5 Types of OCD You Might Not Have Heard Of

During OCD Awareness Week (October 8 to October 14), we spread information about what obsessive-compulsive disorder (OCD) is, explain why saying “I’m so OCD” (when you’re really not) is hurtful and, hopefully, encourage people who are struggling silently to get help for their intrusive thoughts and compulsions.

While it’s important to spread awareness about the intensity and true motivation of more well-known fears and compulsions (like hand washing and checking to see if the stove is on) there are other, more socially taboo types of OCD that don’t get as much attention. Some of these intrusive thoughts go into the darkest places in the human mind, making them uncomfortable to talk about. For those who struggle with these thoughts, it’s not something they can just dismiss — and they deserve our support and compassion.

If you experience any of these types of OCD, we want you to know you’re not alone and that there’s nothing wrong with you. If you’re ever interested in telling us your story, check out our submissions page here.

Editor’s note: If you struggle with obsessive-compulsive disorder (OCD) or experience suicidal thoughts, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741-741. To find help visit International OCD Foundation’s website.

1. Harm OCD

What if people become afraid of me? What if no one trusts me? What if people think I’m a threat? Your past history of never hurting anyone doesn’t matter. What if I go back to how unwell I was at Christmas? Maybe it would be easier if I wasn’t here. Maybe that’s an option if this doesn’t get better; I will die before hurting anyone.

— A. Burns, from “Why My Harm OCD Made Me Afraid of My Own Children“

Definition: “Intrusive, unwanted, distressing thoughts of causing harm. These harming thoughts are perceived as being ego-dystonic, which simply means that the thoughts are inconsistent with the individual’s values, beliefs and sense of self. Harming obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act.” (OCD Center of Los Angeles)

Have you ever had a quick, flashing thought of a violent image or idea? Like how if you turned your steering wheel hard enough, you could just run your car off the road? Or how about that quick temptations to jump off a high bridge, even though you would never do something like that?

What about stabbing yourself, or your roommate, with a kitchen knife?

While it’s possible you’ve experienced at least one of these quick, harmless thoughts without much worry, for people with Harm OCD, violent thoughts of hurting themselves or others are persistent, and worst of all, full of uncertainty.

For example, when a person without Harm OCD holds a kitchen knife, they know they could hurt themselves but probably don’t think about it much, if at all. We know that just because we can do something doesn’t mean we’re going to do it, and we cut our vegetables in peace, knowing it’s extremely unlikely we’re going to purposely stab our chest.

For people with Harm OCD, even the slightest uncertainty, the possibility that they could hurt themselves or others, is something they can’t let go. And not only can they not let it go, they might think about it, even see the image of them doing it, over and over again.

That’s where compulsions come in. Compulsions, both mental and physical, are meant to ease their worries. (For example, “If I do X three times while I’m in the same room as a knife, I’ll be safe.”) These compulsions can become disruptive and take over a person’s life.

It can be hard to admit these violent thoughts, especially if they are aimed at others. That’s why it’s important to remember that — in an example of the brain’s ability for cruel irony — people with OCD are actually the least likely people to act on these thoughts.

2. Sexual Orientation OCD

People plagued by intrusive sexual thoughts will intentionally summon distressing mental images and scan their body for signs of arousal. For example: why did my eyes fall on that creepy old dude’s crotch? Was I checking him out? Why would I have looked if I wasn’t? Let’s think some more about his crotch and try to figure it out. Cue endless self-confirming thought loop. Only acceptance of uncertainty can ultimately switch off this misfiring alarm system.

— Phoebe Rusch, from “When OCD Makes You Question Your Sexual Orientation“

Definition: “Many people who [have] Sexual Orientation OCD get stuck on the notion that they may or may not find someone attractive… This idea is troubling for [someone with] OCD who feels a strong need for certainty about the meaning of attraction.” (OCD Center of Los Angeles)

I’ve noticed some people don’t know what to think of Sexual Orientation OCD, also called Homosexual OCD. A fear of being gay? Isn’t that homophobic? Also, lots of people are confused about their sexual orientation. It can take a while to figure out your preference (and your preference can change!), and there’s absolutely nothing wrong with that. But Sexual Orientation OCD isn’t simply trying to figuring out your sexual orientation, or being “afraid” of being gay. Someone affected by this type of OCD spends an intrusive amount of time obsessing about who they’re attracted to, and perform compulsions to confirm of deny this fear. Also, people in the LGBTQ community can have sexual orientation OCD, too. It really has nothing to do with who you’re attracted to, it’s about the obsession with uncertainty.

For example, if a straight woman with Sexual Orientation OCD glances at another woman’s butt, but then isn’t able to interpret her physical reaction with certainty, she might start obsessing: Did I feel turned on? Do I like looking at women’s butts? Does this mean I’m gay? Does this mean I’m not supposed to be with my boyfriend? Who am I attracted to?

That’s why compulsions for Sexual Orientation OCD might include “checking” your sexual attraction by glancing at another’s crotch (like in the quote above), to double check, sometimes over and over again, you’re not attracted. Someone with Sexual Orientation OCD may also have intrusive images about engaging sexually with someone they’re not attracted to, confusing them even more.

