This is exactly what is going on in Schiz OCD, hence Schiz OCD is never psychotic by definition.

What Percentage of Homosexual People Is Acceptable To You in a Given Population?

Answered on Queera.
Believe it or not, all of the answers said that if a country’s population was 100% gay, that would be absolutely wonderful! I’m sure having all the population of your country gay would be the greatest thing since sliced bread! What the Hell’s the matter with people? It would be catastrophic for any country to be 100% gay, though we’re probably headed that way in the US at the rate we’re going here.
How could having 100% of the population of your country gay possibly be a good thing!? Color me mystified.
A given population as in for a country? 3%. That’s the percentage in the US, and it’s just fine by me.
Understand that homosexuality is bad for society in the sense that it causes a lot of costly problems for society. Furthermore, taxes paid by gays do not make up for the costs that society incurs from homosexuals.

  • Homosexuals live 20 years less than heterosexuals. This is horribly sad for gay people that they miss out on so many years of wonderful life, but it seems to me that reduced lifespan is costly to society.
  • Gays have higher rates of mood and anxiety disorders. While this causes a lot of suffering to gay people, and this is sad, at the same time, mental illness is costly to society.
  • Gays have much higher rates of drinking, smoking, and drug abuse than straights. The gay male party and play, scene revolving heavily around methamphetamine and club drugs is particularly alarming. Lesbians in particular smoke a lot. The costs of drinking, smoking, and drug abuse to gays themselves are no doubt significant in terms of disease, mortality, and the suffering that can come from excessive substance abuse, nevertheless, this incurs a lot of costs to society.
  • Gay men obviously have a very high STD rate. At 20% infection rate, the HIV rate is especially alarming. Most of these diseases remain confined to the gay community and have not broken out significantly to the straight community, with the exception of the Black community with all the down low men. But the great heterosexual HIV epidemic spreading from gays to straights never occurred mostly because HIV goes from men to women and then it stops, as spokesmen from the New York Department of Public Health said as early as the 1980’s. That’s not completely true, but it is very hard to get HIV from a woman. Hepatitis A, B, and C are or were very common in the gay community, vastly more common than among heterosexuals, most of whom only acquire B and C from IV drug use. Parasitical diseases such as shigella, ameobiasis and giardiasis are also extremely common among gay men, whereas they are quite rare among straights. In recent syphilis epidemics, up to 85% of cases are among gay men. Syphilis is quite uncommon among straights. Gay men have elevated rates of anal cancer, and the rate is rising. The rate is vastly higher than the rate among straights.I would like to point out that it is gay men themselves who suffer most from these diseases, and this suffering, although self-imposed, is often tragic, horrifying and heartbreaking in particularly in the heart-wrenching case of HIV. Lesbians have very low rates of STD’s but higher rates of breast cancer. I doubt if lesbians impose a disease burden on society. The very high gay male STD rate, in particular the HIV rate, obviously imposes considerable costs to society.
  • Tragically, gay men have a suicide rate 3X higher than straight men, even in San Francisco, the most gay-friendly place in the US. The attempted suicide rate is also very high. Gay male teenagers have a tragically very high attempted suicide rate at 8X the normal rate. Suicidal behavior causes unfathomable and heartbreaking suffering on gay men. However, attempted and completed suicides impose considerable cost on society.
  • Domestic violence rates are very high in gay and lesbian couples, especially the latter. A gay man is much more likely to beat his partner than a straight man is. A woman is much less likely to be beaten by a male partner than by a female partner. This causes immense suffering to the partners of gay and lesbian batterers. In addition, domestic violence is costly to society.
  • In gay areas, gay men typically take over all of the public restrooms and turn them into miniature sex clubs. This renders most public restrooms unusable by the rest of us. Most gay men typically vociferously support the use of public restrooms as sex dens for gays. I don’t have much sympathy here. Gay men are simply being very irresponsible with this depraved mindset. Further, this is a cost to society.

It is first of all most important to point out that gay men themselves suffer worst from most from these largely self-imposed conditions, a suffering so profound that it almost moves you to tears. Compassion is essential. Nevertheless, there is a cost to society. Some of these issues may be caused by discrimination (see the high teenage gay male attempted suicide rate), but there is a cost to society no matter what causes it. Some of these problems would lessen with increased acceptance of gays, but others would linger or possibly even worsen.
The question comes up whether gays pay for the costs they bring to society. Many gays seem to have above average intelligence for some reason, especially gay men. Gays seem more artistically talented than straights. More gays than straights seem to get college degrees, in particular gay men.
Gay men seem to earn higher than average wages and are disproportionately employed in high paying and prestigious professions. I am always hearing about a homosexual, often a gay man, who is contributing something noteworthy and exemplary to our society such that it mentions a media notice. Obviously, gay men contribute more to the tax base per capita than straights. So gays, especially gay men, offer considerable benefits to society, not flowing from their homosexuality but from other aspects of their lives.
I have not discussed lesbians here because I know little about them, but I doubt that they impose serious costs on society other than reduced lifespan.
However the question rises whether gays pay for themselves. Despite their excellent contributions to society and their higher than normal tax contributions, I still do not think that homosexuals pay for themselves.
The question then arises about whether the rest of us should be willing to carry a small burden for our gay brothers.
Personally I feel that at 3%, I am willing to shoulder the costs of homosexuals to society, as the numbers are so small that it is something we can cope with. I would be willing to tolerate up to 6% gay men in society. I think we could deal at that rate.
However, if the rate of male homosexuality went higher than that, all of these problems above would increase in scope with attendant costs.
Honestly, even when you get to 10% gay men in any country, your problems are going to go up a lot. The % of gay men in New York and San Francisco is quite high, and they definitely impose considerable costs on these cities.
Once you start heading up to 15–20% of any country’s population being gay, I think it would be unsustainable for many reasons (see above).
Homosexuality in society seems to be one of those things, like many things in life, that is best in small doses.

What Makes an OCD Thought More Rooted in the Mind and Makes It Even More Difficult to be Removed?

I understand exactly what you are talking about. OCD thoughts or obsessions have some peculiar power to them. Something “sticks” about them. I call them Super-thoughts and believe that they are much more powerful than regular thoughts. They seem to have some odd “pull” to them that seems to almost force you to think about them.
I have had clients who have told me that they feel that they have to think these thoughts. Unfortunately, I felt that way somewhat myself at one point. Keep in mind that OCD’ers often feel that they “have” to do all sorts of things. This is the compulsive nature of the illness, but the broken record nature of the obsessions also looks compulsive or habitual. If OCD is a disease of doubting, as the French say, it is also a disease of repetition.
To determine if something is an obsession or not, the great psychiatrist George Winokur told his med school students, “Look at how hard the patient resists the thought. The harder they resist and fight the thought, the more likely it is to be an obsession.”
I will take it even further. “If you try to stop it, it’s an obsession.” That’s not literally true, but it’s pretty much true.
The thoughts also become your friend in a sense because they are with you most of the time. In counseling, I sometimes tell my clients to think of the thoughts as your best friend. After all, they are always with you, and they will never leave you, right? Just like your best friend.
The thoughts also seem to be “alive” in a sense, and it seems like they do not want to die.
Before I realized I had OCD, I just thought I was going insane in my head. For some reason, this was projected out at the world, and everyone seemed to think there was something wrong with me.
The OCD had set up bizarre rules that I had to live my life by, mostly designed to make my life as miserable as possible. I was terrified to break the rules. Finally I had had it with these stupid and frankly masochistic rules, that I started to stand up and fight them. I remember every time I did that, the OCD would stand up and fight and “try to stay alive.” Finally, I would beat the OCD and the the OCD would back down, cower, and say, “Ok, you win.” But then it would come up with a new rule that was often not quite as bad as the previous rule.
In my opinion, it is almost as if these thoughts are living beings. Living beings do not wish to die, so neither do these thoughts.
This ties in with the bizarre nature of the illness where the sufferer himself thinks the thoughts are stupid or absurd, but they still can’t stop thinking them.
Many times I have heard, “Why in the Hell am I even thinking about this?…This is something I would like to think of as infrequently as possible, or never if I could…Of all the thoughts I could think, this is the worst one of them all…Please give me a new thought to think, OCD!”
So the person feels that the thoughts are preposterous, idiotic, and senseless, nevertheless the thoughts have this bizarre pull or stickiness to them as if they are almost demanding that you think about them.
People get so used to their obsessions because they think them all the time that some OCD’ers say, “There is a part of me that wants to stay ill for some reason…I’m afraid to kill the thoughts for some reason…as much as I hate them, the thoughts seem like my friend, and it feels sad to kill them.”
Now why obsessions have this bizarre stickiness, power, or pull to them, I still have no idea. I can’t even come up with a theory. But it’s definitely a part of this very strange illness.

Does Borderline Personality Disorder Cause Obsessive Behavior?

Answered on Quora.
If by obsessive behavior you mean OCD-type behavior, there is no connection at all other than perhaps the coincidental incidence of both illnesses in some individuals.
However, the presence of BPD in an individual with OCD greatly complicates the OCD and makes much harder to treat than without the BPD.

Does Fearing Homosexuality Make Someone Gay?

Answered on Quora.
No. I believe most straight men find the thought of being gay to be frightening if not terrifying. A number of straight men told me that they would rather get shot in the head then have sex with a man. Fear of being gay is fairly normal for straight men. There is even a type of OCD called Gay OCD in which straight people fear that they are gay. 0% of these people are actually gay.
There has been an attempt by PC types to conflate fear of homosexuality with hatred of homosexuals, but they seem to be very different things. Yes, there are a few closeted gay or (usually somewhat bi) men who overcompensate and engage in reaction formation or projective self-hatred by hating gays, but that’s not common.
Most gay haters are not gay at all; in fact, they are quite the opposite. I have known many homophobes in my life. In fact, I know some at this very moment.
Generally it is associated with masculinity. The more masculine the man is, often the more homophobic he is. Most of the strong homophobes I have known were extremely masculine men, I mean some of the most masculine men I have ever known. They were also probably some of the least gay men I have ever known. All were aggressively heterosexual and some had had sex with many women.
I would say that homophobia or hatred of gays is associated with masculinity, particularly hypermasculinity, extreme masculinity or as they call it toxic masculinity more than anything else.
I doubt if most homophobes really fear homosexuality all that much. Instead they just hate gay people for some reason or another. Gay people need to wake up and figure out that the “homophobes are all closet cases” is a big fat lie. There are a lot of people out there who are just assholes and openly hate gay people simply because of what they are.
They really ought to come up with another word. Gayhaters pretty much sums it up.

Borderlands: Obsession, Delusion and Their Differential Diagnosis

The Borderland between Obsession and Delusion

Anxiety processes can at times escalate all the way to psychosis. I have had some OCD clients who I had a very hard time figuring out if they were psychotic or not. With one, I told a retired therapist of their symptoms, and the therapist immediately said, “Well, they’re psychotic. That’s a delusion.” The things that they believed or almost believed did look like psychotic delusions. However, they did not entirely believe them. OCD with Overvalued Ideas was probably a better diagnosis. There are a few cases of Psychotic OCD. I have never seen one though, although this case was getting close.
When OCD gets very bad, they appear psychotic. However, they generally are not, and in 95% of cases, I can figure out that they are not psychotic. That is because Severe OCD That Looks Psychotic has this particular look, feel, or vibe (gestalt) about it where the cases all give off this particular vibe. It’s like they are all reading off the same script in a sense.

The Problem of Psychotic People Hiding Symptoms

You get a different look, feel, or vibe (gestalt) with an actively psychotic individual, but they can be hard to figure out too because sometimes they lie about their delusions.
I have caught them hiding symptoms from me.
Some people with psychoses learn to hide symptoms because they figure out that every time they say “The FBI is after me,” someone grabs them and hauls them off to the hospital. So they continue to believe the FBI is after them, but they learn to shut up about it.
You look at what the person is doing in reaction to the thoughts. They thought the neighbors were hacking into their computer so they disconnected their computer from the Internet? Delusion. A person who just had the fear or obsession that the neighbors were hacking in would not disconnect the computer, and their description of the fear would be full of all of these strange doubts and uncertainties.

The Difficulty of Differentiating between Thoughts and Voices

Psychotic people sometimes refer to thoughts as voices. I had one client who referred to thoughts telling him to do bad things, in this case, to kill animals. He had recently killed five puppies in response to these thoughts ordering him to kill these animals. I suspected these were more than thoughts, so I had him describe them, and he said, “It’s a thought, you know. You hear it like someone standing next to you and talking.” Ok if you hear it outside your body like that, it’s not a thought, it’s a voice.
Some people with schizophrenia hear their thoughts spoken out loud in the environment, and they fear or believe that others can hear their thoughts being broadcast out there. However, if you corner them on it, some will try to deny it by saying that they just have very loud thoughts in their heads, and the thoughts are so loud that they worry or fear that maybe others can hear them. That’s not quite precisely a delusion, and it’s not a hallucination like the thought broadcasting. It’s off into the obsession/delusion borderland.

Schiz OCD – OCD with the Fear of Psychosis Theme

There is a type of OCD where the person fears that they are going psychotic. OCD’ers have made up a term called Schiz OCD for this illness, which is really OCD with the Fear of Psychosis as the theme. Some clinicians have complained to me about these “hokey names” for the different OCD types and accused me of making them up. I didn’t make up any of them.
The sufferers make up these names for the different themes that they have. I feel that the sufferers have a right to own their symptoms and illnesses and call them whatever they want to call them. That’s their right as sufferers.
Who are we to tell them that their name for their symptoms is the wrong name? Do we have a better name? Of course not. “We” are just arrogant clinicians who think we know these illnesses better than the sufferers themselves know them. I realize Schiz OCD is a confusing name, but it’s the name they picked, and we don’t have a better one, so let’s go with it.
They develop all sorts of “psychotic” symptoms, including fake delusions, fake hallucinations, and even perceptual disturbances. Once again the Schiz OCD symptoms have a completely different quality – look, feel, vibe or gestalt – than you get with someone who has actual delusions and real hallucinations. In addition, all of the Schiz OCD symptoms have a very similar quality across many different people – once again, it’s like they are all reading off the same script.

The Problem of Misdiagnosis in Schiz OCD

I have now seen more people like this than I can count, and I’m an expert on this illness. But I still get people with this type of OCD coming to me all the time with diagnoses of various types of psychoses, schizophrenia, psychotic depression, etc. They received these diagnoses from qualified clinicians such as psychiatrists and clinical psychologists. They were misdiagnosed in 95% of cases, so you see even skilled clinicians can’t tell this OCD type from a psychosis in a lot of cases.

Do Therapists Ever Think Their Clients are Unfixable?

Question from Quora:
Some people are utterly unfixable or even improvable, but they are quite rare.
There are clients who are just too far gone, and they cannot be helped at all. It is as if the person were a ceramic bowl that was dropped on a hard floor. The bowl is now in 100 pieces, and the person who dropped it is on the ground looking at the pieces and throwing up their hands. “Where do I start?” he asks in exasperation.
All sociopaths and psychopaths are unfixable by their very nature. We can’t cure the sociopathy and psychopathy because they don’t want to get better. They enjoy being antisocial, and they do not wish to change. However, we can get them to change their behavior. For instance, a homicidal sociopath may show up in the office. A good therapist may be able to convince this sociopath that acting on their homicidal fantasies would be one of the stupidest things that they could ever do. This sociopath may then be able to go through life without killing an innocent person. So we can’t fix sociopaths, but we can change their behavior somewhat, tone it down, or reduce the amount of damage they do to society.
All paraphilias are unfixable by their very nature. The paraphilia quite literally will not and cannot go away. It’s etched in stone.
Schizophrenia is largely unfixable. They need a great deal of medication, and even then in most cases, they are repeatedly hospitalized. A few can go on to lead somewhat normal or even successful lives, but these people still need continuous medication and regular psychotherapy. In addition, they need frequent interventions to stay out of the hospital.
Many illnesses such as OCD, Bipolar Disorder and Chronic Major Depression are unfixable by psychotherapy. Most of these people will need medication for the rest of their lives. However, psychotherapy can improve their conditions a lot at least in the first and last cases.
Long-term suicidality is very hard to fix. It tends to become chronic with repeated attempts over the years. The suicidal person is typically defiant and is furious with you for challenging their suicidality. You are expected to sympathize with their condition, which is actually a very bad idea. Most suicidal people are what I would call “defiantly suicidal.”
Personality disorders are generally incurable. Theoretically, they could be fixed, but these people almost never present for therapy, and when they do, it is often at the behest of others, and they do not really wish to be there or get anything done. People with personality disorders, like sociopaths, literally do not want to get better. They like their personality disorder, and they are incredibly resistant to change. There are some case reports of cures of personality disorders, but in general the prognosis is grave.
I have never been able to fix long term low self esteem, and I have tried with a few people. There is something about that condition that hammers itself into the brain as if into concrete. I do not know why, but long-term low self-esteem seems to be one of the hardest psychological problems to fix. Why this is, I have no idea. Perhaps someone else can offer some ideas.
In many cases, long-term mental disorders simply cannot be fixed or cured. However, with psychotherapy and drugs, people can often get much better than they were before. We need to stop thinking in terms of cures and start thinking in terms of amelioration.
I realize that many clinicians insist that most people can be fixed or cured of long-term conditions, but I think they are lying. They are probably trying to drum up business. Many clinicians fear that if word got out that a lot of long-term mentally ill people cannot be fixed or cured, people would stop coming in for therapy. There goes their paycheck. Therapists are a lot more money-oriented than most people believe, and don’t let anyone tell you otherwise. I know this field very well.
Clinicians have nothing to worry about. Even if a lot of conditions could only be ameliorated and not fixed, I am sure a lot of folks would show up to try to get some improvement. Some mental disorders are so painful that any improvement feels like a miracle cure to the client. A lot of people have given up on being cured anyway, just want to at least get better and are quite happy to do so.

