Obsessive Compulsive Disorder (OCD) can take many forms. When we talk about an OCD theme or subtype, we simply mean that a person’s intrusive thoughts tend to focus on a particular topic or content area. For example, people struggling with Harm OCD may be flooded with fears of harming themselves or someone else, while people with Relationship OCD may be fixated on whether or not they are with the right romantic partner.
Often people report that they have struggled with more than one OCD subtype across time. Intrusive thoughts can hop from theme to theme, like the game Whac-a-Mole, where one topic is “resolved” and then another pops up. This can be exhausting and frustrating. The good news: once you understand the principles of Exposure and Response Prevention (the gold standard treatment for OCD), you will know how to respond to any OCD subtype that you encounter. All OCD subtypes are treated the same way and many overlap. The purpose of outlining subtypes is to help sufferers find community, reduce shame, and feel seen and understood.
Below you will find descriptions of a few common OCD subtypes. This list is not exhaustive. There are endless ways in which OCD can manifest, so don't worry if you don't see your exact symptoms listed below. Our team of OCD specialists will be able to comprehensively assess your OCD symptoms and help you understand how they fit into the OCD treatment model.
1. Harm OCD
What if I did harm to myself or someone else? How do I know I’m not a murderer? Am I capable of harming another person? What if I snap, lose control, and hurt someone I love?
Do you:
Avoid driving in fear of turning the wheel and hurting yourself or others?
Avoid places where you might “snap” and hurt someone (e.g., subway platforms)?
Avoid being around or using knives or other sharp objects?
Avoid family members or close friends, in fear of acting on your thoughts and hurting them?
Reassure yourself over and over that you would never be capable of harming anyone you care about?
Read stories of people who “snapped,” and anxiously compare yourself to them?
2. Pedophile OCD
How do I know I’m not a pedophile? Did I look at that child the wrong way? Did I stare at that baby for too long? Have I been hiding my true nature from myself this entire time? How can I be 100% sure I am not a pedophile?
Do you:
Avoid places with lots of children (e.g., parks, schools, toy stores, the beach)?
Avoid looking at children on the street or deliberately look at children to "test" yourself?
Anxiously check for arousal when in the presence of children?
Avoid or feel highly anxious being around your children or family members’ children?
Avoid television shows or advertisements featuring children?
Confess your scary thoughts repeatedly to others?
Seek reassurance online to confirm that you are not a pedophile?
3. Sexual Orientation OCD
How can I be sure that I’m not gay (or straight, bisexual, etc)? How can I ever truly know my sexuality? Am I living a lie? Do I find that person on the street attractive? Did I feel aroused when I saw a picture of that model, or was it something else? What if I'm wrong about my sexual orientation and I end up devastating the people in my life?
Do you:
Anxiously check for arousal when you look at people of the same or opposite sex?
Anxiously check for attraction when having sex with your partner or avoid physical intimacy entirely?
Read “coming out” stories and compare those stories to your own experience?
Seek reassurance from friends and family about your sexual orientation?
Mentally gather evidence in an effort to confirm your “true” sexual orientation?
Avoid being around people who are very open about their sexuality?
4. Relationship OCD
How do I know if I’m with the right person? What if I’m stuck with the wrong person and end up living a miserable life? Will I be bothered by my partner’s flaws forever? Do I find another person more attractive than my partner, and if so, what does that mean?
Do you:
Compare your partner repeatedly to other people, to make sure that you are with the “right” person?
Mentally gather evidence for and against staying with your current partner?
Anxiously correct your partner or search for flaws to “confirm” that you are with the wrong person?
Search for hidden meaning in your partner’s facial expressions or words?
Seek reassurance from others about whether or not you are with the “right” person?
Frequently check to see if you are feeling “love” and whether that feeling of love is strong enough?
Avoid romantic movies because they trigger incessant doubts about your relationship?
Avoid taking steps that would increase commitment (e.g., moving in together, marriage, etc.) because you can't find total certainty about how you feel?
5. Responsibility OCD
Did I make sure to turn off the stove? Did I leave something on the floor that my dog might choke on? What if the apartment burns down and it’s my fault? What if I get someone else sick because of my actions? What if someone trips on an object because I didn’t pick it up? What if something happens and I could have done something to prevent it? Did I hit someone with my car without realizing, leaving him or her dead in the street?
Do you:
Repeatedly check to make sure that the environment is “safe” before you leave or before you sleep at night?
Go back to check on items that have been deemed “risky” (e.g., return home to make sure you definitely locked your door)?
Pick up items that you see on the street in case someone trips on them?
Excessively decontaminate yourself or other items to “protect” others?
Check your mirrors repeatedly or retrace your steps to make sure you didn’t hit anyone with your car?
6. Suicidal OCD
How do I know I’m not suicidal? How do I know I won’t become suicidal?
Do you:
Mentally gather evidence for why you would or would not kill yourself?
Avoid triggers that might make you feel sad or down?
Check constantly to see if you are feeling depressed?
Avoid knives, sharp objects, or other triggers for suicide (e.g., subway platforms, pill bottles, tall buildings)?
Read stories of people who are depressed and suicidal, and anxiously compare yourself to them?
Avoid being alone for fear you might act on these scary thoughts?
