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Types of OCD: A comprehensive list

The cycle of OCD follows a very similar pattern throughout all cases. The afflicted will have a fear, something they believe could bring harm onto themselves or others, be it physical harm, emotional distress or something that doesn’t align with their beliefs. Whatever the fear may be, this becomes their obsession.

The sufferer will be tormented by intrusive thoughts, images, triggers and impulses surrounding that worry and as these thoughts are unwanted, they cause a great amount of distress to the sufferer. These intrusions will cause the sufferer so much anxiety that they will feel compelled to take action, to do something that will keep them safe from their worries becoming facts, to perform a compulsion.

These compulsive behaviours are usually performed in an effort to rid themselves of anxiety and in turn preventing their fears becoming a reality. This is where the cycle of OCD begins. An intrusive thought appears, and then anxiety, and then the need to perform a compulsion, until the sufferer is in a perpetual loop of obsessions and compulsions.

Though the routine of OCD generally does not waiver from the above, there are great differences in the content of the condition. Patients will have drastically different worries, intrusions and compulsions, these are known different the different types of OCD. Now, it should be made very clear, OCD is a very personal disorder and can take form in an infinite number of ways, we do not claim to cover each and every possible type of OCD, the below are just the most common cases that have been observed. If your type of OCD or your fears do not appear on the list, this is nothing to worry about.

Let’s get into it. The most comprehensive list of types of OCD.


Checking OCD

Probably the most commonly seen type of OCD, checking OCD is generally portrayed as someone going back to make sure their door is locked or that their stoves are turned off, and while this may happen it’s a great misinterpretation of this condition.

Those suffering from OCD will perform physical checks as their compulsive behaviour, this could be checking to ensure things are turned off, locked or just right in some sort of way. This is generally to ensure the physical safety of themselves or their loved ones. These checks will be performed over and over again, even when they may have just checked, the afflicted will feel an all-consuming need to check again, just in case.

Here are some of the most commonly seen fears and compulsions they will perform in response. It’s very possible for OCD sufferers to worry about several of these at any given time.

Common Obsessions & Compulsions
Burglary or Theft

This is the concern of their house being burgled or their personal belongings being stolen from them directly. Secondary worries may also appear of what the burglar may do while being in their home, aside from stealing their possessions i.e vandalising their home or harming someone that may be in the house.

Here are some of the compulsions that the sufferer is likely to perform:

  • Checking doors including car doors are locked
  • Checking that they still have their purse or wallet on them
  • Checking that burglar alarms are correctly installed and are working
  • Checking windows are locked

The worry of causing a fire by leaving an appliance or some other electronic device in their home, or other places where they feel they have responsibility.

Here are some of the compulsions that the sufferer is likely to perform:

  • Checking stoves have been turned off
  • Checking lights have been turned off
  • Checking other electronic appliances have been turned off
  • Checking that others have turned off anything that could potentially start a fire

The worry of flooding their home, work space or other area by leaving taps or another water based appliance on.

Here are some of the compulsions that the sufferer is likely to perform:

  • Checking taps have been turned off
  • Checking others have turned off taps after using them
  • Checking taps have been turned off in a workplace, even taps that they have not used
Harm to or upsetting loved ones

The concern that their actions will in some way bring harm to or upset their loved ones.

Here are some of the compulsions that the sufferer is likely to perform:

  • Calling or texting loved ones to see if they are okay
  • Asking loved ones if you have upset them
  • Checking the reaction of loved ones to see if you have upset them
Car accidents

The worry that their actions or mistakes will result in an accident which could harm or cause distress to someone else.

Here are some of the compulsions that the sufferer is likely to perform:

Reading & Understanding

The fear that they are losing the ability to or have already lost the ability to read and understand information that they are given

Here are some of the compulsions that the sufferer is likely to perform:

  • Re-reading sentences over and over again
  • Replaying things over in their head to ensure they have understood it
  • Reading complicated text to check if they can understand it
Illness & Disease

The fear that they are showing the signs and symptoms of an illness or disease, and they may get sick or potentially die.

Here are some of the compulsions that the sufferer is likely to perform:

  • Checking their body for symptoms
  • Researching illnesses thoroughly and comparing with symptoms they show
  • Hyper analysing sensations in their body in fear that they are symptoms of illness

Here’s a short look into the life of someone suffering from checking OCD:

Harry lived a normal life, working a normal job and was very content . Then he read a story of a burglary on his road. This wasn’t too out of the ordinary, as burglaries had happened near where he lived before, but this was before he had children. Now, he had a family to protect.

As a precaution, he installed an extra bolt on the door, just as an added form of security. Once he had installed the new lock, he carried on his day, it was a saturday so the kids were home and he was spending the day with them.

He began to make his way upstairs to put away some laundry, when a thought popped into his head, had he locked the front door? He was on his way upstairs and his kids were downstairs, with his wife being out, he wanted to double check, so he did, and it was.

While putting laundry away, the thought popped into his head again, he wasn’t completely certain that he had locked the door with the bolt. He began to feel hot and flustered, his kids were downstairs, he wanted to make sure they were protected. Harry raced downstairs and checked the bolt, it was locked. He made his way back upstairs and the thought entered his mind again, was the door definitely locked? This was the beginning of Harry’s OCD.

From this day onwards, Harry would be intruded with the thought of leaving the door unlocked on an hourly basis. Even while at work, where he had no way of checking the door had been locked, he worried that he might have left the door unlocked. He even went as far as coming back home from work to check, multiple times in a day.

This responsibility Harry felt of protecting his family became all he thought about, it consumed his every waking moment.

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Contamination OCD

It’s been seen time and time again in the media, germaphobes and people who wash their hands often claiming to have OCD, but really not being anywhere close.

Contamination OCD is really what it says on the tin, the fear of being contaminated by an external source which will cause some sort of turmoil in the sufferer’s life. This is usually broken down into two categories.

Physical Contamination

A fear of physical contamination within contamination OCD generally manifests as an excessive worry of being contaminated by coming in contact with external objects, people and places. To an OCD sufferer being contaminated could mean becoming sick and worst case scenario, even death.

To avoid any of these outcomes, the sufferer will perform a number of compulsive behaviours to ensure that they remain safe. This is usually seen through the following obsessions and compulsions.

Common Obsessions and Compulsions
Becoming sick, ridden with disease or dying

This is the ultimate fear for most suffering with contamination OCD, they worry that they will come in contact with something that will make them sick and potentially. Sometimes the worry extends even further and the afflicted will be concerned about passing on this could-be illness to loved ones.

Here are some of the compulsions that the sufferer is likely to perform:

  • Washing hands excessively
  • Bathing excessively or taking extremely long showers
  • Cleaning unnecessarily and excessively
  • Avoiding places thought to be unhygienic e.g public bathrooms and large crowds
  • Avoiding contact with strangers
Contracting HIV

This fear was much more prominent during the HIV pandemic, where lives were being lost around the world. The worry being contracting HIV and potentially aids by coming in contact with blood, needles or having sex with someone who could potentially be a host.

Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding red blood-like stains
  • Avoiding vaccinations and injections at all costs
  • Avoiding sex with people who they cannot confirm does not have HIV
  • Checking their body for the symptoms of HIV
Gingivitis or Severe Gum Disease

This is the fear of developing gum disease or some other dental issue from a negligence of proper dental hygiene.

Here are some of the compulsions that the sufferer is likely to perform:

  • Excessive and extended tooth brushing
  • Excessive and extended flossing
  • Excessive dentist appointments
  • Checking the symptoms of dental issues to see if they have any of them
A Case of Physical Contamination OCD

Jane was a journalist and worked tirelessly for a very popular online publication. She was looking for a promotion to Editor, but this was dependent on the next feature piece she was writing. This article became her entire life, she wanted this promotion so badly and made sure she was doing everything in her power to get it.