The Untreatable Borderline Personality Disorder Client: A Therapeutic Nightmare

Borderline Personality Disorder (BPD)is one of the hardest disorders of all to treat. It can be improved with some therapies, but the road is long and hard. Many seem to go on for years or decades with little or no improvement. There are reports of cures, and I am familiar with a woman whose BPD cleared up at age 55 after having come on in childhood. That’s probably a typical cure. Decades of nasty illness followed by a lifting of the illness in middle age.
Many mental disorders improve in middle age, and even many personality disorders improve during this age period.
Schizophrenia often ‘burns out” in middle age, and florid positive symptoms are replaced by more negative symptoms.
Many anxiety disorders attentuate in middle age.
Even psychopaths often get better or at least less destructive in middle age, as many of them also burn out in a similar fashion as schizophrenics. A number of highly antisocial psychopathic men get better in middle age as the antisocial behavior attentuates. It is often replaced by depression, heavy drinking and a pessimistic, cynical, imbittered and misanthropic person who nonetheless does little damage to society anymore.
It should be noted the clients with BPD vary widely in their symptom pathology.  Some are much more functional than others. Quite a few can even function well at their jobs all day, but when they come home from work, they fall apart and shift into full BPD pathology.
However, some people with BPD are so ill that they seem nearly untreatable. It is these people who will be the subject of this post, not BPD’s in general. These people seem so far gone and broken that one wonders how anyone could ever even begin to put them back together again. I suppose some progress could be made, but the damage is so severe that I have a hard time seeing how even the best therapist could possibly fix these people in any significant way.
A typical case might be a young woman who, only in her late 20’s to early 30’s, already has 8 -13 suicide attempts and many hospitalizations behind her. She goes into the hospital on a regular basis. Therapy seems to do nothing but feed her pathology as she manipulates gullible new therapists to believe her lies, nonsense, and projections as the new therapist confuses symptom pathology with the truth. Drugs do almost nothing.
Diagnosis itself is often difficult because the BPD is so severe that the person often appears psychotic/delusional. One wonders what are delusions and what are not. Even the delusions do not seem to last for long, as they are dropped, changed around, added to or substituted in a wildly chaotic fashion.
Usually there is a lot of combativeness and involvement with the court system, as the extreme rage leads a litigious person.
Splitting is severe and textbook.
Self-image is so unstable that the person almost literally adopts the full personality and even persona of whomever is on their radar at the moment. The clinician needs to be prepared that this person will so identify with the clinician that they will adopt the therapist’s image and persona as their own. Boundaries nearly do not exist for these people, and they often fall in love with their therapists, try to seduce them, or on the other hand become furious at them to where sessions became rage attacks at the therapist, and the therapists is at odds of how to respond without violating ethics.
The client can become overtly suicidal even during sessions, and infatuation with the therapist can quickly split to where the therapist is the source of all evil. Homicidal threats and homicidal-suicidal threats against the therapist may now appear. The client then hospitalizes themselves due the “horrible trauma from the evil,  incompetent therapist” and soon finds sympathetic new therapist, typically a feminist woman, to unload her story on. The new female therapist forms an alliance with the client against the “evil male” former therapist and accuses him of damaging the client.
Commonly, the therapist gets angry and tells off the client. This leads to abandonment and a vengeance agenda against the therapist, who has now “irreparably damaged” the BPD and “caused them to spiral out of control.” Be prepared to get accused of abandonment, causing severe trauma in the client and making them dramatically worse. The client may become hospitalized due to allegations of damage from an incompetent therapist.
These people are so difficult and chaotic that many clinicians refuse to see Borderline patients. Some are on the record as saying that when they say a Borderline client coming their way, they hide under their desk until they go away. For a lot of therapists, these clients are nothing but trouble, and endless parade of drama and chaos. Therapy itself is chaotic, mercurial, and wild with severe splitting and often extreme idealization of the therapist for good or ill or both, interrupted by fairly regular hospitalizations. The therapist begins to wonder what’s in it for them and thinks you could not pay them enough to suffer through such clients. These clients make an excellent argument that therapeutic abandonment is the proper choice with some clients.

Do Psychologists Make Their Patients Aware of the Diagnosis of Narcissistic Personality Disorder or Sociopathy?

I recently answered this question on Quora.

Do Psychologists Make their Patients Aware of the Diagnosis of Narcissistic Personality Disorder or Sociopathy?

These personality disorders seem to carry a lot of social stigma, therefore are patients made aware of their diagnosis or does the therapist just continue behavioral therapy to treat the symptoms rather than informing them of the diagnosis?

I am not a psychologist. I am a counselor. I only work with one disorder, OCD, and I can quite accurately diagnose that condition, I assure you. Nevertheless, I am not allowed to give out legal DSM diagnoses. However, I can obviously give out my opinion on a diagnosis. I can also tell the person my opinion on what they do not have. For instance, I have gotten many clients with OCD who have been misdiagnosed with some sort of psychosis. I am an expert at telling the two apart. I simply tell them that in my opinion, they are not psychotic. Then I tell them to fire your clinician and go get a new one that will recognize the difference between OCD and psychosis (many clinicians are very poor at telling these apart).
Other than OCD/psychosis, I also have to make differential dx on OCD/sociopathy, violent thoughts, etc., OCD/pedophilia, pedophilic thoughts, etc. and OCD/homosexuality. In a limited number of cases, I told clients that in my opinion, they did not have OCD but instead had some psychotic disorder, or sociopathic traits, or pedophilia, or that they were homosexuals. Most of this differential dx is pretty straightforward.
I have never had any narcissistic clients, God forbid clients with NPD. One thing nice about working with OCD clients is that they are usually very nice people. Not all of them, mind you. But if they are not nice, there is often some other reason, for instance, Borderline Personality Disorder in an OCD client could possibly make them impossibly vicious, cruel, unstable, not to mention extremely crazy, far crazier than any OCD sufferer ever gets.
OCD by its very nature strikes nice people. The fact that they are so nice, meek and kind is actually one of the main reasons that they have the disorder in the first place! For the most part, only nice people get it, and the nicer you are, the more likely you are to get it. I will leave it at that for the moment and give you a chance to think of why that might be. I know why but it goes beyond the scope of this post at the moment.
But in general, I never even give my opinion on other anxiety disorders or on any mood disorders or personality disorders. I only rarely see clients who have psychotic disorders, and the two that I have seen were already diagnosed. I also very rarely see people with personality disorders, and the few that I have seen were all females with Borderline PD diagnoses. I did see one woman for two sessions with obvious Borderline Personality Disorder, but I had not figured it out yet in the first session, and by the second session, I declined to diagnose her. She has already been diagnosed by a psychiatrist from afar anyway. So apparently I am guilty of failing to dx a Borderline PD client.
The session was about her OCD, not her BPD and she was very nice through the whole session. It would have ruined the whole thing if I told her she had BPD, and I doubt if she would have accepted it anyway. At any rate, I am not allowed to give legal dx’s anyway, so it’s apparently proper for me not to diagnose someone!
That only comes up if there is differential diagnosis. I simply say that I not only can I not legally give these out but that I am not qualified to work with any condition other than OCD, which I can actually work very well with. If they want me to work on their depression or whatever, I tell them that I have no expertise or training in that area so I can guarantee nothing and it would be similar to talking to a friend or family member.
If I were able to give out diagnoses, I think I would simply give them out in most every case. Possibly if it might make a suicidal patient go over the edge, I might decline to give one out. But I will disagree with the clinicians below. In my opinion, physicians and other medical professionals in addition to all licensed clinicians should give out whatever diagnosis is appropriate. I feel it is a moral matter. The patient or client is simply owed a diagnosis on the part of the clinician or MD and I feel it would be remiss of the clinician or MD not to tell the patient what is wrong with them, and I mean everything that is wrong with them.
This is just my personal opinion and I believe there no ethical rules on the subject. Also I respect the clinicians below for not giving out diagnoses in cases where it would not be helpful. I simply feel that this is a case were morals or even the categorical imperative trumps pragmatics or even common sense.

Repetition in OCD and Other Disorders

Optimus Prime: Fair enough, he’s said what he wanted to say and has repeated it a gazillion times. As you said, the man cannot control himself. Robert, apart from NPD does he suffer from OCD as well?

Sure, I actually wish Trash well honestly. He’s just not a good fit for the site.
OCD does not = constant repetition. The thoughts repeat in the brain (definitely in my case), and some of the compulsions can be repetitive, but that is because they are trying to get it right or perfect or make perfectly sure they did it right.
That’s not what is going on here. This is different. We are looking at NPD as the primary process here.
It’s like he’s not sure you heard him the first time, so he’s saying it again or shouting it to make sure you heard. Also I think he is in love with the sound of his own voice.
I will admit that Trash is a talented and even entertaining writer. He makes this cool statement or analogy and then he repeats it in the next post because he thinks it’s such a neat little bit of prose. It often is a nice sentence or phrase, but you are not supposed to repeat it no matter how damn good the image is. You say it once and move on. He’s saying it again because he thinks it is a nice image, and he is impressed with himself, so he says it again to make sure you heard him the first time, like what people do when they say something and get no response. They often repeat it because they are not sure you heard them the first time.
I do not wish to single this man out as being “Mr. Crazy.” Face it, we’re all nuts.
And as we are dealing with a personality disorder here, I would like to point out that in my opinion, we all have disordered personalities of varying degrees. I think we all have adaptive personalities to varying degrees too.

False Memories in OCD

False memories are quite common when OCD gets bad. I have dealt with a number of people who were going round and round about false memories. They are not an extremely common symptom, but you do see them sometimes when the illness is bad. It’s generally a sign of a bad illness.
Ms. Z was periodically convinced that she killed people. She would have a conversation with someone for 5-10 minutes, then walk away ,and then suddenly think that she had killed them somehow during the conversation. Perhaps she had suddenly swung her fist out and beat them to death? Perhaps she had pulled out a knife and hacked them to death? Perhaps she had shot them with a gun? She would have all sorts of false memories of how she killed these people.
In the course of these false memories, she would become 100% certain that she had killed that person she was talking to in that store that day. In the next few days, she would ask around to people she knew if anyone got murdered or if she killed someone in the store that day. Of course she would always be told no. I’m sure her friends must have tired of answering these weird questions. As soon as she was told that no murder had occurred, immediately the firmly held belief that she had killed that person would vanish, and she would never think about it again. Until a little while later when she would be talking to someone again and then walk away and once again become convinced that she had killed that person…
Another woman, Ms. S., was a young college student. She was at a large California university that had a lot of long, winding trails with undergrowth. There were deep gullies on the sides of the paths that were overgrown with foliage. Ms. S. would be walking down the paths and as she walked, she passed all sorts of people coming her way. At some point, she would suddenly get an idea that she had grabbed one of the people coming her way and thrown them down into one of the gullies.
She had a pretty clear memory of who the person was she threw down there and exactly how she had done it. She would be overwhelmed with guilt, and she would take off down into the gully searching for the “body” of the person she had thrown down into the gulch. She did this on a pretty regular basis, and eventually the university wondered what she was doing floundering around in the gullies, and they sent the university police down there to see what she was up to. After a while, it become clear that she needed to go to the university counseling center.
In both cases, the women received a diagnosis of schizoaffective disorder in addition to OCD. This was an incorrect diagnosis, and it was based on the fact that for a short while after Ms. S  was clamboring around in the gullies or after Ms. Z became convinced that she had somehow killed someone she was talking to, that both women were absolutely convinced that they had either thrown someone down into the gully or had killed the person they were talking to in the store.
The diagnosis was incorrect because as soon as the women were told that there was no one in the gully or that they had not killed the person in the store, the “delusion” completely vanished and they didn’t think of it again until next time. Delusions just don’t go away like that. It’s not a very strongly held conviction if can vanish with a mere word of reassurance.
We look at the whole process in a holistic sense. What is the nature of the process? Is this a characterological process (personality disorder), a mood process (mood disorder like Bipolar Disorder or Depression), an anxiety process (OCD, PTSD, GAD, Panic Disorder) or a psychotic process (schizophrenia, manic psychosis, psychotic depression, schizoaffective disorder)? It is important to look at things in an intuitive sense and get the “smell” or “feel” of what the basic process is that you are dealing with.
In the case above, this is an anxiety process, specifically an OCD process. It’s not a psychotic process, despite the fact that it superficially resembles a psychosis.
Some of these folks with false memories actually go to the police station and turn themselves in for crimes that they did not commit.
“Hi, I am here to report a murder.”
“Ok, what happened?”
“Well I think I killed someone last night.”
“You think you killed someone?”
“Yes.”
“Well, where did this happen?”
“I am not sure. I think maybe the bridge over the river.”
“What time did this happen?”
“I’m not sure. Maybe midnight?”
“Who was the victim?”
“I’m not sure. I think it was a man, maybe.”
“What weapon was used?”
“I am not completely sure. I think it was a knife maybe.”
After a while the police started to get the message. He was not there to report a murder at all. He was there to find out whether or not he was a murderer!
As the conversation degenerated, the man started repeating, “How do you know if you killed someone or not?”
The police did not know what to say to that. After he left, the police were talking among themselves. “That’s so weird,” one of them said. “What does he mean, ‘How do I know if I killed someone or not?’ How could you not know something like that? That’s so weird.” The cops were shaking their heads.
 
As you can see, false memories are quite common in OCD when it gets very bad.
I dealt with them myself at one point in 1985 or 1986. I have to admit it was a pretty nutty way of thinking. I was so ashamed of my false memories (which I temporarily convinced myself were true) that I never told anyone except for a couple of therapists. I have not dealt with any false memory nonsense in over 30 years, and I hope I never have to deal with that again. It’s truly a crazy way to think.

I Am Now a Published Author

Here.
You can download my first published work above. I was published for the first time this spring in a book called:

Before the Last Voices Are Gone: Endangered Turkic Languages, Volume 1: Theoretical and General Approaches

This is the first volume of a four volume set called:

The Handbook of Endangered Turkic Languages

The first volume alone runs to 512 pages. Articles are in English, Russian and Turkish, variably. It was published out of the International Turkish-Kazakh University in Istanbul, Turkey and the International Turkic Academy in Astana, Kazakhstan. These are two campuses that are part of one joint Turkey-Kazakhstan shared university.
I contributed one chapter that runs from pages 311-384 titled:

Mutual Intelligibility among the Turkic Languages

It’s 83 pages long and has ~100 references. It may have taken me 500 hours to write that chapter. Tell that to my enemies who claim I do not work, ok? When all is said and done, I figure I may make 75 cents an hour on this work. But this is how academic publishing works. There’s just no money in it. It’s all a labor of love. In addition, most work is done by professors who have to publish as part of their professorship (publish or perish), so in effect, their professor salary is covering their publishing.
That document had to go through two rather grueling peer reviews. I had to make many changes in it to get it to publication. The second peer review had to get past the top Turkologists in the world today, and I am amazed that I made it through review to be honest.
Most people publishing in academic books or journals are academics, professors working at universities. There are only a few of us independent scholars out there (I am an independent scholar because I am not at a university). Also most folks have PhD’s, and I only have a Masters, but there are some folks with Masters publishing academically.
In general, this is a rather selective game where everyone is hyperspecializing as is the trend nowadays. Although my mentor at the project calls me a Renaissance Man, I wonder if the autodidact/polymath is an endangered species if not extinct. Everyone has to specialize nowadays.
For instance, common knowledge in this particular field would be that the only folks who could publish in Turkology would be linguists with a PhD in Linguistics, preferably with a emphasis in Turkology. Beyond that, they may prefer say 5-10 years publishing in the field of Turkology in addition to a professorship in Turkic linguistics. You can see where this is headed. I am not knocking it. I am just pointing out that microspecialization is the game now.
What follows is that since I lack the PhD or professorship or any background at all in Turkology, I should not be allowed to be published in this field, or if by some error I am somehow mispublished, all of my work should be promptly ignored as done by a nonspecialist who could not possibly know what he is talking about. Needless to say, I don’t agree with that, and I carry on tilting at windmills like a good deluded Renaissance Man who never got the memo and wouldn’t read it if he did.
The odd thing is that I knew nothing about Turkology until I plunged into this mess. I had written a short piece of mutual intelligibility in Turkic, as MI is one of my pet subjects and put it up on Academia on my scholarly papers site, and a professor in Turkey happened to read it. He wrote to me telling me he agreed with me, he wanted me to expand it into a document, and they would publish it for me. So off I went, down the Turkic rabbit hole. If you study the very high IQ types (140+), they tend to go on “crazes” like this. They also lose interest after a bit, drop the craze and move on to some new craze. Dilettantism for the win.
I also have an anxiety disorder called OCD which is well controlled. A good side of it though is that you tend to do dive down rabbit holes a lot, and the OCD makes you burrow maniacally into the rabbit hole with the notion that one is going to become the world’s leading expert on whatever rabbit hole you are digging in now. So for one or two years, I went absolutely berserk into Turkic, whereas before I scarcely knew a thing about it. The end result can be read above.
The sad result is that either due to the savant stuff or the mental quirk, I also tend to lose interest in my rabbit holes after a bit. I follow them about halfway to China, make several revolutions around the molten core, and after a year or so, come up for air gasping with incipient Black Lung, and next thing you know, I am bored, and it’s onto a new craze. It’s a bit silly, but we all have our crosses to lug, and as eccentricities go, there are many worse things that dabbling, er hobbyism, er dilettantism, er polymathy, er autodidactism, er Renaissance Manism.
Most of you will probably not find this very interesting, as it is pretty specialized stuff that is mostly of interest to people in the specialty, linguists and those interested in the subject. It’s not exactly for the general reader. But if you have any interest in these languages, you might enjoy it.
I expanded Turkic from 41 to 53 languages, eliminated some languages, turned some into dialects, turned some dialects into full languages, combined languages into a single tongue, created some new languages out of scratch and did quite a bit of work on the history of the languages.
I also reworked the classification a bit because I thought it could be done better. Even though this work does not pay much, the pay is in fame if it is at all. My work will either be accepted by the field or rejected outright or somewhere in between. I have already earned the praises of some of the world’s top Turkologists, much to my surprise. If I get fame, well, I get quoted in papers, maybe invited to conferences, and maybe even referenced in Wikipedia. There are groupies in all status fields, and what the heck, there may even be linguist groupies. If not, there are always starry eyed coeds dreaming of professor types to mentor them. I am already working that angle as it is. Writer Game, Scholar Game, there’s Game for everything.
Or my work does not go over and maybe the field decides I do not know what I am talking about.
Crap shoot, like most of life’s endeavors. Roll em, and wish upon a star…snake eyes!
PS. The title of the series, Before the Last Voices Are Gone, was created by me. I think it has a nice little song.

