Understanding the Different Subtypes of OCD

When most people think of obsessive compulsive disorder (OCD), they picture excessive handwashing, checking locks repeatedly, or organizing items until they feel “just right.” While these can be part of OCD, they are only a small part of a much broader and more complex condition.

OCD is defined by the presence of obsessions (unwanted, intrusive thoughts, images, or urges) and/or compulsions (behaviors or mental acts performed to reduce distress or prevent a feared outcome).
The way OCD shows up can vary greatly from person to person. That is where subtypes come in.

Below are some of the most common OCD subtypes:

1. Contamination OCD

Core fear: Being harmed or harming others through germs, chemicals, or other contaminants.
Common compulsions: Excessive handwashing, cleaning, avoiding public spaces, discarding “contaminated” objects.

The distress can be overwhelming, and compulsions may take hours out of the day.

2. Checking OCD

Core fear: That something bad will happen because of a mistake, oversight, or forgotten task.
Common compulsions: Repeatedly checking locks, appliances, emails, or even one’s memory (“Did I hit someone with my car?”).

The cycle can be exhausting, and people often feel unable to trust their own memory or perception.

3. Harm OCD

Core fear: Causing harm to oneself or others, either intentionally or accidentally.
Common compulsions: Avoiding sharp objects, seeking reassurance, mentally reviewing past actions to ensure no harm occurred.

These intrusive thoughts are ego dystonic, meaning they go against the person’s values and desires.

4. Relationship OCD (ROCD)

Core fear: Doubts about the “rightness” of a romantic relationship or feelings for a partner. Or concerns with infi
Common compulsions: Constantly analyzing feelings, comparing the partner to others, seeking reassurance from friends or online.

This can cause significant relationship strain, even in otherwise healthy partnerships.

5. Scrupulosity (Religious OCD)

Core fear: Sinning, breaking religious rules, or falling short of spiritual expectations.
Common compulsions: Excessive prayer, confession, research on religious guidelines, avoiding situations that feel spiritually risky.

Anxiety and rigidity are driving the behaviors. It goes beyond being devout.

6. Morality OCD

Core fear: Being a bad or immoral person, acting unethically, or causing harm through moral failure.
Common compulsions: Excessively reviewing past actions for signs of wrongdoing, seeking reassurance about being a “good” person, avoiding situations that might involve moral conflict.

While morality is a normal concern for many people, Morality OCD is fueled by anxiety and an inability to tolerate uncertainty about one’s goodness.

7. Sexual or Taboo Thought OCD

Core fear: Having unwanted sexual thoughts or urges that feel wrong or disturbing (for example involving inappropriate partners, aggressive themes, or non consensual acts).
Common compulsions: Avoiding people or places that trigger thoughts, mental reviewing, reassurance seeking, or compulsively testing one’s reactions.

These thoughts are not a reflection of someone’s character. They are intrusive symptoms of OCD.

8. Sensorimotor (Somatic) OCD

Core focus: Becoming hyperaware of bodily sensations like breathing, blinking, swallowing, or heartbeat.
Common compulsions: Trying to control or “fix” the sensation, checking bodily functions, avoiding triggers.

The awareness itself becomes distressing and hard to let go of.

9. “Just Right” OCD

Core feeling: An intense need for things to feel complete, balanced, or symmetrical, even if no harm is feared.
Common compulsions: Rearranging objects, repeating actions, or doing tasks until they feel “exactly right.”

This can be extremely time consuming and is not simply a preference for neatness.

10. Postpartum OCD

Core fear: Harming the baby, either accidentally or intentionally, or failing to keep the baby safe.
Common compulsions: Avoiding certain caregiving tasks, excessive checking on the baby, mental reviewing of actions, seeking reassurance from loved ones.

Postpartum OCD is different from postpartum depression. The intrusive thoughts are unwanted and cause intense anxiety, often leading parents to feel guilt or shame.

Why We Care about Subtypes

Understanding the subtype or subtypes someone experiences can help guide the most effective treatment approach. Many people have symptoms from more than one subtype. The gold standard therapy for OCD, exposure and response prevention (ERP), can be tailored to fit the individual’s specific fears and compulsions. In some cases, medication may also play a role in treatment.

If you or someone you care about struggles with intrusive thoughts or compulsive behaviors, know that effective, evidence based help is available.