ocd can be a confusing and difficult to understand condition characterized by
seemingly strange obsessive thoughts and bizarre rituals or compulsive behaviors
in today's video i'm going to be talking about eight common subtypes of ocd
hi everyone you've probably heard of ocd and some of the ways that it can present itself
in different people in today's video i'm going to be talking about different types of ocd
some of these you may have heard of and some that might surprise you but before we get into
that just a couple of disclaimers to go over i'm a registered psychologist in the province
of british columbia canada and this video is for informational purposes only it is not intended
as a substitute or replacement for advice from your doctor or mental health professional now
with those things out of the way let's start talking about obsessive-compulsive disorder
now ocd is a condition associated with upsetting intrusive thoughts images or
urges that cause a person extreme distress and causes a person to experience a lot of anxiety
which they then try to neutralize or eliminate by engaging in compulsive behaviors which just tends
to make the whole situation worse now i've done some videos on understanding how ocd works and
why it happens so you may want to check out some of those videos if you're interested in learning
more about ocd now the thing with ocd is that it can present differently in different people and
it can present in a lot of different ways even though the underlying process even though the
underlying mechanism behind ocd is the same so what we're going to be talking about in today's
video are eight of the most common subtypes of ocd to give you a sense of the variety and the
different forms that ocd can present with so the first subtitle subtype i'm going to
be talking about is contamination ocd which is one of the most common forms of ocd that people
often think about now at the core of this uh form of ocd is a fear of getting sick or infecting or
contaminating someone a person cares about so the obsessions in contamination ocd are things like
i've contracted aids or some sort of disease from a public bathroom i didn't wash my hands
well enough after handling the chicken and now i'm going to make my children sick those types
of contamination fear of i've been contaminated or i'm going to contaminate someone else
and so in response to these fears what people will do is they will engage in compulsions
things like repeatedly washing their hands or sanitizing things around the home avoiding public
restrooms or doctors offices avoiding being around children just in case i contaminate the children
so though that's contamination ocd really again that form of ocd that focuses on
germs and contamination either to myself or to other people
now second subtype of ocd is harm ocd and at the core of harm ocd is disturbing or
violent thoughts images or impulses of harm coming to myself or harm coming or me inflicting harm
on other people so examples things like stabbing my wife while she sleeps or
throwing my child down the stairs the thought of having hit somebody with my car and so some
of the common compulsions you see in harm ocd are things like hiding all of the knives in the house
not allowing myself to be alone with my child going back repeatedly to check if i hit somebody
when i was driving another type of sub type of ocd is pedophilia ocd and this is characterized
by thoughts of sexual acts with children now this form of ocd is especially prone to stigma
and people often have a lot of shame about this type of ocd because of how strongly people feel
about pedophilia now the key thing to understand is that these thoughts are not desires they're
distressing and disturbing it's not that the person actually is
uh interested in children they're mortified by the fact that they have these thoughts about children
so some of the common obsessions are things like what if i have sexual thoughts about my child
or i had a sexual thought when i was near my knees what does that mean um
what if i molested my child while i was changing their diaper and didn't even realize it
and so some of the compulsions would include things like researching pedophiles to find
information about pedophilia as a way of convincing myself that i'm not a pedophile
um staying away from my niece or refusing to change the baby's diaper unless somebody
else is in the room with me in order to ensure that i don't do anything
another subtype of ocd is sexual orientation ocd and this involves obsessions around um
my sexuality like the fear that i may be in denial of my true sexual orientation or a fear that my
sexual orientation could abruptly change so some of the obsessions in this type of ocd are things
like uh i looked at that guy back there a little too long that maybe that means i'm gay how do i
know if i'm actually straight uh am i really into my girlfriend am i or am i more into other guys
uh one of the the funny examples of this type of obsession uh was in the show seinfeld years ago
there was a an episode in which the character george is having a massage from a male masseuse
and midway through the massage you see the look on his face change and he looks a bit shocked and so
later in the episode he's talking to jerry and he says i think it moved and he's sort of questioning
what uh what does it mean that he was aroused or could have been aroused
while this male masseuse was massaging him that's kind of the idea of these types of obsessions
so common compulsions in this form of ocd is often checking to see if i'm attracted to
women by looking at them or looking at pictures of women and seeing okay do i find them attractive
am i turned on by looking at these women i could be seeking reassurance from friends
do i seem straight like there's i'm not getting off and gave up am i um i may avoid people of
the same sex entirely to avoid the temptation of looking at them so these compulsions are designed
to neutralize those concerns or those fears that i might have about my sexual orientation
a fifth subtype of ocd is relationship ocd or sometimes referred to as relationship
substantiation ocd and the idea behind this is i i'm questioning if this is the right relationship
