Henri de Toulouse-Lautrec, In Bed: The Kiss, 1892-3

(Spike warning: this article treats themes that might be triggers for a lot of HOCD sufferers. Much of the article is a defense against pretty ridiculous suspicions, which are nonetheless alarming. I also, with some reluctance, have chosen to make specific substantive claims about the disorder itself; but if my interpretation of the disorder somehow clashes with your own, feel free to ignore me. As usual, you’re the expert.)

My article last issue presented a little-known but probably wide-spread disorder, HOCD, and a few theses about the tactical context of its terminology. If you haven’t read it, and haven’t heard of HOCD, I recommend glancing at Mark-Ameen Johnson’s or Steven Phillipson’s excellent introductions before reading on.

In my glossary entries for “Denial,” “Reassurance,” and “Groinal Response,” I argued that the HOCD community’s homegrown concepts function as a cure by disarming concepts that reinforce obsessive questioning, e.g. “repression” and “denial.” These latter, along with their clichés and dramatizations, must be seen as part of the disorder’s etiology.

But I didn’t say whether spike-inducing concepts like “denial” are by themselves sufficient to explain where the disorder comes from. The concept of denial is ubiquitous, but not everyone suffers from HOCD. I was avoiding an obvious question: why the people who get HOCD get it. This omission was the first of several my non-HOCD readers perceived; it inflamed their suspicion.

Many non-HOCD readers seemed to see HOCD as a kind of sexual insecurity, which was taken, predictably, as evidence of a sexuality that was itself insecure, unstable, and volatile. By contrast, an ease and comfort in sexuality would seem to confirm a kind of sturdy, adult straightness. This straightness would explain their lack of disorder. It followed that the cause of HOCD was really homosexuality.

In general, inquiry into etiology is legitimate and scientific. To that extent it may seem that I, avoiding the question, ceded scientific thoroughness to my suspicious non-HOCD readers who not only asked it but rapidly answered. In fact this appearance is misleading, for three reasons. Firstly, the etiology of OCD in general is, at present, known only vaguely. It has to do with chemicals, according to experts. And HOCD, whatever the sexuality of sufferers, is very clearly a kind of OCD according to the DSM. So this omission isn’t remarkable: it’s common to write about the features of OCD experience without reciting whatever vague allusions to chemicals make up our present knowledge of its etiology.

Secondly, these suspicions do not draw their plausibility from any scientific discourse on OCD, or even on common sense about OCD. Indeed, they are nonsensical when applied to other forms of OCD. Let’s see how it sounds: “I can’t help but thinking that there must be some reason why you, of all people, obsess about leaving the gas on. After all, I have a gas stove as well. Couldn’t it be that, in truth, you have left the gas on?” What’s the difference between homosexuality and leaving the gas on? (Begs for a punchline: “When you leave the gas on, your house doesn’t explode.”) The difference is that we're used to the idea that people “deny” and “repress” homosexuality, and we're used to the idea that homosexuality is horrible enough that you'd want to do so. To some extent this suspicion works for harm-OCD: we might suspect that somebody who obsesses about hurting another person does so because they secretly want to. But in both cases these intimations are tenuous, despite their ability to take on such an authoritarian character. The fact that some people might want to repress their homosexuality and even succeed in doing so doesn’t mean that everyone on earth is in denial.

Thirdly, there are other, very obvious, explanations for HOCD besides homosexuality. Even if we leave out chemicals and predispositions, which probably play a decisive role, there are cultural factors. Boys who like girly things are usually assumed to be gay. Girls who like masculine things are called lesbians by their classmates. Asexual adolescents and adults are sometimes advised to “figure out” “whatever” is “going on” with them. But do these assumptions make any sense? To say to an asexual woman: “You don’t want to have sex with men, therefore you want to have sex with women.” No! None of it makes any sense! But it’s still fatally compelling and confusing for effeminate boys, boyish girls, asexuals, and anybody else outside the norm. Their weirdnesses get confiscated and assimilated into our culture’s big binary obsession, straight/gay, which is where they're told to look for them. So they look, and those susceptible do so obsessively.

The question, “Why do these particular people get HOCD, but not everybody?”, is no more portentous than similar questions about, e.g. insomnia, susceptibility to addiction, or OCD in general. If my readers' suspicions about etiology are so unscientific, maybe that’s because they're really standing in for another question that’s far more titillating, but too gossipy to be asked directly. A lot of non-HOCD readers expressed, more or less politely and euphemistically, their confusion about what HOCD “is.” Some asked me outright. What everybody wants to know about HOCD is, are they gay or not?

In my article, I ignored this question on purpose. But it was a mistake not to have justified this omission. There’s something here that can’t be left both unasked and undiscussed. It begins to ask itself.

