Obsessive Compulsive Disorder (OCD)
What is OCD?
Obsessive Compulsive Disorder (OCD) affects 1-2% of the adult population and 1 in 200 children. Obsessions are defined as intrusive, unwanted, thoughts, images, and/or urges for which a person is compelled to do a behavior to reduce the resulting anxiety or distress. Compulsions are actions, in the form of thoughts or behaviors, that are taken by the person to reduce anxiety and/or discomfort brought on by the obsessive worry.
Untreated Obsessive Compulsive Disorder can be debilitating however it is very treatable. Exposure and Response Prevention Therapy (ERP), is the gold-standard treatment for OCD. Essentially, it involves having a person face their fears directly in a hierarchical and structured fashion.
What follows below are several of the more common content areas or obsession subtypes. We have listed these as a way to educate about different presentations of Obsessive Compulsive Disorder and to de-stigmatize some of the more taboo types like Pedophilia and Harm OCD. The list is not exhaustive but represents many of the common subtypes for which people seek treatment.
However, we want to add a word of caution about the content. The specific content/subtype of OCD is, in reality, a pointless distinction. As far as treatment goes, content does not matter much. A person with OCD may “switch” subtypes over time. For example, a person may have contamination as an obsessive subtype when they are young but then have harm obsessions once they have their first child. Content can change but the underlying condition of OCD is still present. ERP Therapy uses content as an in-road or mechanism to help people learn skills to face their fears directly. In other words, yes, we talk about specific content in ERP Therapy but only for the purpose of creating a treatment plan that promotes the direct confrontation with fear.
Finally, a person with 3 content areas is no better or worse off than a person with 5 or more content areas. People often get the impression that the more areas they have, the worse their prognosis is but this is not necessarily the case. The severity of Obsessive Compulsive Disorder is judged on how much negative impact it has across different areas of their life. We measure this impact at the start of treatment and again after it is completed to demonstrate progress in therapy.
Types of Obsessive Compulsive Disorder
Many people mistakenly believe that OCD simply refers to people who like to keep things orderly, neat, or clean but there are many different presentations of OCD. Our therapists are familiar with all types of OCD and can find the right treatment for you. Here are some of the many versions of OCD can take:
"Just Right" OCD
Typical obsessions: I can’t concentrate unless everything is “just right”
Typical compulsions: Straightening objects, “redding-up”, excessive organizing
Sexual Orientation or SO-OCD
Typical obsessions: What if I’m gay?
Typical compulsions: Reassurance seeking; checking to see if aroused in the presence of the same sex
Typical obsessions: What if I harm my loved one?
Typical compulsions: Avoiding knives or objects that can be used to harm others
Typical obsessions: What if I become a pedophile? What if I abused my child while changing her diaper?
Typical compulsions: Avoiding children, being alone with children; Checking for arousal
Typical obsessions: What if I contaminate myself and get sick or get my family sick? What if I am disgusted and can’t get over the disgust?
Typical compulsions: Excessive hand washing; reassurance seeking; avoidance; excessive cleaning
Typical obsessions: What if my partner is cheating on me? What if I don’t fully and completely love my partner? How can I ever know?
Typical compulsions: Reassurance seeking; Checking partners text messages; Checking arousal
Hypochondria or Health-Related OCD
Typical obsessions: What if I have cancer? What if I get a terminal illness in the next 5 years; What if this body sensation I’m having is a sign of cancer?
Typical compulsions: Checking; reassurance seeking; multiple doctors visits
Mental or "Pure-O" OCD
Typical obsessions: What if I can never stop thinking about (a thing)?
Typical compulsions: These compulsions are purely mental.
Typical obsessions: What if I can’t stop thinking about my blinking? What if I can’t stop breathing manually?
Typical compulsions: Trying to ignore breathing/blinking/heartbeat, etc.