The 4 Types of OCD: Symptoms, Examples, and Treatment
Popular culture often depicts OCD as one thing: fear of germs. Although this can be one way OCD presents, it is certainly not the only. Although not an official diagnostic classification, researchers identify four prominent ways OCD presents. These are often called the four types of OCD, which we’ll cover in more detail. If you are struggling with OCD or think you may have OCD, you can reach out to us for online OCD therapy.
What are the Four Types of OCD?
The four types of OCD are not diagnostic classifications offered in the DSM-5. They come from research beginning in the 1970’s. Many researchers and studies support this four-dimensional structure of OCD, and it’s become more and more common to view OCD through this framework.
Contamination and Cleaning OCD
Contamination OCD is generally marked by a fear of germs, dirt, and/or illness. It can lead to compulsive cleaning, handwashing, or avoidance of public places to prevent perceived contamination. This is often the type of OCD that is portrayed by popular media.
Common Symptoms
Fear of germs, viruses, bodily fluids, or chemicals
Feeling contaminated after touching objects or people
Worry about spreading contamination to others
Avoidance of public spaces like restrooms, shared surfaces, or particular places
Common Compulsions
Excessive handwashing or cleaning
Repeatedly changing clothes or showering
Avoidance or asking others to handle or clean things
Mentally tracking where contamination may spread
Checking (Doubt) OCD
Checking OCD involves verifying things repeatedly, often in order to prevent perceived harm or disaster. This is also sometimes portrayed in media. It may include checking locks, appliances, that text messages went through, or that someone is safe.
Common Symptoms
Fear of leaving an appliance on or a door unlocked
Worrying about making a mistake and harming another
Doubting whether you completed a task correctly
Feeling unable to trust one’s memory, perception, or opinion
Common Compulsions
Returning home to check a lock
Rereading a message (email, text) many times before sending
Checking repeatedly if the stove is off
Checking in with a child’s safety despite having already confirmed it
Symmetry and Ordering OCD
Symmetry and ordering OCD is characterized by a need for objects to be arranged in a particular order, often tied to symmetry. It frequently is driven by a belief or feeling that something bad will happen if order is not kept.
Common Symptoms
Preoccupation with objects being arranged symmetrically, or in some specific order
Persistent feelings that an action, sentence, or task was not completely perfectly
Underlying fear or dread that bad luck or harm will come if something is left unbalanced, unfinished, or disordered
Common Compulsions
Meticulous straightening, spacing, and organizing items
Repeating physical movements in order to have balance on both sides of the body
Redoing tasks to get them “right”
Counting, tracing, and measuring items
Intrusive Thoughts and Taboo Themes OCD
Intrusive thoughts OCD is characterized by intrusive thoughts, images, and urges. They often surround taboo subjects like harming oneself or others, sexuality, religion, or ethics. Although we may not believe the thought, want it to happen, or act on it, the intrusive thoughts persist.
Common Symptoms
Unwanted thoughts related to sex, violence, or other taboo subjects
Fear of offending a god, commiting a sin, or act in way that goes against ethics
Persistent and distressing thoughts about a relationship
Common Compulsions
Silent praying or repetition of mantras
Analyzing a thought to work out what it means
Seeking reassurance from partners, friends, or the internet
Testing one’s feeling and reactions for certainty
DSM-5 Specifiers
The DSM-5 doesn’t recognize these four types of OCD. It does offer two specifiers. The first in insight. This is a measure of how much the person recognizes the beliefs as untrue. With poor insight or delusion, the person is often completely convinced the OCD beliefs are true. With better insight, they may recognize that the OCD-related beliefs are untrue or question their legitimacy.
The second specifier is tic-related. This specifier looks at whether the person has a current or past history of tic disorders such as Tourette’s or a chronic motor/vocal tic disorder. Those with tic-related specifiers often have an earlier onset and are more likely to fall into the symmetry and ordering type of OCD.
Can You Have More Than One Type of OCD?
Although these are traditionally presented as four unique types of OCD, many people experience several types at once. Furthermore, an individual may experience different presentations of OCD over time, especially during stressful periods. Like many mental health disorders and general personality traits, how OCD looks may change throughout the years.
How Do You Know If You Have OCD?
OCD is one of the “popular” diagnoses these days on social media and the internet. The graphic below shows the interest according to Google Trends in symptoms of OCD. You can see that it’s become more and more commonly searched, especially in the last few years. Although OCD is very real, and impacts nearly 1 in 40 adults, it’s important to know what is OCD and what is not. OCD is diagnosed by a trained mental health professional such as a licensed therapist, psychiatrist, or clinical psychologist, not an internet checklist.
The presence of intrusive thoughts or unwanted images does not mean you have OCD by itself. Neither does being a “neat freak” or wanting things to be clean. You may be experiencing something like retroactive jealousy that involves continually checking, but that doesn’t mean OCD is the underlying cause. To get a clear understanding of whether or not you have OCD, you can reach out to our OCD therapist, Blake Skibiski.
How is OCD Treated?
OCD is treated via a variety of therapies and methods. ERP (Exposure and response prevention) is a common form of CBT in which people gradually face the situations they fear while learning to not perform compulsions. Research suggests this is an effective treatment and should be used as a first-line therapy.
Some people benefit from SSRI’s (selective serotonin reeuptake inhibitors) in treating OCD. This is something that must be discussed in detail with a psychiatrist, and treatment also generally involves therapy sessions.
Schedule a Free Consultation
To find support with OCD or get a clear diagnosis, please use the form below to reach out to One Mind Therapy. Blake Skibiski, LCSW will get back to you shortly.
