What Is OCD? What Are The 7 Types Of Obsessive Compulsive Disorder?

When you hear someone claim, “I am OCD," your first reaction is generally, “They must be obsessed with cleanliness.” OCD’s full form is obsessive-compulsive disorder, which has so many connotations attached to it, but most of them might not be clinically accurate. OCD’s meaning differs across cultures, too. But what is OCD, and what causes it? Let’s find out.

What Is OCD?

To put it plainly, obsessive-compulsive disorder (OCD) is a mental illness characterized by two symptoms: obsessions and compulsions. Obsessions, at a colloquial level, may appear to be widespread. OCD is not a disease but a mental illness that can be treated. When you are binge-watching a TV show, it is easy to obsess over a certain character. However, psychologists may beg to differ on this stance. Symptoms of OCD are given below:

Obsessions in OCD

In a strictly clinical context, obsessions manifest as persistent, intrusive, and unpleasant thoughts, ideas, or images that have the potential to cause distress or anxiety. If you've ever had a tough time controlling or dispelling a thought, it may turn into an obsession. 

Compulsions in OCD

When a person is overcome with this anxiety, they engage in repetitive behavior called compulsions in a bid to deal with the anxiety. It's also worth noting that, despite many attempts, obsessions and compulsions are both difficult to control, which adds to the distress. Washing hands is one of the most prevalent compulsive behaviors that you may have seen, yet it is only one of several compulsions that emerge from obsessive thoughts affecting people with OCD. OCD can disrupt one’s social and occupational areas of life.

Obsessive-compulsive disorder (OCD) has many different types, each with its own set of thoughts and compulsive behaviors. 

Know when should OCD symptoms not be ignored.

What Are The 7 Types Of OCD?

Harm OCD

A  person with Harm OCD has thoughts of harming, poisoning or killing someone. They may resort to safety behaviours such as avoiding the concerned person altogether or hiding lethal weapons, as they might find it difficult to distinguish between their thoughts and actions.

Symptoms of harm OCD

Obsessions:

• Intrusive thoughts, images, or impulses of harming oneself or others (e.g., stabbing a loved one, pushing someone in front of a train, accidentally causing a fire).
• Fear of losing control and acting on these violent urges.
• Fear of accidentally harming someone (e.g., hitting someone with a car, poisoning food).
• Doubts about one's character or intentions (e.g., "Am I a bad person for having these thoughts?").

Compulsions:

• Avoidance: Avoiding people, objects (knives, chemicals), places (balconies, high places), or situations that trigger harmful thoughts.
• Reassurance-seeking: Constantly asking others if they believe one would act on the thoughts, or if they are a "good" person.
• Mental review: Replaying past events in detail to ensure no harm was caused.
• Self-reassurance: Repeating phrases to oneself like "I would never do that," or "I don't want to hurt anyone."
• Checking: Repeatedly checking to see if harm has been done.
• Neutralizing thoughts: Trying to replace "bad" thoughts with "good" ones.

Contamination OCD

Contamination is the most frequent type of OCD, in which a person has a fear of being polluted, dirty, or diseased, leading to washing compulsions. They may have a fear that touching a certain object or a person might contaminate them and, further, make them sick. To deal with such thoughts, they tend to engage in compulsive behavior such as washing themselves, avoiding touching anything with their bare hands, or double-checking.

Symptoms of contamination OCD

Obsessions:

• Intense fear of being contaminated by germs, dirt, bodily fluids (blood, urine, saliva), chemicals, or other "impure" substances.
• Fear of contracting a deadly disease (e.g., HIV, cancer, COVID-19).
• Fear of spreading contamination to others or one's belongings.
• Persistent, unwanted thoughts about cleanliness.

Compulsions:

• Excessive washing/cleaning: Repeatedly washing hands, showering, cleaning household items, disinfecting surfaces. This can be highly ritualized (e.g., washing hands a specific number of times or for a specific duration).
• Avoidance: Avoiding public places, touching certain objects, or interacting with people perceived as contaminated.
• Discarding items: Throwing away clothes or household items believed to be contaminated.
• Seeking reassurance: Asking others if something is clean or if they have been contaminated.
• Using barriers: Wearing gloves, using paper towels, or using clothes to touch objects.

Scrupulosity

Especially common in India is scrupulosity, wherein the person experiences pathological guilt or obsession with moral or religious issues. What is interesting to note here is how their disabling confusion can culminate in them trying to actively resolve their relationship with their god. An example of this could be confessing to their wrongdoings to multiple authorities to relieve themselves of their guilt.