Unfortunately, this was right before Christmas, flu season. Jane didn’t want to get sick, she couldn’t, she didn’t have the time. So she began taking all precautions. Antibacterial gels, vitamins and not being in vicinity of other ill colleagues. She had also begun washing her hands after opening the door to the office. She had read an article about the mass amounts of bacteria that lived on public door handles. So each time she went in or out of the office she washed her hands, in an effort to remain perfectly healthy.

One morning, after arriving at work and settling in, she started to wonder if she had to wash her hands upon entering the office. She couldn’t remember and decided to do it again, just to be safe. Sitting back at her desk, she noticed a colleague across the room sneezing, she looked at her hands pondering if she had cleaned her hands thoroughly enough or if she was carrying the bacteria that made that woman sick. Just to be absolutely sure, she washed her hands again. Moments later, the exact same thoughts arrived . This was the beginning of her OCD.

From this day onwards, Jane would be intruded with the thought of being contaminated by bacteria, both at work and at home. Even while in her own home she wouldn’t touch specific items in fear of picking up some sort of illness. This led to incessant washing of her hands and other inherently irrational hygiene behaviours.

Mental Contamination

For those suffering with mental contamination, the fear isn’t coming into contact with something that they think will make them sick, it’s an internal feeling of being “dirty”. For OCD sufferers who have experienced something degrading, unethical or immoral, thoughts of this experience can sometimes make them feel dirty, essentially mentally unclean. They may not even need to experience these events directly, just the knowledge of them existing and occurring in the world around them can cause a mental contamination

The fears within can take an infinite number of forms, the curious part of this condition is that though the feeling of “uncleanliness” is internal, it can cause physical compulsions to the sufferer. Here’s a few examples of the most common obsessions and compulsions seen with mental contamination

Common Obsessions and Compulsions

In this case the sufferer will be triggered by the idea of being cheated on or them being unfaithful to their partner. They’ll be consumed by the “dirty” feeling that they associate with infidelity. They’ll imagine the acts of being unfaithful, how it made them feel, how it made their partner feel and be overcome with a sensation of uncleanliness.

Here are some of the compulsions that the sufferer is likely to perform:

  • Washing hands or body to cleanse themselves of this dirty feeling
  • Avoiding all things that remind them of their partner
  • Performing as many good deeds as possible to counteract this internal uncleanliness

For those who have been involved in a crime, no matter how big or small, the mental contamination could stem from how this made them feel, how much of a bad person they are, how only the lowest of the low would even consider committing a crime. These thoughts and triggers will cause the sensation of feeling dirty, causing a need to rid themselves of this contamination.

Here are some of the compulsions that the sufferer is likely to perform:

  • Washing hands or body to cleanse themselves of this dirty feeling
  • Avoiding anything that involves crime or discusses it
  • Repenting or asking for forgiveness for their crimes

For some sufferers, current or previous abuse in their life can be the nature of their contamination. Whatever form of abuse they have been on the receiving end of can cause a feeling of worthlessness. It can create the idea that they deserved this in some way.

Here are some of the compulsions that the sufferer is likely to perform:

  • Washing hands or body to cleanse themselves of this dirty feeling
  • Avoiding anything that reminds the traumatic experience
  • Ruminating on what they did wrong to deserve that treatment
A Case of Mental Contamination OCD

Unbeknownst to her, Kate’s boyfriend was part of a well known gang, which is why it was extremely surprising and worrisome when he came home with a wad of cash. He explained that he earned it and that she could spend the money on whatever she liked. With reluctance, Kate took the money, and went shopping.

She made a whole day of it, buying the most expensive clothes she had ever owned. What an experience it was, never in her wildest dreams could she imagine such a shopping spree.

After arriving back home and dropping her bags, the excitement had left her, she began to wonder where the money had come from. Kate confronted her boyfriend, she knew there were no reasonable means for him to have this amount of money, after a while of questioning he conceded that it was stolen.

Kate’s heart sunk. Stolen? How could it be stolen? Why would he steal? He’s not like that? These questions raced through her mind at lightspeed. As she attempted to make sense of it all, Kate felt betrayed, cheated and most of all like a criminal. She had spent stolen money, she was an accomplice to a crime, she was a criminal.

Kate needed to shower, she felt dirty. It offered little relief, she still couldn’t shake this feeling, she could still feel the money in her hands, the stolen, dirty money. Kate washed her hands. As soon as she began to think about it, she felt dirty, she felt as though she wanted to wash away any trace of this event from her body, and that’s what she did.

As Kate was intruded by or thought about the money or boyfriend she felt an incessant need to clean herself, to wash away the thoughts, the anxiety, the filth. This became her OCD.

Rumination OCD

Rumination OCD differs from all other subtypes of the condition as the majority of the obsessions and compulsive behaviours will happen internally, in the mind.

Sufferers of this condition are intruded by thoughts and images that bring them worry, these intrusions will be so powerful and frightening that they force the afflicted to question them, to ponder on them, to ruminate. These ruminations will ask what if’s, look for evidence from the past or even imagine a future where these thoughts are true. The sufferer will do whatever they can to rid themselves of these thoughts and the anxiety that they bring, these ruminations are their compulsions.

Rumination OCD generally takes things that are important to you, or things that don’t align with what you thought about yourself, with your values and morals. It takes these things and makes them a worry, things you never thought could be true about yourself appear in front of you.

Due to the personal nature of this condition, the content of worries can literally be anything and will differ from cases to case. However, as humans, we tend to have commonalities in things that we find important, meaning rumination OCD is commonly seen in a few different subtypes.

Relationship OCD

In this instance the sufferer will be tormented with worries and concerns about their relationship. This usually occurs in romantic relationships, where there is more room for doubt. The fears will usually manifest in attraction, love and compatibility . Here’s a look into the most common obsessions and compulsions seen in relationship OCD, it’s expected for sufferers to have many of these at the same time.

Common Obsessions and Compulsions
Do I love them?

Love being an abstract concept and not a tangible metric that we can gauge, leaves a lot of room for worry in OCD patients. They become concerned with whether or not they love their partner, how they would know and if they do love them, how they know it’s enough. Of course these are concerns that everyone has had in a relationship, it’s the obsession with these concerns that makes this OCD.

Here are some of the compulsions that the sufferer is likely to perform:

  • Remembering past experiences to prove they love their partner
  • Imagining a future with their partner to check if they would love them
  • Asking others to see how they feel about their partners and checking if it matches with their own feelings.
Do I think they’re attractive?

In the beginning of a relationship attraction is one of driving factors for pursuit, this is what would have drawn you to the person in the first place, be it physical or emotional attraction, this is at the heart of any quality relationship. Which is the exact reason that it can be the epicentre of distress for a relationship OCD sufferer. They can begin to wonder if they’re still attracted to their partner or even if they were ever attracted to them.

Here are some of the compulsions that the sufferer is likely to perform:

  • Analysing their partner to check if they feel attraction
  • Ruminating on experiences or times where they have found their partner unattractive
  • Checking their physical attraction to others to see if it’s comparable
Are we compatible?

Attraction aside, compatibility is what keeps a relationship going. The interests you share, your values and morals, sexual drives, stances on children, we could go on and on. This unspoken and infinite list of criteria is what makes one want to pursue a relationship with someone. Most of the time we’re willing to compromise on one thing, if it’s made up in another, it’s impossible to think that two people will be 100% compatible in every way. And it’s this uncertainty that fuels the obsession. The OCD sufferer will begin to ruminate and question their compatibility, to analyse and check it’s up to the standard that they expect.

Here are some of the compulsions that the sufferer is likely to perform:

  • Continually checking on and adding to the ways that they are incompatible
  • Asking others about their experience of compatibility with their partners
  • Asking their partner if they think they are compatible
Could I do better?

We’ve all in some way wondered if we could do better in our relationship. Could we find someone better looking? More ambitious? Richer? Though these are usually shallow fleeting thoughts, for an OCD sufferer, this can be an obsession. They’ll ruminate and worry about the idea that they are settling in their relationship, they could potentially be wasting their time and could find someone better suited to them.

