Common OCD Subsets

Somatic (Sensorimotor) OCD

People with somatic OCD become hyperaware of their bodily sensations such as breathing, swallowing, blinking, heartbeat, urge to urinate (anything physical).  They can fear that these automatic bodily functions will cease to work properly,  that there is something "wrong," or just hyper-focus.  The obsession then becomes the sensation itself and when/why it's happening or if it will continue to happen.  This can lead to additional obsessions over one's health and morbidity.

The compulsions then become checking for the sensation or the lack thereof, analyzing or trying to get it to stop, excessive trips to the doctor, etc.  Unfortunately, these compulsions only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.

Sexual Orientation OCD (SOOCD)

People with sexual orientation OCD experience intrusive (unwanted, disturbing, or anxiety provoking) thoughts or images (aka obsessions) about their sexuality or gender.  Following these thoughts are compulsions or coping mechanisms designed to ease the anxiety such as looking at one's body to check or question how they feel or identify, avoiding thinking about or seeing stories of those who may be gay or transgender, looking at pictures of attractive men or women to see how you feel, Googling or searching the Internet for articles about the subject.  While these compulsions do offer short-term relief, they only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.

Moral Scrupulosity or Religious OCD

People with scrupulosity OCD experience intrusive (unwanted, disturbing, or anxiety provoking) thoughts or images (aka obsessions) about beliefs, morals, faith or religion.  While this is common with those who grow up with a religious background, it can also manifest in those without such history.  

Following these thoughts are compulsions or coping mechanisms designed to ease the anxiety such as hand washing, avoiding people/places/things/words/etc., frequent sterilizing, changing clothes often, not allowing others in their space, and even avoiding leaving home.  Mental compulsions also exist with contamination OCD such as checking and reassurance seeking.  While these compulsions do offer short-term relief, they only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.

Relationship OCD (ROCD)

People with relationship OCD (ROCD) experience intrusive (unwanted, disturbing, or anxiety provoking) thoughts or images (aka obsessions) about the incompatibilities or flaws of their relationship or their partner.  While someone without OCD understands that there are going to be incompatibilities in all relationships and flaws in all people, someone with ROCD has trouble letting these go and experiences a lot of anxiety and discomfort when these thoughts come up.  Additionally, this can cause them to have unrealistic expectations of their partner or relationship.  Examples of these thoughts include "what if I don't love my partner enough?" or "what if I'm not in the right relationship?" and MANY others.

Following these thoughts are compulsions to ease the discomfort, such as avoidance of the person, situations, or feared objects/places.  Reassurance seeking, from friends, family, or the partner as to whether or not they're in the right relationship.  Confessing of thoughts and fears, googling about relationships, and mental compulsions such as overanalyzing, reviewing past memories/future scenarios.  While these compulsions do help alleviate the anxiety in the short-term, they actually reinforce the ROCD and fuel more intrusive thoughts, leading the person to stay in this fearful, OCD loop.

Real Event OCD

This is just another "name" given to someone who has OCD and obsesses over a real event that happened in the past.  The person will obsess about what happened, what they did in response, whether or not it was "wrong" or not, or what they should do currently or what they should have done then.

The compulsions are mental and include replaying the situation over and over in the mind, thinking about what happened and what should or could have been done differently.  Compulsions here can also be physical by asking reassurance seeking questions or rehashing the event with friends and family.  Avoidance of this thing happening again is another way the person may try and get certainty around this topic.

It's important to understand that OCD can attach to anything, and often does attach to current or real life events, no matter the subset.  It's not the situation or the thoughts that are the problem, it's the reaction you have to it that causes the suffering with OCD.

Pure Obsessional OCD (Pure-O)

I have yet to work with someone who has this.  It was originally thought to be a subset where intrusive (unwanted, disturbing, or anxiety provoking) thoughts (aka obsessions) existed with mental compulsions only, and no physical compulsions.  But, when I dig deeper, I've always found that the person is also doing physical compulsions like reassurance seeking, avoidance, checking, confessing, and others that do exist.

Unfortunately, these compulsions only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.  It is usually easier for most to eliminate physical compulsions before fully eliminating mental compulsions, but both usually exist until treatment is started.  All compulsions need to be completely stopped, so learning yours is crucial to getting to the recovery stage for OCD.

