What are the 5 Main Types of OCD?

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In popular culture we often hear the phrase ‘I’m a little bit OCD’ casually bandied around. This phrase reduces OCD to a simple personality quirk. Despite greater understanding of mental health conditions over the last few years, if you were to ask lay members of the public what they think of when they hear the letters OCD, it wouldn’t be unusual for many to come up with images of someone who is very neat and tidy; think Monica from the popular 90s TV show Friends.

However, though being very orderly and clean may be a feature of some types of OCD, for many people it is far from a defining aspect of it. OCD is a complex condition, often dominated by desperate attempts to quell uncontrollable anxiety, discomfort and distress. For lots who experience the condition, it is not viewed as a humorous quirk, but something which has a major impact on many areas of their lives and their day to day functioning.

Many individuals with OCD are tremendously conscientious and resilient and because their brains work in a unique way, they may also be remarkably creative. However, no two individuals with OCD are the same and so the way the condition manifests is different from one person to another, saying this, many people’s traits fall within five main areas. In this article we’ll explore these areas of OCD. 

A bit about OCD

•       In the United Kingdom, approximately 1 in every 50 people will experience obsessive compulsive disorder (OCD) in their lives.
•       OCD is classified as a mental health condition which is characterised by frequent uncontrollable thoughts (obsessions) and repetitive, excessive behaviours (compulsions) often triggered by intense anxiety.
•       OCD can occur in children as young as 6, however it typically emerges around late adolescence and young adulthood.

Are there different types of OCD?

OCD is a multifaceted condition which typically impacts areas which are most important in a person’s life. For example, if someone is deeply religious, they may experience distressing thoughts centred around religion and feel compelled to perform compulsive rituals in order to alleviate the anxiety caused by these thoughts. There are many different forms of OCD, however, most types fall into five common categories. It should be mentioned that one individual may experience multiple types of OCD. Below we’ll outline the five common types of OCD, with examples of how each of them may present.

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What is ‘Checking OCD’?

In response to distressing, or obsessive thoughts a person may feel compelled to carry out checking compulsions, to provide reassurance and to reduce anxiety. Checking can be carried out many times over long periods. Some common checking compulsions include:

• Reassurance seeking: Individuals may seek to alleviate their fears by seeking reassurance from loved ones, social media, news reports, or via the internet.

• Memories: People may check their memories in an attempt to recall whether or not they have caused injury to another person. Unfortunately, constant checking doesn’t often remove their doubts and more checking is required to feel reassured.

•  Texts/Emails:  Before sending an email, or text a person may spend a lot of time checking and rereading the text until everything feels ‘just right’. This may be driven by many fears, including, for example, a fear that they may write something offensive.

Individuals with checking OCD are often highly vigilant and are able to pay great attention to detail. Their drive to ensure things are perfect may be reflected in the way they approach their work. This can help them to produce high quality, accurate work.

What is ‘Contamination OCD’?

Individuals with ‘contamination OCD’ are usually consumed with a fear of being unclean. This concern may lead them to avoid areas, people, or activities where they fear they could become contaminated. If an individual feels that they have been contaminated they may compulsively wash their bodies. It is often typical for cleaning rituals to take many hours and for people to only stop when they ‘feel’ clean, even if this involves, for example, scrubbing their hands until they bleed. Having contamination OCD can have a significant impact on an individual’s relationships and working life. Some common contamination areas may include:

• Public transport: A person who has a fear of coming into contact with germs from public transport may try and avoid public transport and if this is not possible they may have to carry out a series of ‘decontamination’ rituals after travelling. These can include going home and discarding all of their clothing and showering several times. 

• Home: Individuals may spend many hours disinfecting and cleaning surfaces in their home and may refuse visitors in a fear that visitors may contaminate their environment. 

• Hospital: Individuals who have a fear of coming into contact with germs and becoming unwell may avoid hospital waiting rooms and GP surgeries. 

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What is ‘Rumination OCD’?

Many people with ‘rumination OCD’ experience long trains of deep thoughts, often centring around philosophical, metaphysical and religious topics. Individuals often become fixated on a topic and can spend many hours consumed with mulling over their thoughts. Rumination never leads individuals to a satisfactory conclusion and a person can often appear to be distant and removed from their surroundings. Some examples of rumination OCD include:

• Preoccupations with death: A person may become preoccupied with thoughts about what may happen when they die. They may imagine different scenarios and ponder what different philosophers have said about death.

•  Good, or evil?: An individual may repeatedly question themselves and dwell on whether or not they are a good person. They may find themselves stuck in a loop of trying to find evidence for and against the idea that they may be an evil person.

What is ‘Intrusive thought-based OCD’?