My failure to pose this question is also controversial from the point of view of the HOCD community. I’d like to justify myself to them first (I’ll speak to a broader audience below.) On HOCD forums, it is generally held that sufferers are by definition not gay. There is a therapeutic utility to defining HOCD in opposition to homosexuality, but doing so has the structure of reassurance and the same drawbacks.

It might be useful at a certain point in the spike-cycle. A sufferer might be aware of the fact that they’re thinking disorderedly, but still suspect that they’re gay. At such a moment, it will be reassuring to them to hear (A) that their confusion and disorderedness is part of a disorder called HOCD, and that (B) having HOCD means you aren’t gay. Phew. But as always, reassurance is double-edged. First, because the sufferer will at some point realize that nobody has scientifically demonstrated that having HOCD means you’re not gay. Second, because the opposition of HOCD to homosexuality leaves two options, and sufferers might not be able to diagnose themselves with confidence. Many with HOCD have been convinced, at some time or other, of the reality of their homosexual arousal. At such moments, a two-option chart tells them that they don’t have HOCD, depriving them of all the concepts that have made their experience intelligible and allowed them to escape from the obsessive logic of “denial” and “repression.” Uncertainty is part of the disorder, so if being uncertain interferes with sufferers' use of the label “HOCD,” that label is unusable for sufferers.

Another reason not to define HOCD in terms of the sufferer’s sexuality is that the label can be useful to people who actually do consider themselves gay or bisexual. All the symptoms of HOCD can be present: reassurance cycles, spikes, and checking. Consider, for example, a self-identified gay woman who chooses not to have sex with other women. This shouldn’t seem far-fetched; people can choose what to do with their bodies, and there are plenty of reasons why someone might be abstinent. This person, whose life may be quite exciting and interesting to her, might begin to worry that her desire will get out of control, that it will force her to do something she doesn’t want to do. She may begin to monitor her arousal, checking obsessively to see if it is increasing or spiralling. At times she may suffer debilitating attacks of obsession, spend hours in solitary “checking,” or ask her friends for reassurance, repeating the same questions day after day. None of this will be unfamiliar to straight HOCD sufferers, who also worry that their desire will explode, that they will do something they don’t want to do, etc. And a person like this might really benefit from the anti-obsessive ideas developed by the HOCD community. She could be told that her obsession is not proof that her desire is exploding; that she should stop checking, and stop asking for reassurance. It’s extremely important not to exclude from our definition of HOCD people who obsess about the sexuality that they identify as having. They need the concept too, and there’s room for them. It’s better for sufferers, straight- and gay-identified, if we define the concept of HOCD symptomatically.

My main concern is to maintain the usability of the concept for sufferers. And for reasons I discussed above, taxonomies based on the “truth” of the obsessive idea are inherently unusable for sufferers. For this reason, it’s best to define HOCD by its symptoms, without reference to the sexuality of the sufferer. That’s why, in an article introducing and presenting the concept of HOCD, I avoided posing questions about sufferers' “true desire.” Instead, I discussed symptomatic regularities like “spiking,” “reassurance” cycles, “groinal responses,” and “checking” (see my glossary for more on these terms.)

But, though I prioritize the use of these concepts to sufferers, I’m sure members of the HOCD community will also be interested in what I would say to outsiders. After all, if they ever choose to discuss their HOCD publicly, they might have to justify themselves to skeptics. Before I return to the question “Are they gay or not?”, this time for a non-HOCD audience, I’d like to address another source of skepticism. Some among my non-HOCD audience may mistrust my insistence on “utility to the sufferers” and “self-treatment” as criteria of diagnostic categorization. It may seem like a “vicious relativism” that undermines the idea of scientific psychology. Indeed, where utility is concerned, usefulness for therapy is probably prioritized over usefulness for self-treatment.

Scientific rigor and utility in therapy are perfectly legitimate objectives, and I’m not trying to undermine them. But they needn’t prevent us from recognizing self-treament as an equally legitimate purpose. The HOCD community has found a use for this homegrown diagnostic category that remains just as valid as any other. Suppose, for example, that a more complicated category were useful in therapy. Some people may still prefer self-treatment, for a number of reasons—some people prefer to treat themselves, and it can be hard to find a therapist. And the support of the HOCD community is helpful even to people in therapy. For these reasons, the “wild” concept of HOCD, so useful in self-treatment, remains indispensable.

I would also claim something more controversial. I think the usefulness of the concept of HOCD, especially in self-treatment, should trump any questions about its validity or accuracy. Given that the concept of HOCD is meaningful and even vital to many sufferers, I don’t see how it would be okay to deprive them of this category, even if it lacked scientific rigor. The privileges of truth should not go unquestioned, especially when they justify harm.

