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Experience treating the following subtypes of OCD:

Harm OCD

This type of OCD makes people feel like they cannot trust their own mind. They experience violent intrusive thoughts about harming somebody, or harming themselves. OCD tends to latch onto things that we care deeply about. Obsession around harm may include the fear that they are going to harm other people with intent or on accident. If a person sees a knife, they may get obsessive or intrusive thoughts about stabbing a person near them. A person with harm OCD related to harming somebody on accident could be a fear of a hit and run. A person might wash their hands excessively in fear of harming whomever they are serving food to. A parent may avoid hugging their child in fear of strangling them. Since we are instinctively wired to do something to feel better when we feel anxious, these people will engage in a compulsion. Compulsions may include hiding objects that trigger us, such as knife, forks, and sharp objects. They may engage in checking behaviors such as checking their past to make sure they aren’t capable of harming others. They may start mentally reviewing a memory to make sure they didn’t accidentally harm somebody. They may check the Internet for reassurance that these thoughts are normal. They may check old journals to see if they are capable of harming somebody. The may seek reassurance from others that they aren’t capable of harming others.

These disturbing thoughts or images manifest into the person feeling as if they are a bad person. HOCD is one of the most common subtypes of OCD that many individuals experience.

Contamination OCD

Contamination OCD is the most common form of OCD that we hear about in movies and TV shows. The most common fear with contamination OCD is touching certain things that can make them sick or the feeling of getting dirty. However, contamination isn’t just limited to dirt, germs, and viruses. Other things may be body excretions (urine, feces), bodily fluid (sweat, saliva, mucus), blood, garbage, semen, household chemicals, poisons, lead, spoiled food, soap, sticky substances, radioactivity, garbage, asbestos, dead animals, or newsprints. There are practically no limits to the things that people with OCD can perceive as contaminated. Individuals can also believe that thoughts, words, names, places where bad things have happened, mental images, or colors can be contaminated.

Magical thinking can also occur with contamination OCD. If I just had a thought that was unclean, then that person may believe that they are contaminated. It could be just watching something on TV, and then the person feels contaminated because they just watched it.

What does it mean to be contaminated? Sometimes it’s hard for people to describe because it can just be a feeling. Sometimes it can be a thought, or something more tangible. For example, they feel that now they are going to get sick or pass it along to somebody else.

Common COCD compulsions include:

  • Excessive hand washing
  • Showering
  • Washing certain parts of your house
  • Disinfecting
  • Throwing things away
  • Frequently changing clothes
  • Avoiding certain places
  • Avoiding touching things
  • Avoiding certain foods
  • Reassurance. Asking, “hey did you clean that?” “Are you sick?”
  • Internal Reassurance
  • Researching or Googling
  • Praying

Just Right/Perfectionism OCD

“Just right” obsessions are thoughts and/or feelings that something is not quite right or that something is incomplete. Instead of ruminating topics within someone’s mind, it’s more of a feeling that the individual gets. It’s a feeling of discomfort or tension within the person’s body. This can be incredibly time consuming for somebody because it can look like so many different things, not just washing hands. Grabbing a door handle, picking up an object, saying a word the right way, touching a light switch one more, time are all JROCD. People tend to do things over and over staying stuck in this mode until what they are doing “feels right.”

An example might be somebody that just washed their hands, but they get the feeling within their body that say “something doesn’t feel right about this, wash your hands another time.” So then they do it again. And again. And again. They do it until it feels right..

Some individuals may worry about making the wrong decision. They might put on a certain shirt and when they get to work, they might think they chose the wrong shirt and that they are going to be uncomfortable all day.

Things to look for if you are trying to figure out if you have Just Right OCD:

  • Difficulty making decisions
  • Counting Rituals
  • Perfectionism
  • The need for control or predictability

Relationship OCD

This subset of OCD comes in the form of doubts towards their relationship or partner. They may question their love, attraction, and/or compatibility for their partner. Having doubts about a relationship is normal. However OCD takes those doubts and turns them into irrational thoughts and a lot of jumping to conclusions. Individuals with ROCD tend to have this Hollywood picture perfect idea of what a relationship looks like. They feel that their relationship should be 100% all the time. Instead of allowing the relationship to grow together, they expect it to be 100%, 100% of the time. There are two types of relationship OCD, which include Partner focused, and Relationships focused.

Relationship focused OCD is when an individual is preoccupied with thoughts about the relationship. They may think, is this relationship good enough? Is this the right relationship for me? Am I in the right relationship? Is there somebody else better out there for me? They may see other couples and start comparing their relationship to their own. This then causes doubts that their relationship isn’t good.

