Lesser-Known forms of OCD

Some subtypes of OCD are more familiar to the public, whereas others remain less widely recognized. In certain cases, obsessions may focus on sensitive or ‘taboo’ themes, which can make it particularly difficult for individuals to disclose them even to mental health professionals. This reluctance often results in heightened feelings of fear, guilt, and shame. Highlighting these forms of OCD is crucial not only for educating individuals and families but also for reducing the stigma that surrounds them.

Sexual Orientation OCD (SO-OCD)

Sexual Orientation OCD (SO-OCD) is a subtype of OCD in which the individual experiences obsessions about their sexual orientation.

These thoughts conflict with the individual’s true sense of identity and cause intense anxiety. In order to relieve this distress, the person resorts to compulsions such as mental reviewing or seeking reassurance from others.

It is important to note that SO-OCD can affect people of any sexual orientation. For example: A heterosexual person may be overwhelmed by obsessions that they are gay. A gay person may fear that they are actually heterosexual.

Examples of Obsessions in' SO–OCD:

  • “What if I’m gay and I’ve been repressing it?”
  • “What if I’m really straight and only think I’m gay?”
  • “What if I’ve been lying to myself or others about who I really am?”

Examples of Compulsions in SO-OCD:

  • Seeking reassurance from others (e.g., “Do you think I look gay?”).
  • Mentally reviewing past experiences or relationships to find “evidence” of their true orientation.
  • Exposing themselves to photos or videos to “test” their reaction (“Do I like this? What do I feel?”).
  • Checking physical responses, such as monitoring for signs of sexual arousal.

Gender Identity OCD

In Gender Identity OCD, the individual experiences obsessions related to their gender identity. These thoughts are unwanted and do not reflect the person’s true self-perception, while they are accompanied by intense anxiety, guilt, or doubt. It is important to highlight that Gender Identity OCD is different from the natural and healthy exploration of one’s gender identity, as in OCD the vicious cycle of obsessions and compulsions causes significant distress and greatly impacts the person’s functioning.

Examples of Obsessions in Gender Identity OCD

  • “What if, deep down, I actually want to belong to another gender and I’m just not admitting it?”  
  •  “What if I’m hiding something from myself?”
  •  “What if I’ve been lying to myself or others all this time?”

Examples of Compulsions in Gender Identity OCD:

  • Overanalyzing thoughts, feelings, or physical reactions when exposed to gender-related triggers.
  • Closely observing people of different genders and comparing similarities or differences.
  • Asking friends, partners, or therapists questions such as: “Do I really seem like a woman/man to you?” or “Do you think I’m hiding something from myself?”
  • Spending extensive time online searching for articles, videos, or personal stories in hopes of finding a definitive answer.
  • Avoiding discussions, media, or social situations related to gender identity.

Pedophilia OCD (P-OCD)

Pedophilia OCD (P-OCD) is a subtype of OCD characterized by intrusive, unwanted thoughts or images with pedophilic content. These obsessions commonly involve fears of being sexually attracted to children, causing harm to a child, or behaving inappropriately, despite lacking any desire or intention to engage in such acts. Such thoughts are typically experienced as profoundly distressing, shame-inducing, and ego-dystonic fundamentally incongruent with the individual’s values, desires, and identity.

 Examples of Obsessions in P–OCD:

  • “Did I feel something strange when I saw that child on the street?”
  • “What if I’m actually a pedophile and don’t know it?”
  • “What if I harm a child without meaning to?”
  • “Was my gaze inappropriate when I changed my baby’s diaper?”

Examples of Compulsions in P-OCD:

  • Avoiding contact with children or places where children are present (e.g., schools, parks, even family gatherings).
  • Seeking reassurance from others that they have not acted inappropriately.
  • Mentally reviewing past situations to check for possible signs of sexual misconduct.

Relationship OCD (R-OCD)

Relationship OCD (R-OCD) is a subtype of OCD in which individuals experience obsessions about the nature, quality, and future of a relationship most often a romantic one, though it can also affect friendships or family relationships. Obsessions may revolve around questions such as whether they truly love their partner, whether their partner is “the right one,” whether they feel “enough” attraction, or whether the relationship has a real future.

Examples of Obsessions in R–OCD: (Romantic Relationships)

  • “What if I’m not really in love and I’m just pretending?”
  • “What if I don’t truly love my partner?”
  • “I don’t feel the same ‘attraction’ every day. What if I’m not with the right person?”
  • “I didn’t feel excited when I saw my partner today. Does that mean something about our relationship?”
  • “What if I don’t feel moved when they say ‘I love you’. What does that mean?”

Examples of Compulsions in R–OCD: (Romantic Relationships)

  • Constantly comparing the relationship to others (real or imagined), e.g., “Do other people feel more in love than I do?”, “Couples on social media seem happier than us…”
  • Asking friends or the partner for confirmation, e.g., “Do I seem happy with them?”, “Do you think I really love my partner?”
  • Monitoring reactions during moments of intimacy (e.g., kissing, hugging, sex) “Did I feel enough attraction?”, “Did I enjoy this as much as I should have?”
  • Spending significant time online looking for information about love, relationships, or signs that someone is “the right person.”

Existential OCD

Existential OCD is a subtype of OCD in which individuals experience intrusive, unwanted, and repetitive thoughts about deep philosophical or existential questions. Unlike ordinary curiosity or reflection, these thoughts are accompanied by intense anxiety, doubt, and a desperate need for certainty.

A variant of Existential OCD involves obsessions that focus on derealization.