Perfection, Symmetry or "Just Right" OCD

Perfectionistic tendencies are a common trait of those who struggle with OCD, but people with this subset experience intrusive (unwanted, disturbing, or anxiety provoking) thoughts about the "rightness" of things often saying "it just doesn't feel right" or a sense of incompleteness.  This sense of incompleteness creates more feelings of discomfort and tension, as opposed to physical symptoms of anxiety, than other subsets.  Additionally, someone with this subset will feel a lot of discomfort and anxiety if things are not in the right order or arranged the way they see perfect.

Following these thoughts are compulsions, coping mechanisms that our brain creates to ease the discomfort, such as the need to put things in order or in the "right" place, rearranging, reassurance seeking over mistakes, checking repetitively for completeness, mental rehearsal, counting rituals, procrastination due to imperfections, etc.  Unfortunately, these compulsions only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.

Pedophilia OCD (POCD)

People with pedophilia OCD (POCD) experience intrusive (unwanted, disturbing, or anxiety provoking) thoughts or images (aka obsessions) about children and the possibility that they might do something inappropriate with one.  While these thoughts can be very disturbing, they are just thoughts and the intention to do anything harmful or inappropriate with children is not actually there.  Unfortunately, the thoughts themselves persist when it goes untreated, further convincing the sufferer that they may actually do something to act on them, despite the desire not to.

Following these thoughts are compulsions or coping mechanisms designed to ease the thoughts and anxiety such as mentally reviewing time spent with children in the past, avoiding being around children alone or all together, trying to "get rid of" or "argue with" the thoughts.  Unfortunately, these compulsions only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.

Harm OCD

People with harm OCD experience intrusive (unwanted, disturbing, or anxiety provoking) thoughts or images (aka obsessions) about harming oneself or others.  Examples of these thoughts include "what if I stab myself?" or "what if I drown my child?"  Images of these, or similar scenarios, can also seem to just pop into one's mind.  While these thoughts are not uncommon to those without OCD, people who struggle with OCD get "hooked" into these thoughts and fear that they may actually act on them.

Following these thoughts are compulsions, coping mechanisms that our brain creates to ease the discomfort, such as avoidance of the person, situations, or feared objects/places.  Reassurance seeking, from others or repeating reassurance statement to ourselves, is another common compulsion. Mental rituals are also common such as reviewing past memories looking for evidence that their thoughts are or are not true.  While these compulsions do help alleviate the anxiety in the short-term, they actually reinforce the OCD and fuel more intrusive thoughts, leading the person to stay in this fearful, OCD loop.

Existential OCD

This subset of OCD involves intrusive (unwanted, disturbing, or anxiety provoking) thoughts (aka obsessions) about the meaning, purpose, or reality of life.  Additionally, you may question the existence of the universe or even your own existence.  While everyone has these questions from time to time, you may spend hours contemplating this topic and the feelings following these episodes cause high levels of anxiety and discomfort.

Following these thoughts are compulsions or coping mechanisms that our brain creates to ease the discomfort, such as the need to mentally contemplate these ideas, looking at yourself in the mirror and questioning your existence, or physically doing things to prove that you (or the universe) actually does exist.  Unfortunately, these compulsions only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.

Contamination or Health OCD

Contamination OCD is the most widely known subset of OCD and consists of the fear of being contaminated by germs, bodily fluids, food, or any other substance.  Some people with this subset of OCD also struggle with the fear that they can be contaminated by words, names, places, images, people, colors, etc.

Health OCD is the fear of something being wrong with one's own health, or that of someone they care about.

Following these thoughts are compulsions or coping mechanisms designed to ease the anxiety such as hand washing, going to the Dr., googling symptoms, avoiding people/places/ things/words/etc., frequent sterilizing, changing clothes often, not allowing others in their space, and even avoiding leaving home.  Mental compulsions also exist with contamination OCD such as checking and reassurance seeking.  While these compulsions do offer short-term relief, they only keep you in the OCD cycle and fuel more intrusive thoughts and anxiety.

Other Common OCD Themes

• Forgetting
• Suicidal intrusive thoughts
• Boredom
• Losing control
• Decision making
• Numbers
• Magical thinking
• Don't see your theme here?  Remember, OCD can attach to ANYTHING!

Common Co-Occurring Disorders

• Phobias
• BFRBs (body-focused repetitive behaviors) - skin picking, hair pulling, etc.
• Body dysmorphic disorder
• Eating disorders
• Hoarding