Here are some of the compulsions that the sufferer is likely to perform:

  • Ruminating on the things their partner is lacking
  • Asking others if they think they could do better
  • Checking with their partner to see if they have plans to improve on certain aspects of their life
A Case of Relationship OCD

Kevin had been happily married for 5 years, he’d never doubted his marriage not even for a second. Unfortunately for him, OCD wasn’t aware of this.

While sitting at a bar and listening to his friend go on and on about how in love he was with his new girlfriend, Kevin started to think about his own relationship, he started to think about how “in love” he was in his honeymoon phase and how “in love” he still was with his wife. But it didn’t feel like what his friend was describing. “That’s odd” he thought, “do I not love my wife as much as he does his new girlfriend?”. Strangely, this thought stuck with him. That night lying in bed next to his wife, he started thinking about their relationship e, he started looking for times where he felt very in love with his wife, but he couldn’t. He couldn’t find any examples where he felt the love his friend was describing. Was he in love with his wife at all?These thoughts began to trouble Kevin regularly, he couldn’t shake them, they would just pop into his head and make him feel terrible. He did love his wife, so he would prove it to himself, each time these thoughts popped into his head, he would remember all of their happy times together or tell his wife that he loved her. That would get rid of the terrible feeling in his chest.This was Kevin’s OCD. The compulsion he would perform only temporarily removed the anxiety, the thoughts would pop up again, and he would become anxious again. This was his relationship OCD.

Pedophilia OCD

Pedophilia OCD is probably one of the most misunderstood conditions in the world. For most people, having pedophilia OCD makes you a pedophile and you should be reprimanded as such. This however, could not be further from the truth, there hasn’t been any recorded cases of a pedophilia OCD sufferer ever actually committing any pedophilic acts, and the reason for this is very simple, they are not pedophiles, they are suffering from OCD.

The misunderstanding of this illness lies in the name, the shock factor of seeing the word pedophilia leads everyone to believe that they person must be a pedophile, however, they are the exact opposite. The root fear in all cases of pedophile OCD is actually being a pedophile, losing control and committing a heinous act. Whereas those who have committed sexual acts on children, have done so because they wanted to, because they gained sexual gratification from doing so.

Those suffering do not have any sexual attraction to children, nor so they feel urge to have sex with children, they are worried that they do or will have in the future. POCD patients will be constantly bombarded with thoughts and images about being a pedophile, graphic and horrible scenes, which will cause them a great amount of distress. What’s more, they’ll also be terribly triggered by being around children, even the sight of them on TV can cause severe anxiety.

Unfortunately, the only way to relieve themselves of this anxiety is to perform a compulsive behaviour which in some way disproves the idea that they are a pedophile. Here are some of the most common obsessions and compulsions that are seen in pedophilia OCD.

Common Obsessions and Compulsions
Attraction to children

The primary fear in pedophilia OCD is an attraction to children. The afflicted will be intruded by thoughts and images of being attracted to children, such as; Am I attracted to children? What do I do if I am? Does this make me a pedophile?

Another very common symptom is being triggered by the sight of children in public, they’ll analyse how they feel towards them, looking for any sign of attraction, they may even feel what’s known as a groinal response: where in sexual cases of OCD, the sufferer will feel a sensation in their groin despite there being no sign of attraction or arousal. They’ll then take these thoughts and ruminate on them, consider what they’ll do if it comes to light that these worries are true.

Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding children in public, on tv or otherwise
  • Checking their arousal around children
  • Conjuring evidence that they are only attracted to adults
Losing control

Even to an OCD sufferer, they can be aware that having thoughts does not mean you’ll act on them. What sometimes offers salvation to POCD sufferers is the refuge that these are just thoughts, that one cannot be convicted for the thoughts in their mind and it’s especially true when you don’t want them to be there. This is where another worry can appear, the fear of losing control.

Pedophilia OCD sufferers know that they don’t want to be pedophiles, but they can then start to fear that they will somehow lose control and commit a vicious crime. This is likely to make them take precautions to ensure that this does not happen.

Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding children in public and being left alone with children
  • Not drinking alcohol or using drugs in fear of losing control
  • Conjuring evidence that they are only attracted to adults
A Case of Pedophilia OCD

After just finishing her degree, Stacey had started her new job; as a primary school teacher.

Of course being around children had never been a problem for Stacey, she loved kids and knew when starting her career that this is what she wanted to do. She had never considered anything else, even as a little girl, Stacey knew she would grow up to be a teacher one day.

Then the thoughts started appearing.

Her first week was a breeze, it was everything she thought it was going to be, tough but rewarding. While lounging around on the weekend, she began to think of her students, their bright little faces, running around and laughing, it brought a smile to her face. Then the thought popped into her head “Is it weird I’m thinking about my students on the weekend?”. “No, of course not, they’re my students, I’m meant to care about them!”. And just like that, the worry was gone, no need for further analysis.

A few hours later, Stacey began thinking about her students again and for whatever reason this seemed alarming to her. She began to worry about how much she was thinking about this. Was this normal? Do the other teachers think about her students this much? Laughably the thought appeared that she may be a pedophile, but was easily dismissed. However, when the thought started popping up again and again, it wasn’t nearly as funny.

Gradually, Stacey had become fixated on the idea that she may be a pedophile. As these ideas would intrude her mind it would come with a severe anxiety, a panic that she had never felt before, she felt an intense urge to do things that would get rid of the anxiety, to prove to herself that she wasn’t a pedophile.

So as these worries entered her mind, she would start to think about her adult relationships, how attracted to those men she was, which in some way eased the anxiety. From this point onwards Stacey felt a need to perform a compulsion like this each time the thoughts of being attracted to children appeared, and with her job that was very often. Her life became a cycle of intrusions, avoidance, anxiety and compulsions. This was Stacey’s OCD.

Homosexuality OCD

Homosexuality OCD sufferers excessively worry about their sexual orientation. This condition isn’t exclusive to any particular orientation, it can occur in any person. Essentially, it’s the fear that they are not the orientation that they have or do identify with. As we’ve come to understand that sexuality can be fluid and can change with time and experiences, for most the resolution to this would be simple, you’re interested in whomever you’re attracted to but it’s unfortunately much more complicated than that in OCD.

The conflict occurs when sufferers are sure that they identify one way, all evidence in their life has pointed to this orientation, they truly believe that this is the orientation that aligns with them. Which is why when doubts appear, they can be very concerning.

For example a straight male, who has identified as a straight male their entire life, has had several heterosexual relationships, been in love and has been sexually satisfied throughout, may find it very difficult to warm the idea that they may be gay. And the reason for this is because they most likely aren’t. Our sexual attraction is derived from a place of happiness, of joy and curiosity, not from a place of worry.

Homosexuality OCD or sexuality OCD will cause sufferers to doubt their sexuality with intrusive thoughts and triggers, forcing them to compulsively prove that they are the orientation that they believe they are. The concern in this condition is not knowing, you will never be able to prove or one hundred percent know that you are a specific orientation, it’s this uncertainty that causes the discomfort. In most cases, the afflicted may not even mind what their orientation was, as long as they were sure about their sexuality, it’s the not knowing and doubt which perpetuates the condition.

Common Obsessions and Compulsions
Attraction to opposite of sexual orientation

Obsessions around attraction is one of the main symptoms of HOCD. The afflicted will look for certainty in attraction, searching for a definitive answer on which type of persons they are attracted to. They’ll test their attraction with everyone they see, either looking to prove or disprove attraction to that person. If they feel any response that isn’t what they’re looking for, they’ll feel anxious and need to perform a compulsion to rid themselves of this anxiety.

In severe cases, sufferers are not even able to look at pictures or see people opposite to their sexual orientation without feeling anxious. They’re so engrossed in the idea of attraction, that the mere sight of another person can trigger distress, even more so if the person is good-looking. They’ll begin to question and check their arousal to that person, using any response from their body as evidence.

