Obsessive-Compulsive Disorder (OCD) is a complex mental condition that can take many different forms—called themes or subtypes—that target subjects you care about the most.
While all kinds of OCD have the same defining features (namely: obsessions and compulsions), the specific sources of your intrusive thoughts are unique to you. And you’re not alone.
According to therapist and clinical trainer April Kilduff, MA, LCPC, LMHC, “Knowing these themes can give you a sense of relief that this is a real thing, and it has a name, which means that other people have it. I can tell you that so many people feel a huge sense of relief and normalization knowing this, when they might have been thinking they were the only ones with these ‘crazy’ thoughts in their head.” It also makes it easier to find resources to help you on your unique recovery journey, like NOCD’s support groups.
So what are some of the most common subtypes of OCD in 2023? Read about each one, in alphabetical order.
The 10 common OCD subtypes
- Existential OCD
This is a subtype of OCD where you experience intrusive thoughts and compulsive behaviors that relate to philosophical questions about life, reality, and your existence.
Existential OCD can be especially scary because there are often no definitive answers to the abstract intrusive thoughts and questions that you feel. While just about everyone has likely pondered the meaning of life and questioned our purpose as humans, people with Existential OCD can’t accept the uncertainty that these questions bring, and face extreme anxiety because of it. They may then engage in compulsions as a way to ease their pervasive existential dread.
Obsession examples can be questions like:
- Do I have a purpose in life?
- Is there a God?
- Do I really exist?
- Is reality what I really know it to be, or is this a simulation?
Compulsion examples:
- Compulsively reading religious texts or philosophical writings to try to get answers to your questions
- Seeking reassurance from friends, family members, or religious figures to find clarity about your questions on life, purpose, and existence
- Repetitively going over memories, information, or conversations that you’ve had in search of answers
- False Memory (or Real Event) OCD
If you constantly wonder whether the things that you recall actually happened, or if you have done something “bad” in the past that you can’t quite remember, you might be experiencing False Memory OCD.
People with False Memory/Real Event OCD have intrusive doubts about how well they remember things that have happened in their past. You may wonder if you’ve done something wrong because you question your ability to remember things accurately. And that uncertainty can create dread, fear, and anxiety that you’ve done something to hurt another person, or that goes against your morals—even if there isn’t much evidence to suggest that anything bad actually happened.
Obsession examples are questions such as:
- Have I committed a crime that I can’t recall?
- Is it possible that I hurt my loved one, either physically or through emotional or mental abuse?
- I was at this place where a serious crime took place, and the suspect wasn’t caught. Was I the one who did it?
- Did I accidentally seriously harm someone and then suppress the memory?
Compulsion examples:
- Having repeated conversations with other people about their memory to validate whether or not the thing you fear actually happened
- Obsessively going over every detail you can remember to find proof that you didn’t commit the bad action you’re worried about
- Confessing to the action and repeatedly apologizing, even if there’s no good evidence that you actually did it
- Distracting, replacing, or suppressing thoughts by reassuring yourself that you didn’t do the action
- Trying to recreate the memory or find video evidence or news articles about your suspicions
- Harm OCD
Harm OCD is a subtype of OCD in which people experience intrusive thoughts or images that involve hurting people by accident or on purpose, usually those who are closest to them, or even themselves.
It’s important to note that having these thoughts doesn’t mean that you want to actually hurt your loved ones, and it’s fairly normal to experience these random intrusive thoughts. However, if you have Harm/Violent OCD you might believe that having these thoughts mean that you really want to hurt someone, which triggers understandable fear and anxiety.
Examples of obsessions:
- What if I just drove off of this cliff right now?
- I could hurt my family with this kitchen knife.
- I just had an unwanted thought about hurting my child; is it a sign that I want to do that?
Examples of compulsions:
- Physically distancing yourself from the loved ones in question to minimize the risk
- Removing all potential weapons in the home
- Seeking reassurance from people around you, or mentally reviewing to find proof that you aren’t the kind of person who is capable of hurting other people
- Health Concern/Contamination OCD
Health Concern/Contamination OCD involves intrusive thoughts and compulsive actions that center around your health, or the health of your family. People with this subtype will often fear that they have or will develop a serious health condition, or that they’ve been exposed to bacteria and viruses that can carry illness. They may also fear infecting others, and even being responsible for their death.
This goes well beyond simply wanting to be clean, or stay healthy. These obsessions and cleaning rituals can take over your whole life and seriously impact your well-being and quality of life.
Examples of obsessions:
- Lots of other people have touched this doorknob. Am I going to get sick from touching it?
- I’m scared that I have developed a serious chronic condition.
- I accidentally touched someone; what if I transferred germs to them and got them sick?
Examples of compulsions:
- Avoiding going to places with other people to prevent potential contamination
- Compulsive cleaning and sanitizing to get rid of bacteria
- “Doctor shopping” and making multiple appointments with health care providers to seek reassurance and hear other opinions
- Perfectionism OCD
One of the more popularly understood themes of OCD, this subtype has to do with obsessions and compulsions that relate to organization, perfection, and making things feel right to you.
It’s more than just perfectionism as a personality trait—people with Perfectionism OCD experience intrusive and anxiety-inducing fears that aren’t relieved until they perform their rituals to a degree that feels perfect or complete. While you might fear that something bad will happen if things aren’t perfectly straightened out, symmetrical, or “just right,” you might also feel a pervasive sense of fear and dread that’s hard to define.
Examples of obsessions:
- Someone touched my right arm, and it feels “off” if I don’t even it out and touch my left arm.
- Something bad is going to happen to me if I don’t even out the way these books are arranged on my bookshelf.