Partner Focused OCD is when an individual is preoccupied with thoughts about their partner. This may include obsessing on the way their partner looks, talk, their intelligence, and their mannerism. They often find flaws in their partner’s appearance, such as certain body parts like their nose, ears, eyes, shoulders, and/or legs. They may obsess on their mannerism; such as the way they chew their food. They may think, “Wow, my partner chews his food so loud, can I really live with this for the rest of my life?” These are typical obsessions that people with ROCD struggle with. They are having constant intrusive thoughts, wondering, question, doubting.

Common compulsions may look like:

  • Checking your relationship
  • Comparing your partner to other people
  • Asking for reassurance if your partner is good for you
  • Analyzing your partner
  • Googling/”doing research” on what a health relationship looks like.

Scrupulosity or Religious OCD

Scrupulosity means to be obsessively preoccupied with doing the right thing. This can be religiously, morally, or ethically. It is common to be preoccupied with the thought that you are sinning, or that God is disappointed in you. You may fear that you are doing something against your moral or ethic values. These obsessive thoughts are followed by compulsions with the false idea that doing these will bring you relief and feel better about the obsession you have. Often times these people will have the urge to confess. This could be to a religious leader, partner, teacher, or parent. When confessional urges happen, an individual will gain the reassurance that they are not a bad person. The reassurance may help in the moment, but a day later the over analyzing starts to occur again. Did I give them all the details? Did I tell them the right things? You may start doubting the compulsion, which leads the person back to the religious leaders or parents again. The cycle then repeats.

Individuals may go overboard in the acts of service to orders. This person will continue to serve others, yet feel like they didn’t do enough. Some people may excessively pray, reciting a scripture they feel they need to do to be a good person.

Scrupulosity doesn’t have to believe in a higher power. They still can be excessively concerned about doing the right thing.

Symmetry OCD

Individuals who suffer from symmetry OCD become fixated on positioning things a certain way. This results in them feeling stressed and frustrated. They feel that they must arrange objects in a certain way or order. If it’s not arranged correctly, their brain will tell them it’s incomplete.

Symmetry OCD can manifest in multiple different ways. For example, how the individual writes. Their brain says to erase that letter, or throw it away and do it again. Individuals can get stuck looking at a specific line and see one specific letter that isn’t symmetrical, so they get rid of the whole thing and do another.

Other behaviors may include tapping, moving their body so that it feels just right. Children may align their stuffed animals in a certain way. They may align their pencils in a certain way or their homework before they can even start it. Their backpack straps may need to have the same exact pressure on both sides.

This can happen with body parts as well. You may stare at different parts of your body making sure it is symmetrical. This could be your face, shoulders, or feet. If you notice your right shoulder is higher than the other, the person may obsess on keeping their right shoulder down or bringing their left shoulder up to make it symmetrical. If something brushes against their left shoulder, they may feel that they need to do the same on their right shoulder so that it feels right or even it out. The individuals may obsess on the way that they walk, making sure each step they take puts equal pressure on each foot. They engage in these behaviors because they want to relieve the anxiety within them.

These symptoms can be very subtle, and go unrecognized by parents or even within ourselves. Because it can go undiagnosed for so long, it can be difficult for your brain to learn something different.

Sexual orientation OCD

This is not homophobic or denial. This is a subtype of OCD. This is where a person will obsess about their sexual orientation. People may have a fear of being gay, or a fear of becoming gay. People fear they will lose their identity, go against their religion, or ruin their relationship.

Common compulsions may include:

  • Avoiding all things associated with homosexuality. This could be friends, TV shows, or movies
  • Checking your own groins for sensations when around others that are the same sex
  • Asking for reassurance, whether it’s online, a friend, or parents. Asking them, “Do you think I could be gay?”
  • Neutralizing thoughts
  • Repeated phrases “I am not gay, I am not gay.”
  • Mentally reviewing their sexual history
  • Looking for evidence that they are straight
  • Praying

Existential OCD

It is normal to question the meaning of life and what our purpose here on earth is. However if your brain doesn’t stop ruminating about the existential aspects of life and/or these big philosophical questions, then you may be struggling with Existential OCD. In addition to the frequent rumination, individuals suffering from EOCD may have an urge to find a solution right now. These questions get stuck in an endless loop of intense evaluation, research, and testing. It involves questions that are impossible to answer. These questions revolve around the meaning, purpose, or reality of life. It may also revolve around the existence or the universe, or the existence of your meaning in life. You may feel this overwhelming urge to have all the answers.

Do you ever find yourself questioning:

  • What is the meaning of life?
  • What if I never find my purpose?
  • How do I know this is real of not?
  • How do I know I’m not in a dream or a simulation?
  • What if when I die, I’m completely forgotten?
  • Why am I the person I am?
  • What is my purpose in life?

