Hi, I'm Patrick - Chief Clinical Officer at NOCD. Ask Me Anything in the comments below!

I can't spend even a minute in day free from ocd it'll be there throughout day

Hi, I'm really struggling a lot, I hope you read this. Tomorrow I'll see a local counselor but I would like some advice from a therapist aswell. Some time ago I cheated on my boyfriend and that was my breaking point. That's when I think my ocd came out of the shell. I felt so bad and guilty from what I did and felt the need to confess everything and I had to remember every single interaction I had with the person I cheated with and every single thought I had. Then once I confessed all I confessed all the bad things I did years prior and then it went even into my childhood mistakes. Then It became pocd for a while,where I was scared and convinced I was a pedo and tried to sadly end it because I couldn't bear it. This was also when I had my current struggle that is : I'm scared I am in denial and I don't love my boyfriend anymore and I want the person I cheated with. Even typing this makes my heart race SO much and I feel like I'm going in apnea. I also have groinal responses aswell to this because my mind floods me with sexual scenarios to test how I'd react and I swear I don't want these thoughts but I'm convinced I'm just in denial. Everytime I see myself in the mirror or get read my mind is like " what would X think?" And I get distressed. I can't watch or listen to romantic songs because I know my mind will associate them with X and it makes me feel awful. I'm scared to go to school because I know X will be there and I'll javw thoughts like "X is hot" and ruin my whole day and I'll try to disprove it over and over. I'm terrified of being attracted to someone that's not my boyfriend and cheating on him even in my mind. For a while I avoided talking with my boyfriend and couldn't because these thoughts were flooding my mind and I felt I was being a fraud until I figured them out . I just wish to be happy with my boyfriend because he is amazing, he is a sweet pure soul and my ray of sunshine, he was always there for me through thick and thin. I just wanna stay with him but it seems like I csnt even stay 1 second without these thoughts. I wish X person disappeared. Also the people around me keep telling me things like I need to accept it and whatever and it just makes it worse because I keep thinking about it. I got nowhere to put my hands and I don't know what to do. I don't know what kind of ocd is this and I'm scared that if I go to a therapist they might say this isn't ocd and that I'm just in denial and I need to accept it. Please answer. Thank you.

Dr. McGrath, First of all, thank you for this opportunity :) I’m wondering if some people develop OCD without a clear cause. I don’t have significant trauma, and I’m the only person in my family with OCD, as far as I know. I’ve tried several antidepressants, but nothing seems to be helping, and my psychiatrist is uncertain as well. My OCD was mostly dormant for six years before flaring up, shifting from harm OCD to POCD, relationship OCD, with morality always being a theme but now feeling like my primary focus, with everything else falling under it. I sometimes feel lost because I can’t relate to others whose OCD seems tied to genetic, biological, or environmental factors. I’m in therapy through NOCD, but my compulsions are complex, so it’s taking time. Could developing OCD just be random?

Hi I have a lot of thoughts about molesting partner but I don't want to do it and it worries me, coud it be ocd and if what type?

Dr. McGrath, thank you for this opportunity. I was away from home for over a month and a half due to POCD. I am home now and keep getting the urges, which get to me every time. I've raised my 2 kids for over 6 years and NEVER have I ever experienced this theme. I recall different themes that I've dealt with looking back, not realizing it was OCD until just recently with NOCD. Since I've been home, I've been battling with the thoughts and feelings and urges, including the well-known groinal. How can I get past this when the urges get extremely strong? I am trying to face it head on and not leave again, but the OCD makes me try to believe that I want to act on the thoughts. That's why I have been so afraid. This has NEVER been a thing to me.

Keep in mind that OCD has to feel real or else it has no power. But feeling real and being real are different. Virtual reality feels real but take off the goggles and you are home again. OCD is like that. It tries to trick you so you will do a compulsion. But if compulsions were actually helpful I would assign them to people instead of try to help people decrease them.

Can you have health OCD. I find a lot of my anxiety is related to my health. I am currently obsessed with my blood pressure.

