OCD is called the ‘doubt disorder’ and with good reason. It will do everything in its power to convince you that distressing thoughts are real, intentional, and that you have a reason to be scared and anxious. The truth is, 80-90% of us will have intrusive thoughts at some point. The difference is that non-OCD brains can have a thought, acknowledge it as unusual/scary, and move on. The OCD brain grabs onto that thought and holds it. Often targeting the things we value most. Let me clarify something: having a “bad” thought does not make you a “bad” person. Merely having a thought does not make it come true. A thought is just a thought and yes it can be extremely distressing. Those with OCD generally have a combination of obsessions and compulsions. Triggers and obsessions happen to people while compulsions are an active response to the obsession and they serve a purpose.

Obsession subtypes

Harm/Violent: Fear of acting on an impulse to harm oneself or someone else. Also, fear of horrific violent images.

Sexual:  Unwanted sexual thoughts, sensations, or images; fear of sexually harming children or others, fear of acting on a sexual impulse or acting sexually aggressive.

Responsibility: Fear of being responsible for harming someone else (physically, emotionally).

Perfectionism: Things must be just so (even and exact) and includes fear of making a mistake.

Some other obsessions include contamination, religious/moral, excessive concern with one’s gender identity/sexual orientation, and relationship (romantic and non-romantic). 

Individuals with OCD do not act on their obsessions.

Compulsions

Compulsions are rituals performed, with the intention to reduce distress from one’s obsessions. Not all routines are considered rituals. You can like something a certain way or do the same routine every night at bedtime and this does not mean you have OCD. OCD rituals are different in that the one performing them feels like they have to do them in order to prevent a negative consequence, finds them time-consuming, and often would rather not do them.  Rituals can be mental, physical, or both. Some examples are counting, canceling (a bad thought for a good thought), checking that nothing bad happened or you did not hurt someone, repetitive behaviors to avoid harm coming to someone or to manage discomfort, reassurance seeking, specific cleaning routines and avoidance of certain cleaners, routine behaviors-always doing something so many times in a certain way, and avoiding triggering situations. This list is not comprehensive.