Obsessive Compulsive Disorder

 

When people think of Obsessive-Compulsive Disorder (OCD), they often picture someone who’s excessively neat, loves organisation, or is constantly cleaning. But this is a stereotype. While contamination fears and compulsive cleaning can be part of OCD, the disorder is far more complex than that.

 

At its core, OCD is a disorder of doubt. It’s not about wanting things to be tidy—it’s about the fear of uncertainty and the distress it brings.

 

What makes OCD so tricky is that it’s literally your doubt response misfiring. You fall into the trap of trying to feel certain—but you’re doing it through the lens of doubt, which is a paradox. The more you try to find certainty, the more uncertain you feel.

 

Most people with OCD don’t struggle with visible compulsions like excessive hand-washing. Instead, the most common compulsions are mental, such as intrusive thoughts, compulsive reassurance-seeking, and rumination—repetitive thinking that feels impossible to switch off.

 

The Two Main Components of OCD

 

OCD is usually divided into two key elements:

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1. Obsessions – Unwanted, distressing, and intrusive thoughts, images, or urges that cause anxiety.

2. Compulsions – The actions, rituals, or mental strategies used to relieve the distress caused by the obsessions.

 

Many people assume OCD is just about external behaviours, such as checking locks or avoiding germs. But the majority of OCD sufferers struggle with rumination—mentally trying to “solve” or “undo” intrusive thoughts.

 

This is why the term Pure O (Purely Obsessional OCD) is misleading—because even if compulsions are invisible, they still exist.

 

Common Types of OCD

 

OCD can latch onto anything that matters to you, making you doubt your thoughts, actions, and even your identity. Below are some of the most common types of OCD:

 

1. Relationship OCD (ROCD)

 

People with ROCD obsess over their relationships, constantly questioning:

• Do I really love my partner?

• What if they’re not “the one”?

• What if I made a mistake staying with them?

 

This leads to compulsions like constantly seeking reassurance, comparing feelings, or mentally reviewing past interactions.

 

2. Harm OCD

 

Harm OCD involves distressing, intrusive thoughts about hurting yourself or others. These thoughts can feel completely opposite to who you are, making them especially terrifying. Common fears include:

• What if I lose control and hurt someone I love?

• What if I push someone in front of a train?

• What if I snap and do something awful?

 

People with Harm OCD don’t want to act on these thoughts—but the distress makes them seek reassurance, avoid situations, or perform mental compulsions to “neutralise” the fear.

 

3. Sexual and Taboo OCD

 

This subtype involves intrusive thoughts about inappropriate, disturbing, or taboo sexual themes, such as:

• What if I’m attracted to something I shouldn’t be?

• What if I did something wrong and don’t remember it?

• What if I develop inappropriate urges?

 

These thoughts lead to compulsions like avoiding certain situations, mentally reviewing past experiences, or seeking reassurance that the thoughts “don’t mean anything.”

 

4. Checking OCD

 

This is one of the more well-known subtypes, where compulsions revolve around checking things repeatedly to prevent a feared outcome. Common checking behaviours include:

• Repeatedly locking doors and windows.

• Checking the oven, stove, or appliances to prevent a fire.

• Re-reading emails or texts to make sure nothing is offensive or incorrect.

 

This cycle is exhausting because checking never truly satisfies the need for certainty—it only reinforces doubt.

 

5. Health Anxiety (Health OCD)

 

Health anxiety (sometimes called Health OCD) is another form of OCD where people obsessively worry about having an undiagnosed illness. This leads to:

• Excessive Googling of symptoms.

• Constantly checking the body for signs of disease.

• Seeking reassurance from doctors (or avoiding them entirely out of fear).

 

6. Real Event OCD

 

People with Real Event OCD obsess over something that actually happened in their past, questioning:

• What if I did something wrong and didn’t realise it at the time?

• What if I was rude to someone years ago and it makes me a bad person?

• What if I hurt someone unintentionally and they still think about it?

 

This leads to compulsions like mentally reviewing past interactions, trying to remember details perfectly, or confessing to people unnecessarily to “make it right.”

 

7. Somatic OCD

 

Somatic OCD revolves around obsessing over bodily functions or sensations, such as:

• Breathing patterns (Am I breathing too fast? Too slow?)

• Blinking or swallowing (Now I can’t stop noticing it!)

• Skin picking, hair pulling, or other repetitive behaviours (If I don’t stop, something bad will happen.)

 

This can lead to extreme distress as the person becomes hyper-focused on bodily sensations that were previously automatic.

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These are just a few common examples, but OCD can present in many ways. 

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OCD Doesn’t Just Make You Anxious—It Weaponises Guilt

 

A major aspect of OCD that’s often overlooked is how it exploits guilt.

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• If I have this thought, does it mean I’m a bad person?

• If I leave this alone, does it mean I don’t care?

• If I don’t feel bad about this, does it mean something is wrong with me?

 

OCD convinces you that if you don’t engage with the thought, it must mean something negative about you. The disorder plays on your morals, values, and integrity, making you feel like you have to act, check, or fix something—otherwise, you’re somehow responsible.

 

This is why OCD is so distressing: it doesn’t just create anxiety, it makes you doubt yourself as a person.

 

Reassurance Addiction: Why OCD Makes You Chase Short-Term Relief

 

One of the biggest traps people with OCD fall into is reassurance-seeking. The feeling of anxiety is uncomfortable and often feels chronic, so it makes sense that people look for ways to instantly relieve it.

 

Some common reassurance-seeking behaviours include:

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• Googling symptoms over and over.

• Asking a loved one, “Do you think I would ever do this?”

• Replaying memories to “check” if something bad happened.

• Checking forums and Reddit threads to see if other people have the same thoughts.

 

The problem? Reassurance only works for a moment—but the doubt always comes back. The brain learns that you need to check in order to feel safe, so the cycle continues.

 

Treatment for OCD

 

The gold standard treatments for OCD are:

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• Exposure and Response Prevention (ERP) – Gradually exposing yourself to fears without using compulsions.

• Inference-Based Cognitive Behavioural Therapy (ICBT) – A different approach that helps break down the faulty reasoning behind OCD doubts.

 

If you struggle with OCD, I highly recommend reading my e-book, Unravel Your Intrusive Thoughts, where I go deeper into how to stop getting caught in the OCD loop.

 

You can also listen to our Disordered Podcast, where we explore OCD, anxiety, and how to recover.

 

For more daily insights, follow me on Instagram at @anxietyjosh.

 

Disclaimer: This article is for informational purposes only and should not replace professional medical advice. If you’re concerned about your symptoms, consult a healthcare professional.