OCD Subtypes: Common Types of Obsessive Thoughts
Obsessive-Compulsive Disorder (OCD) can show up in many different ways. While OCD is defined by the presence of obsessions (unwanted, intrusive thoughts, images, or urges) and compulsions (behaviors or mental acts done in attempt to reduce distress), the content of these obsessions often follows recognizable themes and falls into an OCD subtype.
Some people experience only one OCD subtype, while others experience several. Themes can also shift over time. Below are some of the most common types of OCD and some examples of what intrusive thoughts associated with each subtype might sound like.
Fear of Harm OCD
Fear of Harm OCD involves intrusive fears about harming oneself or others, even when there is no desire or intention to do so. These fears may also involve worries about being responsible for something bad happening due to negligence.
Examples of intrusive thoughts include:
“What if I cause a car accident?”
(This can include fear of causing an accident and being unaware of it, sometimes referred to as “hit-and-run OCD.”)“What if I become violent out of the blue one day?”
“I just had an intrusive thought about self-harm; that must mean I want to hurt myself.”
Contamination OCD
Contamination OCD involves fears related to dirt, germs, illness, or exposure to substances believed to be harmful. These fears are often accompanied by intense anxiety or disgust and may lead to avoidance or excessive cleaning.
Common fears include:
Germs in public places such as restrooms or public transportation
Fear of illness spreading through touch or shared objects
Disgust related to bodily fluids, animals, or animal feces
Fear of contamination spreading from one surface or person to another
Sexuality OCD
Sexuality OCD involves intrusive doubts or fears about one’s sexual orientation or the possibility of engaging in sexual thoughts or behaviors that feel unacceptable or disturbing. These thoughts are typically not reflective of a person’s values or desires, so this can feel extremely confusing.
Examples of intrusive thoughts include:
“What if I am secretly gay and don’t realize it?”
“What if I become attracted to someone I shouldn’t be?”
“I’m scared that I could become attracted to a child or a family member.”
Relationship OCD (ROCD)
Relationship OCD centers on persistent doubts about one’s romantic relationship. These thoughts often involve questioning feelings, attraction, or the “rightness” of the relationship, even in the presence of care or a long-term commitment.
Examples include:
“What if my partner doesn’t really love me?”
“What if I don’t love my partner enough?”
“What if this relationship is wrong and I’m wasting my time?”
Moral or Religious OCD (Scrupulosity)
Moral or Religious OCD, sometimes called scrupulosity, involves excessive concern about morality, ethics, or religious beliefs. Individuals may fear being immoral, sinful, or fundamentally “bad,” even when their behavior aligns with their values.
Examples include:
Fear of offending God or breaking religious rules
Excessive guilt over minor or imagined moral mistakes
Constant self-monitoring to ensure one is being “good enough”
“Just Right” OCD
“Just Right” OCD is characterized by a persistent internal sense that something feels off, incomplete, or not quite right. Compulsions are often performed to relieve discomfort or achieve a sense of internal relief rather than to prevent a specific feared outcome.
Examples include:
Repeating actions until they feel “right”
Needing objects to be symmetrical or evenly arranged
Restarting tasks if they do not feel correct
This subtype can also involve magical thinking, or the belief that certain actions, thoughts, or sensations can influence events in a non-logical way. Individuals typically recognize these beliefs as irrational but feel compelled to act on them to reduce distress.
Existential OCD
Existential OCD involves intrusive, distressing thoughts about existence, reality, or meaning. These thoughts are experienced as urgent and anxiety-provoking, with a strong desire for certainty about questions that cannot be definitively answered.
Examples of existential obsessions include:
“What if nothing is real?”
“What is the purpose of life? What if there is no purpose or I never find my purpose?”
Questioning one’s own perceptions and autonomy
Health Obsessions (Health-Related OCD)
Health-related OCD involves persistent fears about having or developing a serious illness, despite medical reassurance or an absence of symptoms. Individuals may become hyper-focused on bodily sensations and interpret normal physical experiences as signs of danger.
Examples include:
“What if this symptom means something serious?”
“What if the doctor missed something?”
“What if I don’t catch it in time?”
When to Seek Help for OCD
This is not a comprehensive list of OCD subtypes. OCD can attach itself to nearly any topic that is important to a person. If you are experiencing intrusive thoughts, mental rituals, or behaviors that feel distressing, confusing, or time-consuming, these symptoms can be explored in therapy.
I provide assessment of OCD symptoms, diagnostic clarity, and evidence-based treatment. If you are unsure whether what you are experiencing is OCD, we can work on exploring symptoms and getting you clarity.