Loss of capacity to experience affect as reaction to OCD

Hi all, I have been treating a 22 yr. old patient who suffered from obsessional thoughts surrounding homosexuality from age 18-21. Having believed that the intrusive thoughts/impulses meant he was homosexual, he recently explored a gay identity and found that he is in fact heterosexual and then stumbled upon OCD literature that best described his problem. Currently he does not suffer from the obsessions but he has somehow lost the capacity to experience any type of affect. He complains of a pervasive "flatness" in his inner life. My hunch is that he has undergone some type of disavowal of the emotional implications of his thoughts in response to the tremendous anxiety he experienced when he contemplated the implications of his intrusive homosexual thoughts/impulses. However, with such a schism between thought and affect, the parameters of CBT have left me with little to offer. I was wondering if this phenomenon has been encountered in anyone else's clincial experience with OCD, and if there are any therapeutic techniques for restoring his connection between cognitive appraisals and his emotions. One final example of his problem is that his mother is currently dying of cancer and he has yet to experience any type of intense affective reaction to this situation. Thanks.

• Just an idea... by Ilan S., 2/10/99