Obsessive-compulsive disorder (OCD) is a psychological disorder characterized by recurrent and distressing unwanted thoughts (obsessions), and repetitive behaviors (compulsions) which are performed with the intention of suppressing the obsessions and lessening the distress.
OCD manifests differently in different people. In today’s article, I will discuss five common types of OCD symptoms. Please note that some people’s obsessions could fall into one, several, or all these categories.
People often associate OCD with contamination obsessions. Many movies also depict OCD as obsession with cleanliness (e.g., The Aviator, with Leonardo DiCaprio as Howard Hughes).
Contamination obsessions involve the fear that one may have been contaminated; for instance, that one was exposed to dirt or germs (e.g, viruses, bacteria, fungi). Some people with this type of obsession also worry about contaminating friends and family (or fear they have already done so).
People with contamination obsessions try to avoid what they consider potential sources or settings associated with germs (e.g., animals, public transportation, public bathrooms, the hospital).
Hoarding refers to excessive acquisition and saving of large quantities of possessions that clutter one’s place of living. Hoarding disorder is considered a separate disorder from OCD, but hoarding itself occurs in other disorders, including in OCD.
Why do people with obsessive-compulsive disorder hoard?
Possibly because of emotional attachments to the particular objects, or fears of losing important items that they might need in future. In other words, they probably associate discarding items with some kind of harm (loosely defined).
This category contains obsessions related to counting, ordering, and symmetry. Some researchers group these obsessions into one category, some do not, but here I follow DSM-V in grouping them together.
Counting obsessions include the need to count to some magical or safe number, or count or touch objects a certain number of times.
Order-related obsessions are associated with ordering and arranging things in a particular way. People with this type of obsession likely insist that their clothes or the furniture should be arranged the right way and be placed in the right spot. Things have to look balanced, look just right. Naturally, any changes to these arrangements can cause great distress.
Some people report having forbidden or taboo obsessions. Some of these are aggressive in nature; for example, despite not having a criminal record, these people may fear that they will murder someone close to them.
Taboo thoughts can also be religious or sexual. The religious preoccupations usually focus on having immoral or blasphemous thoughts, being evil, worshiping the Devil, and so forth.
What about sexual obsessions? One type of sexual obsessions concerns whether one is sexually deviant (i.e., has thoughts or feelings that fall outside the socioculutural norms and expectations). Depending on the society and the culture, these can include thoughts about being gay, bisexual, pedophile, interested in having sexual relations with a family member, etc.
Checking obsessions are associated with constant and never-ending doubts. The doubt usually concerns the possibility of harming oneself or others.
Consider the train of thoughts of a person with this type of obsession:
Did I turn off the stove? Yes. Or was that yesterday? No, I turned off it today. But did I? (Goes back, checks that it is off, returns…but is not satisfied, so goes back, turns it back on, turns it off again, back on and off once more). Okay it is off. (But now he wonders if the second time he turned it back on he forgot to turn off).
Sometimes the checking obsession involves something the person has said, something that could have potentially hurt another person.
Here is an illustration. Imagine Isabella refusing Lola’s invitation to come over for dinner. Did Isabelle hurt her friend’s feelings? Isabella might call to make sure she did not. And let us imagine that Lola replies that no harm was done.
But Isabella might doubt Lola’s honesty. She could call again or try to find other ways to make sure she did not hurt Lola. But can she ever be really sure? Probably not. Obsessive doubt often results in constant reassurance-seeking.