Broadly speaking, people who struggle with OCD experience some combination of obsessions and compulsions.
Are unwanted thoughts, images, or urges that are experienced as extremely fear or anxiety-provoking. Obsessions tend to be more intense than basic worry, and often feel very intrusive. People with OCD typically struggle with 1 or more obsessive themes. Common themes include germs/contamination, fears of hurting self or others, or religious worries. Sometimes the exact fear may be vague or ill-defined. Because obsessions are experienced as so unpleasant and unwanted, they trigger urges to do something about them.
Are mental or physical acts focused on trying to manage obsessions and the anxiety associated with obsessions. Common physical compulsions include checking the locks on doors and windows repeatedly, trying to stay scrupulously clean (e.g., excessive hand washing), or repeating body motions or movement. Compulsions may also be mental, which include counting, praying, or some other specific way of mentally trying to get rid of obsessions. People may spend several hours each day engaged in compulsions, and the amount of time they spend or the complexity of the ritual often increases over time.
Some Common Types of OCD
Obsession with Germs or Contamination
One of the most common examples of OCD is fear about germs or being contaminated. The person may spend a great deal of time and effort avoiding germs and staying clean through:
- Excessive or ritualized hand washing, showering, bathing, brushing teeth, or grooming routines.
- Frequent or intensive cleaning of particular objects or household items.
- Inconvenient or time-consuming measures to avoid contact with germs.
Symmetry, Precision, Exactness
Sometimes people feel extremely uncomfortable when things are out of order or “not right.” This goes beyond being orderly. Some people may feel extremely uncomfortable when books are not precisely lined up at their spines or arranged according to height. Clothing may be organized by gradations in color. A lot of time may be spent organizing and reorganizing, or the person may feel paralyzed to even begin a task (e.g., organize the pantry) because, “it has to be perfect.” Once something is organize one way, the obsession may change, and they may feel the need to organize it a different way.
Some people spend hours checking and rechecking doors, locks, appliances, and other items. Common fears underlying checking behaviors is that terrible harm will come to person or others (e.g., burglary, fire) if doors and windows aren’t locked, appliances turned off, etc. They may retrace their driving route to make certain they didn’t accidentally hit someone without realizing it, or they may agonize over mailing letters or sending emails for fear of errors or accidentally writing something offensive.
Some people feel the urge to repeat movements, motions, or activities, or to engage in counting. A common obsession is the need to “do it right.” For example, someone may need to re-enter their front door multiple times until it feels right, or they may need to engage in an extraneous action when they engage in a routine task.
(such as fear of doing something harmful or sacrilegious)
Some people are troubled by what they consider “bad thoughts.” Common themes include religious themes (i.e., scrupulosity), sexual obsessions (e.g., “I might be a pedophile”), and violence (e.g., “I might deliberately harm my baby”). Some people fear they may harm others, whereas some may fear they are a potential harm to themselves (e.g., “I might snap and commit suicide”). To be clear: this does not mean that people with OCD are more likely to be violent or aggressive—quite the opposite, which is why these thoughts are experienced as so frightening.