Is What I have OCD?
OCD takes many shapes, and it takes a skilled therapist to properly diagnose OCD. Clients come to me who have OCD symptoms that don’t fit into the types of OCD people recognize; namely hand washing, or “being very neat”. In reality OCD is much more complex and multifaceted. I put together this list of lesser known types of OCD to hopefully help those with OCD recognize their symptoms and seek the appropriate treatment from an OCD specialist. Treatment for OCD has many moving parts, but Exposure and Response Prevention is ALWAYS part of the treatment plan. Otherwise treatment is unlikely to work.
Relationship OCD
ROCD is diagnosed when the object of the obsessions is a past or current relationship. Obsessive “what if” thoughts about the relationship present themselves repeatedly creating immense anxiety. Such “what if” thoughts can include any of the following:
- What if I’m not in love anymore?
- What if my partner doesn’t have all the qualities I want?
- What if they don’t love me anymore?
- What if I cheat on my partner?
- What if I’m not good enough?
- What if they’re not good enough?
- What if they’re cheating on me and I don’t know it?
These obsessive thoughts intrude relentlessly often to the point that the OCD sufferer can’t eat sleep or function due to constant rumination, and an intense need to figure the problem out now. They might engage in compulsions such as these:
- Asking friends or family for reassurance.
- Staring at their partner to try to figure out whether they love them.
- Constant questioning of their partner about their whereabouts that day to figure out if they are cheating.
- Avoidance of their partner.
- Constant internet searches about relationships and love.
- Always thinking about this to try and figure it out.
Pedophile OCD
Individuals with POCD are afraid they might be pedophiles. Individuals with P-OCD are not pedophiles. They only have an intense fear of being one because this is the subject that their OCD has attached itself to. Obsessive “what if” thoughts might include the following:
What if I am attracted to children?
- What if I have sex with children?
- What if I already had sex with a child and forgot?
- What if I get aroused by a child?
- What if what I feel in my body is arousal when I’m around a child?
Compulsions include any of the following:
- Avoiding children or any depiction of children in films or TV shows.
- Constant body checking for arousal when around children or looking at images of children.
- Constant internal debates about the issue and the urgent need to figure this out.
- Refusing to leave the house in order not to see a child.
Sexual Orientation OCD
This kind of OCD is characterized by the fear of having a sexuality that is other than the person’s own experienced sexuality. Core fears for this kind of OCD can include the fear of being different from others, the fear of being ostracized by their family, or the fear of living the a life that is wrong for them and therefore never being happy. Obsessions include:
- What if I’m aroused by men/women/other?
- What if I’m gay and have to change my whole life?
- What if I’m straight and I have to leave my partner?
- What if I’m not living a genuine life because I’m really gay/straight?
Compulsions include:
- Constant body checking for arousal.
- Avoidance of sex.
- Avoidance of sexual depictions of men/women.
- Rumination and trying to figure out the problem with urgency.
Somatic OCD
Somatic OCD involves constant noticing and evaluating of ones repetitive physical movements such as blinking, swallowing, breathing, walking, heartbeats or chewing. This kind of OCD can cause insomnia, and intense panic. Usually the core fear is that this constant noticing will disable them from living a normal life or being able to function at work. It can feel like one is trapped in their body. Common obsessive thoughts include:
- What if I can never stop noticing my breathing?
- What if I’m blinking too much?
- What if my chewing distracts me from eating?
- How can my heart just keep beating?
- What if I can never sleep because I can’t stop noticing my breathing.
- What if I can’t function because I keep noticing my swallowing?
Compulsions can include:
- Trying to figure out how to stop focusing on their breathing etc.
- Trying to distract themselves from noticing.
- Asking others about how many times a day they notice their breathing etc.
- Avoiding going out as to not make symptoms worse
- Avoiding exercise in order to not notice their heartbeat.
Harm OCD
This kind of OCD is fixated on doing something, or having done something in the past that has hurt others or yourself. Common obsessions include:
- What if I ran someone over on my way home?
- What if I pick up that knife and cut myself?
- What if I kill someone by accident?
- What if I’m really a serial killer and I want to hurt people?
Many individuals with this OCD have intrusive images of hurting others, and other horrific scenes of murder and injury. Compulsions include:
- Trying to figure out if they’ve hurt someone.
- Going back and seeing if they ran someone over.
- Hiding and avoiding knives.
- Sitting on their hands to make sure they don’t use them to hurt someone.
- Avoiding looking at parts of their body they are afraid of cutting.
I hope this is helpful. If you have questions about the treatment for OCD, or to schedule a consultation contact me at negarkhaefi@gmail.com.