OCD can attach itself to nearly anything. What these presentations have in common is a cycle of intrusive thoughts, feelings, images, urges, or doubts followed by attempts to reduce distress or gain certainty through compulsions, reassurance, avoidance, checking, or mental analysis.
You do not need to see your exact experience listed here for it to be OCD. Many people have symptoms that cross several themes or do not fit neatly into a category.
There is no cure for OCD, but it is highly treatable. Exposure and Response Prevention (ERP) is the first-line treatment for OCD.
At Valeo Mental Health, I provide evidence-based treatment for OCD using Exposure and Response Prevention (ERP). I offer in-person therapy in Holland, Michigan, as well as virtual OCD treatment for teens and adults throughout Michigan.
Obsessive Compulsive Disorder (OCD)
Common presentations of OCD:
ContaminationFears of being contaminated or contaminating others through germs, bodily fluids, chemicals, dirt, illness, or even things that simply feel “dirty” or disgusting. Compulsions may include excessive washing, cleaning, changing clothes, avoiding certain objects or places, or asking others to follow contamination rules.
Religious Scrupulosity
Obsessions involving sin, faith, blasphemy, religious rules, or fear of offending God. Compulsions may include excessive prayer, confession, reassurance seeking, repeating religious practices until they feel correct, or trying to achieve certainty about one's faith or salvation. These compulsions are fear based and done to prevent or erase something terrible. They do not represent a person's genuine relationship with their faith or God.
Harm
Unwanted fears, thoughts, images, or urges about harming oneself or someone else. This can include fears of losing control, acting violently, causing an accident, or being responsible for someone being hurt. Suicidal OCD can involve frightening, unwanted thoughts or images about suicide and repeated attempts to determine, “What if I actually want to do this?” or monitoring mood/physical symptoms.
Fear of being immoral, dishonest, selfish, offensive, irresponsible, or simply a “bad person.” Someone may repeatedly review interactions, confess perceived mistakes, seek reassurance, apologize excessively, or analyze whether their intentions were completely good.
Moral RelationshipRepeated doubts about relationships, such as “Do I really love my partner?” “Are they the right person?” or “What if I'm settling?” Relationship OCD can also involve intense fears about cheating or infidelity—for example, worrying that you might cheat in the future, or repeatedly trying to determine whether you have ever been unfaithful. Compulsions may include comparing a partner to others, checking feelings of attraction, analyzing interactions, confessing thoughts or perceived transgressions, reviewing past events, or repeatedly seeking reassurance.
PedophiliaIntrusive fears about being sexually attracted to children or potentially harming a child, despite these thoughts being unwanted and distressing. People may repeatedly analyze their thoughts, emotions, memories, or physical sensations; seek reassurance; or try to “prove” to themselves that they are not attracted to children. Avoidance may include children, family gatherings, schools or playgrounds, children's media, physical affection, being alone with a child.
Sexual Orientation/Identity
Persistent doubts about one’s own sexual orientation, gender, attraction, or identity. Compulsions often involve checking reactions or physical sensations, reviewing past experiences, comparing attraction to different people, researching, or repeatedly trying to achieve certainty about one's identity.
Sensorimotor
An intense awareness of bodily sensations or normally automatic processes such as breathing, blinking, swallowing, heartbeat, eye contact, or the position of one's tongue. A common fear is becoming permanently aware of the sensation or never being able to stop noticing it. Attempts to monitor, control, suppress, or determine whether the sensation is still noticeable can make the awareness even more persistent.
Health
Persistent fears about having, developing, or failing to detect a serious illness or medical condition. Compulsions may include repeatedly checking body for symptoms, researching illnesses, seeking reassurance from others or medical professionals, reviewing test results, or avoiding health-related information because it triggers anxiety.
Real Event
Intense doubt and guilt about something that actually happened in the past. OCD may demand repeated analysis of what happened, what it says about the person, whether they caused harm, or whether they deserve forgiveness.
Existential
Persistent, distressing questions about existence, reality, consciousness, free will, death, or the meaning of life. Rather than simply being curious about these questions, someone with existential OCD may feel an urgent need to solve them or reach certainty before they can move on.
Just Right
A strong sense that something is not quite right, complete, symmetrical, balanced, or exact. This can also include a need to “even out” sensations on the body—for example, touching something with the left hand after touching it with the right hand, repeating a movement on the opposite side of the body, or making sensations feel equal on both sides. Compulsions may also include repeating actions, arranging things, rereading, rewriting, redoing tasks, or continuing an activity until it produces the “right” feeling.