Again, it’s about that uncertainty, the frequency of the intrusive thoughts and the compulsions people adopt to help ease these thoughts.

3. Pedophilia OCD

You’re evil, Sam. Nobody can love you now. You have to stay away from children, do you hear me? I heard him. I heard his panic, his fear, his urgency. I will never go near a child again, I replied to him. I’ll stay away from children, I promise. I’m a monster. Oh, God! I’m so, so sorry. I promise I’ll never ever go near a child. I won’t. I won’t.

— Autumn Aurelia, from “I’ve Spent 17 Years Hiding From Children – This Is My OCD Story“

Definition: “Pedophilia OCD, or POCD, is a subset of OCD in which [a person] has unwanted harmful or sexual thoughts about children. This subtype often results in panic, anguish, shame and depression. People living with POCD have no desire to harm a child, yet they’re tormented by thoughts of doing so.” (IntrusiveThoughts.com)

Let me begin by first reminding you: People with OCD are the least likely people to act on what they fear.

Pedophilia OCD is the fear of sexually abusing children, and this can be one of the toughest types to talk about. Let’s put a human face on it.

The author quoted above was sexually abused as a child. One day she heard someone on the radio say: “Abused children always go on to abuse others.” A fear was planted in her head, and she began to perform compulsions to assure herself she would never hurt a child, including avoiding children all together. Someone who has OCD typically obsesses about what they fear most, so people who have Pedophilia OCD are not “tempted” to sexually abuse a child — quite the contrary, they go through extreme measures to make sure they won’t abuse a child.

4. Scrupulosity OCD

I became trapped in a vicious cycle: Praying not to die for thoughts too unthinkable to mention, thoughts I did not feel in control of but took absolute responsibility for. Praying I would not experience condemnation, hell.

— Eliza Blissett, “When Obsessive-Compulsive Disorder Meets Religion“

Definition: “Those with Scrupulosity hold strict standards of religious, moral and ethical perfection. For example, if held in a black and white view, certain passages in the Bible and other religious texts may carry with them intense burdens of condemnation. In holding a strict view of these religious verses, the [person with] Scrupulosity experiences not just intense guilt, but also anxiety about the threat of eternal punishment for having violated religious precepts.” (OCD Center of Los Angeles)

If you were raised in an ultra-religious household, or were taught to fear God, the fears that come with Scrupulosity OCD sound familiar to you. According to the OCD Center of Los Angeles, common obsessions include: repetitive thoughts about having committed a sin, exaggerated concern with the possibility of having committed blasphemy, excessive fear of having offended God, excessive fear of failing to show proper devotion to God, repeated fears of going to hell/eternal damnation.

A person with Scrupulosity OCD will sometimes experience intrusive thoughts about what they fear — or try to avoid — most, like unwanted sexual thoughts about God, Jesus or a religious figure such as a priest. Compulsions vary, but include confessing about something you haven’t done, just in case, and excessive, ritualized praying.

5. Postpartum OCD

Every time I stood at the top of our steep, 100-year-old staircase, the fear of accidentally dropping my baby down the stairs would flash through my mind. I didn’t carry him down the stairs for weeks after he was born. If I was cooking something on the stove, even if my baby was safely strapped into his swing on the other side of the kitchen, I would be terrified of him being splattered with hot grease. I feared even touching anything potentially dangerous, like scissors or kitchen knives. Each intrusive thought was like a punch to the gut; the fear would literally knock the wind out of me. And of course, I felt so isolated. I was terrified anyone I told would think I was a horrible mother.

— Kimberly Poovey, from “What I Wish I Had Known About Postpartum OCD“

Definition: “A condition in which a woman’s OCD symptoms begin or are exacerbated either during pregnancy or soon after giving birth… he focus of the obsessions is often on the fear of purposely or accidentally harming their newborn child.” (OCD Center of Los Angeles)

If a new mother experiences postpartum depression and anxiety, she’s often filled with doubt and fears about not being good enough, not connecting with their baby and even their baby being “better off without them.” For someone with Postpartum OCD, these same feelings may arise — but for a slightly different reason.

While the obsessions that come with Postpartum OCD very from mother to mother, common ones include: horrifying, intrusive thoughts of stabbing or suffocating a newborn child, unwanted images of throwing or dropping a baby, fear of accidentally harming a child through carelessness, fear of being responsible for giving a child a serious disease.

Like other types of OCD, the last thing a mother affected by this wants to do is harm her child — and Postpartum OCD is often misdiagnosed because mothers don’t want to come forward about the horrible thoughts they’re having.

But mothers who have Postpartum OCD, and anyone who has any type of OCD, should not be denied proper treatment simply because they’re too afraid to share their thoughts. Our thoughts do not represent who we are — and OCD is only fueled by the silence. If we refuse to be silent and educate others, hopefully more people will get the help they deserve.

If you’re interested in learning more about OCD, or need help seeking treatment, please check out the resources below:

Thinkstock photo via stevanovicigor