OCD Subtypes

Most often, people assume OCD is just the classic handwashing, cleaning, organizing or door checking, but there are many themes OCD can latch onto. OCD presents differently for every person, especially because OCD latches onto what is most important for that person. These different variations are called subtypes and although it can be informative to know and understand your subtype, treatment for OCD looks the same for each one.

What are OCD subtypes?

OCD subtypes are the specific content of the obsessions and compulsions, such as contamination, relationships, harm, health, etc. There are many themes or subtypes OCD can hook us into! More importantly, it’s vital to understand the OCD cycle. There is a trigger, obsessive thought, urge, compulsion and temporary relief. The OCD cycle remains the same, but the content or subtypes can change, and it usually does!

Why do the subtypes matter?

OCD is still misdiagnosed fairly often, so recognizing what OCD can look and sound like in these subtypes helps clients get the proper diagnosis and treatment. For example: Relationship OCD is becoming more prominent, and instead of working with a client to “figure out” what went wrong or if they are responsible for the relationship ending, the wrong lens turns a compulsion into a therapy goal. Likewise, OCD thoughts can create shame and in my personal experience, it helps reduce the shame when I know that these thoughts are “just OCD” doing its work. Lastly, some clinicians like to treat only certain subtypes so it can when looking for specialized treatment. 

Most common OCD subtypes

Contamination OCD
∙ Obsessions: germs, illness, spreading contamination, feeling “dirty”
∙ Compulsions: handwashing, avoiding surfaces, reassurance seeking, cleaning rituals

Harm OCD
∙ Obsessions: fear of causing harm to self or others either intentionally or deliberately, images of people being harmed
∙ Compulsions: reassurance seeking, checking (locks, emails, appliances), avoidance, mental reviewing

Just Right or Perfectionism
∙ Obsessions: Something feels “off” or incomplete
∙ Compulsions: redoing tasks, erasing and rewriting, seeking confirmation

Symmetry and Order
∙ Obsessions: things feel out of place, uneven
∙ Compulsions: arranging, straightening or touching things in order

Sexual OCD
∙ Obsessions: Unwanted thoughts about inappropriate sexual content or taboo content
∙ Compulsions: reassurance seeking, avoidance

Scrupulousity
∙ Obsessions: fear of sinning, blasphemy, betraying God or moral issues
∙ Compulsions: mental rituals (praying in a certain way, cancelling thoughts), confessing, avoiding church

Health OCD
∙ Obsessions: developing a serious illness
∙ Compulsions: googling, Chatgpt, medical reassurance, checking (body scanning or device)

Intrusive Thoughts/Pure O- compulsions are mental
∙ Obsessions: unwanted violent, sexual, or taboo thoughts/images
∙ Compulsions: mental rituals, thought suppression or neutralization, reassurance-seeking

Relationship OCD/ROCD
∙ Obsessions: doubt about love, attraction, partner’s flaws, being “the right one”
∙ Compulsions: seeking reassurance, comparing, mentally reviewing feelings

Existential OCD
∙ Obsessions: meaning of life, reality, consciousness, death, free will
∙ Compulsions: mental rumination, philosophical research, reassurance-seeking

False Memory/Real Event OCD
∙Obsessions: fear you did something wrong or embarrassing in the past; uncertainty about what actually happened
∙Compulsions: mental reviewing, confession, reassurance-seeking

Perinatal and Postpartum OCD
∙Obsessions: fears of harming the baby, something going wrong during pregnancy/birth
∙Compulsions: checking, avoiding baby care tasks, seeking reassurance

Responsibility OCD
∙Obsessions: fear of being responsible for harm to others through action or inaction
∙Compulsions: confessing, over-apologizing, seeking reassurance, excessive caution

Hoarding OCD
∙Obsessions: fear of discarding something important or needed
∙Compulsions: saving items, inability to throw things away; distinct from hoarding disorder

Magical Thinking / Superstitious OCD
∙ Obsessions: fear that thoughts or actions will cause harm
∙ Compulsions: rituals, counting, repeating actions a “safe” number of times

Pedophilia OCD (POCD)
∙ Obsessions: fear of being attracted to or harming children
∙ Compulsions: avoidance, mental checking, seeking reassurance

Sexual Orientation OCD (SO-OCD)
∙ Obsessions: doubt about one’s sexual orientation
∙ Compulsions: mental reviewing, testing attraction, reassurance-seeking; distinct from genuine questioning

Sensorimotor / Somatic OCD
∙ Obsessions: hyperawareness of bodily sensations (swallowing, breathing, blinking, heartbeat)
∙ Compulsions: monitoring, checking, seeking reassurance that the sensation will go away

What type of OCD do I have?

A licensed professional that specializes in treating OCD can help you identify which subtype(s) your OCD is currently latched onto. An OCD therapist will do a proper assessment and help identify your presentation. Remember, OCD themes can shift and overlap, and they simply just describe the focus of OCD.

OCD Quiz

There are not any validated quizzes that help you identify your theme but it can be helpful to take the Obsessive Compulsive Inventory if you are interested in seeing if you might have OCD: https://www.onlinecbtresources.co.uk/obsessive-compulsive-inventory/

How are different forms of OCD treated?

The first line of treatment for OCD is Exposure and Response Prevention (ERP), the gold-standard for all subtypes. As mentioned before, subtypes are just the content of the OCD and with ERP, the process of OCD is treated, not the content. A complementary therapy commonly used alongside ERP is Acceptance and Commitment Therapy (ACT). The second line of treatment is ERP and medication (SSRIs). Not everyone needs medication. 

OCD types FAQ

How many types of OCD are there?
There is no official number as the subtypes reflect common themes and we are still discovering all the ways OCD manifests. There is only one diagnosis for OCD, as these are not separate diagnoses. 

What’s the rarest OCD?
There is no specific answer for this and I’ve heard people say sensorimotor, but I personally struggled with sensorimotor OCD, and I’ve had clients who have experienced the same. 

What is the hardest type of OCD to treat?
OCD treatment is in fact fairly simple but poor outcomes can come from clients not ready to do the work or engaging in hidden compulsions. It doesn’t matter the subtype because we are treating the OCD cycle—the content is in fact irrelevant, except that it’s ego-dystonic for you. 

What if I don’t fit neatly into one subtype?
Most people do not! OCD can show up in multiple themes at any given time. 

Why do my OCD themes keep changing?
OCD latches onto what matters most so if you experienced OCD contamination and then had a baby, your OCD might shift to harm OCD around the baby. 

Final Thoughts

When I found an OCD therapist, it was life changing! OCD made me question my sanity and it felt as though I was the only one experiencing these types of thoughts and intrusive images. I had no idea OCD could fall into all these other subtypes and sadly, I had been to many therapists over the years who missed this diagnosis. I struggled with sensorimotor OCD for over 10 years and when I learned that my issue was in fact OCD, I felt so much relief because that meant there was treatment. Now, I know what to do when the OCD obsessions present themselves after learning ERP.