What is OCD?: Understanding Obsessive-Compulsive Disorder and Its Many Forms
October marks OCD Awareness Month, an opportunity to shed light on what obsessive-compulsive disorder (OCD) really is, how it manifests, and the impact it can have on daily life. While OCD is widely discussed, it remains deeply misunderstood and is often trivialized as a quirk or personality trait. This misunderstanding can make living with OCD feel isolating. In reality, OCD is a chronic mental health condition that affects thoughts, behaviors, emotions, and daily functioning.
What Is OCD, Really?
OCD is defined in the DSM-5 as the presence of obsessions, compulsions, or both, which are time-consuming (typically more than an hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Obsessions are intrusive, unwanted thoughts, images, or urges that provoke anxiety or distress.
Compulsions are repetitive behaviors or mental acts performed to reduce the distress or prevent a feared outcome.
What makes OCD particularly challenging is the intensity and persistence of these thoughts and urges, as well as the powerful drive to neutralize them. Unlike common habits or preferences, these compulsions are not voluntary; they are anxiety-driven attempts to regain a sense of control or safety.
Examples of how OCD symptoms can affect daily life:
Difficulty concentrating at work because intrusive thoughts are constantly looping.
Avoiding social events due to fears of contamination or embarrassment.
Exhaustion from repeated checking, counting, or mental rituals.
Strain on relationships from constant reassurance-seeking or conflict over compulsive behaviors.
These examples show that OCD extends far beyond the behaviors most commonly associated with it. It can be mentally, emotionally, and physically draining, interfering with nearly every area of life.
Common Myths About OCD
Even with growing awareness, misconceptions about obsessive-compulsive disorder persist. Here are a few important clarifications:
Myth 1: OCD is just about cleanliness.
Some people experience contamination fears, but OCD has many forms unrelated to germs and cleanliness.
Myth 2: People with OCD can just stop their behaviors.
Compulsions are not conscious choices. They are driven by intense anxiety and often require structured intervention to manage.
Myth 3: Everyone is a little OCD.
While habits and preferences are common, this is a diagnosable disorder that can significantly disrupt daily life.
Understanding these myths helps foster empathy and reduces stigma for those living with OCD.
Types of OCD (and How They Manifest)
OCD manifests in multiple ways, and individuals often experience more than one subtype. Here are the most common forms with examples:
1. Contamination OCD
Fear of germs, illness, or health-related dangers. This may lead to excessive handwashing, sanitizing, or avoiding public spaces.
Examples:
“I can’t shake the thought that touching the doorknob will make me sick and pass it to my family, so I wash my hands repeatedly.”
“I can’t eat that sandwich. What if it’s contaminated?”
“I avoid public restrooms entirely because I fear germs.”
2. Checking OCD
Driven by fear of harm or mistakes, leading to repeated checking of locks, appliances, or messages.
Examples:
“If I don’t check the stove multiple times, it might cause a fire.”
“I need to re-read every email I send to make sure I didn’t offend anyone.”
“I replay every interaction to ensure I didn’t accidentally hurt someone.”
3. Symmetry and Ordering OCD
A need for objects or actions to feel “just right,” often accompanied by discomfort or unease until the arrangement or sequence feels complete.
Examples:
“I can’t relax until my books are perfectly aligned on the shelf, or I’ve arranged my pens in a specific order.”
“I have to arrange my kitchen tools in a specific order before cooking, or I can’t start.”
“If my socks aren’t exactly matched, I can’t leave the house.”
4. Harm OCD
Intrusive violent thoughts about oneself or loved ones. These thoughts are ego-dystonic, meaning they go against the person’s values.
Examples:
“I have a thought about hurting someone I love, and it terrifies me because it doesn’t reflect who I am.”
“What if I accidentally ran someone over while driving?”
“I worry that I might snap and lash out violently, even though I would never act on it.”
5. Sexual or Religious (Scrupulosity) OCD
Distressing, taboo, or blasphemous thoughts that conflict with personal morals or beliefs.
Examples:
“I keep replaying an inappropriate thought in my mind and fear it makes me a bad person, even though I would never act on it.”
“I feel compelled to repeat my prayers because I’m worried I didn’t do them correctly.”
“Distressing thoughts about my faith keep coming up, and I feel guilty for having them.”
6. Relationship OCD (ROCD)
Obsessive doubt about one’s relationship or partner, often paired with reassurance-seeking.
Examples:
“I keep questioning whether I truly love my partner or whether my feelings are ‘real,’ and I can’t stop thinking about it.”
“I constantly seek reassurance that my partner still loves me.”
“I obsess over minor details in our relationship, convinced they mean something about our future.”
7. Pure Obsessional (Pure O) OCD
Intrusive thoughts without outward compulsions, often paired with mental rituals like rumination or seeking reassurance internally.
Examples:
“I can’t stop thinking that I might secretly be a harmful person, even though I consciously know I’m not.”
“What if I secretly harmed someone in the past without realizing it?”
“What if I have a serious disease and haven’t noticed it?”
The Emotional Toll of OCD
Living with OCD often feels like being trapped in a loop of fear, doubt, and repeated rituals. Even when individuals recognize that their thoughts are irrational, the anxiety remains intense and persistent. OCD can lead to:
Exhaustion from repeated mental and physical rituals.
Shame and fear of judgment from others.
Isolation due to avoidance of situations that trigger obsessions.
It’s important to understand that intrusive thoughts and compulsions are symptoms, not reflections of character.
Healing OCD: Evidence-Based and Integrative Approaches
OCD is treatable, and recovery is possible. Traditional approaches include:
Cognitive Behavioral Therapy (CBT), especially Exposure and Response Prevention (ERP), which gradually helps people face feared situations without performing compulsions.
Medication, typically SSRIs, which can reduce the intensity of obsessions and compulsions.
Beyond these, integrative approaches are increasingly recognized as valuable:
Parts Work (IFS-Informed Approaches)
Parts work helps individuals identify and connect with internal “parts” that hold fear or control. For someone with OCD, the part performing compulsions is often trying to protect them from perceived danger. Meeting this part with curiosity rather than judgment allows for greater self-understanding and reduces the power of compulsions.
Somatic Work
OCD is not only cognitive; it lives in the body. Somatic approaches focus on noticing tension, anxiety, or distress physically and learning ways to regulate it through grounding, breathwork, and nervous system awareness. This can create a greater sense of internal safety beyond compulsions.
Raising Awareness and Compassion
Awareness begins with understanding and language. Using accurate terminology, listening without judgment, and sharing knowledge reduces the stigma and fosters empathy. Thoughtful awareness promotes connection and the belief that recovery is possible.
Finding Support
OCD is complex, nuanced, and deeply human. It affects thoughts, behaviors, emotions, and daily life, yet it is treatable. By understanding OCD beyond stereotypes, we create space for compassion, informed support, and hope.
If you recognize these thoughts or patterns in yourself and are ready to take the first step, you’re not alone. For those in Indiana or Colorado, reach out today to learn more about how therapy can help you navigate OCD with understanding, compassion, and evidence-based care.