Severe OCD: When the OCD Takes Over

Disgusting or Terrified?: Can intrusive thoughts turn you into whatever it is you are afraid of?
Does breaking your rules mean you don’t have OCD?
I’m afraid of…. Sometimes I’m scared that… I’m…I can’t actually type it. Think of the worst thing you could do to someone, and you are on the right track.
But I’ve been breaking my rules. I work with ____, and I don’t even think I should be near them. My job requires that I am around _____, and I feel like I am already a thing that is bad and may have done bad stuff but probably not but you never know. This is killing me. I feel like if I actually had OCD, I wouldn’t break my rules. Ever. Period. But since I have been breaking my rules I’m worried that I am actually ____.

Yes it is still OCD, if you break your rules.
I used to have all sorts of insane rules that I had to live by. They were secret, and I never told a soul. But I was terrified of breaking them. I slowly got up my nerve and started breaking them one by one. But as soon as I broke a rule, a new one would come in! Not as bad as the previous one, but still. It was like the illness was mad that I was breaking the rules that it set up for me, and it was retaliating by setting up new rules. Then I would get up some nerve and break the new rule. It went on and on like this. This was over 30 years ago when I was in terrible shape.
If the illness gets bad, the OCD pretty much takes over and even though you know it’s insane, it starts running your life. Your mind goes split between the crazy part (the OCD) and the sane part, and you end up with a war in your head like all such people have. But if the illness gets really bad, the sane part of your mind will slowly get weaker and weaker. Like it’s a voice in your head, and it gets softer and softer and quieter and quieter. At the same time, the crazy voice (the OCD) will get louder and louder. Eventually the sane side says, “OK, look, forget it. You win. I give. You take over and do what you’ve got to do. We are running up the white flag here.”
And then the crazy part takes over. It tries to screw up your life by making you miserable and saying negative things all the time. In my case, it set up all sorts of lousy rules designed to screw up my life and make me miserable. But I became convinced that this was how it was supposed to be. I had to suffer in all of these ways because the voice (the OCD) told me that I was the worst person on Earth, the worst person that ever lived. I actually became convinced that this was true for some time.
The craziness was very carefully calibrated. I remember I used to ask the voice (the OCD) about being crazy. “Well how crazy am I going to go anyway?” The voice would come back that I had to be crazy, that there was no alternative to this. This was somehow logical, don’t ask me how. It would say that the craziness was going to be completely invisible, all in my head, and I wasn’t going to do anything even 1% crazy because we had to keep the crazy stuff secret.
We were not going to believe anything too weird, and we were not going to see things. We were not going to commit any acts of violence, and we would try to be as rational as possible. Actually one of the Rules of the Craziness was that my actual behavior had to be as close to 100% normal as possible. All the craziness was supposed to be in my head. It was amazing how calibrated the whole thing was. It implies to me that I actually was not all that nuts.
It took me about four years to work my way out of this crap. It was like a journey to craziness. A trip to Crazy World. While I was crazy, I tried very hard to fix all sorts of things about myself that I thought were screwing me up in life, so that was beneficial. I was working full-time or in school the whole time. Most people figured out that there was something wrong, but the illness was pretty much invisible and all you could see was a strange or bizarre stare in my eyes along with a lot of anxiety. I didn’t actually do much of anything nuts.
Eventually after four years, it was like I just got sick and tired of it. It was like I took some sort of a journey that I needed to take for some reason, like I got something out of my system. Being crazy is pretty lousy, and if you have any self-esteem at all, you will get pretty sick and tired of it after a while and just want it to be gone. I also grew a lot as a person and changed a lot of things about myself that needed changing.
I had one other episode five years later in 1991 that was very, very bad, but I went on pills for the first time, and that dealt with it. I haven’t had any serious episodes like that in 25 years.
Even though I have not had any serious episodes in 25 years, I am still very much afraid that it will come back, and I will be like that again. But if you take pills, that seems to keep it away. Also it seems like you have to work on your head a lot, like all day,  every day to keep your mind in a nice, sane place.

Borderline Personality Disorder Versus Sociopathy

Herehere and lots of other places.
There are definitely some major differences, and a Borderline Personality Disorder is generally not the same thing as a sociopath, but there is also some overlap. In fact, I would say there is overlap between all of these horrific Cluster B types.
Sociopathy and BPD can occur in the same individual. One of Jeffrey Dahmer’s diagnoses was BPD with sociopathic traits, among other things.
Horrifically violent people need not be sociopaths, though they often are. Some men who slaughtered their entire families – wives and children – had such diagnoses as Obsessive Compulsive PD and Narcissistic PD.
One serial killer, a long-haul trucker who was roaming around northern California, was said to be unusual in that he was not a sociopath. This was the guy who hacked a woman’s breast off and walked into a police station with her tit in his pocket to confess. Forget his name.

OCD and Homicidal Thoughts

Homicidal thoughts or harming thoughts are quite common in a type of OCD called “Harm OCD.” It can get pretty bad. As a counselor and a sufferer, I have dealt with many people who had this particular type of OCD. In fact, they come to me all the time! I typically do some sort of differential diagnosis with them to make sure it’s OCD and not something more serious.
Below are some cases of obvious OCD or OCD-like thinking:

1. OK so one day me and my sister were just talking and all of a sudden I get this weird urge to choke her. I would never do that to her. I can’t even kill a bug and I’m not bi polar. This has happened again recently with my other sister, the thought just randomly occurs. If it helps I have been diagnosed with panic disorder. Please don’t be mean and say I’m a psychopath or I’m crazy. I need to know if any one else has experienced this to. Please help!
2. I do too sometimes. Sometimes while I’m driving I feel the urge to swerve into traffic. Sometimes for no reason I get the urge to choke my dog or hit her to death. (Of course I’d never do it.) It feels like you have no control over yourself. It feels like your actually about to do it but you don’t.
3. Believe it or not I’ve been through the exact same thing I had violent and sexual urges that I couldn’t control but I never hurt anyone I just always felt like I would, some specific urges I had were to drown my sister in the pool , every time I was someplace high up I would have a strong urge to jump off. I had these urges from age 10-15 and I was scared to be around people but I found out it is OCD look up OCD violent urges online.
I finally talked to somebody about it and said I was worried I would hurt somebody and they said the reason the urges don’t make me a violent dangerous person is because I’m worried about it were somebody dangerous would either not care or enjoy it.
4. i think everyone thinks these thoughts, not because you want to do them, but because your brain can think it. Its just putting yourself into a scenario, kinda like a daydream. Ive thought that way…”what if i just punched her…what if i slipped and fell and hit my head….what if i swerve into traffic??” tons of things will cross your brain…you’re human and its curiosity. I think you’re just fine. Unless you start getting the urge to actually follow through with it, or attempt it. Don’t sweat it.
5. Guys… I have that too. Sometimes ill sit and watch tv and suddenly ill have a random thought of killing my mom or hurting my dogs. Anyone in my house hold. I’m completely fine when these thoughts occur. I’m not mad, nor upset. And my family never did anything wrong to make me think such things…I would NEVER hurt anyone…
And it scared me. Sometimes i avoid certain objects i could hurt people with and i stopped watching my favorite crime shows. It all freaks me out now.. Ive asked a friend, and he has it too but not as extreme. More of a “what if” thing. He says im fine and he thinks everyone has these thoughts at one point.

Some of these folks may not even have OCD, but at any rate, all of these thoughts have an OCD-ish feel to them. It’s quite common for non-OCD’ers to get thoughts like this once in a while.
This case is more difficult:

Hello. This isn’t very easy for me to let go into the world, but I would like people’s opinions. I am on the other end of a 1.5 year bout with OCD and being terrified that I am going to indulge in homicide. Things are much better now, but yesterday at work, I got all my issues worked up in my head and at one point I genuinely wanted to indulge in homicide. I actually wanted to do it.
During that I had slight panic attacks running and of course it worries me that the curiosity of doing such an act is attractive. Now, I have read many posts here on how to self help your OCD, but this is the first time I have ever been genuinely attracted to the horrible thing I’ve been afraid of for such a long time, and that’s the difference between being afraid of intrusive thoughts and being attracted to them. Is that normal psychology for an OCD sufferer, do you think my thoughts got twisted in knots and then I deceived myself into thinking I wanted to do it, or do you think I should seek some help?

The thread goes on and on, and some folks are are telling him to go to the ER and check himself in. The guy who posted this is worried that he felt like he really wanted to do it. However, many of the OCD’ers I have dealt with have told me that they feel like they want to act on these thoughts. In every case, they were given a diagnosis of OCD by multiple clinicians. The thing is that OCD itself can make you feel like you want to do these things. It can also make you feel like you might or would enjoy them. All of this causes more panic, anxiety and attempts at thought suppression.
So if someone comes to me with classic Harm OCD stuff and then tells me that they feel like they want to act on these thoughts, I am not particularly worried. It’s probably more the OCD convincing you that you want to act on the thoughts or that you might enjoy them more than anything else.
This case is much more disturbing.

Hello, My name is Ryan. I’m 17 years old. I’m posting this here today because for quite some time i have been obsessed with murder, blood, torture, and rape. When I see someone walking down the road, my mind unconsciously comes up with random ways of torture I could try on them, I’ve been doing this since I was around 15, but now something’s changed – I feel its getting harder and harder to control, I’ve had to start journaling and drawing what I would like to do to my victims.
I feel I could take countless human lives and not stress about it. Will someone please tell me what’s wrong with the way I think? My parents told me its a stage, but I know it’s more. Just someone please try to give me insight on why this is happening.

I am honestly not sure what is going on with this guy, but one thing it is not is OCD. No way does a Harm OCD’er journal and draw pictures about torture, rape and murder. Forget that. The OCD’er would be terrified of having the thoughts in the first place, would not enjoy them at all, and would most likely viciously fight them from the first time they showed up until they went away, if they ever did.
The OCD’er doesn’t want those thoughts or feelings in his head for even one second. He would never just indulge in them for pleasure or write journals and draw pictures that delight in murder, torture and rape.
Truth is most Harm OCD’ers are so scared of their thoughts, etc. that they start avoiding all situations that might set them off, including any TV shows, movies or writing that has to do with murder, rape, torture, etc. If they watch or read something along those lines, they will feel serious anxiety and nearly have a panic attack.
In the thread, a few of them ask him questions to see if this is OCD. He says he enjoys the thoughts and feelings very much. That doesn’t sound like OCD one bit. However, he does say that he tries to resist them at times, but he can’t. Now that is very odd. But there may be occasional resistance with non-OCD stuff.
The fact that he feels like he could kill countless people without a single worry in the world is also disturbing. No way would an OCD’er feel that way.
It is interesting that a number of other commenters said that they had similar thoughts and feelings, especially when they were teenagers, and at some point, they just went away. That is very hopeful. I had assumed that once you get to the point where you are fantasizing about rape, murder and torture all the time, even to the point of doodling and journaling about your fantasies, you are pretty much gone. But apparently this is not so, and people can easily move out of this kind of thinking. That is a very good thing indeed.
The following are some cases of homicidal thinking in schizophrenia:

1. Yes but not intentional homicidal thoughts more like random ones that come in my head like if I see a bus pass by me sometimes I would have thoughts of breaking the windows with a baseball bat and screaming at the passenger or punching someone randomly passing by me but not of anger I barely get angry anymore just random thoughts.
2. Hi, I’m new here to this board. I was just curious if anyone feels these symptoms. I feel this way all the time. Whenever someone looks at me wrong. All I want to do is hurt or kill that person. I was recently hospitalized a couple months ago. I’m always scared to death. All I wanna do is crawl in to a dark room and cry. Sometimes when I’m driving I think what if I just turn the wheel and kill that jogger running.
Seriously I see a pdoc and have seen the same doc since I was a little kid. My pdoc says it’s just delusions. But it’s so real!!! I was diagnosed with paranoid sz. about 3 years ago. Does anyone feel this way? Please anyone I would love to know that I’m not alone here.
3. Hello Weenska, you most certainly are not alone. I get homicidal thoughts too. The scary thing is that they are all about killing children. You see, I work in a children’s’ hospital, and for some reason my mind is set on hurting the patients there. I get so nervous when I have to go clean a room with a patient sleeping in there.
The nurses are outside of the room sitting at the nurse’s station, and I’m alone in the room with the patient. While I’m cleaning I get evil thoughts of how I could swiftly kill the child without anyone seeing. My mind comes up with so many ways on how I could get away with it too. It’s like I’m constantly fantasizing about being a secret, mysterious child killer. Isn’t that awful?
4. I know I’m not a bad person and could never harm anyone. You’re not a bad person either. Why we get these kinds of thoughts flowing through our head is beyond me. I want you to know that whatever filthy person our minds may try and persuade us to be, that its not who we really are. 🙂
5. Princess is right, you’re definitely not alone! I have homicidal thoughts about my hubby. I don’t sleep well at night so a lot of the times I am just sitting in bed watching my hubby sleep. I would think about what it would be like to actually commit a murder. I can picture myself smashing his head in with a baseball bat, or poisoning his food, I even can see my self sneaking up on him and stabbing him in the back.
I’ve told him and at first he thought it was kinda funny, but now I can tell he’s sometimes a little edgy around me. I love him so much and I don’t want to lose him…To me, this is so much more than some kind of delusion. Its like the devil himself is tempting me. I hate feeling so sick and twisted inside. Anywho, yes I can relate. I know I’m not bad, and I will fight these thoughts off as hard as I can for as long as it takes!
6. I’ve always been a real docile person, but when I got sick I had some homicidal thoughts.
7. In 1980, I had a lot of violence in my head and I was afraid for about a week that I would get violent. It scared me and made me feel bad, but I managed to control it.
8. I get these thoughts of hurting people sometimes too. I haven’t acted on them so far.
9. I used to get terrible homicidal thoughts. There were command voices, and there were the videos/images that played in my head about terrible crimes I was committing. I have been hospitalized over 20 times, and many of these were for homicidal ideation. I would be taken to the inpatient unit and put in isolation because I could not control myself.
But after the fact when I would get re-stabilized on meds, my T told me that she did not think I had it in me to hurt another person. I have never hurt another person. I am generally very kind and calm. She wanted me in the hospital because she was afraid I would hurt myself. After I had the homicidal thoughts I would feel SO guilty about having the thoughts that I wanted to kill myself because I was such a “bad” person. But, I am not a bad person. Now I have been stable on Clozaril for 6 years, and I no longer have homicidal thoughts… ever.
10. From my perspective, It might b “normal” 2 have homicidal thoughts about some 1 I don’t like or doesn’t like me. But I have homicidal about the ppl i LUV the most! It’s like the thought pops up in my head then I got a whole bunch of cause n effect scenarios.
It could b like if i c a hammer on the table, I could bash my loved one in the head. Or it could b some insecticide, n I could add a dash of death 2 a meal. I mean yea, I been thru some bad shit, but this is just fucked up! After i realize what I just wuz thinking, then I start feeling all bad, then the potential bad endings, n it bothers me. I mean, I’m ain’t necessarily a bad dude, but damn that shit ain’t cool, feel me?
11. I get homicidal thoughts when I am deeply disturbed. I make up shit in my head on how I could kill someone and get away with it. I have really good self control, and I’m a good person, and it bothers me deeply. Most of my homicidal thoughts are about my brother though because he is clearly the Antichrist. I talked to God when I was actually planning on killing him and he stopped me. He’s a crackhead and pill popper big time and only uses my disabled mother for more crack money.
Luckily he has found a place to live so he doesn’t bang on our doors at 530 or call my phone anymore. He threatens a lot towards our family, but I can do so much more harm than he could. My father passed away in January and he was the only person who could keep him in line. The constant family feuds we’ve been having has at times caused me to the point of pure insanity. I talk about killing him openly with my family and how he just needs to die.
Of course, they’re very freaked out. I’ve always had homicidal thoughts even before schizophrenia. But they have just been getting worse about my brother. I think about killing other people sometimes, but it’s mostly my brother because he’s a piece of shit. This morning he came by again and I couldn’t sleep. I haven’t heard voices in over a week, they come and go, but this morning voices were telling me to murder someone.
12. When I read this post, I immediately remembered my early teen years, when my illness really started getting bad. I had my first hallucinations when I was about 14 or 15, and that’s when I started having thoughts of killing people. At first the thoughts were of killing people at school, like a random school shooting, and then killing myself. Then came the thoughts about killing my family members and then myself. I skipped school all the time because of it. I feel sick just typing this. I want to delete it and pretend it never happened.

