When I say “OCD,” what comes to mind? Probably the television show, Monk, or a person washing their hands for an hour. Or maybe you picture empty shelves in grocery stores because of people panic-buying cleaning supplies and toilet paper during the COVID-19 pandemic. Did you know there are actually a number of different OCD types?Maybe you picture yourself sanitizing your hands before you go into the grocery store, or maybe you think of all of us as we face ongoing quarantine — after all, we’re all “a little OCD,” aren’t we?
These are all woefully incorrect images of what OCD really is. The world’s population did not magically get Obsessive Compulsive Disorder overnight, and surprise, Adrian Monk did not have OCD, he had OCPD, Obsessive-Compulsive Personality Disorder (highly recommend this show for a quarantine binge despite its inaccuracy). And no, we are not all “a little OCD” right now.
What is OCD?
So, what is OCD? Obsessive-Compulsive Disorder is comprised of intrusive thoughts, feelings, or urges (obsessions) that spark intense anxiety combined with compulsive behaviors done to reduce the anxiety the intrusions bring about (compulsions). It is a biological brain disorder. OCD latches on to what people value most and then warps those things into terrifying fears that feel like reality.
To use the example the world is most familiar with, this would involve a person having the thought pop into their head that they might have touched a contaminated object, so they wash their hands 52 times just to be sure. This thought and action pattern would likely occur multiple times a day or any time they touched the item they believed to be contaminated.
However, generally, when OCD is displayed by popular culture, the context of extreme anxiety and unwanted thoughts, images, or urges are entirely left out or are made fun of. Besides, contamination OCD, as described in the example, is only one of the many OCD types.
There are many different OCD types, referred to as “themes.” The most common OCD types are contamination, loss of control, harm, perfection, sexual, religious scrupulosity, reality, and relationship OCD. Health is often a theme as well, though currently Health Anxiety can be diagnosed apart from OCD.
Common compulsions include washing, checking, repetitive behaviors, seeking reassurance, avoidance, confessing, and even prayer.
What do these OCD types look like?
Contamination OCD involves having an intense fear of becoming contaminated by certain substances such as bodily fluids, germs or disease, environmental contaminants such as radiation, household chemicals, dirt, and many more. The fear of encountering one of these substances is intense, so the person takes precautions either out of fear they have been contaminated or will become contaminated.The precautions, also known as compulsions, either have no logical connection to the contaminant (i.e. – praying ten times every time they touch a bottle of bleach) or are connected but are done in excess (i.e. – meticulously cleaning their apartment all day every day to purge potential germs from their home).
Losing Control OCD
Losing control OCD is just what it sounds like. A person with this subtype may have thoughts about impulsively harming something or experience violent images that pop up in their mind or have a more general fear of going crazy. Compulsions are done not only to relieve the anxiety around the thoughts but also to protect people from themselves.
It is important to note that people with OCD are in no way a danger to others as their obsessions are ego-dystonic, against their values, which is the very core of why the thoughts are so terrifying.
Harm OCD is another common subtype. This involves fears of harming yourself or someone else. People with this theme experience thoughts or images ranging from stabbing a loved one to accidentally causing a fire that burns down a house. They can also have thoughts of harming themselves even though they have no desire to die. This is different from suicidal ideation due to their lack of desire to leave this earth.
An important form of Harm OCD is Postnatal OCD. This is where moms who adore their children have thoughts of hurting them. An example here is a mom having an image of dropping her baby. There can, of course, be paternal OCD as well, but the name is given in response to new moms experiencing this type of OCD.
Compulsions for Harm OCD are often avoidance based. For example, for the wife who has an image of stabbing her husband, a compulsion would be to never touch a knife when he’s at home. Another common version would be checking whether she wants to kill her husband or not. She could spend hours analyzing in her mind whether she is really a violent person.
