Obsessive Compulsive Disorder (OCD)

All humans have thoughts and all humans engage in behaviors to make themselves feel better when these thoughts are distressing. What makes this phenomenon a disorder is when it starts impacting a person’s ability to function in various domains of their life (work, school, home, relationships, etc).

Obsessive Compulsive Disorder is defined as having intrusive, unwanted, or ruminative thoughts coupled with compulsive behaviors that seek to reduce the distress these thoughts create. Many people do not realize that their symptoms fall on the OCD spectrum either because they do not fit the stereotype of having contamination fears and excessive hand-washing, or they are not aware of how mental compulsions serve the same purpose as behavioral compulsions, or they believe their symptoms are so embarrassing or bizarre that there must be something terribly wrong with their actual character.

Harm OCD & Violent Intrusive Thoughts

• Fears that you have inadvertently run over someone with your car
• A belief that you might accidentally jump in front of a train or drive your car the wrong way on the highway
• Concerns that you have poisoned someone’s food or your belongings have been tampered with
• Fears that you might accidentally or purposefully stab someone, lose control
• Images or “movie clips” of suicide, command thoughts about suicide or self-harm that you can’t get rid of

Contamination OCD

• Avoidance of raw meat, chemicals, or touching objects that are perceived to be ‘contaminated’
• Preoccupation with bodily fluids and spreading them (urine, feces, semen, saliva, etc)
• Excessive fear of contracting an illness from a public place (persistent health anxiety)
• Frequent showering or hand-washing to rid self of perceived contaminants
• Persistent fears you will become sick or make someone else sick

Emotional Contamination

• Fearing you will take on the traits of another person, especially unwanted traits (common examples include unattractiveness, obesity, etc)
• Concerns that you will turn into a zombie/other bizarre or taboo intrusions
• Cleansing rituals are common to ‘wash away’ the negative traits
• Avoidance of people and places are often common

Relationship OCD

• Obsessive fretting over the suitability of oneself or one’s partner in a relationship
• Chronic fears your partner does not want to be with you, will cheat on you, is about to break up with you, etc
• Frequent reassurance-seeking from a partner that all is ‘okay’ in the relationship
• Fears that you will inadvertently cheat on your partner, leave your partner, or ‘break their heart’

Sexual Orientation OCD

• Obsessive questioning of your sexual orientation
• Fears that you are attracted to the same sex (Homosexual OCD/HOCD)
• Avoidance of gestures, clothing, or mannerisms that you believe will make others perceive you as ‘gay’
• Fear of being in denial about sexual orientation
• Fear of losing control around other people and spontaneously kissing them, etc

Pedophilia OCD (POCD)

• Fears that you might have inappropriately touched a child even though the thought of doing so makes you ill
• Running over events in your mind to make sure you did not inappropriately touch a minor
• Fears that you will lose control around your own children or children you often spend time

Scrupulosity

• Intrusive thoughts about religion, God, saints, or religious figures
• Repeating prayers, even nonsensical ones, compulsively
• Fears that you will scream blasphemous words or phrases in a religious institution
• Chronic fears that your behavior is sinful and that you are going to hell
• Concern that intrusive thoughts during a religious service will ‘undo’ or contaminate the value of the activity

Perfectionism, Symmetry, & Orderliness

• Editing a piece of written work compulsively, checking for mistakes
• Insisting that all objects be in a particular place, that pictures be hung a certain way, feeling excessively uncomfortable when objects are askew or out of order
• Having all food in the pantry facing with the labels out at all times
• Making sure books are lined up on the bookshelf perfectly
• Believing that if you do not fulfill a role ‘perfectly’ (as husband, parent, worker, etc) that you are worthless

Checking Behaviors

• Checking that the stove knobs are turned off
• Checking door locks even though you are 99% sure you locked them
• Checking your route after driving to make sure you didn’t hit a cat

Magical Thinking/Superstitiousness

• Fears that driving by a graveyard will cause someone’s death or that stepping on cracks will literally break your mother’s back
• Belief that your thoughts can make disasters occur or prevent bad things from happening
• Compulsive knocking on wood, using a ‘lucky number,’ or making decisions based on arbitrary rules such as your favorite color or what day of the week it is

Body-Focused OCD (Sensorimotor)

• Obsessive checking of specific body parts to make sure they do not have cancer, Lyme disease, or other illness
• Hyper-awareness of bodily sensations such as grumbling stomach that gets interpreted as norovirus (emetophobia) or monitoring your breathing to see if it is too shallow or deep
• Obsessive focus on how much one is swallowing, how much saliva is produced, etc

Postpartum/Perinatal OCD

• Excessive anxiety and obsessive-compulsive behaviors that originate or worsen during pregnancy or after the birth of a baby
• Fears that you might accidentally harm the baby, throw them out the window, smother them, etc
• Excessive fears that the baby is not breathing; frequent checking on the baby’s well-being in the middle of the night
• Ruminations about being a ‘bad mother’ or ‘unattractive wife’
• Difficulty or inability to leave the baby alone for short periods of time due to anxious thoughts