This one is deeply disturbing. Some sort of homicidal thinking she had actually led to her trying to kill her brother, probably when she had schizophrenia:

I’ve had thoughts like that before too. I used to go to school with a girl who I thought was perfect. I wanted to kill her because I felt so flawed next to her. The point is, NEVER act on these impulses. Never hurt anyone or you will regret it horribly. I tried to kill my brother once and he avoided me for years (can you blame him?).

As you can see, homicidal thinking is extremely common in schizophrenia. In fact, the vast majority of schizophrenics seem to experience it at some time or other. Some of this stuff looks very OCD-ish to me. Whether it justifies an additional diagnosis of OCD or not, I have no idea. You will notice that in many cases, anti-psychotic medication specifically for schizophrenia made the thoughts go away. This implies that it was not an OCD process driving the thoughts but instead it was a schizophrenic process. If it was an OCD process, the anti-schizophrenic drugs would not have worked.
The question is how does the schizophrenic homicidal thinking above compare to the OCD-type ideation in quality? Honestly, I do not have the faintest idea.
One way it differs is that in schizophrenia it can take the form of command hallucinations ordering the person to commit violent acts. Fortunately, they do not give in to the thoughts most of the time. There is something a bit similar in OCD where the person experiences thoughts inside their head ordering them to carry out various homicidal and violent acts. The difference is that in OCD it will be a thought and in schizophrenia it will be an external voice. And in schizophrenia, there is much more likelihood that the person will act on it. The chance that a person with OCD will act on the thoughts is just about nil.
However, in schizophrenia, this thinking is much more dangerous as it regularly leads to episodes of violence. However, as you can see above, only one of the schizophrenics above ever acted on their homicidal thoughts, so in many cases, they are able to control themselves.
I have never worked with schizophrenics, and I don’t know how to deal with homicidal ideation in schizophrenia. I imagine it is a very tricky area to determine a schizophrenic with this type of thinking is dangerous or not.
People come to me after reading my articles. They are basically self-diagnosing with OCD, or they have already been diagnosed by a clinician. I have found that people are pretty good at self-diagnosis for this condition. They often write me telling me that it is as I could see inside their minds and tell them what was going on in there. All of the people who came to me with homicidal or violent thoughts had OCD so far, so I haven’t had to worry much about differential diagnosis. I did have one client who was truly homicidal, but that person was thinking in a completely different way and it wasn’t OCD driving the homicidal ideation, it was something else altogether. There wasn’t much I could do about that person either.
Unfortunately, I think most of the people who are truly dangerous are simply not going to show up for counseling or therapy. They either like to feel this way or don’t care, and they don’t see any problem with their way of thinking.

Normal Guy With Irresistable Urge to Kill People

Link here, and see responses. I have written about this before. This guy is now convinced that he has OCD, specifically Harm OCD. I know Harm OCD very well as I have spoken with and worked with scores of people who have it. There is no way on Earth that this guy has Harm O. Forget it. Not possible. Harm O doesn’t work like this.
As far as what is wrong with him, I have no idea. Not all unwanted thoughts, feelings and urges are obsessions. Some might be more classified as “addictions.” We may be looking at more of an addiction here. I am also thinking, if he really doesn’t want to feel this way, why doesn’t he just knock it off? You don’t want to think about killing people? Great. Just stop doing it. It’s not that hard. That won’t work for an obsession due to the nature of obsessions, but it should work just fine for a non-obsession.

I’m a relatively normal, happy guy. I have an almost irresistible urge to kill people. What’s wrong with me?
READ FIRST/UPDATE AT THE BOTTOM: I guess I should clarify that I am definitely NOT going to kill anyone. I only want to. I know the difference between wanting something and having to have something, and have never once in my entire life actually tried to hurt anyone. The furthest my desires have ever gone is thinking about how I would go about doing it. I have never owned a weapon or thought about obtaining one outside of knowing that I would have to in my little day-dreams.
I am a normal guy in my early 20s. I work full time, I have lots of friends, people generally like me when they meet me, and I work very successfully in a people-oriented business. I care deeply about my friends and family, and I stand up for people I don’t know when I feel they’re being taken advantage of. I am of above-average intelligence, and I’ve been told by more than one person that I’m their favorite smart person because I never make anyone feel like I think I’m better than them.
I’m happy with the person I am, and I’m confident in the decisions I make on a daily basis. I don’t have any money problems that can’t be solved by budgeting for a week or two, and generally always have the time and means to pursue the things I want.
I am moderately successful with women; I’m no Casanova, but in general if I make an attempt to woo someone, they are wooed. I have recently been getting serious with a girl I’m really into. She’s smart and funny and full of life, if not a little talkative sometimes, which I find endearing.
My ambition in life is to be happy without damaging the happiness of those around me. I get along great with animals and would never intentionally hurt or kill one, and hearing stories/seeing pictures of people who torture or even just mistreat animals bother me. Something as simple as a neighbor leaving their pet out in bad weather can ruin my morning.
I don’t think I’m a psychopath or even a sociopath. I’m no more selfish than the average person, as far as I know. When I hurt people’s feelings I do everything I can to make up for it if I feel I was in the wrong, which is relatively often.
I also really, REALLY want to plan and execute a murder. Or several. Usually the first solution that pops into my head when someone is in the way of my happiness is to murder them. I’ve gone as far as learning someone’s schedule and patterns and planned a fairly thorough method of killing them and disposing of their body without getting caught. Most of the people I contemplate killing are not people that are close to me, though I do occasionally get intrusive thoughts about taking the life of friends or co-workers I genuinely get along with.
I don’t think I’ll ever go through with it, but if I did I would probably choke my victim to death with a thin, strong rope or wire of some kind. Guns don’t appeal to me and knives are messy.
The main thing stopping me from going through with it isn’t a fear of getting caught or the belief that killing is morally wrong (which I do believe, but I’m not so hypocritical that I’m going to pretend I don’t betray my morals every now and then), but a fear of what it would mean about me as a person. I don’t want to hurt anyone, I just feel like I need to sometimes.
Is there something wrong with me or are these just normal invasive thoughts? I feel like I should talk to someone but as far as I know I have my desires under control.
UPDATE: Thanks for all the feedback guys. I’m getting an equal mix of Dexter quotes, troll accusations, and suggestions to see a therapist. Rathosaur’s post here made me realize I have probably have a pretty serious form of OCD that I’ve just been managing internally for a while. I plan on talking to a therapist as soon as I find out what kind of mental coverage my insurance has. I don’t feel like I’m a dangerous person, but I also don’t like having thoughts that bother me in my own head. I really, truly appreciate the input of those who have offered help.

One thing that jumps out loud and clear in this post is the narcissism of this fellow. It is also disturbing that the only thing preventing him from acting on these fantasies – and that is what these are – fantasies – is what people will think of him if and when he gets caught. People will hate him so much that his self-esteem won’t be able to handle it. What stops him from killing is how it would affect him, not the people he kills, his victims. That is rather disturbing right there.
Posters post about how this guy is a sociopath or a psychopath, but I am not getting that. A sociopath could care less what anyone thinks of him. If he likes the idea of killing but does not do it (very common in sociopaths as many fantasize about homicide but few carry it out) it will be for reasons other than his own self-image and what others think of him, since by definition, the psychopath cares nothing about his self-image or what others think of him.
If the psychopath is not carrying out these acts, it may be because he doesn’t want to go to prison. Many psychopaths have very active antisocial fantasy lives, but they don’t engage in a whole lot of illegal activity because they don’t want to go to jail or prison. So they become “legal criminals” instead.
Here is what a poster posted about this fellow in saying he was a psychopath. Notice all checks by the narcissism stuff but almost no checks by the parasitic lifestyle stuff.

Factor 1: Personality “Aggressive narcissism”
**Glibness/superficial charm** [if he woos her, she’s usually wooed]
**Grandiose sense of self-worth** [he’s everyone’s favorite smart person]
Pathological lying
**Cunning/manipulative** [if he woos, she’s usually wooed; everyone likes him]
**Lack of remorse or guilt** [see immediately below]
Shallow affect (genuine emotion is short-lived and egocentric)
**Callousness; lack of empathy** [isn’t worried about hurting his would-be victims, but is concerned about *his* self-image if he kills]
Failure to accept responsibility for own actions
Factor 2: Case history “Socially deviant lifestyle”.
**Need for stimulation/proneness to boredom** [fantasizing about murder]
Parasitic lifestyle
**Poor behavioral control** [stalking people]
Lack of realistic long-term goals
Impulsivity
Irresponsibility
Juvenile delinquency
Early behavior problems
Revocation of conditional release

A Harm OCD’er would never, ever, ever plot of plan to kill anyone. They would never learn anyone’s schedule in order to fantasize a plot to murder them. It doesn’t work that way!

Problems in the Diagnosis of OCD

The criteria used to diagnose OCD give rise to a lot of confusion among sufferers and clinicians.
Resistance: Resistance is certainly the hallmark of OCD. Obsessions often provoke the most ferocious resistance. However, not all OCD’ers resist their thoughts. Some just hate them and want them to go away. Also, when the illness gets bad, resistance is often gone and the thoughts just take over and resistance is impossible. Others choose not to resist.
I talked to a female OCD’er with Harm OCD who said she didn’t want to fight off the thoughts because that would be “going against who I really am.” This is a case where the obsessions have taken over so badly that the person is starting to believe them. Unfortunately, this is quite common in the illness, and the sufferer often feels that the obsessions are completely real, because that is how they feel. Nevertheless, resistance is still an excellent marker for OCD. My feeling is, “If you try to stop it, it’s an obsession.” And that’s pretty much true.
Resistance can turn into a cause of endless doubting and ruminations. I have talked to people who spend a good part of their time resisting and fighting off and trying to stop obsessions. Nevertheless, one of their worries was, “Am I really trying to stop the thoughts?”
Anxiety: Certainly, anxiety is prominent in OCD. However, as OCD goes on, the anxiety often attenuates and the person does not feel so much anxiety anymore about the obsessions. For instance the Gay OCD’er feels that the gay thoughts do not cause anxiety anymore, so this means that they are gay. The pedophile OCD’er does not feel much anxiety about the pedo thoughts anymore, so that means they must be a pedophile. The Harm OCD’er finds that the violent thoughts do not cause much anxiety anymore, so they must be a murderer or a psychopath. It is uncertain why the anxiety goes down in OCD. Some think that the body simply tires of being anxious all the time and simply becomes attenuated to the anxiety.
Feelings of numbness and lack of feelings: This is very common in OCD. Why this happens is not certain, but it may be because the anxiety has gone down.At any rate, numbness is very common. This often causes a lot of worry, particularly in Harm OCD, when the person feels that that they have lost their feelings and are turning into a psychopath.
Lack of desire to carry out the actions: It is often said that the difference between someone with OCD and someone without it is the lack of desire to carry out the actions associated with the obsessions. “The person with OCD does not really want to do these things,” is how it is often phrased. However, this causes a lot of confusion because in many cases, the OCD will make the person feel that they want to carry out the acts.
A person with Gay OCD will feel gay and feel like he wants to have gay sex, a person with pedophile OCD will feel like he wants to have sex with children, and a person with Harm OCD will feel like they want to attack or kill people. So this isn’t a very good barometer. However, in general, they do not want to have these feelings, and they fight them very hard. So you look at such things as unwantedness and resistance instead. Whether the person with OCD really wants to do these things is more of a philosophical question. They probably don’t, but OCD can make them feel like they do.
Obsessions as repugnant: While it is probably true that the OCD’er finds their obsessions repugnant on a deep level, hence all the discomfort, anxiety and resistance, this can cause problems because when the illness is bad, the OCD will try to convince the person that they like the thoughts and don’t want to get rid of them. I have spoken to many OCD’ers who were panicked because they felt they were starting to enjoy the pedophile, gay or violent thoughts. This is just OCD trying to convince you that you like something that you really don’t. But the repugnant criteria can result in endless ruminations along the lines of, “Do I really find them repugnant?…Maybe I don’t…Maybe I like them…”
Sometimes this leads to endless compulsions where the person tests themselves over and over again with the images to see if they are disgusted or not. A Gay OCD’er may look at gay images on the Net to see if they generate the proper amount of disgust. A pedo OCD’er may conjure up images of sex with children to see if they are properly disgusted by them. A Harm OCD’er conjures up images of crime scenes, homicides, or themselves committing a violent act over and over to see if they feel the proper amount of disgust and horror.
I talked to one OCD’er who had an image of himself slitting his father’s throat in his head. He had to conjure up the image over and over until he “got it right” and had the proper feeling towards it. This compulsion could take some time and was accompanied by some interesting physical maneuvers in conjunction with it.
“Am I really disgusted by the thoughts? Am I really horrified by them? Do they really bother me?…” These are the sorts of endless ruminations that one encounters.
“I am going to do X…”: It is actually fairly common for an OCD’er to think that they are going to carry out the unwanted act. For instance, a someone with pedophile OCD may think, “I am going to have sex with this child,” and someone with Harm OCD may think, “I am going to kill this person,” or, “I am going to shake the baby right now.” Often these more dramatic forms cause a lot of anxiety because the person worries that the thinking is too extreme to be OCD. However, this thinking is quite common in OCD.
Confusion of voices with thoughts: The person with OCD often describes the thoughts as “voices,” but what they are describing is their inner voice only, not external hallucinations. Also the inner voice in the person with OCD often goes through a lot of changes in tone, etc. to where it seems there are different internal voices going on. Sometimes the obsessions seem to be in a voice other than one’s own, and this is very frightening.
An internal voice is just a thought. Thoughts are internal voices. You hear them in your head, as the phrase “inner voice” implies. You can have one internal voice or many. It’s probably better to have as few as possible since otherwise you might find yourself confused. A hallucination is something you hear with your ears. It is external to the environment.
Confusion of “fake hallucinations” with real hallucinations: In the form of OCD called Schiz OCD, the person worries that they are developing schizophrenia. They often worry that they are starting to hallucinate. They listen intently for all sorts of noises in the environment and start to either mistake them for voices or wonder if they are really voices. A person with true hallucinations will be quite clear that they are hallucinating. Usually careful questioning can ferret out the fake hallucinations from the real hallucinations.
“Lack of empathy” in Harm OCD: In OCD, the obsessions often feel very real. So a person with Gay OCD feels 100% gay. A person with pedophile OCD feels that they are a pedophile. A person with Harm OCD feels like a killer. I have had many Harm OCD’ers tell me such things as, “I feel evil…I feel like the devil…I feel like I could kill!…I feel like a serial killer…I feel like a murderer…I feel like a psychopath.” The OCD simply creates a situation where the person feels that they have become the theme of their obsession.
In Harm OCD, many times persons report a “lack of empathy.” Many Harm OCD’ers have told me this. “I feel like I don’t care anymore…I feel like I don’t love people anymore…I have lost the feeling of love…I feel like I don’t care about others’ lives or value them…I feel like I could take a life and not even care…” One told me, “You know, when my grandfather died, everyone around me was sad, but I felt like I didn’t even care. I felt like I wanted to laugh.” He was terrified as he told me this.
On the surface, this looks like the lack of empathy associated with psychopathy and I have had OCD’ers tell me that their therapists told them that this sort of thing was not associated with OCD and was instead associated with psychopathy. This just caused them even more worry as they were already afraid they were psychopaths.
Typically, this person had felt decent empathy for others before the onset of the Harm OCD. They are generally alarmed that they “seem to be losing their empathy” and see this as a sign that they “are turning into psychopaths.” They make desperate efforts to regain their empathy and feelings of love, but it often doesn’t work very well. This often turns into a form of a compulsion where the person can spend hours a day “practicing feeling love or empathy for others.”
Presumably, a person with psychopathy or a true lack of empathy would not feel bad about it.
The “lack of empathy” is probably a “false feeling” created by the OCD.
Confusing obsessions with delusions: Unfortunately, many OCD’ers are still diagnosed with psychosis. I have had many of them come to me with a diagnosis of psychosis. In all cases, I felt the diagnosis was wrong. However, at times, obsessions take a very strange form in which the content looks like a delusion. In these cases, you look at how much the person believes in the thought, whether they are resisting it, etc.
Confusion of checking with interest: I have talked to some pedophile OCD’ers who had looked at child porn or had masturbated to pedophilic imagery as a form of checking to see if they were interested in it or not. They were now terrified that they did not have OCD and instead they had pedophilia. They were not doing this because they were pedophiles. Instead they were they were checking to see if they were pedophiles or not.
Concerns about escalation: It is quite common for OCD’ers to accept a diagnosis of OCD but to then feel it is “turning into something worse.” In other words, at first they had Harm OCD or Pedophile OCD, but now it is getting worse, and they are turning into pedophiles or psychopaths. Escalation is a strong worry in the form of OCD called Schiz OCD where the person worries that they have schizophrenia. Invariably these persons feel that they are developing schizophrenia. Realistically almost none of them are. I do not regard this as much of a worry. My feeling is, “Once it’s OCD, it’s always OCD.”
“Is it really OCD?” This is not so much a matter of diagnostic confusion as it is a hallmark of the disorder. I cannot tell you how many OCD’ers I have talked to who ask me, “Is it really OCD?…I am worried it is not OCD…What if it isn’t OCD?” It is called the doubting disease after all. My feeling is that if you are asking yourself over and over, “Is it really OCD?” then in all probability it may well be OCD. Sometimes a person without OCD will wonder if they have it, but they are not usually so obsessive about it.