Please anwser me im really struggling. so I think I might have HOCD (Homosexual Obsessive Compulsive Disorder). It started one day when I watched a video of a girl realizing she’s bisexual. While it made me uncomfortable at first, I didn’t think much of it. But then, the thought “What if I’m a lesbian?” wouldn’t leave my mind. So, I started searching online for answers like, “How to know if you’re a lesbian.” Things worsened when I came across a YouTube video where a girl said that if you even think about being a lesbian, it might be a sign. Before all this, I was 100% sure that I was straight and had always wanted a boyfriend so badly—having a boyfriend was my biggest wish for as long as I can remember. But I never really had intense crushes on anyone, so I began analyzing my past to look for any evidence that I might be a lesbian. I realized that I often admired girls, thought they were pretty and cool, and wanted to be friends with them. I wanted them to like me, but I also felt extreme jealousy and even wished bad things upon them (which I know isn’t right). There was one time when I had a physical response to a girl (before my hocd), and I thought this was evidence that I might be a lesbian. I also watch girls more in movies and they are always my fav character or inspire me and I was overall more focused on girls and i was sooo anxious and thinking that this is the proof. I was so scared and convinced that im a lesbian. But I never considered being intimate with girls in the same way I have with boys. Despite this, I convinced myself that I might have been secretly crushing on girls and just didn’t realize it. I became overwhelmed with anxiety, crying often, and constantly comparing my attractions to people I saw in real life or online. If I found a girl attractive, I’d freak out. I started imagining scenarios in my head, comparing what it would feel like to be with girls versus boys. Even if I didn’t want to be with a girl, I felt like I was lying to myself and not admitting the truth. I was analyzing my feelings and if some feeling felt wrong i’d freak out. I also became easily triggered by anything related to LGBTQ topics, especially on TikTok. It felt like everything was proof that I’m a lesbian, even though I know it may not mean anything. I find myself asking, “What if?” questions all the time. I also realized that I had previously been obsessed with the idea of having OCD (I feared going crazy and being imperfect). That obsession now feels similar to the one I’m experiencing about my sexuality. This uncertainty is overwhelming. It feels like the most important thing in my life right now. I’ve been struggling with this for about three months, and the thoughts, doubts, and fears are constant. Sometimes, it gets a little better, but then I start doubting whether it’s really HOCD or if I’m just in denial and hiding the truth from myself. I hate not being able to figure it out, and I feel like my mind is clouded. I just want to know for sure that it’s only HOCD and that I’m straight, but the fact that I can’t be 100% certain is really stressing me out. I constantly reassure myself by looking for answers online—through ChatGPT, Google, and YouTube. It helps for a while, but the anxiety/doubt always comes back. Most of the day i don’t even have anxiety and im just thinking about it. Anxiety comes just when something triggers me or i find a new “proof” for me being a lesbian. It feels like there is just so much proof and i just need to accept it. It’s stressing me out. Im also scared about what other people would think or if they would change a view on me like I did at the start but now i feel like ive normalized it and that it’s a part of me. So because of that my mind are saying that this is the proof that im in denial. I’m scared because I really want a boyfriend, but I’m afraid I won’t be able to fall in love with one. I worry that I’ll fall in love with a girl, and that I won’t be able to control it. It feels like my biggest dream—having a husband and kids—might not be possible for me. I don’t know what to do.

I have blasphemous thoughts about my family members. While reading or writing, I sometimes have thoughts like, "What if something happens to my family?" I even get intrusive images of them being hurt. I also have a fear of failing exams. When I see people who have failed, I start feeling anxious and try to avoid them because it triggers my OCD. Additionally, I struggle with religious OCD. Plz help me in any way u can because I can't afford

Hello Patrick McGrath, I would like some advice if possible on how to accept uncertainty that my fear of not getting a job can happen because I dont have a matric certificate it's a high probability, thank you

Dr. McGrath, first of all a big thank you to you from Germany - I learned so, so much from your videos. I have a question regarding ROCD. I am officially diagnosed with severe OCD and keep thinking about my relationship. Thus, I had planned to start doing ERP with a specialist. Now, another doctor was sceptical regarding the diagnosis because I don’t wash my hands for 30 min or something like that and she told me that my fear of my partner leaving or me having to leave her without wanting to were „normal human core fears“ and something that should be addressed in talk therapy. I do think about this for hours and hours though, trying to solve it, or I try to push those thoughts away or I keep the mug that my partner used unwashed as a memory in case she breaks up. Now, I‘m confused. Is this not OCD? Should I talk it out instead of doing ERP? Any advice?