I’m not saying specialists should stop developing concepts that are useful for therapy, or stop pursuing the truth. Nor are these endeavors unwanted—I think everybody in the HOCD community wishes psychiatry would catch up with them. But it’s important that the HOCD community’s self-understanding be respected. They know enough to decide what concepts work for them.

Of course, members of the HOCD community, tending as they do to obsess about self-knowledge and truth, won’t find these defenses particularly reassuring. To some extent that’s good: reassurance, we all know, undermines itself. Being cured of obsession means being able to stop asking questions, giving oneself permission to stop trying to verify or uncover the truth. They have a community now, so if they stick together they can resist corrosive and invasive queries from without.

The paradigmatically invasive and corrosive question is the one we were just discussing: “Are they gay or not?” I’ve already argued that HOCD sufferers don’t need to worry about this question, and that it’s better if they stop asking it. But in practice it’s often difficult to ignore other people’s skepticism, even with the help of a community. So I’d like to offer three further arguments for ignoring this question and any outside attempts to answer it. Unlike my reasons above, these three arguments are not therapeutic recommendations, but are based on weaknesses in the question itself, and are relevant to anyone from the non-HOCD world who wants to understand the disorder.

First of all, the question “Are they gay or not?”, is almost harmless by itself. It only seems so portentous, to sufferers and to the rest of the population, because it is buttressed by a host of weighty assumptions that should themselves become questions. Suppose sufferers are gay—then what? Does unacknowledged desire necessarily explode? Do resisted urges build up and damage a person? Or are they dangerous to others? Does celibacy mean an unhappy life? Does celibacy mean an empty life? Is self-knowledge indispensable to happiness? Is self-knowledge indispensable to individuality, creativity, and growth? Is self-ignorance pathetic? Does self-ignorance necessarily lead to conservatism and homophobia? Are unscientific ideas more politically hazardous than scientific ideas? Does self-defense produce weakness? These questions, ranging over philosophical, moral, and dramatic registers, lurk unasked in the background of the question, “Are they gay or not?” What’s remarkable is that, HOCD sufferers, far from shirking inquiry, are among the few who ask these neglected questions. They conduct this research experimentally, constantly, and often unconsciously, because they have to.

The fact that HOCD sufferers are among the few who think critically about this background of philosophical, moral, and dramatic assumptions (and they do so with their whole existence), is indicative of a second cause for optimism. It doesn’t matter if outsiders ask or answer the question “Are they gay or not?”, because they’re not usually knowledgeable enough to do so. HOCD sufferers know things about sexuality that the rest of the public does not know. So they have a reason to be skeptical of what other people say. And they should be equally savvy about any research on HOCD that isn’t conducted by affiliates of the HOCD community (such as Monnica Williams and Steven Phillipson.) We’ve seen enough examples of dogmatism and ignorance masquerading as psychology. Specialists have a lot to learn from the HOCD community before the community will have anything to learn from them.

A third reason to ignore the question “Are they gay or not?”, is that this question is unscientific and nonsensical. Earlier, discussing HOCD’s cultural etiology, I analyzed the way every departure from the norm gets confiscated and assimilated into the straight/gay binary. I’d like to expand this critique by way of a somewhat long digression, because I want to acknowledge two very illuminating responses I received to my article.

The first is that of Mark-Ameen Johnson, a NeuroticPlanet member who wrote one of the first and best pieces available on HOCD. He pointed out a serious error in the “HOCD” entry of my glossary. That section includes a very inane table mapping sexual orientation to HOCD: there are straight people who worry about being bi, straight people who worry about being gay, bi people who worry about being straight, bi people who worry about being gay, gay people who worry about being bi, gay people who worry about being straight.

The problem with this table is that it seems to be complete, but isn’t. Mark pointed out that I’d left out asexuals. First, there are aromantic asexuals, who are interested neither in romance nor in sex, and probably get HOCD a lot because, in our culture, we often interpret the absence of heterosexual desire as a sign of homosexuality. I also left out hetero-romantic asexuals, who want romance but are not interested in sex; they interpret it as a sign of homosexuality. And I also left out homo-romantic asexuals, who like romance with people of the same sex but aren’t interested in having sex with them. Mark told me he’d talked to one homo-romantic asexual who started to fear that he would have sex with men. There are almost certainly homo- or bi-romantic asexuals who’ve engaged in the same obsessive “checking” that characterizes HOCD in general.

Here’s where the second response comes in. A friend of mine told me, after reading my article, that he’d had HOCD in middle school. He said it started because he was attracted to girls in an “idiosyncratic” way, one that wasn’t included in the discourses on sexuality he was offered. By leaving out so many groups from my table, I may have reproduced this confusing exclusion.

So I’d like to redo my table. This time my table won’t corral everything onto one tyrannical axis (gay - bi - straight); in fact these groups don’t seem to fit on any axis at all. And, most importantly, this time it won’t pretend to be exhaustive.