Threat Assessment in OCD

This is an excellent article.
Examples of obsessions:

Examples of normal intrusive thoughts include the image of touching the genitalia of a child, worry (in the absence of any evidence) as to whether one had caused an accident on the way home, urges or impulses to attack a loved one with a kitchen knife, or thoughts and images of jumping onto a railway track in front of an oncoming train.

That is a pretty good list, and the author points out that 80% of the population report having these thoughts also.

The risk is that the patient will act on an obsession (e.g. suicide or sexual acts with a child) or impulsively act out an obsessional fear. At its simplest, this need never be a concern: there are no recorded cases of a person with OCD carrying out their obsession. By definition, such intrusions are unacceptable and ego-dystonic, and the person is no more likely to act on their intrusions than a person with height phobia is to jump off a tall building. The obsession represents a type of fear or worry that the patient does not want to happen; like all fears or worries, it concerns ideas that the patient wishes to avert at all costs.

That seems to be correct, however, when the illness gets severe, the person can become convinced that they actually want to carry out these acts. I have spoken to quite a few people with OCD who told me that the illness made them feel like they wanted to have gay sex or have sex with children or assault and murder people. This is probably correct though in that people with OCD do not act on their obsessions. I have not met one person who acted on an obsession of causing harm to themselves or others, or how did anything sexual to a child in response to an obsession.
However, there are cases of people with gay OCD who get so convinced that they are gay that they go out and have sex with someone of the same sex. Usually this is a complete disaster and I would not advise it.
There are also cases of people with Relationship OCD who have left their partners or spouses. Generally, this does not solve the ROCD dilemma.

Where compulsions are concerned, urges that are themselves obsessions need to be distinguished from urges arising as responses to obsessions. Once this is done, the risks are relatively obvious. Thus, if someone has an obsessional fear of cutting themselves, you can be very certain that they will not harm themselves.
However, if the idea of harming others is the obsession, they might respond by cutting themselves rather than harming someone they love. Secondary risks are often subtle. For example, a parent who is constantly preoccupied with their obsessions may become less responsive and emotionally available to their children.

This is interesting. I have dealt with a few OCD’ers who cut themselves. All were women.
The next part goes into differentiating Sexual OCD from the type of thinking that goes on in a sex offender.

OCD or potential sexual offender?
Various factors differentiate the intrusive sexual thoughts of people with OCD from those of sexual offenders

  • Ego-dystonicity of the thoughts
  • Failure to act on or masturbate to the thoughts
  • Avoidance of trigger situations
  • Efforts to suppress the thoughts
  • Very frequent or constant occurrence of the thoughts
  • Dominant anxiety, distress and guilt about the thoughts
  • Overdisclosure of irrelevant past sexual history
  • Wanting help and seeking referral to mental health services
  • Presence of additional obsessive–compulsive symptoms

That is a pretty good list.
Assuming that in a sex offender, we are dealing with some sort of a paraphilia, I had one OCD’er who had obsessive thoughts of slitting his father’s throat. He was terrified that he was going to act on these thoughts and that he got some sort of sexual arousal out of them. His therapist told him that this was OCD, and that paraphilias are “about desire, not fear,” and “no resistance.” This is about right. I would expect to see little to no resistance in a paraphilia. OCD is a problem of fear and paraphilia is a problem of desire.
You are also looking at something that is occurring all or almost all of the time. If it is, it is likely you are dealing with an obsession. With paraphilias, they are much less likely to be going all the time, and when they are frequent, the person is likely to be fantasizing.
The anxiety, distress and guilt over the thoughts is often profound. I have had quite a few OCD’ers tell me that they were crying for hours on end, either could not sleep or were lying in bed all day or had even lost weight due to not eating. It is quite common for them to say that they are suicidal; however, OCD’ers usually do not attempt or commit suicide. I have only had OCD’er who attempted suicide and she tried twice.
Presence of another disorder like Borderline Personality Disorder is likely to greatly increase the risk of suicidality. In such cases, the suicidality is likely due to the BPD and not the OCD. It is curious that OCD’ers are so commonly suicidal but they rarely attempt or carry it out. The OCD’er is a shy, almost meek person whose dominant emotion is fear or even terror. Quite simply, they are too scared of dying to kill themselves, so the fear associated with suicide prevents them from carrying out the act. In contrast, a violent of sexual offender is likely to see the thoughts as fun or enjoyable, though sometimes they feel guilty for enjoying them so much.
Wanting help is a great one. When someone comes to me on the brink of suicide due to their “horrible pedo thoughts that popped up out of the blue,” I am quite certain that this person is not a pedophile. I have only have one pedophile come to me in all the time I have worked with OCD’ers, and he went away pretty quickly. In contrast, sex offenders or pedophiles will rarely show up for help. One man who was interested in working with pedophiles as a career was told that unless he was working in a prison setting, he would never see one in clinical practice.
Resistance is the hallmark of OCD. George Winokur, a famous psychiatrist, said, “Look at how hard the person fights the thoughts. That is a clue to whether you are dealing with OCD or with something else.”
Another interesting thing you will see is checking. So the person with pedophile thoughts will constantly conjure up pedo thoughts and then examine their reaction to them to see if they are properly horrified. A person with gay thoughts tests himself to see whether or not he finds gay sex repulsive. A person with violent thoughts frequently conjures up violent thoughts or scenarios to check to see if they are actually repulsed by them or if they are repulsed by them enough. Sometimes the thought or image must be repeated over and over until the person finally feels that they have obtained the “right” level of disgust. You will see much less resistance in paraphilias; in fact, typically, there is none.
Failure to masturbate to the thoughts is not a great checkpoint, as I have had quite a few folks who were masturbating to pedo thoughts as a way of checking to see if they were turned on by this sort of thing. In the paraphilias, the person masturbates, often compulsively, to the imagery of the paraphilia, pedophilic, sadomasochistic or other fantasies or pornography. They get great pleasure out of this, and they generally do not want to stop.
Ego-dystonic is excellent. Paraphilias are much more likely to be ego-syntonic. Although this one is a bit tricky, and the OCD will often argue with the person and tell them that they actually like the thoughts when they do not. This leads to a lot of confusion over whether they enjoy the thoughts or not.

They will avoid trigger situations.
Harm OCD’ers will avoid other people or avoid weapons, heights or pill bottles if they worry about self-harm. Pedophile OCD’ers will avoid children like the plague. Gay OCD’ers will avoid anything to do with gay people. Sometimes they avoid their own sex or even the opposite sex. In contrast, many pedophiles will actively seek out places where children are present.
Overdisclosure of irrelevant past. Many times, those with pedophile worries will reveal all sorts of incidents in their childhood past that they feel prove that they are pedophiles. Usually this is just harmless child sex play of the sort that all children engage in. A Harm OCD’er will reveal incidents in his past in which he was violent in order to prove that he is a murderer. Usually this sort of thing is sort of a back-checking and doubting sort of thing in which the mind is trying to come up with reasons why the obsession is true. In contrast, a sex offender will often hide their past due to fears of being caught.
Presence of other OCD symptoms. This is an excellent clue that you are dealing with OCD, and I use it often when I am trying to figure out if I am dealing with OCD or something else. With a sex offender, usually you will not find any OCD.

Factors suggesting OCD in thoughts of violence

  1. Ego-dystonicity
  2. Absence of past behavior consistent with the thought
  3. Presence of avoidance behavior (e.g. avoidance of knives or sharp implements)
  4. Frequent thoughts
  5. High degree of distress
  6. Strong motivation to seek help

The ego-dystonic nature of violent thoughts is often profound, and the resistance provoked by them is often extreme. In contrast, real violent thoughts are typically ego-syntonic and are quite pleasant to the person.
Absence of past violent behavior. The Harm OCD’er is typically a very nice, kind, sweet and gentle person – the last sort of person you would think would do such a thing. They typically have little violence in their past, certainly little violent crime or unprovoked attacks on innocents.
Presence of avoidance behavior. The Harm OCD’er is often afraid of knives, weapons, etc. and tries to put them away or hide them. In contrast, a violent person may be quite comfortable with weapons.
Frequent thoughts. When the violent thoughts are going all the time like a broken record, you may be dealing with OCD. Violent people do not necessarily think violent thoughts all the time. Instead they only think them some of the time.
High degree of distress. Harm thoughts provoke severe anxiety. Some people hospitalize themselves to avoid hurting other people. I talked to one woman who had been in a hospital for four years with Harm OCD. In contrast, violent people tend to like their violent thoughts and they think them anytime they want to with great pleasure.
An OCD’er with Harm OCD told me that they went to a forum for psychopaths and asked them about the harm thoughts that he was experiencing and whether they experienced the same thoughts. The sociopaths were mystified that the man felt the thoughts were abhorrent. One of them said, “Actually, one of the few things I like to think about is hurting people and killing people.” The rest of the sociopaths all endorsed that statement. Dangerous people like to think violent thoughts; they get kicks out of it.
Strong motivation to seek help. The OCD’er is panicked over is violent thoughts and desperately wants to be rid of them. By contrast, a truly violent person likes to feel violent and doesn’t want to feel any other way. I have not yet had a truly violent person come to me wanting help with violent thoughts so they don’t carry them out.
I had one homicidal person, but they very much wanted to feel that way, and there was nothing I could do to talk them out of it. The whole problem with this sort of thing is that the people who are actually going to carry out violent and sexual offenses, the people who are really going to do these things – well, they never show up. Instead the only ones clinicians see are the people who are never going to act on any of this stuff.
Resistance. I would add this one to the list. Violent thoughts often provoke furious resistance in an attempt to keep them out of the head. In contrast, someone who is actually going to carry out an unprovoked act of violence against an innocent person spends little if any time resisting thoughts. One Harm OCD’er was afraid he was a serial killer, but he had never committed any violent acts along those lines.
He asked his therapist, “What about a person who actually does these things? Do they ever try to stop the thoughts?”
“No.”
“Not even once.”
“No, not even once, of course not.”
So resistance or the lack of it really is a good marker for OCD versus something else.
Therapists often make OCD worse in various ways. Here are some of the ways that they can make it worse.

Examples of patients’ comments regarding their assessments
‘He gave me a differential diagnosis which made me panic as it increased my doubts about whether I did have OCD.’
‘She said that, to be on the safe side, it would be better if I avoided working with children until I had received treatment.’
‘He said SSRI’s might reduce my sexual urges so I assumed he must think there was a problem.’
‘She said I was unlikely to act out any urges but she was still obliged to notify Social Services.’
‘He implied I might have an unconscious wish to stab my baby.’
‘He said it was extremely rare for such thoughts to mean that someone was dangerous, but if I was still worried, I could go for a specialist assessment at the sexual offenders unit.’
‘She said it was very rare for this type of violent thought to lead people to act on it, but “as you obviously have a problem dealing with anger, then therapy would be a good idea”.’

There is no point in saying any of these things, and I try very hard not to make OCD’ers worse when I deal with them.

References

Veale, David; Freeston, Mark; Krebs, Georgina; Heyman, Isobel and Salkovskis, Paul. 2009. Risk Assessment and Management in Obsessive–compulsive Disorder. Advances in Psychiatric Treatment 15: 332-343

Asperger's or Non-Aspergers?

Tai writes:

Well I strongly agree about your idea that many people who are antisocial or perhaps just a bit on the odd side are falsely diagnosing themselves with Asperger’s Syndrome or diagnosing others, I do not agree with the over simplification you suggest stating “people with Asperger’s” as in all people with Asperger’s do the exact same things.
I am a 20 year old female and I was diagnosed when I was 7 years of age by a child psychologist, Dr. Seymour.
Asperger’s Syndrome or Autism Spectrum Disorder (spectrum meaning a great variety of “symptoms” from person to person) is the Highest Functioning form of Autism. A diagnoses of Asperger’s excludes any mental retardation.
It is characterized by significant difficulties in social interaction, along with restricted and repetitive patterns of behavior and interests. Also hypersensitivity with touching, hearing, tasting and smelling.
Albert Einstein had ASD, and television characters Brennan from Bones and Sheldon from Big Bang Theory also have Asperger’s.
Though not everyone with ASD is a genius, they tend to be extremely bright in classes and situations that interest them and my excel greatly among their peers.
Some things take people with ASD longer to learn though, to which extra help and a new way of learning and patience will help them along.
For example, lets say 10 year old Bobby has Asperger’s. He knows everything about Dinosaurs and can memorize the lines 100% from his favorite movie. He is also very good with math and amazes his teachers and parents with his intelligence, as well as exhaust them when all he CAN talk about are his hobbies! Not all he chooses too, all he can do! However he still can’t tie his shoes, writing is very difficult for him and he has trouble making friends and adjusting to new people. People think he is odd, and he thinks everyone else is odd. He hates being touched and takes every thing he hears very literally. (when his mom asks got a Kleenex he says “sorry we only have tissue”.) He also hates LOUD unexpected noises like fire works. It hurts physically some how. And he can’t eat bananas or avocados because they “feel too mooshy” and he will “tantrum” if tried to force to eat them out of sensory overload causing him to panic.
That is one example of someone with AS. Another person with AS might love fireworks and hate the sound of car motors, love mushy things but hate crunchy things, be able to tie shoes but can’t jump rope, knows everything about his favorite cartoon instead of dinos and is an excellent writer but a poor learner with math. They may be able to NOT take things as literally but are unable to look someone in the eye.
It is a spectrum disorder. Because of this is can be hard to get a proper diagnoses. However I would suggest to all people who assume they have AS to go get evaluated. And to get evaluated by 2 or 3 doctors for more professional opinions. Falsely diagnosing oneself can only lead to issues, especially if there is another psychological problem.

My understanding is that Aspergers comes on at an early age, say age 2-3. In 100% of cases, symptoms will be present from a very early age. Any adult who has previously functioned well, or God forbid very well, cannot possibly have Aspergers.
People’s functioning varies with time. I know people who used to function perfectly but now they can barely leave their houses. So functioning can dramatically collapse in any given individual.
One thing that I noticed was that many people self-diagnosing as Aspies had anxiety disorders. I work with OCD patients, and many of them think that they have Aspergers. I generally do not think that they have it. Aspies do not seem to be very common. I think I met one in my life so far and another couple on the Net.
The problem is that a very large number of people are odd, weird, strange or out of it in some way or another. I run into them all the time. They can’t possibly all have Aspergers. Schizophrenics are obviously pretty odd. I have met some odd OCD’ers. A lot people with anxiety disorders can seem pretty weird. Many very shy people seem out of it and odd. Just being weird doesn’t mean you have Aspergers!
In addition, many introverts to super introverts are identifying as Aspergers. Obviously many introverts have problems in social interactions, but just because you have problems dealing with other humans because you are an introvert does not mean that you have Aspergers!
I read a recent paper that said that Aspergers and introversion are along a continuum, with introversion at one end and Aspergers at the other. I agree with this, and this is where the confusion sets in.
Although I am quite an introverted person and many people think I am pretty damn weird, I certainly do not have Aspergers. For one thing, my social skills are actually excellent, but my brain works in funny ways so that right there turns people off. They see my brain apparently working in a weird way and they just don’t want to have a conversation. But I am a master of social rules and not only that, I understand other people very, very well. I even know what they are thinking most of the time, to the extent that you can do that at all. Of course I know what they are feeling too. I read people very fast and I respond very fast too. I get all the subtle little nuances in conversation, the tricks and hints and whatnot and usually respond to them right away.
Things that I think are odd about Aspergers:
Not wanting to be touched. WTH?
Sensory overload. I don’t really get it, but we introverts have a bit of this. Parties are a bit much for me anymore, but the Aspie sensory overload just seems downright bizarre.
Not wanting to eat something because it’s too mushy or too crunchy? Huh? I eat anything and I don’t care what it feels like in my mouth. Who cares!
Hypersensitivity with hearing, touching, smelling or tasting. Ok that is just weird to me.
Wanting to talk about one thing all the time and not shutting up when you are boring people. I do this too sometimes, but I usually shut up when it seems like people don’t want to hear what I am saying.
Think everyone else is weird. Huh? No way, they are normal.
Takes everything very literally. This makes no sense to me either.
Hates loud unexpected noises like fireworks. Looks like sensory overload to me. I don’t care about fireworks. They are going off around me for the last few days now, and I don’t even care. Someone lit one in the street near the path of my car the other night and it was no big deal, but it was a little weird to drive past the burning, fizzling, crackling thing.
Why would I love one loud sound but hate another. They are all the same to me, just another loud sound. You get used to them sooner or later.
Ten years old and can’t tie your own shoes? Sorry, but you have major, major problems, kid.
Excellent writer but bad at math or great at math but poor at writing. This I can relate to, and I have known many non-Aspies who are like this. Intelligence is variable, and abilities differ even within the individual.
Can’t look someone in the eye. I have been accused of this myself sometimes. A lot of very shy people have problems with eye contact. I have gotten a lot better at this over time, but I still hardly think this is diagnostic because you are going to suck in a lot of introverts. Although I imagine an Aspie might be quite strange about not looking you in the eye to the point where it seems they are just being strange about it as it is so extreme.
As you can see, I obviously do not have Aspergers at all. But believe or not, some folks have insisted that I must have it!
Introversion and Aspergers are not the same thing, but they make both be part of a spectrum.