Dr. McGrath, I have Somatic OCD, with a core fear that my OCD will continue at this level of suffering for the rest of my life. I am currently receiving treatment here and have made some progress. For instance, I used to be at a 8-10 level of anxiety and now I am at 7-8 level all day. However, the thoughts and the fear are always there. My main problem is that I want to recover so bad, that I am constantly scanning my thoughts to see if I’m still having OCD thoughts. Of course, that makes me have them. I have been sick since November. I just want to feel like myself again. I guess my question is, how can I develop confidence in ERP and myself? I start each day thinking, “oh crap, here we go again”.

Hi Dr, thank you for opening up this forum. I’m very new to NOCD — just had my intake yesterday. My current themes are PURE O regarding “losing control,” harm ocd, etc… I’ve been in a constant (literal 24 panic) for 2 weeks that I’m going to snap/lose my mind/ “go crazy.” It feels so real and I can’t focus on anything else but these sensations. I didn’t actually START ERP yet, but is ERP meant to help any theme? I’m really scared I’m just stuck here forever and I’ll never recover. I’ve battled ocd over 30 years but these new themes are beyond debilitating and I have no life :(

Hi, I'm really struggling a lot, I hope you read this. Tomorrow I'll see a local counselor but I would like some advice from a therapist aswell. Some time ago I cheated on my boyfriend and that was my breaking point. That's when I think my ocd came out of the shell. I felt so bad and guilty from what I did and felt the need to confess everything and I had to remember every single interaction I had with the person I cheated with and every single thought I had. Then once I confessed all I confessed all the bad things I did years prior and then it went even into my childhood mistakes. Then It became pocd for a while,where I was scared and convinced I was a pedo and tried to sadly end it because I couldn't bear it. This was also when I had my current struggle that is : I'm scared I am in denial and I don't love my boyfriend anymore and I want the person I cheated with. Even typing this makes my heart race SO much and I feel like I'm going in apnea. I also have groinal responses aswell to this because my mind floods me with sexual scenarios to test how I'd react and I swear I don't want these thoughts but I'm convinced I'm just in denial. Everytime I see myself in the mirror or get read my mind is like " what would X think?" And I get distressed. I can't watch or listen to romantic songs because I know my mind will associate them with X and it makes me feel awful. I'm scared to go to school because I know X will be there and I'll javw thoughts like "X is hot" and ruin my whole day and I'll try to disprove it over and over. I'm terrified of being attracted to someone that's not my boyfriend and cheating on him even in my mind. For a while I avoided talking with my boyfriend and couldn't because these thoughts were flooding my mind and I felt I was being a fraud until I figured them out . I just wish to be happy with my boyfriend because he is amazing, he is a sweet pure soul and my ray of sunshine, he was always there for me through thick and thin. I just wanna stay with him but it seems like I csnt even stay 1 second without these thoughts. I wish X person disappeared. Also the people around me keep telling me things like I need to accept it and whatever and it just makes it worse because I keep thinking about it. I got nowhere to put my hands and I don't know what to do. I don't know what kind of ocd is this and I'm scared that if I go to a therapist they might say this isn't ocd and that I'm just in denial and I need to accept it. Please answer. Thank you.

Thanks for offering this. Sometimes I don't feel anxiety (at least not directly) in my avoidance of tasks, and instead just feel this overwhelming weight and resistance towards doing them—like an unexplainable DREAD. Things that I have the ERP insight on how to approach (I've been doing ERP therapy here for years) and intellectually I understand the importance of going for a walk, taking out the trash, paying my bills, taking the vitamins from my dr that I need to take since my deficiencies can also cause fatigue but sometimes these first steps at feeling better in my life (like even exercising for 5 minutes) is so damn hard for me to start—my brain just says NO. Sometimes I do these things in therapy and it helps, but other days I just don't feel like my engine can start, and as much as I try to practice self compassion like Kristen Neff or Kimberly Quinlan talk about, I'm upset at how I broken and disordered I may be. I tend to take 5 steps forward, and 4 steps back, depending on how my day go, and I sure feel like my days are often at the wrath of my brain, instead of me knowing how to live my life and take better command of the things holding me back. I have the will, but not always the power. :(

Deleted reply.

