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Man: ‘I’m scared to go out in public’

What are the symptoms of obsessive-compulsive disorder, and what can sufferers do to overcome their anxieties? Dr. Gail Saltz advises a man who is having intrusive thoughts — some of which are sexual in nature.
/ Source: TODAY contributor

Q. I am 49 years old and I have this overwhelming urge to ask strange women, women I don't know, to touch my crotch. I have successfully resisted this urge. My younger brother gave me a haircut the other day and noticed I have a soft growth on my head and now I'm scared this growth and my urge to be groped are related and I'm scared to go out in public. What should I do?

A. You should immediately see a psychiatrist to evaluate your symptoms, because I suspect they can be very successfully treated.

Though I haven’t seen you as a patient and therefore cannot (and should not) make a formal diagnosis, this sounds like a classic case of obsessive-compulsive disorder, or OCD.

Having intrusive and disturbing thoughts is not terribly unusual. OCD often makes people feel like they can’t stand germs or they are superneat or wash their hands endlessly. But it can also cause intrusive and unwanted thoughts about doing sexual (or violent) things.

Obsessions are thoughts — you find yourself having these unpleasant thoughts over and over again, without the ability to get them out of your head. The compulsive part is an actual action you take, which in your case you have so far resisted. A compulsion may be a repetitive action that is unrelated to the thoughts like touching, counting or checking, but they seem to reduce the anxiety the thought caused. Unfortunately these actions can slowly take over your life.

A significant portion of people with OCD have sexual obsessions. Often, people with this condition don’t put themselves in situations where they might act on their obsessive thoughts.

You might be avoiding public places or settings where there will be a lot of strange women. So your world starts shrinking. Then, your anxiety rises. The more you try to shift your life to accommodate your condition, the more you want to engage in it and become more fearful. It is likely you would never act on such thoughts at all, but your symptoms are impacting your life nonetheless.

OCD tends to go along with anxiety disorders. This is likely connected with your worry about the growth on your head. That could be a lipoma, which is a benign fatty deposit below the skin. Of course, a growth anywhere on your body should be checked out immediately by a doctor. But your fear of it being a dangerous tumor could also be anxiety related to OCD.

But a psychiatrist can help. Obsessions are very treatable, often with cognitive behavioral therapy, which works to desensitize you to these unwanted thoughts. Sometimes people benefit from therapy alone; others require medication in addition to therapy.

It’s likely you have had other obsessive thoughts in the past — the urge to rearrange your food just so, endless counting or checking rituals, making sure the stove is off or the door is locked, etc. Obsessions can morph and change. This one might go away, but another could replace it.

There is no need for you to suffer in silence. Many people like you find these thoughts morally reprehensible, and would be mortified if anybody knew about them. It is shame, stigma and lack of knowledge that keeps people from seeking the treatment that can give them relief. I urge you to seek help now.

There is an excellent book on this topic. I recommend “The Imp of the Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts” by Lee Baer, Ph.D., which will give you a fuller explanation of these kinds of obsessive thoughts.

Dr. Gail’s bottom line: Intrusive thoughts, often of a sexual or violent nature, are often symptoms of obsessive-compulsive disorder, which is treatable by a psychiatrist.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to TODAY. Her latest book is “Anatomy of a Secret Life: The Psychology of Living a Lie.” She is also the author of “Amazing You! Getting Smart About Your Private Parts,” which helps parents deal with preschoolers’ questions about sex and reproduction. Her first book, “Becoming Real: Overcoming the Stories We Tell Ourselves That Hold Us Back,” was published in 2004 by Riverhead Books. It is now available in a paperback version. For more information, you can visit her Web site, .