This is a Gay Website

Repost from the old site.
I have a little secret. Lots of people think that I am gay. It’s actually a problem.
I get a girlfriend, and if she is not a total moron, she asks if I am bisexual. Or if used to be gay. WTF is this “used to gay” BS? Once a homo, always a homo, right gays I mean guys?
If she’s a moron, she asks if I still am.
This is supposed to be some sort of a horribly embarrassing and humiliating thing for me, as my enemies love to use it to attack me. I must suffer sexual confusion. I must indeed.
I never really understood precisely why people think this way, as I have never seen myself on videotape. I consider myself a fairly masculine acting guy, and that’s how I feel deep down inside and that is what I identify with, but hey, I grew up in the 1970’s when everyone was sort of androgynous, and this is how I sort of ended up.
I have a very soft voice and I like to walk in a fluid way. I’m still kind of skinny in a stupid and now 10 pounds overweight and can’t lose an ounce kind of way. I cross my legs sometimes. I call it relaxing, but others call it gay. Can’t a guy kick back and enjoy himself?
Maybe it’s gay relaxing, in which case, dude, I am all fagged out, but that is ok. One thing you can do if it seems like half of the sentient universe thinks you are a fag is to find a nonsentient partner, who are easy to acquire in our inner cities.
Or else you can get an Asian chick. Asian chicks never think you are gay, cuz compared to Asian guys you are probably like Sylvester Stallone. I was in bed with this Asian woman once, and we still had our clothes on but not for long, and she asked, “So, are you feeling lazy today?” It’s true I was, but actually I was totally exhausted and plus I was totally stoned out of my gourd, as what better to do an Asian chick, then to take a couple of massive bong hits and then go to town on her?
As I am one lazy-ass mofo, and anyway truth is we all are, even so-called workaholics (GMAB), but yet I was insulted, yet I should have agreed and bragged about how I was swindling welfare or something equally lumpen and parasitical.
So Asian chicks think I am lazy but they never think I’m queer, except this Vietnamese woman who pointedly told me, “You look like a gay!” Well, that was nice of her, blaming God and all that. Thanks bitch.
It’s true! My face is all fagged out and I have the queerest features around, and let me tell you man, there’s nothing better. You get girls and guys both after you in whole armies sometimes, and it’s good to be loved.
One consequence of the Dang is that dude fagged out or what? thing is HOCD, or homosexual OCD. This is easily the stupidest mental illness on Earth, except they are terrified they are queer even when they are not, and it totally ruins their life over absolutely no damned good reason whatsoever.
So in a way it is a nihilistic sort of mental illness, a mental illness that only Kafka could have invented, an absurd mental illness that has no right to exist at all, kind of like most of us, you know?
I have done therapy with some HOCD sufferers online. It’s an interesting experience, but it’s also terrifying in a stupid way. If you ever got caught up in the straight person worried they are queer illness (Man, this that the lamest mental disease on Earth or what?), I do have some therapies for you.
First of all, admit it. Admit you are queer, take pride
in it and advocate it in everyone around you. If you are really insane, you can even make sexual offers to the males around you. This is fun, because since you are straight (Yeah sure! LOL) you don’t really want to do it.
It’s the ultimate expression of macho to say you’re queer and shout it to the skies. You hope everyone knows it’s a lie, but if not, you were just gay for a day, and that’s always a blast.
If I were comfortable with this, it would be one thing, but really I am not. I don’t like effeminate behavior in men, and I try to stay as far away from gay and bisexual men as I can. I’ve had far too many experiences with regular guys, married guys, on and on, to not be wary. I can’t even count the number of guys who I felt were getting way too friendly with me.
At least 25% of males are bisexual or at least opportunistically gay, except in Afghanistan, where the figure is 50% or more. Male bisexuality is everywhere, especially with omnisexual men in their 20’s, who will do it with anything, even a hole in a melon, I guess (I understand that this is the best sexual experience of all, surpassing anything a man can do with a live male or female).
Second of all, advocate for gay rights, now that you are gay and all that. Imagine that you are driving down the street and there is a billboard that has your name and picture on it and says, “[YOUR NAME] IS GAY!” And it has your photo and everything.
And then the paper comes and your pic is on the front page with a headline about how you are REALLY GAY! And everyone is laughing at you and calling you a fag and all, but that right there is a great reason to party, so just make one. Now when someone asks you to sign your name, you want to lie and write “Gay fag McCoy” and just leave it at that, but for the sake of social peace, you resist the urge.
Anyway, it took me a long time to just figure out that I am what I am. Not only do I dislike effeminate behavior in males; I also dislike wimpy males. Deep down inside, there is a part of me that is as macho as any man that ever lived – a lumberjack, a trucker, a fisherman – you name it, I can play that role. Not only that but it’s really me, it really is, and if you disagree with that, will kill you will no regrets as my inner Viking dictates.
I guess there is another side to me, and that’s ok. I always idolized Mick Jagger, Steve Tyler, the New York Dolls, Mott the Hoople and all the androgynous rock stars of the 1970’s. We all grew up with that, and it’s just normal to be that way.
These dudes dressed up like chicks and even wrote totally fagged out songs, but really they were just a bunch of gangbangers, a White Crips and Bloods, and they never queered around, or not too much anyway, or at least I don’t even care who fagged off and sucked on knobs and who didn’t.
If I could just tell folks, no, I’m straight, thank you very much, and it would be over, that would be ok. But the questions never stop coming, and the doubts never end. I must say it is discouraging, but only because this is such an important question.
A certain type of woman gets asked if she likes women, says, “No, I’m strictly dickly”, and the questions end, but for us guys, the doubts just linger. Is that stupid or what? I mean, bitch, I mean woman, I said I’m straight and that means I’m straight! You either understand that or you get tied to the bed again, is that understood? And you will answer Sir!”
Society must find male homo- and bisexuality much more upsetting than the female kind.
Anyway, as there is nothing I can do about this, and this unfortunate issue with remain with me for life, I assume, I hereby anoint this website an officially gay website. We will just make macho fraternity jokes about fags and stuff, and guys who are bi-queerious, I mean bi-curious, but all the while we won’t even fag off, not even once, and if he’s real cute, we promise. Kind of like a great bachelor pad or frat house.
I must admit that there is a part of me that loves being called gay. It’s just so wrong. I’ve gotten to the point where the best way to deal with it is to laugh uproariously and say, “I LOVE it when people think I am gay!”
Then I dance around the room and do my best gay imitation while hopefully some dudes go, “Whoa! Is this guy really is a queer?”, in their friend’s ear, and that makes it even better, as long as they don’t try to kick your ass or anything.
Then I love to tell gay stories just to freak people out and keep them guessing. Like, “I’m not gay or anything, but I once went to a gay bar and drank 13 Penis Coladas, one after the other. Oh, man were they great!”
But hey, I was young and experimenting and lots of guys do crazy things once or twice, even Hugh Hefner fucked a guy once, and if you call me a queer one more time, I am going to have to seriously kick your ass or maybe even kill you, do I make myself understood?
So it’s time for an obligatory gay post. How about Heroic Homo Sex? I love to talk about this website, because every time I do, everyone starts freaking out and looking at me like, “Shut up you idiot! Are you a FAG or what?” All the more reason to talk about it more and more and not just piss off a few people, but piss off as many people as possible!
Anyway, even if you are not gay, this is a great site. This is a site that deals with homosexuality and masculinity, gay culture and effeminate men, AIDS and the contours of masculinity. The author is gay himself, and the site has quite a bit of gay erotica and pornography. If that freaks you out, you better not go there.
But it’s definitely worth the look. The purpose of the site is to attack several aspects of modern gay life: anal sex and promiscuity. These are gay men who are not into anal sex; they think it is painful, dangerous and degrading.
And they have a fascinating thesis.
The thesis goes like this: Before gay liberation, gay men met and had relationships and engaged in all sorts of sex behaviors. Anal sex was not even that popular, and gay men were not tremendously promiscuous. But with gay liberation, came the normalization of gay anal sex.
According to the various articles linked on the site: the obsession with anal sex has been linked to gay liberation – gay lib mandated anal sex as a substitute for heterosexual intercourse. But the site painstakingly points out that the two types of sex are not the same. A vagina is designed by evolution to take a heavy duty penis-pounding, after all, this is one of its purposes.
It’s hard to damage a vagina, as it has a lot of redundancy in its walls. Hence the vagina is relatively refractory to getting blood-borne diseases like AIDS and Hepatitis C and B. You pretty much need to bleed a bit to get a disease like this, and it’s not so easy to make a vagina bleed. It amazingly accommodates a full-grown baby easily, another of its purposes.
An anus is not like this at all. Evolution designed it for elimination, and it has a very thin wall that is easily damaged, if even slightly, during anal sex. Bottom line: bleeding, even microscopic, usually occurs during anal sex. HIV is transmitted easily this way, as is Hepatitis B.
Furthermore, no one ever talks about this, but the site points out that regular anal sex causes anal leakage and fissures (small tears in the anus). More heavy duty stuff like fisting (that a lot of gays are into) can cause anal incontinence, fistulas and all sorts of nasty stuff. Anal prolapse can occur with years of this sort of sex.
Yet the gay community relentlessly promotes anal sex in gay pornography and even gay medical sites. On the medical sites, gay docs tell you to go ahead and engage in anal sex and don’t seem to steer men away from it.
Heroic Homo Sex feels that anal intercourse is ultimately damaging, if only slightly, to the anuses of gay men. Plus they are repulsed by the whole act.
They also promote a fascinating theory: it is not possible to get fucked, anally or vaginally, without having to play a submissive role. Getting fucked makes a person submissive. So gay sex, or being on the receiving end of it anyway, makes gay men submissive and ultimately effeminate. This because getting fucked is feminizing. Fucking is masculinizing.
Andrea Dworkin tried to say much the same thing about the violence inherent in the normative heterosexual sex act, but she was raked over the coals.
It is rape, dammit! That’s why you need to encourage your female partners to engage their rape fantasies to the fullest, since tons of women love to think about getting raped. So rape and rape and rape away, and make a satisfactory adjustment to married life anyway, as the old Abnormal Psych textbooks used to say.
Women act feminine in part because they get fucked. Men act masculine in part because they fuck. Have you ever noticed that when a woman wants to get fucked, or if you are getting ready to fuck her, she tends to act more and feminine, to the point where she is some kind of a silly Barbie Doll Southern woman thing?
Then in the sex act itself of course, tons of women want and love pain (trust me), as (my theory) being a woman is so painful, so if you’re a woman, you either become a bit of a sub and enjoy life or you are screwed and miserable and all bitched out.
The sex act itself, and the role one plays in it, has carry-over effects into nonsexual life.
The guys at Heroic Homo Sex are some interesting gay men. Not only are they repulsed by anal sex, but they are also sickened by the effeminate behavior of gay men. They propose an alternative: that gay men should become more masculine. As, deep down inside, I love masculine behavior, I have to cheer this on. This is great: there is a positive value in masculinity for any male, even a gay one.
The site is full of images of masculine gay men acting masculine, and it promotes a masculine mindset among the gay men who go there. Hear hear!
What they promote is something called frottage, which is basically two guys more or less rubbing their dicks up against each other. This is often combined with masculine images like wrestling and various forms of martial arts.
I guess there are variations on this theme, but it’s quite safe in terms of VD (a horrific problem with gay men due to the wild homosexuality many of them pursue), and it enables gay men to have sex with each other and at the same time retain a masculine identity.
They take the theorizing a bit further. They suggest in some of their essays that anal sex is inherently degrading in and of itself, at least as it is practiced in the gay community. So not only does anal sex make gay men effeminate, it also degrades them and makes them into “sluts”. This has been a part of gay porn culture too – the promotion of anal sex and rampant promiscuity in gay men.
The two are connected, the website suggests. For a man to get fucked anally turns him effeminate and has the effect of “turning him into a slut”. Gay culture promotes the image of the gay man as slut, whore, pig, prostitute, etc. The use of degrading terms is encouraged. So getting fucked effeminizes men and degrades them, turning them into promiscuous “fuck pigs”.
There is ample support for this theory if one takes the time to peruse gay culture. Check out the gay personals of any gay website, if you dare, and you will see tons of insane and rampant promiscuity along with a lot of dangerous anally-focused sex and the continuous promotion of the gay slut-pig sort of fellow.
Not that I am against slut-pigs at all, but more of them should be female and disease-free. This is my only wish at age 50 where Viagra moments become normative events.
The site goes so far as to term this whole gay degradation and sluttification process as a death cult. With AIDS raging through the gay community, that’s not just idle talk.
Anyway, interesting website from some gay men who are looking to turn gay culture seriously on its head. In the meantime, they are promoting some fascinating theories to explain hard to explain phenomena – theories that at least look good on paper.
And they promote an alternative image of gay men as sexually responsible, disease free, and masculine in a warrior sense. As a straight man who values masculinity in myself and other men, I have to cheer it on.
There are links all through the site leading to variations of their main theoretical issues, and you need to click around to get a feel for their whole worldview.
I sort of still have a “terror of gay stuff” OCD thing, so it’s really therapeutic for me to click through all this totally fagged out stuff, just to flood myself some more.
You cannot run from your fears. They must be embraced, head on, like diving into a swimming pool from a high board with no worries. Then you climb out and do it again and again and soon it’s nothing.
The author of the site is a gay man who went through the whole hippie thing in the 1960’s like a lot of us. His partner and the love of his life had a similar developmental trajectory and later acquired AIDS and died of it. The whole site is sort of a tribute to this man who he obviously still deeply loves. I found this touching in an odd way, though normally gay romance doesn’t do much for me.
Warning! There is lots of gay male erotica and even gay male porn on that site. I don’t mind; I just kind of speed through that stuff as it isn’t very interesting to me and it bothers me on some level. So if you can’t handle that sort of thing, don’t even go there. If you have HOCD, you need to go there, stop everything, hold the horses, not now, yesterday!

Pedophilia Versus POCD Redux

Anonymous wrote:

I’ve had pure O my whole life. As a child it was both religion and contamination related. As I got older it turned into health and contamination related. (I became an atheist and stopped caring about intrusive anti-religious thoughts.)
But here’s where it gets a little tricky. When I was 10 years old and just discovering my sexuality, I noticed that I especially had a fondness for girls who were 5-7 years old. I knew this was much different than others my age, and felt quite guilty about it. I was also attracted to 10 year olds, however.
As I got older, every time I saw a cute little girl, I would avert my eyes and repeat to myself in my mind “I’m not a pedophile, I’m NOT a pedophile.” It felt very much like the intrusive thoughts from my OCD and happened constantly. This continued until around 16 years old.
At this point, I became interested in anime and the primary school aged characters in these shows. I talked to others who were interested in animated little girl characters also. At this point, I was still having intrusive thoughts, but being interested in the fictional characters didn’t bother me at all.
And then, in the same places where I was discussing these fictional characters, people would also often post pictures of elementary school girl models and actresses. I began masturbating to these photographs, but every time I would feel immensely guilty and hate myself for it.
Awhile later, I met a 6 year old girl. She began visiting us often. I just fell in love. In no other time in my life had I felt this way before. She was a joy to be around and extremely beautiful. We became very close, and I cared for her more than anything. After meeting her, all intrusive thoughts stopped and I accepted my attraction as normal for me.
I’m now in the my early 20s, and have very little interest in women. The pedophilic intrusive thoughts are no longer there, only the ones based on health worries and contamination remain.
I do have sexual thoughts about young girls, but I see them as normal for me now. Although when I see a cute girl that I’m interested in, it’s closer to crushing than lust. “Oh wow, she’s so beautiful.” The girls that I tend to like are between the ages of 5 and 11. They are just so cute.
Now, based on this information, do you think I have a pedophilic orientation? Or do you think it’s possible that I had POCD and just gave up fighting it?
A few things to consider: I would never touch a girl, I know it’s wrong.
It also has nothing to do with being dominant. I actually find the idea of dominating a young girl extremely disgusting.
It also is not only physical, I am extremely attracted to the personalities of very young girls, and just hanging out and playing games with them have been the best experiences I’ve ever had in my life.