Hi Dr. McGrath, what is a good technique or your advice for dealing with the feeling like random things need to be ‘just right’ or avoiding doing things because doing ‘that thing’ might trigger a thought spiral and burst with anxiety? I will not take the last bite of food, or decide and un-decide on eating something because it just doesn’t feel right and it might trigger a spiral. Putting an extra 30secs on the microwave because 1 minute didn’t feel right. Avoiding certain genres of tv/movies, or only listening to a select handful of songs. Basically it’s in the moment ‘just right’ things with other things that have become routine. All of this I believe stems from guilt/shame. Thank you! You are amazing, keep up the good work!

Dr. McGrath, thank you for your help and your efforts. My question is: Can OCD arise as such in adolescence, or is it present throughout life, just to a lesser degree? I've remembered being a perfectionist and having social anxiety since i was 11-12 years old, but my severe rumination and intrusive thoughts started 3-4 years later, i am not diagnosed with OCD but i strongly suspect it

How does virtual therapy work at NOCD?

Hello Dr. McGrath, do you think that a lot of ancient philosophers may have a had a form of existential OCD? I noticed that the idea of thinking of everything as uncertain is a common theme I see when discussing epistemological philosophy.

Dr. McGrath, I don't really know if I have ocd or not cause i don'thave a proper diagnosis. But I freak out everytime I hear anything related to LGBTQ+. I have been overthinking about my sexuality for about 6 months. Ruminating all day long. I saw a girl who is gay and she dresses up masculine, from that day on I am obsessed with how I dress...if I dress too masculine or feminine. Sometimes if I'm not in the mood to wear a dress i get freaked out. I can't make female friends due to this fear. I have one female friend with whom I used to share a room but now I am planning to break that friendship due to my fear of getting attracted to her. I was into boys but now it all seems fake. I feel like I won't be able date a boy. I have done some mistakes in the past I'm not very proud of..it adds up to it more. Sometimes I'm anxious and Sometimes I'm not. If I get a thought of female celebrity then I need to go check if I'm attracted to them or not. I check videos of those celebrities until it feels right or until I don't get THAT feeling. My grades are dropping due to this and I can't get a therapist due to some personal reasons,..so what should I do?

Hi Dr Patrick, I was molested at 8 by a close family member & for many years this abuse persisted till my adulthood. Throughout my growing years, I experience debilitating compulsions due to harm & contamination OCD. I didn't know where to go for help then. Thanks God today I found NOCD & thanks to you & your dedicated team. In my country, there's no specific OCD therapist recognised by IOCDF. Hence, last week (upon my request) I asked my psychiatrist to recommend a therapist & she referred me to a counsellor who is trained in EMDR (Eye movement desensitisation & reprocessing). She is also trained in CBT. In my early teens, I felt I have no one to go to because of the shame that this molestation was done by a family member parental figure, who is no longer around now. The pain, hurt, shame & anger left in my soul is unexplainable/unbearable. I've signed up for Nathan Peterson online courses, however it's hard to practice ERP alone even if you are well-educated on OCD & it's sneaky tactics. My question is will EMDR help me better at this point first to treat the trauma pain? How & when do I practice the ERP part because ERP alone is extremely painful/traumatising. I am hoping that EMDR will ease the process of ERP. I'm in my early 40s & I've just recently started to see psychiatrist this year. Thank you for your response Dr Patrick.

Hello, Dr. McGrath! I'm in such despair! I have an insanely severe magical thinking ocd (and other themes but at this point it would be great to overcome this problem with mystical fears). I'm 35 year old guy from Russia. I watch videos about psychology. I've been to doctors, mental hospitals, tried medications. I constantly do some mental compulsions in my head (EVERY MINUTE)! I have an insanely severe fear of 'swears' - I'm not talking about 'bad words' like f-word. For example, Kylie Minogue is singing in one of her recent songs that she 'swears the music 'bout to change her life'. I'm afraid of such phrases. They go on and on in my head and I constantly suppress them. A psychic told me there's a demon in me and it scared me. It's hard to use the pronoun 'I' talking about this problem because of ocd, and I will try to explain it talking about a third person. it's not easy, it might sound like something psychotic. For example, somebody has the following in the head - 'that a person swears to this demon that he will never watch TV after having a conversation with a friend', and this person cancels this thought because of fear that something bad's gonna happen as a punishment after watching TV. He doesn't want to think or say any swears but they unstoppably torture his mind and he suppresses them every time they come. The problem is they come almost every minute!!! All day long! I think I was scared by some mystical ideas such as existing of entities, spirits, demons. I've had this idea since I don't remember what time that water can hear my thoughts - maybe I've never heard this idea and it's just my fear. it sounds like an absolute non-sense. I do understand that water is just water. But when i wash my hands, these thoughts pop up in my head and I have this fear that water can hear them. For example, the thought can be about swearing to water that I will never listen to music (it feels sometimes like I send such thoughts to water), but I don't wanna swear in this and I don't want to send such thoughts and every time the similar phrases appear in my mind I cancel them. I'm in a constant pressure cuz every time I have a thought suppression in my head. There are many types of intrusive thoughts. I'm afraid of 'deals with satan' or 'deals with an entity' and I suppress them as if somebody can hear them. I'm afraid that something bad will happen. The question is - have you ever heard something similar in your life? I can't ignore them. Another question is - how to do ERP in this case? I do understand that I have to write a hierarchy and do intentional exposures step by step, but it is insane what's in my head. Should I really say all of these awful things out loud?