Do you find yourself engaging in any of these compulsions?:

  • Asking professors, friends, religious leaders, their thoughts on this
  • Excessively reading blogs, books, studies, psychology, or philosophy
  • Excessively praying asking why you are here
  • Researching online
  • Doing anything to gain an answer

Sensorimotor OCD

Have you ever noticed a physical sensation that you were uncomfortably hyper aware of? This can be a normal trait for anybody, for example having a stuffy nose. Maybe you were lying in bed thinking about how awful your nose feels and how the lack of sleep that may follow because of it. It is normal to be preoccupied with these thoughts for a short period of time, however somebody that experiences sensorimotor OCD is preoccupied with these thoughts all of the time. The individual will continue to focus on a physical sensation day after day with no relief. They may notice every time they swallow, breathe, blink, cough, or any other bodily function. This can completely occupy the person’s time making it difficult to pay attention to what is around them, engage in conversations, complete tasks, or just enjoy life. People fear that they will always be distracted by these thoughts, and that they will never feel normal again.

Individuals with Sensorimotor OCD commonly focus on:

  • Breathing: Whether the breath is slow, fast, shallow, or deep.
  • Floaters in their eyes.
  • The positioning of their tongue
  • Pulse and heartbeat
  • Eye contact
  • The sensation of moving body parts
  • The shapes of muscles throughout the body

Common compulsions of Individuals with Sensorimotor OCD are:

  • Holding the breath for a specific amount of times
  • Excessive eye rubbing
  • Excessive blinking
  • Forcing themselves to repeatedly swallow
  • Checking their heart rate throughout the day
  • Continuously scheduling unwarranted medical appointments
  • Avoiding eye contact or forcing excessive eye contact
  • Wearing clothing that covers a certain body part

Body Dysmorphic Disorder

Do you have frequent and obsessive thoughts about your appearance? Do you notice a specific body part, a physical defect, or an imagined physical defect? Maybe not just noticing it, but thinking about it throughout the entire day? You may avoid going places in fear of extreme anxiety because of it. People with Body Dysmorphic Disorder tend to check their appearance multiple times a day and obsess on their perceived flaw, or avoid it entirely. This may be your skin, hair, the absence of hair, hair in certain body parts, nose, ears, eyes, and/or sexual organs. People with BDD have inaccurate views of themselves. This can affect an individual’s ability to maintain relationships, work, and socialize because they cannot stop focusing on their defect.

Many people are unhappy with some way that they look, but they aren’t thinking about it all day long. The biggest difference is the amount of time that the person is entertaining these thoughts each day. People with BDD obsess on it throughout the day, and feel anxious and consumed about their real or perceived physical flaw.

Pedophilia OCD

POCD is not that well known. A person suffering from POCD tends not to talk about it due to shame, guilt and embarrassment. People tend to suffer in silence with this for many years because they may actually believe they are a pedophile and don’t want to share this information with others.

Imagine sitting at the park and you look over and see a group of children playing on a swingset. You think to yourself, “that looks fun!” You watch them play as they run around and enjoy themselves. All of a sudden you get this creepy thought, “did I just look at those kids in a creepy way?” With OCD, the brain is always analyzing, doubting, and questioning. You may start to question yourself why you would look at them in a certain way. You may think that since you were starring at them a certain way, it must mean something, right? Am I looking at them because I’m physically attracted to them? You’re not attracted to them, but why else would you have these thoughts? Now you’re feeling anxious about the thoughts, so then your brain starts to question WHY you are anxious about having these thoughts. Anxiety is supposed to tell us that there is danger, so does that mean that this anxiety is notifying us that we could be a danger to these children? Does this mean that you might be a pedophile? This is an example of somebody that may struggle with POCD.

Somebody with OCD may have unwanted, harmful, or sexual thoughts about children. This can result in panic and anxiety. People living with POCD have no intentions of harming children, but they are tormented with the thoughts or possibly doing so. True pedophiles tend to slowly get closer to children, where individuals with POCD do the exact opposite; they avoid. They will start to avoid looking at children at all costs. They may stop avoiding watching shows with children in them. They could avoid going to places where they think children might be. They may avoid family gathers in fear that children will be there. This subtype of OCD is truly torturous to the person. Individuals tend to suffer in silence due to the fear of somebody confirming their fear that they are in fact a pedophile.

Suicidal OCD

Do you have a fear that you’ll commit suicide? Or perhaps you find yourself constantly thinking about ways you’ll commit suicide? Do you constantly reflect on your life trying to determine if you’ll act upon these thoughts? Do you struggle with the fear of becoming depressed which can lead to suicide? Do you have a fear of acting on an impulse to commit suicide? This could be jumping into traffic, jumping off a bridge, or crashing your car? Having these thoughts is normal and natural. A person can quickly dismiss that thought, however an individuals brain will naturally attach this to anxiety if they have OCD. When our brain attaches anxiety to something, it makes it a catastrophic. Your brain thinks that because you feel anxious, it’s telling you that you may be in danger. Since you are in danger, you must do something to get rid of it. Your brain takes a natural and normal thought and blows it up, making it a big deal. Individuals with Suicidal OCD don’t want to kill themselves; they live with the fear that they could potentially kill themselves.