In this version, the person experiences intense obsessions about the nature of reality and often has the feeling that the world may not be "real" and that they may be living in a dream or hallucination. There is also the form associated with depersonalization obsessions. In this case, the focus of the anxiety is the feeling of disconnection from the self.

Examples of Obsessions in Existential OCD: 

  • "What is the meaning of life? If there isn’t one, why should I go on?”
  • “What if everything around me is just an illusion?”
  • “How can I be certain that I even exist?”
  • "What if I go crazy because nothing seems real?"

Examples of Compulsions in Existential OCD:

  • Mentally reviewing and analyzing the same existential questions over and over.
  • Seeking reassurance from others about existential concerns.
  • Avoiding triggers such as movies, books, or philosophical discussions that spark existential thoughts.
  • Excessive online searching for answers to questions like “What is the meaning of life?” or “What is reality?”

Sensorimotor OCD

Sensorimotor OCD is a lesser-known subtype of OCD in which a person becomes hyper-focused on automatic, natural bodily functions or sensations. Common examples include breathing, swallowing, heartbeat, blinking, or even awareness of certain body parts (such as the position of the tongue in the mouth).

Examples of Obsessions in Sensorimotor OCD:

  • “What if I’m breathing the wrong way?”
  • “What if I keep noticing my heartbeat and go crazy?”
  • “I can’t stop paying attention to when I blink.”

Examples of Compulsions in Sensorimotor OCD

  • Repeatedly checking or focusing on a bodily function (e.g., breathing or heartbeat) to ensure it is working “correctly” or to detect possible problems.
  • Asking others or searching online to confirm whether the experience is normal.
  • Avoiding quiet places, relaxation, or calm environments where awareness of bodily sensations may intensify.

Suicidal OCD

Some individuals with OCD experience involuntary, intrusive, and persistent thoughts related to the idea of harming themselves for example, fears of possibly committing suicide even though they do not actually wish to do so. In Suicidal OCD, these thoughts are ego-dystonic, as they are experienced as unwanted, frightening, and confusing, rather than as a genuine desire or plan.

Examples of Obsessions in Suicidal OCD:

  • “What if I lose control and kill myself without wanting to?”
  • “What if I suddenly go crazy and harm myself?”
  • “What if I feel the urge to jump off the balcony?”
  • “What if I can’t handle it anymore and hurt myself without warning?”

Examples of Compulsions in Suicidal OCD:

  • Constantly analyzing thoughts such as: “Do I really want to die, or is this just a thought?”
  • Frequently asking loved ones or mental health professionals: “Do I seem suicidal to you?”, “Do you think I’m a danger to myself?”
  • Excessive online searching about: The difference between suicidal thoughts and OCD. Forums or communities of people with similar symptoms.
  • Avoiding potential means of suicide (e.g., knives, medications, sharp objects, balconies, ropes).
  • Avoiding triggers related to suicidal themes, such as movies, TV series, news, or images depicting suicide or self-injury.

Scrupulosity OCD

Another form of OCD can manifest with a theme that focuses on issues of religion or morality. This form is known as Scrupulosity OCD.
In this specific subtype, the obsessions involve intrusive thoughts or images related to the individual’s religious faith or moral integrity. The person often experiences intense anxiety or distress with the fear that they have committed a serious sin or a significant moral violation. The presence of these obsessions often leads to compulsions aimed at reducing the distress. It is important to emphasize that Scrupulosity OCD can occur in individuals regardless of their religious beliefs.

Examples of Obsessions in Scrupulosity OCD

  • “What if I didn’t pray enough and that is considered disrespectful?”
  • “What if I forgot to mention an important sin during confession?”
  • “What if a bad thought that came to my mind means I am truly a bad person?”
  • “What if I hurt someone without realizing it?”

Examples of Compulsions in Scrupulosity OCD

  • Repetitive or prolonged prayer.
  • Frequent and detailed confessions.
  • Constant reassurance-seeking from spiritual advisors, family, or friends.
  • Mental “neutralization” through repeated phrases or prayers.
  • Avoidance of situations, conversations, or places that may trigger religious or moral thoughts.
  • Repeated mental reviewing to check whether a thought or action was “right” or “moral.”

Real Event OCD

Real Event OCD is a subtype of OCD in which the individual becomes preoccupied with a real past event, often minor or insignificant to others, and feels compelled to overanalyze it. The person fears that they may have done something “bad” or “immoral” and is consumed with guilt, shame, and doubt about their integrity or values.

Examples of Obsessions in Real Event OCD

  • “What if that thing I said was offensive?”
  • “What if my behavior back then proves I’m immoral?”
  • “What if I’ve forgotten an important detail that changes everything?”

Examples of Compulsions in Real Event OCD

  • Replaying the event repeatedly in an attempt to recall every detail.
  • Asking others to confirm what really happened or how they perceived it (e.g., “Did I seem rude to you that time?”).

OCD about OCD

This is a subtype of OCD, where the individual becomes trapped in a vicious cycle of questioning the diagnosis itself, the authenticity of their symptoms, or even the validity of the treatment they are receiving. 

 

Examples of Obsessions in OCD for OCD

  • “What if I don’t really have OCD?” 
  • “Maybe I’m just imagining it or faking it?” 
  • “What if it’s actually another disorder that has been misdiagnosed as OCD?” 
  • “If I do have OCD, why isn’t the treatment working?” 

Examples of Compulsions in OCD for OCD

  • Constantly seeking reassurance from professionals or loved ones (e.g., “Are you sure it’s OCD?”).
  • Online search for diagnostic criteria related to OCD.
  • Analysis and comparison of the symptoms and experiences of other individuals with OCD.