Obsessive-compulsive (OCD)

A common subtype of OCD that is perhaps the most sensationalised and most understood (though poorly at that). Contamination OCD is characterised by a sensation of distress, discomfort and of uncleanliness of certain objects, environments, people, or animals. There is also often a prominent fear of becoming ill or contracting a disease.

A lesser-known subtype of OCD that is characterised by a fear of becoming morally (or immorally) tarnished. It relates strongly to the fear of being seen as or of believing that oneself is morally corrupt or ‘bad’. A person fears that their actions or thoughts don’t align with their moral compass, or that they are not a ‘good’ person. It is important to note that these fears do not mean a person is morally ‘bad’ – in fact, those who experience moral scrupulosity OCD are usually amongst the kindest, most considerate people. Moral scrupulosity OCD is often seen in partnership with other, more widely-recognised forms of OCD and as such is not well identified.

According to the International OCD Foundation, over 50% of people with OCD will experience ‘just right’ symptoms. Obsessions and compulsions centre around the belief and fear that something is ‘not quite right’. It is deeply associated with perfectionism, but not always in the stereotypical sense.

People with just right OCD typically know that their patterns of thinking are not logical, but it is a feeling of unease that can’t be shaken

Checking OCD is just that – repeated and compulsive checking on something or someone in an attempt to gain reassurance that something ‘bad’ won’t happen.

We are all human, and we all have experienced a compulsion to check on something we have or haven’t done. For instance, it is safe to presume that at some stage, everyone has questioned whether or not they have locked the door or turned off an appliance. For people with Checking OCD, these thoughts can be overwhelmingly loud and suffocating. Not to mention, there is often a fear that if the door is not locked or if the light switch is still on, then something truly awful will happen as a direct result.

Checking OCD can also look very different from just checking whether or not a door has been locked. Some (not all) other ways that it may look include:

• Monitoring and examining one’s health for signs of illness or disease
• Checking that information is correct, even when this has already been done
• Checking for safety hazards or potential dangers
• Checking personal items to ensure that they are all accounted for
• Checking memories to make sure that they are accurate

Harm OCD is one of the most difficult types of OCD to talk about. How do you discuss unwanted and upsetting thoughts that relate to harming yourself or others?

If you’re human, you’ve probably experienced these fleeting thoughts. Maybe it’s crossed your mind what would happen if you were to fall off a balcony, or if you were to push the person next to you into the road. Having these thoughts and having an ideation to perform them are both completely different things.

It is important to note that just because someone is experiencing harm OCD, this does not mean they are dangerous. They have no desire nor intention to inflict harm, they are terrified by the concept that they could.

For people who have harm OCD, these thoughts can be persistent, overwhelming, frightening and all-consuming. They may engage in a number of compulsions aimed at reducing this fear – for instance avoiding sidewalks or removing all sharp objects from their kitchen.

A subtype of OCD that causes people to have repetitive and obsessive thoughts questioning their sexual orientation. They fear that they are ‘fraudulent’ or that they are not being true to themselves and their real identity. People with this form of OCD may engage in compulsions with the hope of attaining some form of certainty around their sexuality.

Counting OCD is – as the name suggests – characterised by a powerful urge to count, tally, record and measure. Typically this is done in order for a person to feel satisfied – a sense of being ‘good’ or ‘right’ or to avoid the discomfort of feeling ‘wrong’ (as you can see, many subtypes of OCD – such as moral scrupulosity OCD, counting OCD, and checking OCD – actually interweave and overlap).

People with symmetry CCD experience intense anxiety when things are not orderly, symmetrical and even. This form of OCD is another one that is highly sensationalised and – to a degree – even glorified and fetishised in the media, however in reality can be incredibly debilitating. It is very similar to just right OCD but focuses more on physical order and organisation as opposed to ideas /intangible patterns.

An OCD subtype in which concerns about memories, blanks in memory, and uncertainty in memories can evoke extreme anxiety and discomfort. A person can become obsessed with the idea that they have done something wrong or behaved in a way, despite there being no evidence of them having done so. Often this fear can become so intense that a person needs to engage in compulsions to alleviate some of their anxiety – these may take the form of reassurance-seeking, confessing to things that never happened, physical checking, avoidance and more.

As with any resource, this is not a comprehensive list and there are many other types and ways in which OCD may show up for a person. Some other subtypes not mentioned here include hoarding OCD, Rumination OCD, religious OCD, Trichotillomania, existential OCD and many more.