Generally what happens in these cases is that the sufferer will not find the attraction they’re looking for when testing against the people they think they’re attracted to, however, when they are exposed to people they feel they are not attracted to, they expect to feel nothing in their body, zero arousal, meaning when any response pops up, it’s taken as attraction and causes anxiety.

Here are some of the compulsions that the sufferer is likely to perform:

  • Checking arousal when seeing people to test their attraction
  • Looking at porn to check their arousal
  • Asking others of the same orientation to see their attraction to certain people
Being in denial

In some cases of homosexuality OCD, the obsession that may occur is being in denial about their sexuality. It’s common in gay community that people may repress or be in denial about their sexuality, however, this is usually due to other concerns. They may feel they can’t come out to their loved ones, or they’ll be judged by society or they may lose the happy life they have now. The difference between this and worrying about denial in OCD is the fact that someone in denial knows that they are gay, they know they are attracted to the same sex and enjoy it, but repress these feelings for external reasons.

Worrying about being in denial in OCD is very different. The afflicted will worry that deep down they are gay, and that they OCD symptoms are just a manifestation of their denial. Someone who is gay but in denial doesn’t obsess over this single idea all day, they do not feel a great anxiety about being gay and do not perform compulsions to prove otherwise.

Here are some of the compulsions that the sufferer is likely to perform:

  • Reading stories of being in denial and coming out to check if their cases align
  • Checking arousal to the same sex
  • Looking at porn to check arousal
Losing control

The reason that HOCD affects the sufferer so severely is because they truly do not believe that they are gay, they know that they are straight, but have no way to prove this, which is what causes the worry about being gay. Further worries can also appear, such as losing control and performing an act that would be considered gay. They’ll be concerned that they’ll lose control of their body and mind they’ll do something which will confirm the fears that they are gay, that these intrusive thoughts have been right all along and where would that leave them? Do they change their life now? To avoid this concern the sufferer will make contingencies and plans so that this is not an outcome.

Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding drugs an alcohol to remain in control
  • Avoiding places such as gay bars
  • Checking their arousal to the same sex
A Case of Homosexuality OCD

As far as he knew, Carl was straight, he had been in several relationships with women and they were great, he was actually in one right now. Carl had met his current girlfriend a year ago and they were infatuated with each other, he really could not be happier. They spent every waking moment they could together and became “that” couple who would never leave each other’s side. That was until OCD threw everything out of whack.

One evening Carl and his girlfriend were watching a movie, she casually asked “he’s hot right?” without giving it a second thought Carl agreed, “yeah, sure”. It was nothing but playful small talk. Later that night the same actor popped into his head, again he thought that’s a good looking man. Less than a few seconds later Carl began to wonder, “why am thinking about another guy?” and “why am confirming that I think he’s good looking?”. This is where the first sexuality worry appeared. Carl fleetingly considered the concept of him being gay, a passing thought that didn’t need any further response. Nevertheless, he gave it a response, he went through the list of all the reasons that considered himself straight and just for good measure, he brought up a picture of the actor, to prove to himself there was no attraction there. He was satisfied. He was sure that he was straight. Until the next morning…

He woke up and performed a play by play of thoughts last night, he couldn’t believe how silly he was being, then he felt a tightness in his chest, “how could he be sure he wasn’t gay?”. It was at this point Carl began to internally recite the list he had created the night before, analysing and embedding each of the reasons he believed he was straight. It worked, it removed the anxiety. But the thoughts popped up again.

Carl had become excessively worried about his sexuality, everything and anything linked to sexuality made him terribly anxious. He would be constantly plagued by thoughts of being gay, of sexual images in his head, all the while feeling an intense anxiety and the need to prove these thoughts wrong.

Harm OCD

Harm OCD or violent thought OCD is the excessive worry of performing violent acts either on themselves or on others.

Each and every person has had violent intrusive thoughts, thoughts where we wonder what would happen if we pushed that person onto the train track or if we jumped off the ledge of this roof. Yes, sometimes these unwanted thoughts can be scary, but for the most part they go as quickly as they came. The difference between this and OCD is the intensity and frequency of the thoughts. A harm OCD sufferer will be tormented by violent thoughts throughout their day, creating a vicious anxiety and the need to perform compulsions.

It’s common in harm OCD for sufferers to start to believe that they are going crazy, to associate these thoughts with that of a psychopath or serial killer. They are not. Everyone has unwanted violent thoughts, and for the most part we know that we will not act on them, the concern for an OCD sufferer is that they can never be sure.

As a violent thought appears the image itself is scary , that accompanied with a fear of acting out these thoughts or the concern that they’ll have to stop themselves from acting out these thoughts, is a recipe for disaster.

From these intrusions, numerous what if’s, doubts and worries will pop up, such as; why am I having these thoughts? Do I want to hurt people? What if I lose control and I go on a rampage? It’s these reactions on the unwanted thoughts which will cause the need for a compulsion.

As with all types of OCD, the content of the thoughts and compulsions will be personal to the sufferer, however, here are some commonly seen obsessions and compulsions within harm OCD

Common Obsessions and Compulsions
Harming others

Probably the most prevalent concern for every harm OCD sufferer is harming someone else, that these thoughts will get the better of them and they’ll seriously hurt or kill another person. This can be even more powerful when the violent thoughts surround loved ones, the idea that they may harm a loved one can be extremely distressing.

Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding or hiding potentially dangerous objects such as knives, scissors or tools
  • Checking the well being of loved ones to ensure you haven’t harmed them in any way
  • Checking the characteristics of serial killers or convicted criminals to see if there are any shared traits
Harming yourself

The fear of harming yourself is easily misconstrued with being suicidal or wanting to self-harm, but they’re completely different. A harm OCD sufferer does not want to harm themselves in any way, they worry that they do, they worry that these thoughts they have about harming themselves will be acted on. OCD is a problem of worrying not harm.

Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding or hiding potentially dangerous objects such as knives, scissors or tools
  • Avoiding alcohol and drugs in fear of losing control and harming themselves
  • Seeking reassurance from others to show that they have nothing to fear
Losing control and harming unconsciously

Many of the issues in OCD stem from control. Sufferers tend to struggle with a lack of control, the feeling of not being in complete command of certain aspects of their lives causes great amounts of distress for OCD patients. This can be seen in the worry harm OCD sufferers have about losing control. They fear that they will act on their violent thoughts unconsciously, that something will cause them to lose control of their body and violence will ensue.

Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding or hiding potentially dangerous objects such as knives, scissors or tools
  • Avoiding alcohol and drugs in fear of losing control and harming themselves
  • Recording themselves when they sleep, in case they act violent when sleeping
A Case of Harm OCD

Alex doted on his new son day and night, catering to his every whim.

One night while putting his son to sleep, a thought popped into Alex’s mind, “what if I hit him?”. As you would expect, this was both shocking and unexpected to Alex, as a loving father why would this thought enter his mind? Nevertheless, he continued with his night and settled into bed. Then the thought appeared again, this time more vicious than the last, with images of him actually beating his son. Feeling very uncomfortable, he began to question this in his mind, why would I have this thought? Do normal people have these thoughts? I don’t want to hit my son, do I?

Desperate to seek some reassurance he wasn’t going mad, he confided in his wife, using the alias of a news report that he’d read about new dads having these thoughts. Her reply was less than positive. They must be psychopaths, she said. This was the beginning of Alex’s OCD.

From this point onwards Alex obsessed over this thought of harming his son, getting into a mental battle with himself each time it would arrive. Looking for evidence against the idea, trying to prove to himself that he did not want to hurt his own son. This had very little benefit. Alex became so obsessed with this idea, that he began taking precautions just in case it was true. He wouldn’t leave himself alone with his son and would only spend a specific amount of time with him each day.

Even the thought of his son made him anxious. Now, he spent most of his time ruminating on these obsessions of harming his son, he had no escape from them and they were controlling his life.

