When most people think about OCD, they picture someone washing their hands repeatedly or checking the stove ten times before leaving the house. Those are real types of OCD, and they’re debilitating for the people who experience them. But there are other forms of OCD that get far less attention.
These lesser-known types of OCD are just as distressing, just as disruptive, and just as deserving of treatment. The problem is that many people who have them don’t even realize what they’re dealing with. They think they’re just anxious, or paranoid, or a bad person. They suffer in silence because their symptoms don’t match what they think OCD looks like.
Here are some of the types of OCD that people don’t talk about nearly enough.
Harm OCD
Harm OCD involves intrusive thoughts about hurting yourself or someone else. These aren’t fleeting thoughts that everyone has occasionally. They’re persistent, graphic, terrifying thoughts that your brain won’t let go of.
Someone with harm OCD might have thoughts like “what if I push someone in front of a train” or “what if I hurt my child” or “what if I stab someone with this knife.” The thoughts feel real and urgent, even though the person has no desire to actually hurt anyone.
The compulsions in harm OCD often involve avoidance. You avoid knives, avoid holding babies, avoid standing near subway platforms, avoid anything that triggers the intrusive thoughts. You might also seek reassurance constantly, asking people “I would never do that, right?” or mentally reviewing your thoughts and actions to prove to yourself that you’re not dangerous.
Harm OCD is particularly isolating because people are terrified to talk about it. They worry that admitting to these thoughts means they’re actually violent or dangerous. They’re not. The thoughts are symptoms of OCD, not reflections of who they are.
Relationship OCD
Relationship OCD, sometimes called ROCD, involves obsessive doubt about your romantic relationship. You constantly question whether you’re with the right person, whether you really love them, whether the relationship is good enough.
The intrusive thoughts in ROCD sound like “what if I don’t actually love them” or “what if they’re not the one” or “what if I’m settling” or “what if I’m only staying because I’m afraid to be alone.” These thoughts create intense anxiety, even when the relationship is objectively healthy and happy.
The compulsions involve constant mental checking. You analyze your feelings, compare your relationship to others, test your attraction by looking at other people, seek reassurance from friends or your partner. You might break up and get back together repeatedly, or stay in a constant state of uncertainty that prevents you from fully committing.
ROCD doesn’t mean you’re in the wrong relationship. It means your OCD is targeting your relationship as the source of doubt and anxiety.
Scrupulosity
Scrupulosity is OCD focused on religion, morality, or ethics. People with scrupulosity are terrified of being a bad person, sinning, or doing something morally wrong.
The obsessions can involve religious fear — “what if I’m going to hell” or “what if I didn’t pray correctly” or “what if I’m offending God.” They can also involve moral anxiety — “what if I’m racist” or “what if that joke I made was offensive” or “what if I’m secretly a terrible person.”
The compulsions include excessive prayer, confessing sins that aren’t actually sins, reviewing past actions to check for moral failures, seeking reassurance about whether you’re a good person, and avoiding situations where you might do something wrong.
Scrupulosity makes people feel constantly guilty and afraid. They hold themselves to impossible moral standards and interpret normal human mistakes as proof that they’re bad.
Existential OCD
Existential OCD involves obsessive, distressing thoughts about philosophical or existential questions. These aren’t casual wonderings about the meaning of life. They’re intrusive, anxiety-provoking thoughts that your brain won’t let go of.
Someone with existential OCD might get stuck on questions like “what if nothing is real” or “what if I don’t actually exist” or “what is the point of anything” or “what happens after death.” The thoughts create intense anxiety and a sense of detachment from reality.
The compulsions often involve mental rumination. You try to logic your way to an answer, research philosophy and metaphysics obsessively, seek reassurance from others, or avoid triggers like movies or conversations that bring up existential themes.
Existential OCD can make daily life feel pointless and overwhelming. You’re stuck in your head, consumed by questions that don’t have answers.
Hit-and-Run OCD
Hit-and-run OCD is exactly what it sounds like. You’re driving, you feel a bump or hear a sound, and your brain immediately jumps to “what if I hit someone.”