- I feel very off and I can’t concentrate because things aren’t perfect. What if I never feel normal again?
Examples of compulsions:
- Performing rituals over and over again to reach a certain number that feels “right.”
- Reorganizing things to make them even or complete.
- Redoing work or school tasks until they feel perfect.
- Pure OCD
Unlike other kinds of OCD that are paired with obvious and visible rituals, Pure OCD is a subtype in which compulsions happen inside of one’s mind without any visible signs. The obsessions that are seen in Pure OCD can encompass virtually any subject, including those that are found in other subtypes. However, people with Pure OCD won’t physically act out compulsions; instead, they follow mental compulsions like mental checking that may not be visibly obvious to others.
Not all experts agree about whether Pure OCD should be considered a separate theme, since mental compulsions can be found in most kinds of OCD subtypes. But here are some of the many possible obsessions and compulsions:
Examples of obsessions:
- Did I forget a memory that I did something bad?
- Am I a bad person?
- What if I can never get “out of my head”?
Examples of compulsions:
- Going over memories again and again to see whether there’s any evidence that you did something bad.
- Reassuring yourself over and over again that you’re a good person and that you haven’t done anything bad.
- Distracting yourself from distressing, obsessive thought patterns.
- Relationship OCD
People with Relationship OCD experience intrusive thoughts and compulsions that relate to their partner, their relationship, or themselves. Of course, it’s normal to worry about your romantic relationships from time to time—but if you have this subtype of OCD, you might have a hard time moving forward from these doubts and may engage in a variety of compulsions to find reassurance.
Examples of obsessions:
- I had a dream about my ex. Does that mean that I’m in the wrong relationship and that I still have feelings about my ex?
- My partner laughed at a joke that someone else said. Are they trying to leave me for that person?
- Are we “meant to be?” What if there’s someone out there who is actually my soulmate who isn’t my current partner?
Examples of compulsions:
- Repeatedly asking your partner if they’re happy with the relationship to seek reassurance
- Asking friends, family members, and other people outside of their relationship if you seem like a good fit for each other
- Comparing your relationship to other people’s relationships
- Religious or Scrupulosity OCD
Religious or Scrupulosity, OCD is centered on morality, ethics, and religious rules. People with this subtype may have fears that they have somehow betrayed their religion or their own moral code and are therefore a “bad person” because of this trespass.
Examples of obsessions:
- I did something that I think might be a sin. Will God forgive me?
- Am I doing things the right way?
- I’m vegan and I accidentally ate honey. Am I a bad person?
Examples of compulsions:
- Going to confession over and over again
- Praying over and over again to ask for forgiveness
- Repetitively reassuring yourself that you aren’t doing anything wrong
- Self-punishment for thinking you betrayed a moral or religious code
- Responsibility OCD
This subtype manifests in fears regarding your responsibilities toward yourself and those around you. You might feel as though you’re to blame for things far beyond your control. Similar to scrupulosity OCD, you may also have a hard time moving on from even the most minor errors or uncertainties about your behavior.
Examples of obsessions:
- Did I turn off the stove before I left the house? My family could be in danger.
- I just dropped off my kid at school. What if something happens to them while they’re there? That would be my fault.
- I forgot to properly sort my recycling this week. Am I to blame for climate change?
Examples of compulsions:
- Seeking reassurance from others that your actions are OK and won’t affect people in the way you fear
- Repeated mental and physical checking to ensure that your responsibilities have been met
- Avoiding situations that might make you responsible for others’s safety, like driving
- Sexual Orientation and Gender OCD
Finally, Sexual or Gender OCD involves fears about your sexuality or gender identity. While many people ponder questions about their sexuality or gender throughout their lives, someone with OCD who experiences these intrusive thoughts will have intense fear and anxiety about what they could mean, and they’ll need immediate answers or need to engage in compulsions to feel better.
Examples of obsessions:
- I’m in a queer relationship, but what if I’m actually straight and am with the wrong person?
- I think I’m straight, but am I actually in denial about being gay and have been living a lie?
- How sure am I that I’m a man? After all, it’s just what I’ve always been told—I need to be 100% certain.
Examples of compulsions:
- Questioning friends, family, or yourself about your sexuality or gender
- Constantly checking for signs of arousal
- Excessively asking others for what they think about your sexuality or gender
The best way to treat all forms of OCD
No matter what themes your OCD may follow, the good news is that exposure and response prevention (ERP) therapy can help.
ERP is widely considered the most successful treatment for OCD. It involves gradual and repeated exposure to the things that bring you the most anxiety and fear—in a safe environment with a trained therapist—as well as learning how to not give in to the compulsions that bring only short-term relief. Ultimately, ERP is focused on taking the power away from your thoughts, so you can enjoy a life free of them—rather than trying (and inevitably failing) to make the thoughts go away completely.
Access therapy that’s designed for OCD
Learn about ERP with NOCDIf ERP sounds scary, it’s important to know that the process is never determined solely by your therapist. You have the power to rank your fears and triggers starting from the least distressing to the most so that you’re never thrown into a situation that is too overwhelming.
ERP is highly successful no matter what kind of themes your OCD tends to latch onto. “OCD is OCD across the board, and the things we’re really treating with ERP is an intolerance of uncertainty, doubt, and discomfort,” Kilduff explains. “The subtypes are just different ways of expressing that uncertainty, doubt, and discomfort. Some tools click better with certain people, but the same basic treatment has been shown to work across the board in a matter of months.”
If you’re interested in learning more about how ERP can help you, schedule a free 15-minute call with the NOCD team today. Our therapist network has over 300 specialty-trained therapists, many of whom accept most major insurance plans and can see you within 7 days.