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Someone who has ‘intrusive thought-based OCD’ may experience distressing, unwanted thoughts and images which repeatedly enter their minds. Many Thoughts may be odd, or disturbing and in complete contrast to a person’s morals, or character. For example, a devoted mother may have the sudden thought, ‘what if I did something to cause harm to my child?’ Or a cautious driver may be consumed by the thought ‘what if I crash this car?’ Intrusive thoughts commonly centre around relationships, magical*, religious, sexual, or violent themes and concerns. These thoughts are produced involuntarily and are frequently experienced as horrifying by the individual. It should be noted that because of how distressing and shocking individuals with OCD find these thoughts, they are highly unlikely to act upon them. Some examples of ‘intrusive thought-based OCD’ include:

•  Sexuality: An individual may repeatedly question their sexuality and may experience unwanted feelings, thoughts and impulses about being attracted to people of the opposite, or same sex. They may perform compulsive rituals in an attempt to ignore and/or suppress these thoughts.

•  Religious Thoughts: A person may have thoughts that they are constantly doing something sinful. They may be compelled to perform rituals in order to cope with the anxiety caused by these thoughts.

• Magical Thinking*: In OCD, magical thinking refers to a cognitive thinking style where an individual experiences intrusive thoughts about being responsible for something catastrophic occurring if they do not perform specific actions. For example, they may think ‘if I have a negative thought whilst I am speaking to my mother, something awful will happen to her.’ Most individuals logically understand that there is little connection between the fear that they have and the action that they perform in order to prevent it, but feel compelled to carry out the actions just to be sure. 

Individuals with intrusive thought-based OCD may be very cautious by nature. This means that they are more likely to give activities great thought before engaging in them and prepare for tasks well in advance. This trait may make some people with OCD proficient at carrying out comprehensive risk assessments and adapting to challenging situations.  

What is ‘Symmetry OCD’?

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Those with ‘symmetry OCD’ feel compelled to ensure that certain objects are symmetrical, and/or require things to be organised in a specific way. Individuals may spend long periods of time trying to make sure things are perfectly symmetrical, which can be both physically and emotionally draining. This compulsive behaviour may be driven by a need for things to feel ‘just right’ in order to alleviate feelings of anxiety, or discomfort. They may also be driven by a fear that if things are not organised in a particular way then something catastrophic may befall themselves, or a loved one. Some common examples of symmetry OCD include:

• Organisation: A person may have specific places for certain objects and must ensure that they are neat and tidy and in their place at all times. For example, they may require certain objects, such tinned items, or books on a shelf to be arranged in perfect lines. This is less about cleanliness and more about neatness and a feeling of ‘rightness’.

• Patterns: A person may feel extreme discomfort if they see objects with patterns, or designs which are mismatched, or asymmetrical. They may find this distressing to the point where they find it hard to think about other things and therefore may become completely preoccupied with reordering objects until they feel that they match. 

• Balancing: A person may feel they need to perform actions which are symmetrical. For example if they perform an action with the right side of their body, such as a handshake, they may feel compelled to also perform this action with the opposite side of their body.

Features of all types of OCD

Virtually all individuals with OCD, regardless of type, feel driven to avoid certain places, specific people, or particular objects which may trigger their obsessive thinking and compulsive rituals. This may lead them to avoid everyday tasks, social situations and work activities. Despite this, In the face of what can be at times a very challenging condition, individuals with OCD have been found to be highly attuned to others emotional states and this frequently results in them feeling heightened empathy. This trait often makes them loving partners, great assets to organisations, prosocial members of society and kind, and caring friends. 

Conclusion

OCD is not a humorous quirk, but a complex and often challenging condition to live with. Each individual with OCD is unique and so their experience of OCD is also unique. We hope that this article has been helpful in providing you with information about some of the many different ways OCD can present. If you are experiencing symptoms the first step is to speak to a licensed professional, such as a general practitioner (GP) who can provide further guidance. If you wish to find out whether you have any traits of OCD, check out our free OCD Quiz today.

Sources

• Occurrences of OCD: https://www.ocduk.org/ocd/how-common-is-ocd/
• Obsessive compulsive disorder:  https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd
• Hidden strengths of ocd: https://uniquecs.co.uk/blog/hidden-strengths-of-ocd/#:~:text=People%20with%20OCD%20tend%20to%20put%20more%20thought%20into%20all,OCD%20Through%20a%20Positive%20Lens
• Types of OCD: https://www.ocduk.org/ocd/types/
• The portrayal of OCD in film and TV: https://www.healthactionresearch.org.uk/selected-blogs/how-ocd-is-portrayed/
• Overview- obsessive compulsive disorder: https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/overview/
• Symmetry OCD: https://www.treatmyocd.com/what-is-ocd/common-fears/symmetry-ocd 
• OCD as a superpower: https://www.psychologytoday.com/gb/blog/live-life-creatively/202212/ocd-as-a-superpower 
• A fresh perspective on the benefits of OCD: https://www.cadabams.org/blog/exploring-ocd-benefits