Even though you didn’t see anyone, even though the bump was probably just a pothole, your OCD convinces you that you might have hit a person and not noticed. The anxiety is intense and feels completely real.
The compulsions usually involve turning around to check the road, driving back to the location multiple times, checking the news for reports of accidents, looking for damage on your car, or avoiding driving altogether.
People with hit-and-run OCD often know logically that they didn’t hit anyone. But the doubt and anxiety are so strong that they can’t move on without checking.
Sexual Orientation OCD
Sexual orientation OCD, sometimes called SO-OCD or HOCD, involves intrusive thoughts and doubts about your sexual orientation. This isn’t about questioning your sexuality in a healthy, exploratory way. It’s obsessive, distressing doubt that causes significant anxiety.
Someone with SO-OCD might have thoughts like “what if I’m gay and didn’t know it” (when they’re straight) or “what if I’m straight and in denial” (when they’re gay) or “what if I’m attracted to this person and that means I’m not who I thought I was.”
The compulsions include checking your physical or emotional responses to people, avoiding situations that might trigger the thoughts, seeking reassurance, mentally reviewing past relationships or attractions, and testing yourself by looking at images or fantasizing.
SO-OCD doesn’t mean you’re confused about your sexuality. It means your OCD is creating doubt in an area of your identity that feels important and vulnerable.
Just Right OCD
Just right OCD doesn’t involve fear of contamination or harm. Instead, it’s driven by a feeling that something isn’t quite right. Things need to feel, look, or sound a certain way, and if they don’t, the discomfort is unbearable.
Someone with just right OCD might rewrite sentences until they feel right, arrange objects until they’re perfectly aligned, repeat actions until they feel complete, or re-read paragraphs until the feeling of incompleteness goes away.
The compulsions are driven by an internal sense of discomfort or incompleteness rather than a specific feared outcome. You don’t think something bad will happen if you don’t do the compulsion. You just can’t tolerate the feeling of things being wrong.
Just right OCD is exhausting because the standard for “right” is subjective and constantly shifting. You can spend hours on simple tasks trying to get them to feel correct.
Pedophilia OCD
Pedophilia OCD, sometimes called POCD, involves intrusive, unwanted thoughts about being attracted to children. This is not actual pedophilia. People with POCD are horrified by the thoughts and have no desire to act on them.
The intrusive thoughts might include “what if I’m attracted to that child” or “what if I’m a pedophile” or “what if that thought means something terrible about me.” The thoughts create intense anxiety, shame, and fear.
The compulsions include avoiding children, mentally reviewing interactions with children to check for inappropriate thoughts or feelings, seeking reassurance, checking for physical arousal, and researching the difference between OCD and actual pedophilia.
POCD is one of the most distressing forms of OCD because the thoughts feel so shameful and dangerous. People are often too afraid to seek help, which makes the OCD worse.
Getting Help for Lesser-Known Types of OCD
If any of these types of OCD sound familiar, you’re not alone. These forms of OCD are more common than most people realize. The problem is that they’re not well understood, even by some mental health professionals.
The most effective treatment for all types of OCD is Exposure and Response Prevention (ERP). ERP helps you break the cycle of obsession and compulsion by exposing you to the anxiety-provoking thoughts without allowing the compulsive response. Over time, your brain learns that the thoughts aren’t dangerous and the anxiety decreases.
Working with a therapist who specializes in OCD is important. Not all therapists are trained in ERP, and not all therapists understand these lesser-known forms of OCD. You need someone who can help you target the specific obsessions and compulsions you’re dealing with.
If you’re struggling with intrusive thoughts that won’t go away, with compulsions that take up hours of your day, or with anxiety that feels overwhelming and inescapable, contact Long Island Counseling Services. We have locations in East Meadow, Melville, Huntington, Rockville Centre, and Jericho, and we offer teletherapy throughout New York.
You don’t have to keep suffering in silence. These types of OCD are treatable, and getting help can give you your life back.