Symptoms of scrupulosity

Obsessions:

• Pathological guilt or intense worry about moral, religious, or ethical issues.
• Fear of having committed a sin, blasphemy, or moral transgression.
• Excessive focus on religious or moral perfection.
• Unwanted thoughts about religious figures (God, saints) or religious texts that are blasphemous or inappropriate.
• Fear of eternal damnation or that loved ones will go to hell.

Compulsions:

• Excessive prayer: Praying repetitively, sometimes with specific rituals or "magic numbers."
• Confession: Repeatedly confessing perceived wrongdoings to religious authorities or others, even when not necessary.
• Seeking reassurance: Constantly asking religious leaders or others for validation that they haven't sinned or violated moral codes.
• Mental review: Ruminating on past actions or thoughts to check for any moral failings.
• Avoidance: Avoiding religious services, objects, or traditions due to fears of unworthiness.
• Self-punishment: Engaging in self-punishing behaviors to atone for perceived sins.
• Ritualized reading/studying: Compulsively reading religious texts to ensure perfect understanding or adherence.

Symmetry OCD

Symmetry or ordering obsessive-compulsive disorder OCD is another prevalent type in which the person has an overwhelming urge to set things in order or maintain them in alignment. They have a continual chorus in their heads that says "This is not right," which can make it difficult for them to operate functionally. They resort to compulsive behaviors such as rewriting a certain paragraph until it has no flaws or adjusting a certain chair to an angle that satisfies their mind.

Symptoms of scrupulosity

Obsessions:

• Overwhelming urge for things to be perfect, exact, symmetrical, or "just right."
• Distress if objects are out of alignment, uneven, or not perfectly organized.
• Intrusive thoughts that something bad will happen if things are not symmetrical or ordered.

Compulsions:

• Ordering and arranging: Arranging objects until they "feel right."
• Aligning: Ensuring items are perfectly aligned.
• Counting: Performing actions a certain number of times or until a specific number is reached.
• Rewriting/re-doing: Rewriting paragraphs, emails, or tasks until they are perceived as flawless.
• Touching/tapping: Tapping objects or oneself until a feeling of completion or "rightness" is achieved.

Sexual obsessions

Sexual obsessions manifest in forbidden sexual thoughts, images, or even impulses to engage in inappropriate sexual acts with other people or children. It is important to note that this, in no way, points to pedophilia. What distinguishes people with these obsessions is the very fact that they have disturbing images and thoughts of such people in sexualized contexts. To cope with this, they engage in healthy interactions with such people (or children) so that they can review them in retrospect to check if anything was indeed sexually inappropriate or not.

Symptoms of sexual obsessions

Obsessions:

• Intrusive, unwanted, and highly distressing sexual thoughts, images, or impulses that go against one's values.
• Fears of engaging in inappropriate sexual acts (e.g., with children, family members, animals, or corpses).
• Fear of being a pedophile, rapist, or having a forbidden sexual orientation.
• Thoughts of sexual violence or aggression.
• Intrusive thoughts about sexual acts are considered blasphemy.

Compulsions:

• Avoidance: Avoiding people, situations, or media that might trigger sexual obsessions.
• Mental rituals: Trying to replace "bad" sexual thoughts with "good" or "acceptable" ones.
• Checking for arousal: Monitoring one's physical reactions (e.g., genital arousal) when encountering triggers to "prove" they are not aroused by the forbidden thought.
• Mental review: Replaying past interactions or experiences to check for any inappropriate sexual behavior or intent.

What You Should Know About Dating Someone With OCD

Somatic obsessions

Somatic obsessions relate mostly to bodily experiences or being excessively preoccupied with bodily concerns, almost believing that one has a serious illness. Such clients seek constant reassurance from experts or people around them, as well as ask them if they notice anything different about them.

Symptoms of somatic obsessions

Obsessions:

• Excessive preoccupation and hyperawareness of automatic bodily functions or sensations.
• Fear that one will lose control of or forget how to perform these functions.
• Other bodily sensations: Awareness of digestion, tongue position, eye movement, or feeling of clothing on skin.

Compulsions:

• Monitoring/Checking: Continuously checking or monitoring the bodily function. For example: Hyper focusing on the act of breathing, worrying about breathing "correctly", or forgetting to breathe; obsessive awareness of blinking, worrying about blinking too much or too little; obsessive monitoring of heart rate and rhythm, fear of a heart attack or other cardiac issues.
• Distraction: Actively trying to distract oneself from the bodily sensation, often unsuccessfully.
• Researching: Spending excessive time researching medical conditions related to bodily function.
• Reassurance-seeking: Asking doctors or others if their bodily functions are normal.
• Avoidance: Avoiding situations where the bodily sensation might become more noticeable or distressing (e.g., not eating in public due to swallowing concerns).

