Does All OCD Look Alike?

If you perform repetitive behaviors or mental compulsions to temporarily rid yourself from obsessive thoughts, you may have Obsessive Compulsive Disorder (OCD). But what is OCD and does it look the same in everyone who struggles with it?

Obsessions are recurrent and persistent thoughts, urges, or images experienced as intrusive and unwanted, often accompanied by distress. In response to the obsessions, people with OCD perform compulsions – behavioral or mental – to reduce the anxiety or distress. The OCD pattern can interfere with your life.

What Are Some OCD Subsets?

OCD can take form in a variety of subsets. Some common subsets of OCD are: 

Need for Symmetry - The need for things to be equal. For example, the glasses in a cupboard must be perfectly ordered from tallest in the center and graduated to the shortest on the outer ends, and being unable to leave the glasses alone.

Fear of Loss of Impulse Control - The obsession that one will act out, temporarily "go insane", then "snap out of it" and be stuck with the consequences. Common presentations include fear of: stabbing someone, blurting out inappropriate statements, or jumping out of a moving car. Avoidance of potentially dangerous or embarrassing situations is usually the response, or engaging in some kind of safety behavior such as or going places with a person who will "keep an eye" on them.

Washing - Obsessions are associated with becoming contaminated from sources such as bodily fluids or solids, but can have a twist. For example, another person may be perceived as contaminated, not because of the germs that might be on that person, but because that person is who they are. The person with OCD might think, "If I come into contact with that person, something bad will happen," or, "I will be like them." These obsessions result in the same avoidance and/or rituals as with the standard contamination fears.

Checking - Making sure that the locks are locked, the oven or iron is off, or other, more subtle forms of checking exist. This is often in the form of repeated questions, and can be anything from, "Do I look OK?" to "Are you sure it is safe?" Any repeated attempt to seek reassurance from another person is a form of checking.

Hit and Run - Also called Motor Vehicle Accident (MVA) OCD. Drivers obsess that maybe they hit someone without realizing it, then drive back repeatedly to check the area for bodies or police. They may go home and check the news for stories about hit-and-run accidents. They tend not to focus so much on whether they actually killed somebody, but more on whether or not they will be punished and publicly humiliated.

Repeating - Repeating can be a result of a specific obsession: "I thought the word 'hate' to myself while I walked through the doorway, so now I have to go back and repeat the behavior while thinking the word 'love' in order to 'erase' the previous activity." It can also be to ward off a feeling: "I need to repeat standing up and sitting down until it feels 'just right' and then I can stay seated."

Scrupulosity - Pathological guilt, fear of going to hell, or violating moral/religious doctrines. The person may excessively worry about being “bad” or “good.” It presents as intrusive, distressing thoughts about blasphemy or damnation, leading to time-consuming rituals like excessive prayer or avoidance of triggers.

Key Take-Aways

·       OCD involves a cycle of obsessions and compulsions.

·       OCD can disrupt daily life in terms of time and energy.

·       OCD does not look the same for everyone.

·       Help is available and it is important to obtain a diagnosis from a mental health professional.

How Can I Get Help?

​Contact me to learn about diagnosing the symptoms you think may be OCD so an accurate treatment plan can be devised on you can get on the path to feeling better.

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