Suicide OCD

Suicide OCD is the excessive worry that the sufferer will kill themselves or feel like they’ll have no alternative but to kill themselves.

This is very different from being suicidal. Someone who is suicidal or has suicidal ideations feels a certain peace with the idea of death, they feel as though there is no point in living anymore or the pain in being alive is too much to bear. In contrast, someone suffering with suicide OCD will worry about the idea suicide, it’s the idea itself which is actually likely to bring them a lot of distress, they do not want to kill themselves, but worry that they do.

The afflicted are constantly tormented by thoughts about suicide; images of them commiting suicide, thoughts that they want to commit suicide or the worry that they may have no choice but commit to suicide one day in the future. This is what makes the thoughts so powerful, as the sufferer will know that they want to live, that they do not want to kill themselves, but their mind will tell them otherwise. These incessant worries will cause compulsive behaviours, behaviours to prove that they do not want to commit suicide or that these thoughts are nothing to worry about.

Common Obsessions and Compulsions
Committing suicide

This is the crux of all obsessions within suicide OCD, the idea that they will commit suicide. This can come in many forms; images of them committing suicide, thoughts that they will kill themselves and triggers in the external world.

Here are some of the compulsions that the sufferer is likely to perform:

  • Ruminating on the idea of suicide and seeing how they feel, essentially checking if they want to commit suicide
  • Hiding objects or items that they could potentially use to kill themselves
  • Researching people who have been suicidal in the past to check if they share similar traits
Having no option but suicide

In moments of great pain or anxiety, it can sometimes feel it would be easier not to be alive. This a very common thought process for someone going through hardship or trauma, but for someone suffering with suicide OCD this could be an everyday occurence. Patients get stuck in paradoxical loop of thoughts appearing which cause anxiety and them believing this anxiety will cause them to commit suicide, which incites more thoughts and more anxiety and so on and so forth.

Here are some of the compulsions that the sufferer is likely to perform:

  • Predicting a future with intense anxiety to check how they would deal with it i.e if they would commit suicide or not
  • Researching what it means to be suicidal and what state of mind people are in when they attempt to commit suicide
  • Avoiding anything that makes them anxious in fear it will cause them to commit suicide
Losing control and committing suicide

As we’ve looked at in other cases of OCD, losing control and acting on their fears is a major worry within the condition, but nowhere is it more final than in suicide OCD. For the sufferer the idea that they may somehow lose control and kill themselves is absolutely terrifying, meaning they’ll do everything to stop this hypothetical from happening.

Here are some of the compulsions that the sufferer is likely to perform:

A Case of Suicide OCD

Mark had just lost his dad. This was the worst period of his life so far, never had he felt such terrible grief and sadness. He couldn’t find the energy or motivation to do anything, even eating and sleeping had become a chore, at points it felt easier to not be alive anymore. And these thoughts terrified him. Mark knew he was grieving, but he also knew that he wanted to be alive, he had so much to live for, his family, his friends, his work. The thoughts of suicide ironically scared the life out of him, why had they started appearing?

Now, Mark was not only dealing with the loss of his father but spending hours of his time ruminating on the thoughts of suicide, considering why they’re popping up and how he could get rid of them. By this point, each time a thought or trigger surrounding suicide appeared, Mark felt an intense anxiety, a fear like no other that he needed to get rid of. He couldn’t even have a conversation about death or someone dying without feeling anxious. To counteract this he began listing all of the reasons he wanted to be alive, most of the time in his head, but when the anxiety was extreme he would do so on a piece of paper and this would ease the anxiety temporarily. Until the thoughts appeared again, to which he would have to find another compulsive behaviour to ease his anxiety.

Existentialism & Philosophical OCD

At some point in our lives we will all ponder over existential and philosophical questions, things that cannot possibly be answered and can be potentially terrifying. Questioning the meaning of life and our purpose in this world is a common trend among adults looking to find their way, luckily, this existentialism is usually fleeting. Most people are able to let these thoughts go and get on with their life, as there is truly no benefit spending extended periods of time questioning the meaning of life. However, for existential OCD sufferers, this will consume most of their waking lives.

Those afflicted with this subtype of OCD will spend large amounts of their day ruminating on questions about their existence, with each thought bringing an intense anxiety, they still look for a definitive answer in their questions. The unfortunate truth is that there will likely never be a certain answer to any of the questions that torment them, they will be stuck in a loop of questioning, feeling anxious and finding an answer to placate this anxiety temporarily.

Common Obsessions and Compulsions
What is the meaning of life?

This age old question will be asked for eternity, and while most of us will be okay in whatever we can find contentment, for some suffering with OCD, this is a catastrophe. Patients of OCD really struggle with uncertainty and the unknown, which is why in existential OCD they become obsessed with finding an answer to these impossible questions.

Here are some of the compulsions that the sufferer is likely to perform:

  • Repeatedly asking family and friends their thoughts on these questions
  • Researching these questions thoroughly to find an answer
  • Evaluating their experiences and feelings in search for an answer
What is my purpose?

Some are able to confidently find their purpose in life, a mission that feels like their true goal, and for others they’re able to see their purpose in a multitude of things, such as; friends, family, their work, charity and maybe even hedonistic ventures. For existential OCD sufferers it isn’t so simple. They may not be able to pinpoint a purpose at all, or may have things that they love but are unable to definitively know that this is their purpose.

Here are some of the compulsions that the sufferer is likely to perform:

  • Repeatedly asking family and friends what their purpose is in life
  • Researching how they’ll be able to find their purpose in life
  • Trying lots of different things to see if that could be their purpose in life
How do I know any of this is real?

There are several theories about the reality of humans, for example, some believe that our entire universe is a complex simulation, that all of our actions are a part of an intricate game. Whether this is true or not will likely be impossible to know, which is why it’ll bring distress to an OCD sufferer. In some cases they’ll worry that they are living in a simulation, or their entire life is a dream. These uncertainties will cause a great amount of anxiety and in turn, a need to perform compulsive behaviours.

Here are some of the compulsions that the sufferer is likely to perform:

  • Pinching themselves or another physical behaviour to prove they are still within reality
  • Asking friends and family if they think the reality we are living in is real
  • Researching alternative reality theories to find an answer
A Case of Existential OCD

Cody has always been a bit of a conspiracy theorist, from 9/11 to the reptilian royal family, he was always down the rabbit hole of conspiracies. He didn’t ever take anything at face value, be it from friends or reliable media sources, he believed that further research was always necessary. It’s this curious nature that caused him to stumble across the simulation theory.

The idea that the universe was created by God or sheer luck never really sounded plausible to Cody, which is why the theory that our world was part of a bigger simulation really resonated with him. But it also made him think, what’s the point? If none of this is real, if our whole life is run by a computer, then what is the point of life? It would be entirely meaningless. This really didn’t sit well with Cody, though he questioned everything, he loved his life, his family, his friends, his school. His life brought him a lot of enjoyment and the idea that it was all now meaningless was a bitter pill to swallow.

Cody became obsessed with this idea, thoughts of life being meaningless barraged through his mind and with it came a feeling of panic he had never felt before. A tightness in his chest, shortness of breath, sweaty palms, all from these thoughts of life swirling through his mind. As with every case of OCD, Cody had to find a way to put his mind at ease, he began researching the meaning of life for hours each, trying to find an answer and would do this even more so when he felt anxious. In times of severe anxiety he even resorted to seeking help from his family, regularly asking them what they thought the meaning of life was and to settle his anxiety they would explain he would have nothing to worry about, that it’s different for everyone and you’ll find your meaning along the way. And while this would temporarily relieve his anxiety, the thoughts would always come back.

Religious or Scrupulosity OCD

Religious OCD is likely one of the oldest subtypes of the condition that has been recorded, in its simplest form it’s seen as the fear of god, living in sin, or acting unethically.

