People often think of obsessive-compulsive disorder (OCD) as a preoccupation with cleanliness or order. In reality, OCD can present in vastly different ways and many that are invisible to the outside observer. This page gives a brief description of the various types of OCD and offers links to further information about each.
Hit and run | POCD | ROCD | HOCD | Contamination | Tourettic | Checking | Harm | Scrupulosity | Just right | Existential | Confessing | Pure O
Hoarding | Hair pulling | Skin picking | Cheek biting | Perfectionism and OCPD
Note: The types of OCD described below are not considered distinct from one another in a scientific way. OCD can shift over time from one type to another. They are all OCD; they have far more in common than they have differences.
Hit and Run OCD
This type of OCD is marked by intrusive thoughts about having hit someone while driving. The thoughts can strike while still behind the wheel or sometimes much later. It can lead to retracing one’s route to make sure there are no signs of a recent accident or to avoiding driving altogether.
Learn more about hit and run OCD here.
POCD (Pedophilia OCD)
POCD is characterized by thoughts, urges or images of sexual behavior with children. This type of OCD is particularly difficult because it’s associated with strong feelings of shame. Sufferers are understandably very uncomfortable telling others about their thoughts.
ROCD (Relationship OCD)
Relationship OCD is a term for OCD that centers on relationship obsessions. These involve doubt about whether your partner is the right person for you or about the depth and authenticity of your feelings for your partner.
Learn more about relationship OCD here.
HOCD or SO-OCD (Homosexual or Sexual Orientation OCD)
HOCD involves intrusive thoughts centered on one’s sexual orientation. The condition can affect men, women, or teens and can occur regardless of one’s actual sexual orientation.
Learn more in our guide to HOCD.
This type of OCD involves a preoccupation with avoiding germs or contamination. Those with contamination OCD often fear sexually transmitted infections, but fear can also center on other conditions such as stomach flu, salmonella, or just illness in general.
Subtype: Mental contamination
People often distinguish between “contact contamination” (a feeling stemming from touching something) and “mental contamination” (coming from a thought, word, or phrase that feels bad, dangerous, or uncomfortable). Some recent research suggests that the two are distinct from one another. Approximately 10% of OCD sufferers with contamination symptoms experience mental contamination but not contact contamination.
Some people with OCD experience compulsions that entail specific physical movements — like tapping their fingers or touching things in a certain way. These compulsions can be difficult to distinguish from motor tics, a symptom seen in Tourette’s Syndrome. This presentation of OCD is sometimes referred to as Tourettic OCD.
Click here to read a compelling first-person account of life with Tourettic OCD.
Sometimes OCD involves checking compulsions. Checking stoves, electrical appliances, door locks, ovens and alarm clocks are all common examples of this compulsion.
This involves impulses, urges, or mental images of harming others. People with harm OCD often describe having intrusive thoughts about stabbing, punching, or pushing others who are unable to defend themselves.
One particularly upsetting variant of harm OCD can be seen in new mothers who are horrified to have thoughts of harming or killing their babies. They can feel trapped by the difficulty of sharing their fears with others, especially if they have not had OCD symptoms before.
Learn more on our harm OCD page.
Scrupulosity (Including “Religious OCD”)
We all need to follow rules in life — at least sometimes. For people with scrupulosity, rule-following becomes a compulsion. Violating moral or religious rules becomes a fearful prospect. This often affects devotees of religions with a strong emphasis on rules or commandments. The fear of being damned or going to Hell can become a big part of life for people with with type of OCD.
Learn more about scrupulosity and religious OCD here.
“Just Right” OCD
Sometimes OCD creates compulsions to do things repeatedly until they feel “just right.” What those things are can vary; it can be repositioning an object, or repeating a bodily movement, or touching something over and over until the desired feeling is achieved.
Learn more about “just right” OCD here.
Existential OCD involves obsessive thinking about what’s real vs. what isn’t real, and generally about the nature of the reality in which one lives. People (and therapists) often mistake this type of OCD for other types of anxiety.
Learn more about it on our existential OCD informational page.
Confessing OCD can be a variant of relationship OCD or scrupulosity (both described above). In this form of OCD the dominant compulsion is confessing perceived transgressions typically to a parent or romantic partner. The transgressions may seem trivial or unimportant to others, but they serve to reduce anxiety in the person confessing.
Learn more on our page about confessing in OCD.
“Pure O” OCD
Most forms of OCD involve both obsessions and compulsions. However, some people report experiencing obsessions without any apparent compulsions. This presentation of OCD is known as “pure O.”
The vast majority (if not the entirety) of people with obsessions do also experience some form of compulsion — although those compulsions can be subtle and hard to identify. Many people who fear they have “pure O” OCD actually have relationship OCD, harm OCD, pedophilia OCD, or sexual orientation OCD.
Not OCD, But Related:
Hoarding is defined by difficulty parting with possessions — regardless of how valuable (or worthless) they are. This results in an accumulation of possessions that can be dramatic or even dangerous.
Mental health providers considered hoarding to be a form of OCD until 2013. Hoarding is now considered a “related disorder” to OCD.
Sometimes plucking or pulling out hairs can become such a strong habit that it changes our appearance. Trichotillomania is the term used for when hair pulling is severe enough that it creates distress or obvious and problematic bare patches. It can involve the head, eyebrows, eyelashes, or anywhere there is hair. Trichotillomania is a related condition to OCD but is not OCD.
Learn more on our trichotillomania resource page.
Picking the skin on our fingers, feet, face, or anywhere else is called “dermatillomania” or ‘excoriation disorder when it becomes a problem. When severe, dermatillomania can produce bleeding and lead to infections and permanent skin damage. This condition responds well to behavior therapy.
Learn more on our dermatillomania resource page.
Cheek biting, cuticle biting, nail biting
These are examples of body-focused repetitive behaviors. They can be harmless when they happen infrequently. However, when they lead to bleeding and other difficulties, treatment can be helpful.
Learn more about body-focused repetitive behaviors
Perfectionism and OCPD
If high standards have stopped being helpful for you and have started to become a problem, you may suffer from perfectionism. Perfectionism doesn’t need to involve a conscious effort to be perfect. It often involves a rigid approach to getting things done that isn’t shared by others. In fact, the approach often bothers those around us.
When perfectionism becomes a dominant force in one’s life, a therapist may diagnose a condition known as obsessive-compulsive personality disorder. This condition is not OCD but often has some overlap. It takes longer to improve than OCD, but improvement is certainly possible.
Learn more about perfectionism, OCPD, and their treatment.
Subscribe to the Manhattan Center for Cognitive-Behavioral Therapy blog!
Leave a Reply