I should make a short disclaimer, however. I'm not laying these categories out as some new means of reassurance, even though some of them can offer alternative interpretations of “signs” of homosexuality. As I've said before, I don’t think a more scientific or accurate system of analysis is helpful for sufferers. What’s more important for HOCD sufferers is the ability to stop questioning their “true sexuality” whenever the pursuit of this truth becomes obsessive. As long as sufferers understand that it’s their right not to do anything that they don’t want to do, and that their desire is not a time bomb, they shouldn’t need any reassurance.

It may be, of course, that sufferers fall into a number of sexual groups at once, and have different relationships towards each desire. In that case, broadening this list may help them articulate their comforts and anxieties more subtly; it could be, for example, that a woman is perfectly comfortable with desire for other women, but frightened by the idea of romantic feelings for them. Or the other way around—both romance and physical attraction are possible sites for HOCD. It might be helpful to such a person to be able to articulate the fact that she’s okay with same-sex physical desire, but not with same-sex romance, which she can choose not to worry about. Hopefully a more realistic and nuanced table of sexualities will facilitate such understandings.

But my main purpose in developing this table remains the following: to demonstrate that the simplistic question “Gay or not?” is awkward and unscientific.

People of the following additional tendencies can all suffer from HOCD, for a number of reasons greatly in excess of the ones I will occasionally point out:

• Straight people
• Bi people
• Sadists, masochists, and people with any other fetish: when such people “find out” that they lack interest in normal straight sex, they, like my friend, very often assume it’s because they’re gay. Then as soon as they “resist” this possibility, the whole machinery of suspicion kicks in and tells them they’re repressing, latent, in denial, etc.
• People who consider themselves to be homosexual. They can also obsess about their own sexuality in many of the ways open to straight sufferers.
• People excited by the idea of having dark secrets, who enjoy being frightened by their desire; phobosexuals. It might not matter what the secret is. It should just be overpowering and catastrophic. So when such people imagine themselves being “in denial,” they get excited or aroused, without necessarily wanting to do the things that frighten them. And moreover, they might be unable to separate these exciting thoughts from the fantasy of being destroyed. But this isn’t really such a baleful way to enjoy, and phobosexuality can be as quotidian and undramatic as any other.
• People who prefer to fantasize things than to do them. Even hetero-fantasizing asexuals might get HOCD because it’s weird not to want to have sex. Homo-fantasizing asexuals probably get confused too, thinking they should force themselves to “live it out.”
• Teases. There are lots of asexuals who are not interested in romance, but are really into sexual tension and attention, and the fun and danger of flirting. There are, to name a few varieties, homo-tease asexuals, hetero-tease asexuals, bi-tease asexuals, and maso-tease asexuals. People treat teases pretty brutally sometimes. Hetero-tease asexuals are often punished with accusations of frigidity or homosexuality. Homo-tease asexuals (who are often otherwise straight) might also be punished through similarly shaming accusations, in any case are often unequipped to recognize their desire as anything but genitally homosexual. In some, such confusion becomes HOCD.

Each of the hetero-oriented sexualities in this list is perfectly compatible with HOCD. And each homo-oriented sexuality raises questions for anyone still asking “Are they gay or not?” For example: are homo-romantic asexuals and teases gay? Or not? What about people who just enjoy being found attractive by people of the same sex? Are they gay? Or not? We’re not talking “yes” or “no,” or even about “degrees” or a “continuum” here. The differences involved here are unrelated to straight/bi/gay: what sex means to different people, whether consummation is important or possible for different people, whether arousal builds towards a climax or is sprinkled through the most quotidian activities, whether pleasure is pleasant or not, whether desire is realistic or literary, what kind of feelings accompany it (self-affirmation? affection? greed? guilt? anger? fear? vulnerability?), how people prefer to indulge in their desire, e.g. alone or socially, physically or mentally... But the sexuality of sufferers is no more complicated than that of the general public, and the question “Are they gay or not?” is stupid, simplistic, and unscientific whoever it’s applied to.

HOCD sufferers are, nonetheless, among those at the forefront of such researches. Many have already discovered that, if they do choose to interrogate their desire, straight and gay aren’t the only possibilities. It’s okay to be arbitrary, creative, or playful about sexuality, to invent new categories without being sure they fit exactly. After all, gay/bi/straight don’t fit and are unscientific, so what’s the worse that could happen?

I’d like to see an even longer list. If you have something to add, I recommend sending it in to the Reader (hypocriterdr@gmail.com) to be printed in next issue’s “Afterthoughts.”

By the way, there’s now an (analog) HOCD zine in the works, and an associated blog. Contribute to both! Instructions are on the blog.

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