It’s reported that in the 1600s monks in catholic church were observed engaging in excessive prayer for extended periods of time, in an effort to achieve a further state of holiness. Of course at the time, this was not considered to be OCD, but it’s now very clear that it was. These monks were attempting to achieve a state of holiness that has never been done before, essentially an impossible feat, they had also probably become obsessed with the idea of achieving this state of holiness and were performing prayer as a compulsion.

With our modern research it’s clear that this was religious OCD and the condition has not disappeared.

From the outside, symptoms of religious OCD may simply look like the behaviours of a very religious person, but they aren’t, sufferers are tormented by unwanted thoughts and triggers surrounding their religion and feel an all-consuming need to perform these behaviours as a way to keep the anxiety and obsessions at bay. Their fears within this condition are likely to be wholly irrational or simply unachievable. The obsessions are vast and can be specific to a certain religion or belief system, nevertheless here are some of obsessions and compulsions seen within religious OCD.

Common Obsessions and Compulsions
Living sin or performing sinful acts

Religious or not, it’s safe to say every single person has committed a sin, be they small or big it would be near impossible to go a lifetime without performing a single act that would be considered a sin. And even for religious people, this is okay, as long as you live a holy life, as a good person and repent for your sins, it’s understandable that sins are going to be a part of life. However, for an OCD sufferer the idea that they have or will commit a sin is intolerable.

They’ll be constantly reminded of the sins that they have committed in the past and may even predict sin they may commit in the future, this will make them terribly anxious and create the need to perform a compulsive behaviour.

Here are some of the compulsions that the sufferer is likely to perform:

  • Excessive prayer to repent for their sins
  • Spending excessive amounts of time in holy places to repent for sin
  • Monitoring their actions and avoiding alcohol in fear of losing control and committing a sin
Prayers being recited incorrectly

In OCD there is a trait perfectionism, where things must be performed “just right”, this is very different to perfectionism seen in those without OCD. Normal perfectionism sees things done to the very best quality or ability, whereas OCD sees tasks being done in a very specific and particular way.

This is observed in the reciting of prayers. As a religious OCD sufferer recites their prayers they will ensure it’s done in a certain way, and meticulously check that nothing has been left out or said incorrectly. This issue is that once a prayer has been recited, they are left with the uncertainty of not knowing if it was done correctly.Here are some of the compulsions that the sufferer is likely to perform:

  • Excessively reciting prayers until they feel they have gotten it right
  • Recording prayers to check that it was recited correctly
  • Analysing each sentence and phrase of the prayer as they are saying it to ensure it is being done right
Unholy or sacrilegious thoughts

All sufferers of OCD are troubled by unwanted intrusive thoughts usually surrounding a greater fear, however, in some cases the thoughts themselves are the greater fear.

Some patients are constantly tormented by unholy, sacrilegious and unethical thoughts and images, thoughts that are completely unwanted and do not align with what they believe in. Yet, they are still there. This is where the concern takes over, the sufferer will begin to wonder why these thoughts are popping up, and what they mean and most importantly how do they get rid of them?

Here are some of the compulsions that the sufferer is likely to perform:

  • Reading religious texts to avoid the thoughts in their and mind and prove their holiness
  • Reciting prayers excessively
  • Looking for reassurance from friends and family about their thoughts
A Case of Religious OCD

Mary was a devout christian. She had been all her life, it’s all she’s ever known. Her parents were practicing and their parents before them and their parents before them, right to the beginning of time Mary assumed.

Though she had been a loyal christian her entire life, she was not exempt from flaws, Mary had committed her fair share of sins, but she assumed she would find redemption in repenting and asking forgiveness. This system worked. Each time Mary did something which would be considered sinful, she would simply repent for her sins and go on with her day. By no means was Mary a hardened criminal, her sins usually consisted of things like lying or occasionally using the lord’s name in vain.

During one of her daily prayers Mary began to wonder, was it okay to sin and then repent? Of course she knew sinning was wrong, she simply assumed that everyone committed small sins and God would forgive them for that. She wasn’t sure, so in that prayer she put extra emphasis on asking for forgiveness for her sins. This felt like enough.

However, a few hours later she began to wonder again, was that enough? Was a single prayer enough to repent for a lifetime of sin? This made her feel uneasy. She decided it would be best to pray again, just to be sure. Gradually the frequency of her prayers increased, she began reciting prayers hours a day, due to thoughts popping into her head about the sins she had committed. Mary monitored every single action and decision she made to ensure she was not acting sinfully, she even got the advice of her family beforehand, just to be sure.

She had become stuck in a loop of religious OCD, fearing the sins she had committed or may commit in the future and praying as a compulsion.

Symmetry & Ordering OCD

This subtype of OCD has been called by many names; symmetry, ordering, arranging, exactness, perfectionism. Despite its titles the symptoms of this condition remain consistent throughout all cases. Those suffering with symmetry OCD will feel a great discomfort when something does not appear the way they need it to be. This is usually a very specific order or arrangement that feels just right to the afflicted. When something is out of the order that they consider perfect, this will cause a great amount of distress, the sufferer will feel terribly anxious and as if something catastrophic is going to happen.

This type of OCD is usually self-diagnosed by people who like having things neat. It’s not uncommon to hear someone announce they are “so OCD” because they like having things in a specific order. This ignorance trivialises the debilitating impact this form of OCD has. Those suffering with this condition do not “like” to have things in a certain way, they feel an all-consuming need to have them in a certain way, and when things aren’t “just right” they’ll feel extreme anxiety.

The reason for the different names for this condition is due to the compulsive behaviours that the afflicted will perform, some will need things to be symmetrical, others ordered in a specific way, but all will need things to be “just right”.

Common Obsessions and Compulsions
Items or objects that are disorderly or uneven

Usually when a sufferer is concerned about items being disorderly, it doesn’t apply to each and every item that they will see. Patients will usually attach significance to specific objects in their life, generally at home or in their workplace, this makes it easier to have control over the order of the item.

The objects or items that they will order really vary from person to person and can be anything in their life, it could be things such as; books on a shelf, pillows on a sofa, pencils or pens on a desk.Here are some of the compulsions that the sufferer is likely to perform:

  • Arranging, ordering or evening out the items when they become disorderly
  • Monitoring the objects so they can immediately fix them if they move from their order
  • Protecting the objects and stopping people from tampering with them
Articles being asymmetrical

Some sufferers will obsess over objects and items being asymmetrical, this could be things like: shoe laces, gloves or even words lining up evenly on a page. Usually the afflicted will have an intense anxiety-driven reaction to seeing the objects or other and will feel the need to fix them appropriately.

Here are some of the compulsions that the sufferer is likely to perform:

  • Fixing things to make them symmetrical
  • Monitoring things to ensure that they remain symmetrical
  • Avoiding situations where they know things may be asymmetrical
Items and objects being unbalanced

In some cases sufferers have shown fears around things being unbalanced, this could be holding things with two hands, or placing items a specific way on a table, or even walking a specific way to maintain a balance that is “just right”

Here are some of the compulsions that the sufferer is likely to perform:

  • Holding everything with two hands to ensure it is balanced
  • Walking everywhere with feet planted in a certain position and shoulders back to ensure balance
  • Checking that objects are perfectly balance on flat surfaces and moving them if they are not
A Case of Symmetry OCD

Tim had always been a perfectionist, if he was going to do something, he was going to do it right. This trait had created a lot of success in his life; a solid education attending one of the best universities in the country and now the career of his dreams. There was very little downside to Tim’s perfectionism, it was simply how he was and helped him achieve what he needed to. However, with his development of OCD, he had gone way beyond perfectionism.

Tim had started compulsively arranging everything in his house and office. It started small, he noticed the books on his shelf were not neatly lined up, so he fixed them. He strongly believed that the way your home and office looked were a direct reflection of yourself as a person, so he needed everything to be perfect. Eventually, this harmless act of tidying a book shelf had become an all-consuming disorder. Tim needed everything he owned to be neatly lined up, if it wasn’t he’d feel an intense anxiety and a flood of thoughts rushing through his head; What will they think of me? I’m such a slob, how could I possibly deserve the position I’m in? If they see this they’ll fire me!