This is a fascinating post. It shows that someone can have both OCD and pedophilia, so the notion that OCD’ers are too good or too moral to develop pedophilia is not correct.
Pedophilia in my opinion is simply a sexual orientation like homosexuality, bisexuality or heterosexuality. It can’t be much changed like any of those. There are countless gay and bisexual OCD’ers. I know because I have talked to many of them. Surely there must be some OCD’ers with a pedophilic orientation.
It’s probably better for a pedophile to have OCD than to not have it. The OCD pedophile will be a lot less likely to act on his urges due to his extreme morality, guilt and conscientiousness. The OCD will act as an inhibitor towards acting on the pedophilia.
I am absolutely certain that he has pedophilia. There’s no way that he could possibly have POCD and just gave up fighting it. Though it shows that there are some similarities between POCD and true pedophilia, and this shows how differential dx is so difficult with these cases.
I am actually sorry to hear that he has no attraction to adult females, but perhaps this is his normal orientation. I wish he had an adult attraction so he could live and love happily and legally in our society. As is, his sex life may well be barren or solitary and his love life may be thwarted.
However, many pedophiles are absolutely happy with their orientation and love being this way. He seems like he is too. I am very glad to see that he is happy with his orientation and his sexual and love desires. I love to see people who are happy. I agree that him that he should not act on this orientation as it’s illegal.
If he ever wants to have a real sex life with a female or really fall legally in love with a female, he will need to expand his love map to include adults, though most pedophiles have no interest in doing this. In fact, many to most pedophiles say that even if there was a cure for pedophilia, they would not take the cure.
I also love females of all ages. I love females period. Little girls are wonderful in a special way as a special kind of female, though I see them as seeds of women rather than fully formed entities and I see women as the fully town product rather than girls that moved on.
But there’s a girl inside every woman, and a budding woman inside every girl. If you love females, you learn to love the sprouted seed of girl in the woman and the sprouting woman in the girl. In a way, they are one and the same – females at different stages.
I actually like teenage girls a lot more than little girls. Little girls seem ridiculous to me, and there’s little sexual attraction there. I had a world full of good and great times with teenage girls, often sexual, when I was young, and I think about those wonderful days all the time. When I see teenage girls, I reminisce. About the teenage girls that I knew and loved, who will live forever in my heart.
Though when I do meet a teenage girl nowadays, they seem silly to me, and I can’t see getting involved with them. I would not do it even if it was legal. But the teenage girl is definitely a special type of female – not a girl and not a woman. Not better than a woman or a girl but only different.
I probably like adult females 18+ best of all, since they are legal. I like teenage girls who are fully developed, around age 16-17 because to me that’s just a woman. But their immaturity is a massive turnoff. Even young women of college age often turn me off now because they seem to immature and silly.
A fully formed and mature woman is not only maximally attractive to me (all females age 16+ are maximally attractive to me) but her mind is also fully matured, and that is a massive turn-on to me as I get older. Sex and love is more than just a hot body you know. And the fully formed and fully matured woman has a joyous wonder and glory about her that is equal to if not superior to that the teenage girl and the girl. All the female maturational types are wonderful in their own special ways.

What OCD Is Not

First of all, let us look at the case of Jack Harrison Trawick. Trawick is truly one sick puppy! He was executed in 2011 in for the rape and murder of a 22 year old woman in 1992. His defense attorneys said he had a lifetime history of schizophrenia since age 11, but he sure planned his murders well.
He had long been preoccupied with sex and violence and treatments were rendered to him to try to cure him of these preoccupations. He also murdered a 26 year old woman, for which he was also convicted. For decades, he committed burglaries to terrify women he saw as attractive. He cut up their underwear and left menacing messages on their mirrors in lipstick.
A man set up a website dedicated to him, vowing to turn him into an international superstar. Trawick sent the website many of his sick drawings and letters, including imaginary conservations with his last victim, sicks jokes and threats to famous women such as Brittney Spears and Jennifer Lopez.
The author says he has been fascinated with serial killers since he was a young boy. He also says he has OCD, apparently with the harm theme. He gets thoughts about killing his cats. “I’ve always been an animal lover,” O’Connor said in the telephone interview. “I have four very cute cats. The cutest of the cats a lot of times I just think about stomping on it until her eyes pop out of her head.” The website supposedly alleviates his symptoms somewhat.
The problem is that this guy seems to love violence. He seems like he likes to think about killing his cats, and he loves to think about serial killers and all of the horrible things that they do. He relishes this stuff and wallows in it.
There are plenty of people like that, but folks with Harm OCD are usually terrified of their thoughts. Many stop reading, listening to or watching video of murders or any kind of violence because it sends them into a panic. Quite a few said they used to like horror movies or violent video games but they stopped enjoying these things after the thoughts came on.
Now I am not saying this guy doesn’t have OCD, but his fascination with the subject of violence doesn’t seem to be normal for these people and paints a false image of people with this problem as some sort of maniacs or sickos.
It is true that some folks with this problem expose themselves to violent material as a therapeutic tool, but I assure you that it’s a painful and anxiety-ridden process for them.
I am not going to reprint the killer’s letters here, but if you go to the site and read them, they are really sick!
On this site, a woman writes that her mother knew the killer as he delivered furniture to a store she worked at. She said he was also so nice and kind that she simply refused to believe that he could do such a thing.

Alternate Identities in OCD

A lot of people with OCD develop “alternative identities.”
Harm O folks develop identities called “the murderer”, “the serial killer,” “the sociopath,” “the rapist,” “the criminal,” etc. HOCD people develop identities called, “the queer,” “the fag,” “the gay,” “the lez,” “the dyke,” etc. POCD people develop “the pedo,” “the child molester,” etc. Others might develop “the racist,” “the misanthrope,” or “the misogynist.” You really start to feel like these other things.
I don’t know much about other themes too much, but there might be identity changes with those too.
If you are really bad, you will be in the alternate identity all the time.
If less bad, it will fade in and out. You will be driving along, and “the fag” takes over. You walk into a store, and all of a sudden, “the serial killer” becomes you. Often a lot of effort is expended trying to shake off the alternate identity and get back into what feels like your real one.
It’s extremely creepy and unnerving.

Do People Without OCD Ever Try to Stop Their Thoughts?

I do not think that most normal go around trying to stop thoughts all the time. Most people just think about whatever they want to, and aren’t resisting unwanted thoughts all the time. I asked a friend of mine if she had ever tried to stop a thought, and she said she had never tried to stop one thought in her entire life. She acknowledged that she worried about things sometimes, but these thoughts were not resisted as unwanted or alien intrusions.
I asked another friend whether she resisted or tried to stop her thoughts, and she told me that she never did. She said sometimes she gets unwanted memories or thinks about stuff she doesn’t really want to think about, but she doesn’t try to stop the thoughts.
Before I had OCD real bad, did I try to stop thoughts? Not much, but I did have obsessions from time to time.
The first one that I remember was when I was 12 years old. I was in Sunday school and they told us that God can hear every single one of your thoughts. Well, that set my mind off. Mind started saying, “Fuck God! Fuck you, God!” over and over. This went on for 10-15 minutes while I panicked and tried to stop the thoughts. They didn’t return that I am aware of.
The next one that I am aware of was about the garbage grinder. Not sure when it started, but I would get very strong urges to stick my hand down in the garbage grinder when it was going. That would be a catastrophe if I did that, so of course I never did it. For a while, I even stuck my hand in my back pocket while the grinder was going to keep from doing it.
I also had some gay thoughts, but those were obsessions and not real feelings.
They started around 1979. I would be sitting there talking to some guy, just him and me together, and all of sudden I would think, “I want to suck your cock!” That thought would just repeat over and over for 30 minutes to an hour. I would try to stop it, but I couldn’t. I seemed to able to carry on the conversations anyway, though it was annoying. I’ve always been heterosexual, so the thoughts didn’t make any kind of sense. They were not accompanied by any erotic feelings or anything like that.
One time I was interviewing a very famous rock star in a record company office in Hollywood when the gay thoughts started up. They went through the whole interview, but he was nice enough anyway. I still got good notes. He just died the other day.
One time when I heard about Hinckley, the guy who shot Reagan, and that he was in love with Jody Foster, my mind said, “I’m in love with Jody Foster!” I thought, “Whoa! Weird thought, man,” and I just dismissed it. I later mentioned this to my father and pointed out that just thinking something like that doesn’t mean you’re insane, but he just glowered at me and shook his head contemptuously. I guess he thought I was nuts.
Another time I was reading about the Lawrence Bittaker and Roy Norris case, a truly horrific case of serial murders that rocked Los Angeles in 1979 and 1980. They tortured one woman to death by stabbing her in the ear with an icepick. When I read that, I got an image of the stabbing with the icepick going into her ear repeatedly while she screamed. Every time the pick went in, my mind said, “Yeah! Yeah! Yeah!”
It was extremely disturbing to have those thoughts, but they only lasted a short time, maybe less than a minute. I was panicking out and furiously trying to stop them the whole time. They didn’t come back, but for a long time afterwards, I was really worried about myself even for thinking that way for 30 seconds one time.
All of the above are more or less OCD symptoms, or obsessions. Science has proven that ~80% of humans have obsessions at one time or another, so in a sense they are normal. But I don’t think it’s normal to fight them for an hour or so at a time.  On the other hand, if OCD symptoms are mild, only going on for maybe 3 hours or less out of a whole year, there’s not a whole lot to worry about.
There were other times when I just felt uncomfortable, but that didn’t feel like OCD. It just felt like a crappy feeling that I wanted to get away from.
For a while there, I was hanging around with people made me uncomfortable because they were ignorant and not that smart. At the time, I was in college. It was annoying to hang around with these people, who struck me as idiots, so I would get uncomfortable a lot of time when we were hanging out. They would come over to my place and put the latest retard Hollywood blockbuster on the VCR and sit there and laugh and cheer while I put my head in my hands.
Another time I was on a date with this 16 year old girl who was wildly in love with me. I was 20 at the time, but I used to screw all kinds of underage girls back in those days. I stopped when I was 21.
The first date was ok, but she was so stupid and idiotic teenage girl girlie that I was almost cringing. We had sex anyway, and it was lots of fun. She was horny as all get out. We planned a date for the next weekend, and that week, I was a wreck.
My friend was over visiting me at my place, and he asked me what was going on, and I said I had a date with girl, and I didn’t even like her. He was outraged. “You’re going out with a chick and you don’t even like her! You’re an asshole!” He shrieked. I felt horrible, like the worst person on Earth, crushed with guilt.
Well, the hottie was even hornier before the second date, so I figured, “Why not, let’s get laid. What the Hell man?” I went out with her, and I felt so uncomfortable, I was almost squirming the whole time.
We tried to have sex, but I had an impotence problem, which made me feel really awful. I relaxed more and an hour or so later, we tried it again, and this time it worked and we had wild sex. But I was still really uncomfortable with her. I am not sure if I was trying to get outside that feeling or what, but I was just stuck with it, and it didn’t feel good. I wanted to fake it with this chick, but my body was just saying,  “No way, dude.”
I dropped her off at her place, and she said her parents were going out of town in a couple of weeks, and she wanted me to come over every time so we could fuck constantly. I was like, “Oh my God. No way can I do this.”
I saw her later, and I dumped her just like that. Her face melted right in front of me, and she burst into a vale of tears like a little girl, then she ran inside her house really fast, like a little girl once again. I stood there feeling like the worst scum on the face of the Earth, just devastated with guilt.
Later she told all her friends about me, and some of her teenage friends saw me one time. They came up to me and said, “We heard about what you did. You fucked her and dumped her! You’re an asshole!” I felt like a sack of worms once again.
Later I was with a friend at some park fair, and she was at a booth. I gingerly walked up to the booth, greeted her apologetically, and maybe bought something. She was pleasant enough. I walked away, and her two teenage girl friends were all over my ex girlfriend, swarming their lips in her ears the way girls do. She was apparently telling them, “Hey, I fucked that guy!” Her friends looked at me like I was a Fillet Mignon.
Another time we were on a bus going to Colorado. We had a keg on the bus and we were getting wasted. Most of us were totaled, and some of us were stoned on weed from a bong. The driver was laughing about the keg, but he was mad about the bong.
This girl was in the lap of this total idiot, and he was doing much about it. I looked at her and worked my magic. Her eyes saw me and went to Heaven. I reached my hand out and she reached out hers, and I pulled her away from the idiot. She was happy to be rescued, a damsel in distress.
We had a hot and wild messing around session for while, and we even had some weird kind of sex, or as much sex as you can have on a bus seat in a bus full of people. My friend came by and saw us messing around. He leaned over, the chick left me, and then he and her made out for a while, him leaning over her while she was in my lap. Weird and almost group sex but not quite.
I woke up the next morning with a hangover, and I looked at her and I thought, “Damn! She sure looked better last night when I was totaled!” She looked like Hell. I went back to a couple of seats where a couple other chicks, friends of mine, were sitting, squeezed in between them and smoked some weed.
Then I went back and felt more and more uncomfortable. I could not wait to get away from this chick. We stopped for breakfast, and she went off with her giggling friends in a whispering gaggle as her friends pointed at me. Some idiot “friend” of mine said accusatorily, “You blew it! You got involved too early in the trip!” I felt crushed. A couple I was friends with came up to me and basically said, “Good score!”
We went back on the bus, and I got more and more uncomfortable. I did not want to be with this chick! Finally, she read the writing and moved to another seat, and it was all over.
So sometimes we struggle with our feelings for this or that reason, but that isn’t the same thing as resisting an unwanted thought, feeling or urge that you get in OCD.
Qualitatively, it’s completely different. I can’t put it into words, but it’s like the two experiences are from different planets.
Bottom line is I just do not believe that normal folks go around struggling with unwanted thoughts, feelings and urges all the time. It’s just ridiculous.

Resistance Is the Essence of OCD

I am familiar with Harm OCD.
At the same time, of course I have had many homicidal feelings and feelings of wanting to hurt people. Generally people who I hated for this or that reason. I have even fantasized about murdering them, how I would go about it, how I would pull it off, etc. Those thoughts were extremely pleasant, and of course I never tried to stop them a single time, although I tried to make sure I didn’t actually do it because I didn’t think it would be a good idea for a lot of reasons.
I might get caught, number 1.
The victim might turn on me and kill me, number 2.
I might not be able to live well with myself afterwards, number 3.
And last, wondering if even my worst enemies on this Earth deserve the death penalty via me.
I assure you that I did not try to stop any of these feelings, urges, behaviors or thoughts! Never, never, never, never, not even one time did I try to stop a thought, feeling, urge or action like that.
True violent feelings are so completely different from OCD they are like from different planets.
I am also familiar with sexual OCD.
I am also heterosexual and have had about a trillion sexual thoughts, feelings, urges, etc. towards mature females of a variety of ages. I assure you that never a single time did I ever resist any of those thoughts, feelings or urges. Not once, not ever, ever, ever.
Real sexual thoughts are so different from sexual OCD that once again, they seem like they’re from another planet.
I have asked people without OCD and they told me that they simply never try to stop their thoughts. One person said, “I only think about things I want to think about.” They said they had never tried to stop a single thought in their entire lives.
In my opinion, if you try to stop the thoughts, feelings, urges, etc., then it’s OCD. Period.

Normal, Happy Guy with Irresistible Urge to Kill People

Seeks female with same desires for fun, games and who knows what else.

Just kidding.

But that’s the title of a post on AskReddit.

Full title: I’m a Relatively Normal, Happy Guy. I Have an Almost Irresistible Urge to Kill People. What’s Wrong with Me?

Well, it’s certainly an interesting question! One of the top-voted responses links an article of mine in which I discuss something called Harm OCD, in which people have unwanted thoughts, urges and feelings about wanting to kill or harm other people. They never act on the feelings to my knowledge anyway, though some say there have been a few cases. I have talked to some of these folks online, and I’m not the slightest bit worried about them. I would go on an overnight trip with any of them no problem. They’re simply not dangerous at all, which is very interesting right there.

The woman who makes this comment says that she has Harm OCD herself, and it’s a nasty illness. It does involve a lot of avoidance as folks sequester themselves away to avoid hurting others.

In my opinion, this guy does not have Harm O. He seems to very much enjoy these feelings, and he doesn’t want to get rid of them or try to stop them. Trying to stop them in particular is pathognomic of Harm O. On the other hand, I don’t think he’s a psychopath either.

He does say that he has gone so far as to plan out these murders in detail in his mind and he has taken careful note of people’s schedules as part of these plans. That is, he knows where certain will be, given their schedules,  most any day or time. The thing that prevents him from doing these murders is mostly the harm to his self-image that would come if he were to be a murderer. He’s not particularly concerned about the fate of his victims, nor is he concerned about the legal implications.

This guys seems like a case of narcissism. I see a lot of narcissism shining through this guy’s post. Other than that, I refuse to give him any kind of an overused DSM diagnosis, mostly because I think it’s ridiculous to pathologize a whole nation or planet. Are his preoccupations healthy? I don’t think so, but we are dealing here with more or a moral question than a case of psychopathology.

I wish we would deal more in terms of good and bad and less in terms of crazy or sane. A lot of so called crazies aren’t crazy at all, they’re just bad. A lot of so called scumbags aren’t really bad at all, they’re just nuts.

What’s going on is more of a case of what I would call bad karma. It’s bad karma to sit around devising ways or murdering innocent people, regardless of whether or not you believe in reincarnation. It’s bad vibes, bad for your mind, a bad idea if you want to have a proper and healthy mind.

Should folks like this guy be imprisoned? Of course not. Unfortunately, you have to wait until someone does something bad before you arrest or imprison them. You can’t lock people up on preemptive charges of dangerousness. Down that way lies totalitarianism.

I did see one case online of a guy who was imprisoned as a danger to others as a potential serial killer, but he was mentally ill anyway, had written down extensive plans for killing his victims, singled out a variety of victims and formed long dossiers on them, gathered a great deal of murder and getaway tools to carry out his plans, and said he was going to start killing people. He was hospitalized for 1 1/2 years, treated, and released. Upon release, he was healthy and free of his fantasies.

The really sick ones won’t even show up for treatment. This guy was cured because he was just healthy enough to show up for treatment about his out of control urges. Serial killers cannot be cured not for some biological reason, but because in general they simply do not want to get better.

I have a sneaky suspicion that guys like this are everywhere. I figure for every serial killer who gets caught, 100 or 1000 fantasize about such things but never do it. Why not? Because they have enough behavioral controls that they are able to keep these urges intact without acting on them. I think most don’t do it either for moral reasons (they think it’s wrong) or due to fear of getting caught.

