OCD Flavors

By Laura L. Smith, Ph.D.

We find OCD one of the most fascinating disorders to work with. Why? First, people with OCD are wonderful to work with. Second, most cases can be successfully treated with a form of Cognitive Behavioral Therapy called Exposure and Response Prevention. Finally, OCD comes in an amazingly wide variety of types. The following list is our attempt to categorize the forms. In reality, OCD types can change over time, overlap with each other, and get pretty convoluted. Professionals don’t have an agreed upon list of OCD types. But here we go with our best take on it:

Contamination: the most common form of OCD. People with this problem worry about either becoming contaminated themselves, or spreading contamination to others.

Doubting and Checking: these folks fret about making sure the doors are closed, the windows locked, the coffee pot turned off, or other potential dangers. Some hit a bump in the road and believe that they might have hit someone or something. Some refer to this last example as “hit and run OCD.”

Symmetry: all books must be ½ inch from the edge of the shelf. The specific issues with this type of OCD vary greatly from person to person. Perhaps the cans in the cupboard must be arranged alphabetically. Closets need to have certain order. Carpet fringe must be combed perfectly straight.

Superstitious: all sorts of beliefs, rituals, and behaviors can be part of this type of OCD. For example, some people must repeat words a number of times to avoid bad luck, others avoid looking at anything related to death, and some people have special rituals to prevent disease or bad things happening to themselves or others.

Shaming OCD: people with this type of OCD worry that they might do something horribly upsetting or embarrassing. For example a religious person might worry that his bad thoughts might mean that he is a sinner. Another person might worry that he’ll lose all control and push someone off a sidewalk into oncoming traffic. A new mother might worry that she might hurt her baby (see earlier post on baby anxiety).

Hoarding: this is not the collector or the person who can’t throw away old books. People with this form of OCD have homes with floor to ceiling stacks of stuff; certain areas are unlivable. The stuff can range from collections of scraps of paper, broken appliances, finger nail clippings, old mail, to animals. Hoarders rarely seek help and do not want to give up their collections. But you can hardly define their accumulations as collections in the usual sense.

As you can see, OCD can come in a variety of symptoms. Happily, treatments can be tailored to match the needs of the client. However, just because you have a few of these symptoms, it may not be OCD if they are minor or don’t take up much time. More on that issue later. We look forward to talking further about OCD in many blogs to come.


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