Of course, Tim’s fears were completely irrational, the order of the pencils on his desk meant nothing to everyone else, but to him, it was everything.

Magical Thinking OCD

Magical thinking is not only a subtype of OCD but also a compulsion that OCD sufferers of all forms may perform. It’s the belief that the certain acts the afflicted performs actually have the ability to protect themselves or those around them from something catastrophic from happening. In contamination OCD for example, a person who is washing their hands for hours in a day may truly believe that doing so will protect their family from becoming sick and dying.

However, magical thinking can also manifest into its own form OCD, where the obsessions and compulsions are all based around the belief that the actions of the sufferer have a great impact on the world around them. It’s important to note that magical thinking OCD is not the same as worrying that actions which could be impactful must be performed i.e driving carefully, or looking both ways when crossing the road, it is generally the fear that their small ritual behaviours must be performed in order to keep everyone safe.

Common Obsessions and Compulsions
Stepping on cracks

Everyone has heard the old saying “step on a crack, break your mother’s back” and while this is usually nothing more than a teasing among children, for some OCD sufferers this is a full blown obsession.

For those suffering from this condition they’ll whole-heartedly fear that stepping on a crack while walking will have a dire consequence to either the health of themselves or their loved ones. If they do step on a crack, they’ll feel an intense anxiety which can only be squashed by performing another compulsive behaviour.Here are some of the compulsions that the sufferer is likely to perform:

  • Avoiding stepping on cracks at all costs
  • Not going outside in fear of stepping on a crack unknowingly
  • Reciting a prayer or mantra if they do unintentionally step on a crack
Specific days of the week

In some cases of magical thinking OCD the sufferer will fear that certain days of the week have bad luck attached to them and in order to keep themselves and their families safe, they’ll perform certain compulsive behaviours.

Here are some of the compulsions that the sufferer is likely to perform:

  • Staying at the home to lower the risk of something bad happening on that day
  • Advising their loved ones to remain at home on that day to keep them safe
  • Checking in on their loved ones on that day to ensure that they are safe
Specific colours

Other recorded cases of this condition have shown obsessions around specific colours. Those afflicted with irrationally fear that certain colours have bad luck attached to them or that being around, wearing or even seeing that colour could cause something catastrophic to happen. For example, a person may fear the colour red, and would perform several compulsive behaviours to ensure that the colour red is not anyway in their life.

Here are some of the compulsions that the sufferer is likely to perform:

  • Not owning any items, objects, clothing or anything else in that specific colour
  • Asking and advising loved ones to not wear that colour
  • Reciting a prayer or mantra if they do come across that colour
A Case of Magical Thinking OCD

Sally had never been superstitious, she actually considered nearly all superstitious behaviour to be silly. However, this did not stop magical thinking OCD from entering her life.

Sally began to think back to her childhood, to the silly games they would play, and remembered the old saying they would shout at each other walking home from school, “step on a crack, break your mother’s back”. Just a childish game to see who could avoid all of the cracks in the pavement on their journey home from school. But this got her thinking; where did this saying come from? Was there any truth to it? Of course, she laughed away her small concern and even jokingly avoided a few cracks while walking home from work.

A seed had been planted.

What at first seemed to be a silly idea, eventually became a deep obsession. By slowly giving the idea of stepping on cracks more and more thought, and reinforcing these ideas with the behaviour of avoiding cracks when she went outside, Sally had manifested this children’s game into Magical Thinking OCD.

The avoidance of stepping of cracks became so important in her life, that she would rather stay inside for most of her week. Rationally, Sally knew that stepping on cracks made no difference to her mother’s health, but, she couldn’t help but think, what if? What if by some insane turn of events, her stepping on these cracks in the pavement caused her mother to die? To Sally, it wasn’t worth the risk.

Sensorimotor or Somatic OCD

Sensorimotor or somatic OCD is a condition where the sufferer becomes hyper aware of bodily functions, be it their own or someone around them, so much so that they are unable to move their attention to anything else.

Sensorimotor or somatic OCD is a condition where the sufferer becomes hyper aware of bodily functions, be it their own or someone around them, so much so that they are unable to move their attention to anything else.

Common Obsessions and Compulsions

Blinking is probably the most common obsession within somatic OCD, the sufferer will focus all of the attention to their blinking, they also likely control the amount and frequency of their blinks. The afflicted will find great difficulty in moving their attention away from the blinks, and will quickly bring the focus back to their blinking if it were to move away.

Here are some of the compulsions that the sufferer is likely to perform:

  • Counting, so their mind is preoccupied with something else
  • Trying to stop themselves from blinking
  • Not looking people in the face to their focusing on their blinks

For those Somatic OCD sufferers obsessed with swallowing, their attention will be focused on the feeling of swallowing, the sound it makes and even what they can taste while swallowing. They’ll also likely swallow when they don’t need to, just as an obsessive behaviour.

Here are some of the compulsions that the sufferer is likely to perform:

  • Counting, so their mind is preoccupied with something else
  • Stopping themselves from swallowing even when necessary
  • Avoiding eating or drinking with others to distance themselves from excessive amounts of swallowing

In many mindfulness practices, it’s advised that you move your attention to the breath, to notice it flowing in and out of your body, however, in somatic OCD this goes far beyond just noticing the breath. The sufferer will struggle to notice or pay attention to anything else other than the breath flowing in and out of them, the sensation in the belly, chest, nose and mouth. The practice of mindfulness teaches us to become aware of the breath in our body, along with the rest of the world, in somatic OCD, this is all they are aware of.

Here are some of the compulsions that the sufferer is likely to perform:

  • Counting, so their mind is preoccupied with something else
  • Controlling or slowing their breath to make it less noticeable
  • Listening to loud music to dull the sensation and sound of the breath
A Case of Somatic OCD

There is a certain randomness to the manifestation of OCD, for some it can come from a traumatic or life-changing experience, for others it can be as simple as a thought popping into their head. For Jacob, it was the latter.

Similar to any normal teen, Jacob spent a lot of his time laying in bed day-dreaming, thinking about the world, his life and his plans to accomplish everything he had ever dreamed of. While spending a significant amount of time in thought, it’s very common for a few unwanted ideas to pop into your head, usually this doesn’t have an impact on your day or even that moment, they can be dismissed as quickly as they came. However, on this occasion, they weren’t.

Jacob began to notice his blinks, and played with them, fluttering his eyelashes as quickly as he could and then blinking very hard. It was nothing more than a bored teenager doing whatever he could to keep himself amused. But it quickly became so much more than that.

For no reason whatsoever, Jacob started paying attention to his blinking more often, whenever he found his mind vacant and wandering he would start noticing his blinks, controlling them. However, he started paying more and more attention to his blinks, so much so, that it started to affect his ability to work. He couldn’t pay attention to the words on the screen or the book in his hands because he was completely focused on his eyes. It was at this point that Jacob began to worry about his new habit, he was concerned that he would be unable to do well in school because his mind was so focused on blinking.

Unfortunately, this concern began to consume his life. He would spend hours either worrying that he may not be able to concentrate on anything or only focused on his blinks. His school work fell to the wayside and he had developed severe OCD.

Perinatal, Postpartum or Maternal OCD

These forms of OCD are the excessive worry or concern about maternal issues during pregnancy or following childbirth. It’s reported that due to the drastic hormonal changes during pregnancy and following, women during this period may be more at risk developing such obsessive issues.

It usually manifests as unwanted intrusive thoughts about their child’s well being and safety; during pregnancy this could be the foods they eat, who they surround themselves with, situations they put themselves, anything that could put their soon to be infant in danger is of paramount concern.

