Although all forms of OCD have symptoms in common (see previous page for more), the way these symptoms present themselves in daily life differs a lot from person to person. As we’ll see, the content of a person’s obsessions isn’t ultimately the important part. But it’s certainly what feels important in the moment.
Someone’s subtype is really just the particular way their OCD affects them. What does the mind focus on– in this case, little kids or the trash? –and what thoughts result from this focus? Subtypes are relatively stable over time, though new symptoms can appear and old ones might fade.
Clinicians call a condition like OCD heterogeneous because it varies so much from one person to the next. But there are a few common “clusters” of symptoms that researchers have noticed:
1. Contamination Obsessions
2. Harm Obsessions with Checking Compulsions
(Fear-of-harm thoughts, Taboo thoughts)
3. Symmetry Obsessions
There’s a lot of discussion about what these symptom clusters might be, which explains why you may not see some familiar ones here. There’s even more debate about whether or not there are more specific categories called subtypes. These are groups of obsessions and compulsions that pop up regularly in people with OCD.
Many clinicians try not to talk about subtypes because there isn’t really any research backing them. And because they’re not perfect categories it’s generally not worth spending too much time trying to figure out which subtype you fit into. Still, for many people with OCD, the immediate recognition of their own experience in a list of subtypes is a powerful comfort at the start of the treatment process.
Imagine that you’ve thought of yourself as uniquely “messed up” for a long time. Suddenly, you see a list of symptoms that match yours exactly. And, recognizing yourself in the subtype you’re reading about, you no longer feel alone in your troubles. You don’t feel hopeless anymore, because other people have apparently faced similar struggles.
Even after this intense relief has passed and the hard work of treatment has begun, it’s helpful to know that other people are dealing with similar types of obsessions and compulsions. The important part, as a person trying to get better, is to never feel alone in it. Listing out subtypes is an imperfect way of doing that, because it often leads people to think of these subtypes as distinct conditions rather than common manifestations of the same condition.
Lastly, subtypes are here to stay in the global community of people dealing with OCD. People have heard about subtypes and want to know more about the ways this condition can manifest itself. So let’s go through some of them now.
Harm OCD causes people to be deeply disturbed by the violent thoughts that just about everyone has experienced. While most people are able to shrug off these thoughts, those with Harm OCD can become completely overwhelmed by them.
Sexual Orientation OCD (Homosexual OCD or HOCD) involves obsessions about one’s sexuality. It’s often called Homosexual OCD, but this is misleading. It can happen to people of any sexuality, about any other sexuality.
Pedophilia OCD is especially prone to stigma because of how strong people’s feelings are about pedophiles. However, as with all types of OCD, these obsessions are not desires. In fact, people are so distressed by these thoughts because they don’t reflect what they really want.
Relationship OCD leaves people completely unable to tolerate the uncertainty of intimate relationships, giving them obsessions about the “rightness” of their own relationship and the countless other possibilities that daily life brings.
“Just Right” OCD is a little different from these other subtypes, in that it’s difficult to identify a specific fear, or set of fears, underlying it. Instead, it’s usually more like a strong feeling that something just isn’t right when things aren’t a certain way. It’s one of the more caricatured forms of OCD, in TV shows, movies, and jokes.
Contamination OCD is probably the most stereotyped form of OCD. People with this subtype are afraid of getting sick, or infecting someone they care about, after coming in contact with serious bacteria.
Pure-O, or Pure Obsessional OCD, is one of the murkier subtypes, and some experts say it doesn’t even exist. The idea is that people with Pure-O have obsessions without visible compulsions, but since they still have compulsions they’re not exactly “purely obsessional.” But whether or not studies back it, many people identify with Pure-O because they don’t have the more obvious compulsions listed in subtypes above. The obsessions can be about sex, sexuality, religion, harm, personal health, romance, and really anything else we discussed above.
There are plenty of other subtypes, but these common ones should provide a good idea of what lots of people with OCD struggle with on a daily basis. It’s not really worth working too hard to figure out exactly what someone’s subtype is, but it can be comforting to know there are others going through something similar.
In some cases, OCD symptoms can become so severe that people consider suicide. If you ever consider suicide, please call your local emergency number or go directly to a hospital. In the United States, you can also call the Suicide Hotline at 1-800-273-8255.
Obsession: Repetitive and unwanted image, thought, or urge
Distress: You feel like the thoughts must be significant, and they bother you
Compulsion: Behavior that you repeatedly perform to reduce distress
Temporary Relief: The compulsions only make you feel better for a little while