OCD Themes and Subtypes
These are some examples of the more common OCD themes or subtypes. Keep in mind not all OCD symptoms will fit into one of these categories, as OCD could latch onto almost anything.
Contamination OCD - Probably the most well-known subtype is Contamination OCD, where individuals have an intense fear of germs, dirt, getting sick, or chemicals. They may engage in excessive hand washing and cleaning compulsions or avoidance behaviors to minimize perceived contamination.
Checking OCD - individuals have repetitive thoughts of harm or danger and feel the need to repeatedly check things like locks, appliances, or personal belongings.
Symmetry obsessions / ordering compulsions or “Just right” OCD " – involves a feeling that things don’t feel quite right, so people engage in compulsions such as counting, straightening, touching tapping, or lining things up until things feel “just right”. Individuals have an obsession with symmetry, exactness, or arranging things in a specific order.
Harm OCD – obsessive thoughts of harm coming to oneself or a loved one, or of causing harm to someone and compulsions to prevent the harm happening and/or thoughts occurring. A variation of this is a fear of running someone over which can result in driving around to check the road repeatedly or checking for reports of hit and run accidents.
Existential OCD – obsessions related to philosophical questions, about the purpose of life and the nature of existence. For example, people might get stuck on questions such as how they could confirm what is real or not. People may also notice a sense of feeling dissociated or disconnected from reality, which can then feed the existential doubts.
Relationship OCD – obsessive thoughts and doubts about a romantic relationship, such as whether their partner loves them, whether they love their partner, whether their partner has cheated on them (or they have cheated on the partner), excessive concern for their partner's happiness, or wondering if they could find a better partner.
Sexuality OCD - obsessive doubts about one's sexuality, such as whether they may really be gay (or straight) or realise they are gay (or straight) later in life. People may express concerns about the consequence of this such as then having to then break-up with their partner despite not wanting to. Compulsions may involve checking how attracted they are to people of different genders.
Scrupulosity OCD – religious or moral obsessions, such as thoughts about having done something wrong, committed a sin or violated a religious or moral doctrine and what this may means about them as a person.
Paedophilia OCD – preoccupation with fears or intrusive thoughts revolving around themes of sexual abuse or pedophilia.
Sensorimotor OCD - preoccupation with monitoring a particular body sensation and fear of not being able to get it out of awareness.
The content of the obsessions and the type of compulsions people perform can be used to distinguish particular subtypes or themes of OCD. These categories can provide a helpful description of what a person with OCD is experiencing, but the same basic treatment approach will apply to all of them. It is not uncommon for people with OCD to be experiencing more than one theme at a time and for their main theme to change over time as people go through different life stages or as they start to make progress in treatment.