Suicidal idealization is different than Suicidal OCD. If you are experiencing suicidal thoughts and/or intentions, please seek help immediately.

PANDAS

PANDAS is characterized by an abrupt onset of obsessive-compulsive behaviors (OCD) and/or motor or vocal tics in pre-pubescent children immediately following a group A Strep infection. These symptoms are extreme and interfere with a child’s daily life. Additionally, children experience concurrent psychiatric and neurologic symptoms. PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection. It is an autoimmune condition initially triggered by strep which disrupts a child’s normal neurologic activity. PANDAS occurs when the immune system produces antibodies, intended to fight an infection, and instead mistakenly attacks healthy tissue in the child’s brain, resulting in inflammation of the brain (basal ganglia section) and inducing a sudden onset of movement disorders, neuropsychiatric symptoms and abnormal neurologic behaviors.

PANS

PANS is the acronym for Pediatric Acute-onset Neuropsychiatric Syndrome, a more recently defined disorder which encompasses the more familiar medical condition, PANDAS or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections. PANDAS is now considered a subset of the broader classification, PANS.

The National Institute of Mental Health (NIMH) acknowledged that PANS, a treatable autoimmune condition, could be triggered by any number of infections (other than strep), and that patients could be diagnosed with the condition even if the infectious trigger(s) was unknown.

PANS can be triggered by numerous infections

Published reports indicate that PANS can be triggered by numerous infections, including Borrelia burgdorferi (Lyme disease), mycoplasma pneumonia, herpes simplex, common cold, influenza and other viruses.

Symptoms of PANS/PANDAS:

  • Presence of OCD, a tic disorder, or both
  • Episodic course of symptoms
  • History of strep, Scarlet fever, or other infections
  • Association with neurological abnormalities such as physical hyperactivity or unusual, jerky movements that are not in the child’s control
  • Very abrupt onset or worsening of symptoms
  • Symptoms of attention-deficit/hyperactivity disorder (ADHD), such as hyperactivity, inattention, or fidgeting
  • Separation anxiety
  • Mood changes, such as irritability, sadness, or emotional liability (i.e., tendency to laugh or cy unexpectedly at what might seem the wrong moment)
  • Difficulty sleeping and insomnia
  • Nighttime bed-wetting, frequent daytime urination, or both
  • Changes in motor skills, such as handwriting
  • Joint pains

Magical Thinking

People with this type of OCD fear that if they don’t do a certain behavior, then something bad will happen. People may believe or think that if they don’t tap something in a specific way or flip the light switch three times before leaving the house, then something bad might happen to a loved one.. This could also happen with colors. They may feel the need to wear the color blue on Tuesdays, or else their mother will get struck by a blue car. Logic may or may not be present, but there is always an overall feeling that something bad is going to happen, and it can be prevented by a specific behavior.

Think about the common saying “don’t step on the crack, you’ll break your mothers back.” This is how individuals with OCD think on a daily basis.

Other symptoms of Magical Thinking OCD may include:

  • Touching certain things in a particular way or a certain number of times.
  • Moving one’s body positioning in a particular way.
  • Performing actions at special times or on certain dates.
  • Performing physical actions, but in reverse.
  • Stepping in particular ways or on particular spots while walking.
  • Arranging objects or possessions in a certain order.
  • Reciting or thinking of certain words, sounds, numbers, images, phrases, or names.
  • Thinking thoughts in reverse.
  • Repeating one’s own words, or the words of others.

BFRB stands for body focused repetitive behaviors. BFRB is a general term that refers to any repetitive self-grooming behavior (pulling, picking, biting or scraping of the hair, skin or nails) that results in damage to the body.

Examples of BFRB include:

  • Trichotillomania (hair pulling)
  • Dermatillomania Onychophagia (nail biting)
  • Excoriation Disorder (skin picking) –
  • Biting (Lip and cheek)
  • Rubbing

Do you spend hours on the Internet researching symptoms for health information? Maybe you developed a small skin rash and you automatically think it’s cancer. This may result in making frequent doctors appointments, even when the doctor tells you that you’re fine. You still doubt the doctor’s advice even though all the tests indicate that you are healthy. Are you ever looking for symptoms or hyper aware of what you’re body is doing? Or do you find yourself obsessing on a small symptom and urgently needing to find answers? If so, you may be experiencing health related anxiety. Health anxiety can trick you into thinking your body may be in danger when you’re not. This doesn’t mean that the person is making up symptoms, but they find themselves catastrophes what the symptoms mean.

Common health concerns that people with health anxiety experience are fear of:

  • Cancer
  • HIV
  • Other mental health related disorders
  • Dementia