Is there anywhere you can watch like a recorded ERP session, like an example of what that looks like in practice? I haven't done ERP (yet). What's sort of the "beginning, middle, end" format of a session? Trigger the obsession and then don't let yourself compulse for 45 mins? How do you calm down at the end of it so you can move to the next thing in your day?

Hi Dr. McGrath. I have difficulty differentiating between thought and reality. I have a fear of the doors being unlocked after I checked if they were locked. So I would constantly have intrusive thoughts/images of unlocking and opening the front door and I wouldn’t be able to tell if that was a thought or if I actually did unlock and open the door. So I would check the front door to make sure I didn’t actually unlock and open the door

Can you give me a few ways to yk like reactions I should do when I have an intrusive thought

dr. mcGrath, PLEASE PLEASE PLEASE, ANSWER MY QUESTION!

Hi, I find my intrusive thoughts difficult to deal with because they're not hypothetical - they're about things that will definitely happen one day, ie the death of my loved ones and myself. I get this intrusive thought that I have 10 fewer years left to live than I did 10 years ago, and it makes me sad and anxious. What's the best way of dealing with intrusive thoughts about inevitable future events? Even if I don't ruminate on the thoughts, it feels like death is always at the back of my mind!

Hi Dr. McGrath, I'm struggling with this specific issue which seems to keep me stuck. During an exposure, my mind gets caught on my ability to really focus and fixate on an unwanted thought which ends up making it feel very intense and vivid. It's almost like a compulsion similar to where one might have to mentally thought replace until they're satisfied with the safer image to feel better. And while I had once done that before, now it's like the opposite, where instead I feel I have to do an "imaginal" to experience the most overwhelming and vivid image/feelings of the very thing I fear in order for me to feel that I've exposed myself enough to my worst fears. I have unwanted sensations paired with thoughts as well and by focusing on my body/breath, the thoughts become more vivid and realistic. So I end up really ramping up my anxiety, seeing how far my imagination and my anxiety can go. But afterwards, I'm overwhelmed by guilt because of the content of the thoughts and my intentional decision to vividly focus on the thoughts and sensations- everything just feels plain wrong. It feels like i took the exposure too far and now i'm partaking in something morally wrong which then discourages me to face my fear/exposure again. I'm wondering what I should do in this situation or next time I do an exposure. Does what I did count as an actual/reasonable exposure (maybe too high level?) or did I just take it too far? What seems to be the compulsion here and is there a name for it? What should I do next time? Apologies for all the questions and the long paragraph. I'd really appreciate any thoughts on this matter. Thank you

Hi Dr. I’ve watched your Lives & they’re helpful. I have contamination OCD. Was wondering if you have any tips for dealing with this type of OCD? Thanks.

Hey Pat, You probably wont see this but what do you do if the thought starts to unfold or manifest and it has to do with pocd. It causes me a lot of disgust and dread and I feel helpless, almost like my eyelids are being strapped open and I have to helplessly watch whatever the thought is. Like do I just let the thought unfold and remain calm? Or do I distract myself continually hoping that itll go away?

I really feel ashamed to write this right now but I have religous ocd and I really feel like I lost my mind I used to have coping mechanism to this obsessions but with depression I couldnt manage my symptoms . Whats your recommandation especially in religous ocd ? I feel like I will never know whats the truth about my thoughts underlying mechanism or If they ever happened in reality by God s orders