Similar issues arise post pregnancy, where mothers will be afflicted with unwanted worries about their child’s current safety, for example; if their bottle is sterilised, if someone is going to harm their child, even worries that they could harm their child.As with all types of OCD, specific behaviours, rituals and actions are performed to ensure their child’s safety when these unwanted thoughts appear.

Common Obsessions and Compulsions
What if I hurt my child or someone else does?

At the root of all maternal OCD is the concern that something will happen to their child, be it caused by them or some external factor. However, a major concern for mother’s suffering from this condition is that they may harm their child. Images and thoughts will pop into their head of them harming their child, things that they find horrific and know that they will never do, yet, makes them feel extremely anxious nonetheless.

Here are some of the compulsions that the sufferer is likely to perform:

  • Excessive checking on their child to see if they are okay e.g every couple of minutes
  • Not taking their child outside of the house in fear something will happen to them
  • Locking away all harmful objects in fear that they use them on their child
What if I abuse my child?

For some mothers their unwanted obsessions may surround the idea of sexual abuse. The concern that they may sexually abuse their child. As you can imagine, this is terrifying to any new mother, they’ll wonder what type of sick and twisted person has thoughts like these, and if they do really want to carry out these horrible acts. It’s important to understand, we do not control the thoughts that pop into our head, just because they have appeared does not suggest they will have any influence on the world around us. This is unfortunately where the issue arises when these obsessive thoughts appear, because they are so frightening in nature, it’s difficult to understand that there is no truth to them.

Here are some of the compulsions that the sufferer is likely to perform:

  • Limiting the amount of time they spend with their child
  • Looking at their child to check if they have any arousal towards them
  • Avoiding alcohol and drugs in fear of losing control and abusing their child
What if my child develops a serious illness or disease?

All mothers will worry about the well-being of their child, and will do whatever it takes to ensure that they do not become sick or harmed in any way. However, OCD causes worry where there needn’t be and behaviours that are unnecessary or negligible to the safety of the child. For mothers who have obsessive concerns about their child becoming sick or ridden with disease, they’ll perform excessive acts to ensure that this doesn’t happen.

Here are some of the compulsions that the sufferer is likely to perform:

  • Not taking their child outside of the house in fear something will happen to them
  • Sterilising everything that comes in contact with their child, even things that are not usually sterilised
  • Not allowing anyone to touch their child apart from them
A Case of Perinatal OCD

Kelly was a new and extremely proud mother. The pregnancy had been a lot harder than she had expected and the labour was indescribably painful, but it was all worth it. She had her new daughter and Kelly had never experienced love like this before. She thought it was a load of nonsense when other parents described the love they had for their children, she knew now they weren’t lying.

This overwhelming feeling of admiration was new to Kelly, she had never felt such a desire to keep something safe, to protect them from all harm forever, a feeling that most parents experience. However, Kelly began exhibiting behaviours that were beyond the instincts of a new mother.

She began having repetitive unwanted thoughts about her child being harmed, she saw images of her falling out of her cot, or being dropped by her grandad. These thoughts terrified Kelly, though they were unlikely to happen, she couldn’t help but think that there was a possibility that they could. Because of this, whenever she put her daughter down to sleep she would check the cot every thirty seconds, no matter what else she was doing, she refused to allow anyone else to hold the baby in fear of her being dropped. These compulsive behaviours allowed her anxiety to settle momentarily, before another worry could pop into her head.

Her worries extended so far that she started to refuse her daughter’s father holding her, Kelly felt she was the only one responsible and concerned enough to keep her daughter safe. Kelly knew these fears were irrational, but she couldn’t control it, she was suffering from OCD.

False Memory OCD

While false memory can also be a symptom of other forms of OCD, for some it is the primary symptom of their condition. Those suffering with false memory OCD are afflicted with intrusive thoughts which they believe to be memories, though they are unable to verify whether or not the event actually happened. For example, for someone suffering from contamination OCD, they may remember washing their hands an hour ago, but have no way of verifying if they actually did or not, so they’ll perform the compulsion of washing their hands again, just to be safe.

This symptom can be seen throughout most forms of OCD, however, in its manifestation as it’s own subtype it appears much more violently. False memory OCD sufferers will usually obsess over thoughts of them committing a crime or some other viscous act. They’ll be able to recall an event in their mind, something usually terrifying to the sufferer, they’ll see themselves in the image and it’ll feel very much like an event that has happened in their life, which causes the worry, what if it did? It’s at this point the patient will ruminate on these thoughts, to see if they can find any validity to the memory, they’ll question, think, and ponder, usually to no end. They won’t be able to find the answer they are looking for because it’s more than likely that this memory didn’t happen, but since they cannot prove it didn’t, they’re left in a loop of remembering, feeling anxious and doing whatever they can to settle their anxiety.

Common Obsessions and Compulsions
What if I’ve killed someone?

In this instance the sufferer is intruded by images and thoughts of a murder they have commited, the memory will feel very real, almost tangible and very much like it did actually happen. Of course, the specific details of the memory will be hazy i.e who the victim was, the exact location, the aftermath. But this thought is vivid enough to be considered a memory and make the sufferer feel as though they are a criminal.

Here are some of the compulsions that the sufferer is likely to perform:

  • Spending hours recalling, ruminating and thinking about the memory to check if it’s true
  • Researching the traits of murderers to see if they share any of them
  • Keeping all dangerous objects hidden in case they are able to murder again
What if I’ve sexually assaulted someone?

The idea of sexual assault in any context is truly frightening, which makes the thoughts of you being the assailant very poignant. The simple thought that you’ve sexually assaulted another person is enough to make most people shudder. In some cases of false memory OCD the sufferer will get unwanted thoughts of them sexually assaulting another person, which they will be unable to differentiate between an intrusive thought and something that actually happened.

Here are some of the compulsions that the sufferer is likely to perform:

  • Spending hours recalling, ruminating and thinking about the memory to check if it’s true
  • Looking for reassurance from loved ones that this did not happen
  • Praying to repent for the crime they may have committed
What if I’ve robbed a bank?

It may seem ludicrous that someone has robbed a bank and cannot remember doing so, but for some OCD sufferers this notion is very real. Patients will recall seeing themselves walk into a bank, hold up the tellers and rob money directly from the safe. This of course did not happen, but as the image and events unfold in the sufferers mind, it becomes more and more believable, and as there is no way they can definitively prove that this did not happen, it creates a cause for concern.

Here are some of the compulsions that the sufferer is likely to perform:

  • Spending hours recalling, ruminating and thinking about the memory to check if it’s true
  • Looking for reassurance from loved ones that this did not happen
  • Researching bank robberies to see if any have occurred in the local area and keeping a lookout for any new robberies being reported
A Case of False Memory OCD

Steven was a very good person. He had never committed a crime, always did his best to help others, he didn’t even tell lies. He was wholeheartedly a good man, which is what made the unwanted thoughts of him murdering someone more impactful.

Steven as with every other person got intrusive thoughts, ideas that popped into his head that he didn’t want to be there, usually they meant nothing and did not affect him in any way. However, after an unwanted thought of him viciously murdering someone appeared, it wasn’t as easy to shake. Simply the idea of this happening made him feel terrible, he was so sure he wouldn’t harm anyone – then why was this thought popping into his head?

The image was vivid, it showed all the gory details and he could see a striking vision of himself murdering someone in cold blood. This felt too real to be just random thought, it must have actually happened. With the frequency of the thought appearing and the graphic detail he could envision, this felt more like a memory. From this point Steven battled with the idea that this could have really happened, that he could be a murderer, he would spend hours of his day contemplating when, how and why this could have happened, usually to no avail.

The time Steven spent trying to convince himself that this was only a thought, not a memory, was all spent in vain. The issue wasn’t if this had happened or not, because it didn’t and he knew that, the issue was he was suffering from OCD. As Steven had no way to disprove the thought being a fact, he spent most of his day worrying about it, ruminating on it, doing whatever he could to prove he wasn’t a murderer, all the while feeling an intense anxiety.

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