Are there different types of OCD?
Although all kinds of OCD have symptoms in common, the way these symptoms present themselves in daily life changes a lot from person to person. As we’ll see, the content of a person’s obsessions isn’t the important part for treatment. But it’s certainly what feels important in the moment. Someone’s subtype is really just the particular way their OCD affects them– it’s kind of like a theme that the obsessions have in common. Subtypes are relatively stable over time, though new symptoms can appear and old ones might disappear.
First, OCD experts divided symptoms into four larger categories:
1) Contamination Obsessions
2) Harm Obsessions with Checking Compulsions
3) Obsessions Without Visible Compulsions
4) Symmetry Obsessions
Though most people fit into one or two of these broad categories, researchers call conditions like OCD heterogeneous because symptoms vary so much from one person to the next. Still, because there are noticeable clusters of symptoms that they’ve noticed, some researchers have proposed that these four larger categories of OCD can be further divided into specific subtypes.
Treatment methods usually aren’t affected by the particular subtype a person seems to have. Most types of OCD treatment focus on changing patterns of thought and behavior, not the thoughts themselves. As it turns out, changing your thoughts is extremely difficult, and trying to do so often makes OCD symptoms worse.
But, while it usually doesn’t affect treatment strategies for OCD, knowing their subtype can help people feel less alone. It’s great when things get tough to know that other people out there are dealing with similar types of obsessions and compulsions. Also, when a practitioner recognizes their patient’s subtype, they might get a shortcut into understanding their patterns of triggers, obsessions, and compulsions.
And, of course, the subtype will affect the actual content of the treatment. Someone with harm OCD might be asked not to apologize to anyone for one day, but this intervention wouldn’t make any sense for someone whose compulsions have nothing to do with saying sorry.
What are common OCD subtypes?
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.
involves obsessions about one’s sexuality. The name is actually a bit outdated, because you can obsess about having any sexual orientation, not just being homosexual.
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.
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.
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.
or Pure Obsessional OCD, isn’t really the best name for this subtype, because people with Pure-O also have compulsions, even though they’re mental. A variety of obsessions can appear about sex, sexuality, religion, harm, personal health, romance, and so on. Basically, this subtype can include obsessions from any of the other subtypes above, but without the visible compulsions.
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 worth struggling 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.
For a small number of people, OCD symptoms become so severe that suicide is a risk. If you ever consider suicide, call your local suicide hotline or emergency number right away. In the United States, this number is 1-800-273-8255.
These resources were developed with:
Michael A. Jenike, MD
Founder, OCD Institute at McLean Hospital
Professor of Psychiatry, Harvard Medical School
Christopher Pittenger, MD, PhD
Director, Yale OCD Research Clinic
Associate Professor of Psychiatry and in the
Child Study Center, Yale School of Medicine