I read a post online by a woman who had sexual fantasies of being murdered. She posted them online and was deluged by offers from young men to “murder” her, apparently just pretend kill her but who knows? She ran it by some male friends and many of them also offered to “kill” her.

She finally acted it out with a male friend, and the guy said he got so carried away during the games that he had to physically control himself so as not to kill her for real. His mind just went nuts and wanted to kill her, and he had to reign himself back in. It was amazing that so many young men apparently have fantasies of such things.

One reason we seem to have fewer serial killers now than we did in the 1970’s is due to the progression of police forensics, especially DNA. Those serial killers now operating are mostly preying on street prostitutes, drug users, runaways and other throwaway types. Some of these types are so isolated from mainstream society that years, even over a decade, may go by before they are even declared missing. On the other hand, killing ordinary people like you and me for fun is going to be a Hell of a lot harder.

Bottom line:

Who wants to kill people for fun? Lots of people!

Who really does it? Thankfully, not so many!

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More OCD and Psychosis: Differential DX

Let us look at some more cases from the Internet.
Case 1 here and here.

I’m trying to pin down one of my major symptoms that can and has completely impaired my life. My OCD revolves around harm, such as fears that I will harm someone, violent thoughts of harming someone, and even urges to harm someone. I don’t think I want to hurt anyone, but my OCD tells me differently. Sometimes I will get a violent thought when I am standing near someone, and I will not hurt them, but I will quickly walk away to avoid any chance of ever acting on my thought/urge.
Ok, here’s the weirdest part: Later on, after I have walked far away from people in order to avoid hurting them, I believe that I actually did hurt someone after all, and that my memory of avoiding him/her is a false memory, or I just forgot the true memory of actually harming the person in question. I truly have believed many times that I was a murderer, despite tons of evidence to the contrary.
Looking back, I realized I’ve wasted so much time believing I’d done something terrible and waiting to be locked up forever. However, at the time, my beliefs were unshakable and persisted despite all the evidence that my family/friends/counselor threw at me to try to convince me that I had done nothing wrong.
I think my OCD may involve hallucinations as well. Whenever I think I may have harmed someone I hear police/ambulance sirens. Coincidence? Maybe, I’m not sure. When my OCD started to improve at school I was hearing less sirens.
This is the situation I’m in. It started with me walking beside people on my (very hilly) campus that has a lot of ravines. I got the anxious thought “What if I pushed someone into one of the ravines?” So I’d actually go DOWN into ravines to search for bodies. Crazy huh?
Well, it got crazier. One day, the thought or belief (delusional) came into my mind: I DID push someone into the ravine and kill him/her. I compulsively searched, but I couldn’t search very well because I was embarrassed and scared because I was getting weird looks.
So I dropped out of school. And I believe that there is STILL a body in one of those ravines (even though I called my counselor numerous times asking if there were missing students and she always said no) and I checked the news for five weeks – nothing. No evidence, but I still believe I killed somebody.
I had to drive today as an OCD exposure and I had to drive very close to a bicyclist because he was hogging the road. I drove as far away from him as possible, even onto the curb to avoid him. Of course my senses were heightened and I would have felt a bump even if I sideswiped him, which I don’t think I did.
There was no damage to my car or anything, and when I drove back on the opposite side of the road cars were driving normally and I didn’t see emergency vehicles but I still believe deep down that I hit him. It sucks. And I can’t check the news either – in program we are discouraged from checking and other compulsions.

There is a lot of back and forth about this in various threads for some reason. She also has a dx of schizoaffective disorder, which is never explained. Various people feel that this symptom is a combination of OCD and a psychotic symptom, but I am not so sure about that. The part about searching the ravines is also OCD, though it’s rather extreme in that it made her drop out of school.
I honestly feel that this presentation is simply OCD of the Harm OCD type. The person fears that they will attack others, but they never do it. Apparently it’s all just fear.
Going back and checking over and over to make sure she didn’t kill someone or push someone into the ravine is also very OCD-like. A psychotic person simply says that they killed someone by pushing them into the ravine, and that’s that. There’s no going round and round about it, checking the ravines, calling people, reading the papers. That’s called “checking,” and it’s an OCD thing.
Although these symptoms are very disturbing in that they involve violence, a person with this type of OCD is very unlikely to act on the obsession, and probably will never act it. They are less likely to commit a violent act than anyone else. The presentation is rather strange in that most OCD folks don’t have this degree of certainty in the obsession.
The hallucinations of police sirens are odd. Some clinicians are saying that there can be hallucinations in OCD, but they are generally minor. The whole idea of hallucinations in OCD seems very strange to me, and I don’t know what to make of it. OCD experts claim that there are no hallucinations in OCD.
Case 2 and here

The other night I had a thought about gouging my dog’s eyes out; it was terrifying to me. I could never do that, but the thought alone was enough to keep me obsessing about it for hours. Made me very anxious.
Woke up the other day worried I was going to spontaneously run someone over or grab a knife and stab someone, like it would be a compulsion I couldn’t control. My therapist said that’s classic OCD.
Sometimes I hear music playing, like tonight I was hearing a band playing, but it turned out to be just some noise from the a/c cause i left the room and returned.
Sometimes I hear people saying “hey” or think I heard someone else say something when they didn’t, but that’s really not a big deal, I imagine everyone has thought someone said something once in awhile, but the music thing is pretty real.
It sounded like a parade going on outside my house, until I got up and moved around. Not a big deal, just enough to make me stop what I was doing and listen.

This is classic stuff – Harm OCD. In general, they never act on the thought, even if they are thinking of it 24-7. There is controversy on whether or not there have been cases of people acting on antisocial or violent obsessions. Some say there have been some cases, but I have never heard of any. I do therapy with some people who have this type of “harm OCD,” and I never worry that they will act on it.
Note that this person is also worried that they are going to go psychotic, just as Case 1 is obsessed with whether she is psychotic or not. The worry that one will go psychotic is pretty OCD like right there. People with psychotic disorders don’t generally worry about such things.
The part about the hallucinations is stranger. First of all, they are not hallucinations. He just thinks he is hallucinating. He heard the AC, and it sounded like music because he didn’t realize that it was the AC. We live in a noisy environment, and mechanical objects will often make sounds that sound like auditory hallucinations. Other noises in the environment can also fool you. These are called illusions, not hallucinations.
Case 3

I have thoughts that someone is going to poison me or slip me drugs or somehow do something “bad” to me. When I was a kid there was all the talk about people putting razor blades and drugs in Halloween candy; there was a rash of OTC drug packages that were tampered with that killed someone and had these drugs pulled from the shelf, and there was also a case of someone getting poisoned by their friends. This was all in a relatively short span of time.
I seem to have latched on to all of that in an unhealthy way.
I don’t think people are out to get me. I don’t think there’s a conspiracy to hurt me. What I fear is that there are a lot of nutty homicidal people out there, and they may decide to tamper with food or whatever, and that it would be my luck to be one of the unlucky people that would be the victim.
I’m afraid that people are crazy, unpredictable, and there’s just a lot of random Bad Shit out there that people do. I also worry that somehow food will be contaminated with deadly microbes – botulism is a fun one to worry about.
I know this is insane. I know that the likelihood of something like that happening is very small. Still, it can drive me to panic attacks and anxiety as well as some fun compulsions. If there’s only one of something left at the grocery store, I can’t buy it. I have to take the package of food that’s the second one back, not the first.
I inspect packages. I give my dog food that is “suspect” knowing that if she’s okay, I’ll be okay. I know it’s stupid and silly, but the actions reduce my anxiety so I don’t have a panic attack or start freaking out.
In some ways it feels like a fear of flying. It could happen, even if the chances are low. Very low.

Strange case. The doc said that these were symptoms of “paranoia,” but I don’t agree. I think it’s just OCD. Thing is, your food could be being poisoned at any time. Most of us just assume it is not and go ahead and eat it anyway. That’s all you can do in life really.
Case 4

I have similar thoughts. Whenever I go to the supermarket, I’m always thinking that the food that I’m about to buy has been tampered with. So for example, when I grab a jar of pasta sauce, I start to think that someone injected poison into the the jar.
So I put that jar back and grab the one behind it. But then I become convinced that the person who poisoned the jar would know that someone like me will be expecting the jar in front to be poisoned, so they must have put the poisoned jar in the second row instead. So then I put the second jar back because I get convinced that it may have been poisoned. Then I sit there debating the whole thing in my mind because I don’t know which jar to buy. Ultimately I just say fuck it and take one of them.
I also worry that people will tamper with my food at restaurants and food courts. So lets say I’m eating at a food court by myself and I sit at the table and realize that I forgot to get a straw, when I go back to food place to get a straw, I always make sure that I keep an eye on my food the whole time.

Not sure what to do with this one, but it looks like Case 3. The way he takes jars our and puts them back and stands in front of the shelf debating which jar to take looks awfully OCD like. It’s a Hell of a way to live your life though, I must say.
Case 5

I was at a comprehensive psychiatric clinic/ward recently, and one of the patients there had very bad OCD. He would often ask me for reassurance about things that really didn’t make any sense at all. On the night that his new roommate was moving in, he was terrified that he brought a bomb in his luggage. He asked me if I thought that his roommate brought a bomb, and I obviously told him no.
Later that night (maybe under an hour later), he decides to pull the fire alarm and make a run for it (he wasn’t able to get too far because of the severity of his OCD). I don’t believe that he ever actually thought that there was a bomb with complete certainty. The uncertainty just became so severe that for him to act as if there was actually a bomb became the better option. It was the only way that he could diffuse his anxiety.

As you can see, the illness gets pretty weird, but it’s just OCD. He pulled the fire alarm because he could not be completely sure that this roommate had not brought a bomb into his room in his suitcase.
Case 6

Does anyone else have such poor insight into their OCD that instead of knowing that its irrational, you think its real? For example, I think that I’m a dead person living in a fake world to the point that its considered delusional. I’m also paranoid to the point that I truly believe people are poisoning me because they have something against me.
My doctors are confused as to whether I have OCD with psychosis or just OCD. Multiple doctors have said they can’t tell, but most lean towards OCD. Anyone else experience this?
Also does anyone else hear voices in their head which aren’t their own but instead like a family member or a priest or even someone you don’t know?

Strange case. The responders are all saying that this is psychosis rather than OCD. I am inclined to believe them. He hears voices apparently, and believes that he’s dead and the world is fake. But he says he hears voices in his head. This is crucial? Are they really just inner voices like we all hear (in which case they are not hallucinations) or is he actually hearing them with his ears (in which they are auditory hallucinations). He also thinks people are conspiring to kill him.
Case 7

Ok I have a boyfriend, and he is 30 yrs old, he said he had OCD and phobias, lately after some stress, he came to me crying and asked, “What if no one else but me exists? I feel so lonely like I am alone in the universe and that everything else is fake.”
Then I asked him, “What r u talking about?” And he replied, “I walked out of my office onto the street, and I thought ‘if I see someone I know this thing I am thinking its true.'” He saw one of his colleagues, and now he thinks that this thought of his is true, and he is anxious and crying.
Do you find this normal for a 30 year old? Then he asked, “I thought, What if I am a cat?” He listened to some cats meowing, and he started crying and asked, “What if I am a cat???” Is this normal? He had lots of stress before he starting saying all these things; he was afraid that he had some serious illness but in the end he didn’t, and after that he started this paranoia.

I am afraid that this is just OCD, but it’s pretty serious. He is not psychotic, although the symptoms are strange.
Case 8

Years ago I went through a serious bout of depression. I had fits of rage and crying and purposely avoided friends and places I enjoyed. A doctor put me on Lexapro, an antidepressant. I got better. Years later, I have a new problem. I thought it was the same old depression with a new twist. But it’s not.
My last psychiatrist tried treating me for a problem I had. He diagnosed it as depression and said that I also had OCD. This was because I had a depressed mood and frequently battled thoughts of anxiety.
This doctor tried me on a few different medications. Either they had no effect or they had terrible effects. They made me more depressed, anxious, and at one point suicidal. They were all small doses, but they showed their effects within days. The drugs that had these disastrous effects were Imipramine and Lexapro.
I’m seeing a new doctor now. This one says the root problem is NOT depression or OCD. He says it’s psychosis. His reasons for his diagnosis are this:
The obsessive negative thoughts are a manifestation of the paranoia attribute of psychosis. These thoughts include worrying about getting diseases, worrying about dying tomorrow from something, worrying about aging or getting Alzheimer’s, worrying about thinning on top, worrying about getting diabetes, worrying that I might be schizophrenic, worrying that I got brain damage from the smell of a dry-erase marker, the list goes on and on.
Some of these are too irrational to list. Some days they’re tolerable, other days they make me anxious, even cry, or prevent me from doing my work.
Another symptom that I had described to both doctors was the fact that nearly every task that I start, or even think about starting, causes me stress and anguish as if it were some daunting job having to clean up after a hurricane. This is true for nearly everything I do, including things I enjoy doing. Hanging out with friends, just watching a movie alone, or painting which I love to do will sometimes feel this way and compel me to avoid these things.
The first doctor said that this anxiety over starting things was possibly ADD. He tried me on Ritalin for that with equally disastrous results. Then he tried me on biofeedback treatment. It improved my memory, that I am sure of. The second Doctor said that symptom was also due to psychosis because it shows there are two thoughts fighting each other simultaneously with each of these actions I take. Things do seem much easier for me when decisions are made for me.

Strange case. One thing for sure, this person is not psychotic. I don’t see the OCD. Where is it? The worries about bad things happening could be a variety of things, GAD, OCD or depression. In the context of the Depression that is going on, these could well be what we call depressive ruminations . Feeling like everything is too much is also not ADD, it is instead just a symptom of Depression. The inability to get things done or even start things in the first place is typical of depressives.
Case 9

When I saw my psychiatrist last year, he seemed to think I had OCD because I was having problems with various obsessions including a morbid fear of death or dying young and several compulsions (such as repeating actions and counting in sets of 4 whilst avoiding ‘bad’ numbers etc) to prevent bad things from happening or ward off my obsessive thoughts and images. I would often see images of myself lying dead in bed, and it would freak me out.
However that was a year ago. He wanted me to change to Anafranil at the time, and I freaked out because I have a fear of chemicals I am not familiar with and didn’t return to my next appointment thinking I could deal with it myself. It did lose its intensity after a while but didn’t go away completely. Now I seem to have developed a completely new obsession, if that is even what it is.
I fear that I am suffering from some kind of psychosis because I feel spaced out a lot of the time, as though I’m walking around in a dream state. I am also having problems with chronic daily headaches. I am now spending hours researching psychosis, schizophrenia and headaches on the internet. I am analyzing every single thought I have to check for signs of psychosis, and it is driving me around the bend.
How much research does one person need to do anyway? It’s not like im a Dr. and can diagnose myself? Why cant my brain just drop the subject until I have seen my Dr. about it again?
I have made an appointment to see my psychiatrist again shortly, but I am terrified that he will want me to try the Anafranil again. Not only do I have to contend with my original fear regarding changing medications (which in short is that I will take it, and I will have a bad reaction it and become ill or die) but now I have this awful fear that I will take it, get worse, won’t know what im doing and will hurt my son as a result.
I’m terrified, I couldn’t stand it if I hurt my son, the thought is making me feel sick. I am worried that I may not know what I’m doing and hurt someone or my son at the best of times, especially with feeling spaced out, but I am even more concerned that the Anafranil will make matters worse. It does say on the cautions list not to give it to patients who suffer from psychosis or schizophrenia.
I used to have a fear of hurting myself or my son in my sleep so I’m not sure if this is a variation of that one or not? I do know that my mother suffered with anxiety and depression and during her later years (65 onwards), she became paranoid and delusional. I am terrified that my depression and anxiety will take a similar course.
I also feel like I can’t organize my thoughts as well as I used to be able to. I will try to organize my household chores for the day, my brain will take one look at the washing pile and give up because it doesn’t quite know where to start! I also can’t remember when I took my medication. I’m on painkillers for sciatica and my headaches, and I will often need to debate with myself over when I took my last dose.
I will go to take one and will find myself thinking “Am I sure I haven’t already taken one?” to which I respond “I’m sure I haven’t, but I could have, but I don’t think I have anyway,” to which I respond again, “Am I sure I haven’t taken one? Perhaps I shouldn’t take it in case I have already taken one,” to which I then respond, “I’m sure I haven’t taken one,” and then start trying to retrace my steps over the last 4 hours to check I haven’t in fact already taken one.
I worry I will forget that I have taken one, take another one and overdose by mistake, become ill and then die as a result. I have tried writing down when I take one but then I find myself questioning if I have written it down correctly. I have tried putting out what I need for the day/hour, but then I worry I that I didn’t put them out correctly in first place.
Also I have a nagging feeling that I have forgotten something a lot of the time, and I don’t know what exactly. The last few times I’ve left the house, I’ve had to check I had my keys and purse 4 times before I even shut the door!
I feel like I’m developing early onset Alzheimer’s or something, its seriously doing my head in.
I also tend not to go out very much at the moment because I’m afraid I will forget who I am, where I live, get confused or not know what I’m doing and hurt someone when I’m outside. So I find myself only going out when I absolutely have to in order to avoid the anxiety it creates.

This really looks like OCD. It doesn’t look like anything else. The doubting about whether or not she has taken her meds, the fears of going psychotic, fear of medication, Harm OCD about her son, having to check for her keys over and over, the endless checking to see if she has schizophrenia or not, etc. The spacey feeling is disassociation, which comes from anxiety. Get rid of the anxiety, and the spacey feeling goes away.