for me if i'm actually in love with my partner or if there's someone else i should be with
now the key is this isn't about relationships in which uh there are significant problems or lots
of arguments and i'm doubting whether or not we should be in this relationship together it's more
we seem perfectly happy but i'm questioning whether or not i actually am happy
so some of the obsessions are things like are we supposed to be together um what if we get married
but we're not meant to get married we're not meant to be together for the rest of our lives how do
i know if i'm actually attracted to my partner is there someone out there who's better for me
than this person so some of the compulsions may include things like looking at pictures of my
partner to see if i'm actually attracted to her and to remind myself oh why am i attracted to or
reviewing times that we've had together and questioning was i actually enjoying myself during
those times or or was i faking it another thing that people often do is take those relationship
quizzes online to see is this the right person for me or is this the right relationship for me
and so it's constantly seeking that reassurance that this is the proper relationship to be in
another type of ocd is uh religious ocd sometimes referred to as scrupulosity and so um
it really sort of centers around things like have i violated moral or ethical beliefs or
religious beliefs or religious norms so some of the obsessions can include things like
thoughts of blasphemy or swearing at god picturing myself being naked in church
questioning did i really mean that prayer when i said it am i misleading god in the way i'm praying
or it could be did i mislead that other person when i told them that thing was i intentional
was i unintentionally lying to them maybe i was trying to lie to them but i didn't even realize it
so some of the compulsions in this type of ocd are things like repeating prayers
over and over again in a certain way seeking confession from religious leaders repeatedly
checking with people over and over again to ensure that
they didn't misunderstand what i said so again seeking reassurance that uh i didn't lie to them
another subtype of ocd is what's called just right or symmetry ocd so in this type of ocd it's hard
to identify that there's a specific fear but it's more of feeling that something isn't right or that
things aren't something isn't right or that things aren't organized in a certain way so this isn't
a preference but it's more about anxiety and discomfort when things are not organized or don't
feel right so some of the obsessions in this type of symmetry or just right ocd are things like i i
need to start the sentence over again because it didn't feel right when i was saying it the
books they're not organized in a proper way on that shelf so i need to reorganize them until
it feels right that they're organized in the right way or it didn't feel right when i got up from
that chair so uh i feel uncomfortable about that that not right feeling so the compulsions in this
type of ocd are things like repeating the actions over and over again so uh i'll if it didn't feel
right when i got up i'll sit back down and get up again until it feels just right i'll rearrange
and order things repeatedly in order to have them in a in a symmetrical way that feels right
i'll have to tap on a desk a certain number of times but before i can move on to my next task
and the final subtype of ocd i want to talk about is pure obsessional ocd or sometimes referred to
as pure o now in this form of ocd the person has obsessions without sort of external apparent
compulsive behaviors so this can include any of the obsessions uh any of the obsession topics
i've already discussed so things like sex sexuality religion harm relationship symmetry
order uh all of those different types of ocd can be uh just pure obsessional ocd as well so
examples of obsessions things like an image of pushing someone in front of a bus or having a
blasphemous thought about god picturing myself with another person when i'm kissing my partner
and so in this type of ocd there are compulsions but they usually involve mental rituals that
aren't apparent on the outside so things like uh compulsively telling myself that i'm not a violent
person that and that i would never push someone in front of a bus repeatedly reminding myself
that god is forgiving and that he he's not upset with me repeatedly telling myself five times in a
certain way that i love my partner whenever i have the thought of another person so this pure o ocd
uh may seem like it's just obsessions but there's usually some mental compulsions that are taking
place so the the thing that tends to differentiate pure obsessional ocd from other forms of ocd
is that there aren't any of those apparent external compulsions or compulsive behaviors
that people will engage in so those are different types of ocd i i think it's important to note that
people can have more than one site some type of ocd at a time or they can have a a mix of subtypes
in their obsessions so i can have an obsession for example of sexually assaulting the virgin mary in
church while i'm swearing at god so that combines harm sexual and blasphemy obsessions all in one
another thing to point out is that these subtypes can change
over time so it's not that a person just has one subtype of ocd and that's how their ocd is forever
this can evolve and it can change and people can move from subtype to subtype
that's why it's so important to understand how ocd works and how ocd treatment works
because the principles of the underlying mechanism of ocd and how we go about teaching people how to
manage ocd those principles apply no matter what subtypes of ocd a person might be experiencing so
it really is about understanding the mechanism and no matter what type or what some type of ocd
a person has we tend to approach it and tend to approach treatment and management of it
in the same way so uh i hope that makes sense i hope that gives you a better sense of some of the
different types of ocd and some of the different ways that ocd can present itself in a person
i'd love to hear your thoughts and ideas about this or if you have any questions
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