Therapy for sexual orientation OCD (SO-OCD)
CBT and ERP for compulsive checking of who you are attracted to — a theme that runs in every direction and is not about the answer. Online across the UK, in English or Spanish.
Does this sound familiar?
A thought turns up — what if I'm not what I thought I was — and instead of passing, it asks to be settled. Since then you have been running tests. You look at someone and watch for a reaction. You watch for the absence of a reaction. You scan your body for any flicker of sensation and take whatever you find, or don't find, as a verdict. You check whether your partner still does anything for you, which is a fast way to make sure they don't.
And the avoidance builds around it. Changing rooms, certain friendships, particular films or actors, conversations that might turn to the subject. You replay your entire history for the moment that proves it — a crush at fourteen, a dream, something you once found funny. You research, at length, what the signs are supposed to be, and every list you find fits you and doesn't fit you at the same time.
This theme runs in every direction. Straight people get it about being gay; gay and bisexual people get it about being straight, or about not being gay enough, or about having got their own life wrong. That symmetry is the tell. If this were really a question about orientation, it would not arrive with such perfect indifference to what the answer is.
Because it isn't about the answer. It is about not being able to close the question, which is what OCD does to whatever you would find most disorienting to be uncertain about. There is nothing wrong with any of the answers here, and that is exactly why the treatment is not aimed at finding one.
How I treat it
First, plainly, because people arrive braced for it: this treatment has no view about what your orientation should turn out to be, and it will never try to steer it. Conversion practices are unethical, ineffective and harmful, and they are the opposite of what happens here. If it emerged in the course of therapy that you were gay, straight or bisexual, my response would be the same in every case, which is roughly: fine, and how do we get the checking to stop.
The treatment is CBT with Exposure and Response Prevention (ERP), which NICE recommends for OCD. Our target is the testing, not the question. Every test you have run has produced an ambiguous result, because attention aimed at your own body reliably produces sensation, and attention aimed at your own desire reliably makes it hard to find. This is well documented and it is worth an early session on its own — a great many people conclude the worst on the strength of a physical response that the checking itself created.
So we map the cycle: the trigger, the thought, what you take it to mean, and everything you do afterwards — the monitoring, the mental reviewing, the reassurance, the avoidance. Then we withdraw them by agreement, and let the question sit unanswered until it stops behaving like an emergency. I-CBT is available here too, and it fits this theme well, because the doubt is built almost entirely out of reasoning about what a fleeting reaction might have meant.
What you get back is a life where you can watch a film, hug a friend, use a changing room and be in your relationship without running a commentary — and where the question of who you are is allowed to be settled the ordinary way, which is to say not constantly re-opened.
What to expect
We start with one or two assessment sessions to understand your cycle and what you want your attention back for. A typical course runs 12–16 weekly sessions of 50 minutes, with practical work between them. Every step is planned together and paced by you.
You will not be asked to prove anything about yourself, and I will not be running my own quiet assessment of what you 'really' are while you talk. That is worth saying, because a lot of people with this theme have been holding the possibility that a therapist would take a view — and it is usually the thing that stopped them coming sooner.
Sessions run over secure video across the UK and worldwide, or in person at Sanctuary Therapy Centre in Prestwich and Hebden Bridge, in English or Spanish.
Common questions
Isn't this just denial, or internalised homophobia? It is a fair question, and it is also the exact question the OCD wants spent on. The two can be told apart, and doing so is a normal part of assessment: someone working out their sexuality is usually drawn towards an answer, even a frightening one, while this theme is characterised by wanting the question closed and being indifferent to which way. Where there is genuine exploration underneath, that is worth having room for too — and you would need a therapist comfortable with any outcome, which is what I intend to be.
Will therapy try to change my orientation? No. Conversion practices are unethical, harmful and rejected by every UK professional body, mine included. Nothing in this treatment is aimed at what your orientation is.
I felt something physically when I checked. Doesn't that settle it? No, and this is the most common reason people conclude the worst. Anxious attention pointed at your own body produces sensation there, in anybody, about anything — it is the checking that causes it. We cover this properly in the first few sessions.
Why can't I feel anything for my partner any more? Because desire does not survive being monitored. Testing for a response is close to the most reliable way to abolish one. It generally returns as the checking stops, which is not a promise so much as an observation about how attention works.
Do I have to have a label to be treated? No. Some people finish therapy certain of their orientation, some finish comfortably unbothered by the question, and both are fine outcomes. The goal is the compulsions stopping, not a conclusion.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
Ready to take the first step?
Send an enquiry and Gisela will be in touch within one working day.