Perfection OCDPerfection OCD is another one that often appears in popular culture. This is otherwise known as “just right” OCD. This is where someone must do something a certain way until they have the feeling of things being “just right.” An example of this would be walking through a doorway three times whenever they entered the room or organizing their closet every day until it’s perfect.
Obsessions here are more related to the concern of something feeling “off.” Compulsions can be repeating activities, doing things in multiples, or counting, among others.
Sexuality-related OCD occurs when OCD attacks a person’s sexual identity. It can also relate to incest or pedophilia (known as POCD) thoughts or images. “What if I’m not straight?” “What if I’m homosexual?” “Why did that image of molestation pop up in my head?” “I love my dog, am I attracted to her?”
Again, the reason these are so distressing is because they are entirely counter to the person’s belief system and are therefore abhorrent to the person with OCD. Yet the OCD monster convinces the person that having those thoughts must mean they are true, and you are therefore a terrible person. Nothing could be further from the truth. The thoughts would not be disturbing if they didn’t go against your beliefs.
Compulsions involve checking to see if you really are attracted to a certain sex or if you are attracted to kids, etc. and avoiding situations that could trigger the thoughts. For example, a female with the fear of being homosexual might avoid watching movies with attractive actresses or homosexual characters. Praying for forgiveness is another common compulsion.
Religious OCD, also called Scrupulosity, attacks a person’s faith system with thoughts that could look like: fear of offending God, being possessed, doing something immoral, not believing in your faith system, and more. A person with this subtype may have thoughts hounding them saying, “You don’t really believe in God,” or “What if you’re possessed?”
Compulsions could be confessing sins, praying in response to the thoughts, and seeking reassurance that God still loves them, to name a few. It is often argued that Martin Luther and John Bunyan dealt with scrupulosity during their lives.
Reality OCDReality OCD deals with existential concerns. What is real? Am I hallucinating? Is the person in the mirror really me? It spins these thoughts around in the mind of the person making them doubt their very existence.
Compulsions can be anything to relieve the anxiety, but some might be avoiding triggers, seeking reassurance from others, trying to find proof and more. Some people may end up staring at pictures of themselves for hours on end, just to be sure that it is really them in the photo.
Relationship OCD attacks relationships, either romantic or platonic. What if I am not attracted to my partner? Did they cheat on me? What if I cheat on them? Is this the right person for me? What if they are not the one? OCD attacks the uncertainty that comes with every relationship and spirals it out of control.
Compulsions would commonly be seeking reassurance through questioning partners or others, praying for God to show you if he/she is for sure “the one,” avoiding situations that make you doubt your relationship even more, checking to see if you love them, and of course, so many more.
Finally, health OCD is another common subtype. People suffering this type of OCD are often afraid they have a disease like cancer, will have a heart attack, have an underlying condition the doctors haven’t caught, or have a brain tumor. Any discomfort in their body is either blown out of proportion or is responded to with severe anxiety, only worsening the symptom.
Examples of compulsions might be excessive doctor visits to check if they missed something last night and googling symptoms for hours, or it could be just the opposite where they avoid the doctor at all costs and avoid seeing anything about health on television or in the news.
So no, we did not all catch OCD when this pandemic hit. OCD is a severely misunderstood anxiety disorder that causes intense distress to those who experience it. It latches onto anything that has a level of uncertainty to it and is in the person’s values system.
Christian Counseling for Obsessive Compulsive Disorder
However, there is hope—Exposure Response Prevention and Acceptance based therapies have proven to be highly effective in treating this disorder and ultimately teach that a thought is indeed, just a thought.
If you or a loved one are battling one of the OCD types mentioned in this article, reach out to a counselor who knows OCD and therefore how to help you with effective treatments.
“Hand-washing”, Courtesy of Curology, Unsplash.com, CC0 License; “Covid-19”, Courtesy of Adam Niescioruk, Unsplash.com, CC0 License; “Fear”, Courtesy of Melanie Wasser, Unsplash.com, CC0 License; “Hope”, Courtesy of Lina Trochez, Unsplash.com, CC0 License