Pure obsessional OCD

Pure obsessional OCD is a subtype of OCD in which the person may experience obsessions at any moment but does not have clear compulsions. It is vital to remember, however, that some people may engage in avoidance behaviors to cope, but they might not always translate into compulsive acts.

Symptoms of pure obsessional OCD

Obsessions:

• Intrusive, persistent, and distressing thoughts, images, or urges that can relate to any theme (harm, sexual, religious, identity, etc.).
• These thoughts are often perceived as unacceptable, disturbing, or out of character.
• High levels of doubt and uncertainty about the meaning or implication of these thoughts.

Compulsions (Mental):

• Mental review: Replaying past events or conversations in one's mind repeatedly to "check" for something (e.g., did I say something offensive? Did I have a harmful intent?).
• Self-reassurance: Mentally repeating phrases or arguments to oneself to neutralize the obsessive thought (e.g., "I'm a good person," "That thought doesn't mean anything").
• Rumination: Prolonged and repetitive thinking about an obsession, trying to solve it or understand its meaning, often without reaching a conclusion.
• Mental counting or rituals: Performing specific mental counting patterns or rituals to prevent feared outcomes.
• Avoidance (mental/behavioral): Avoiding specific thoughts or mental images, or avoiding situations that might trigger them.

Obsessive-compulsive disorder may appear frightening, but it’s important to remember that it is rooted in different causes. Having said that, it is treatable, and there are a variety of treatment modalities to address its symptoms. 

As Obsessive-compulsive disorder can manifest in various forms, it is no wonder that the term is used more lightly than it should be. Being informed about a mental health concern is instrumental in providing appropriate treatment at the appropriate time.

Also read: Can Obsessive-Compulsive Disorder (OCD) Be Treated?

FAQs

Q: Is liking things clean the same as having actual OCD?

A: No. Casual use of "OCD" for liking cleanliness is different from clinical OCD, which involves distressing obsessions and compulsions that significantly impact daily life.

Q: Can I live happily with OCD?

A: Yes, it is possible to live a fulfilling life with OCD. While OCD presents significant challenges, effective treatments and coping strategies can dramatically improve quality of life.

Q: Can OCD be cured?

A: OCD is highly treatable, but not always fully cured. Effective therapies and medications can reduce symptoms and improve quality of life.

Q: What are the main differences between obsessions and compulsions in OCD?

A: Obsessions are intrusive, unwanted thoughts, while compulsions are repetitive behaviors done to reduce the anxiety caused by those thoughts.

Q: What kind of treatment options are available for OCD?

A: Treatment options include therapy, like Cognitive Behavioral Therapy (CBT), and medication, such as selective serotonin reuptake inhibitors (SSRIs). Seeking professional help is recommended.

Q: What are the 5 symptoms of OCD?

• Obsessive thoughts (e.g., fear of contamination).
• Compulsive behaviors (e.g., excessive hand-washing).
• Anxiety or distress from obsessions.
• Time-consuming rituals are impacting daily life.
• Difficulty controlling intrusive thoughts or actions.

Q: What are the main causes of OCD?

A: While the exact causes of Obsessive-Compulsive Disorder (OCD) aren't fully understood yet, research shows potential involvement of brain differences and genetic factors.

Q: Can OCD be cured?

A: While OCD cannot be cured, it can be managed 

Q: What are the 4 types of OCD?

A: 4 types of OCD:

• Harm OCD
• Contamination OCD
• Symmetry OCD
• Sexual Obsessions

Q: What are the 4 R's for OCD?

A: The 4 Rs are used in OCD treatment:

• Relabel: Recognize and relabel intrusive thoughts as OCD thoughts.
• Reattribute: Recognize and reattribute these as obsessive thoughts and compulsive behaviors that are caused by OCD and not by you.
• Refocus: Shift your attention and energy away from the obsessions and compulsions toward constructive and positive activities.
• Revalue: Devalue obsessive thoughts and recognize that the obsessive thoughts and doubts associated with OCD are not significant or worth engaging with.

Q: What are the 3 C's of OCD?

A: Compulsions (repetitive behaviors), Control (struggling to manage thoughts), and Consequences (disruption to daily life).