7. Just Right OCD
How am I going to be able to get started on this task if things feel off? What if I won’t be able to focus until I fix the symmetry or position of this object? Should I redo this action because it didn’t feel quite right the first time I did it? Will I keep feeling unbalanced until I complete the task perfectly in just the right way? What if something bad happens because I didn't do this in the correct way?
Do you:
Repeat an action or sequence of actions until it feels "just right?"
Do things to try to achieve a sense of balance or symmetry?
Rearrange objects or adjust things in a space until it feels "right?"
Have to reread or rewrite something repeatedly until you feel like you understand it perfectly?
8. Health Anxiety/OCD
What if I have a terminal illness that is currently undetected? Could this feeling of pain in my stomach mean that I have colon cancer? Might that mole on my skin have started to change slightly, and should I call the doctor? Am I having an adverse side effect to this new medication?
Do you:
Frequently google physical symptoms to investigate if you could have an illness?
Monitor your bodily sensations closely (e.g., take vitals, inspect skin or other body parts, keep a log of symptoms)?
Reach out to doctors or others for reassurance about your health?
Do body scans to check how you are feeling and if anything feels off?
9. Moral Scrupulosity or Religious OCD
Am I a bad person? Was that thought I just had an indication that I am “bad”? How can I be sure my intentions are pure? What if I don’t really know my “true” intentions? Did I do the right thing? Did I commit an immoral act without realizing? What if I hurt another person with my actions and I’ll never know? Why did I have those “bad” thoughts about God or disturbing religious images? What if God has cursed me? How can I make sure that God does not misunderstand me? Am I perfectly complying with the tenets of my religion?
Do you:
Repeatedly confess or seek reassurance to make sure you are morally “in the clear?”
Rationalize to yourself why you are actually a “good” person?
Mentally review past actions to “make sure” you acted appropriately?
Replace "bad thoughts" with "good thoughts," or "bad images" with "good images"?
Apologize compulsively to others for potential past wrongdoing?
Pray excessively, or repeatedly seek guidance from religious leaders to confirm that you have not been sinful?
Comb your mind for any evidence of blasphemy and if found, repeatedly confess, seek forgiveness, and seek reassurance?
10. Sensorimotor or Hyperawareness OCD
Why can’t I stop thinking about my swallowing, my blinking, my heartbeat, my breathing--these processes used to be automatic and now I can’t stop thinking about them? What if I am always preoccupied by this sensation? What if I can only half pay attention during all of the important moments of my life because I’m focused on this sensation? What if I lose my mind or go crazy because I can’t stop thinking about this sensation? I have to empty out my whole bladder before leaving the house/going to sleep--what if I can’t focus or can’t sleep as a result of having the urge to urinate?
Do you:
Check repeatedly to see if you are “still” thinking about sensation?
Repeatedly compare how you feel now vs. how you felt before the hyperawareness started?
Distract yourself as much as possible to avoid thinking about the sensation?
Avoid situations, words, anything that might trigger you to “start” thinking about the sensation again?
Stay on the toilet as long as possible to make sure that your bladder or bowels have been emptied “completely”?
11. Contamination OCD
How can I be sure that I am free of germs or other contaminants like bodily fluids? How can I keep my “home space” completely separate from the contamination of the outside world? How do I prevent myself from getting sick or feeling dirty? How do I know I won’t become extremely ill as a result of interacting with this public restroom?
Do you:
Excessively decontaminate yourself, your belongings, or other surfaces, or perform elaborate rituals with multiple steps to feel clean?
Track your movements and the movements of others to monitor the pathway of germ spread (eg., monitoring everything you touch, monitoring others’ hands or behaviors)?
Avoid items or places that you have deemed contaminated or filled with germs or tolerate these items or spaces with great distress?
Categorize items or areas as more or less contaminated, and spend a great deal of energy trying to maintain these categories?
Avoid “high contact” surfaces like doorknobs, elevator buttons, shaking hands, or subway poles?
12. Metaphysical Contamination OCD
What if that bad person’s essence rubs off on me? What if I take on the negative qualities of my horrible uncle by coming into contact with his items and it changes my whole personality? What if I contaminate these new clothes with "bad thoughts" and I can’t wear them anymore? If I breathe near this cemetery, will it bring death to myself and my loved ones? If I read about this triggering topic, will it bring bad energy into my day?
Do you:
Avoid people, places, or objects that you fear will contaminate you with their essence?
Avoid saying certain words or phrases out loud?
Breathe out bad energy or exhale in a ritualized manner to avoid “taking in the bad energy?”
Say phrases in your mind to neutralize or expel the threat, or to block another’s essence from intruding?
Other OCD fears
Fear of losing things
Fear of forgetting/hoarding memories or information
Fear of losing impulse control (eg., blurting out something inappropriate or offensive, sending an email that you didn't mean to send, stealing items)
Fear of being misunderstood or a compulsive need to clarify that you were understood completely and correctly
Fear of certain numbers or colors
Existential OCD (e.g., obsessive thoughts about the meaning of life, my purpose, whether or not I actually exist)
Obsessive fixation on a past event
Intrusive violent or sexual images
Superstitious fears
Obsessive fixation on maximizing happiness and making all the best decisions in order to never have regrets or 'miss out'
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