The many faces of OCD

What are the different types of OCD?

Many people mistakenly think of Obsessive Compulsive Disorder (OCD) solely as a condition in which people wash their hands excessively or check door locks repeatedly. However, there are many forms of OCD. OCD can have many facets, and feel complex, overwhelming, frustrating and become extremely debilitating. Due to the nature of the condition, OCD will always 'latch on' or manifest about what we care about, whilst also being influenced by environmental factors. Here are some of the many ways OCD can manifest itself into a sufferers everyday life.

Responsibility OCD

If you have OCD you may have an over inflated sense of responsibility. This means that you believe you have the power to either cause or prevent bad events that are personally important to you. ‘Magical’ thinking, which is the act of performing special actions to prevent something happening (an extreme form of superstitious thinking), is closely related to this. It makes you feel more comfortable, as if you had more influence and control over what happens. With responsibility OCD, the sufferer places great importance on what they do, their actions, their thoughts, their decisions, most elements in their life become a challenge, as they often feel what they do will end up with catastrophic consequences. Things feel like life and death, like it does for any type of OCD.

Intrusive Thoughts

This means the degree of importance that you attach to intrusive thoughts or images. It’s crucial to understand here that everyone experiences intrusive thoughts and doubts, that are usually absurd and are the opposite of what they want to do or think. In recent times professionals carried out experiments where they asked some people with, and without OCD to list their intrusive thoughts. They could find no difference in the types of thought reported by those with and those without OCD. The difference is that people with OCD have more frequent and distressing thoughts than others because of the meaning they attach to the thoughts and the way they respond to them. OCD is maintained when you interpret intrusive thoughts as a sign that is there a serious risk of harm to yourself or others (over-importance of thoughts), and also believe that you can prevent the harm by what you do or don’t do (overinflated responsibility).

Contamination

Contamination OCD refers to the fear of becoming personally contaminated through one’s own actions, being contaminated by others, contaminating others, or different combinations of any of these. The fear of coming into contact with either real or magical things viewed as harmful. The real things may include viruses, bacteria, bodily waste or secretions, people who appear ill or unclean, poisons,· radiation, or toxic chemicals.The magical things may include bad luck, the names of illnesses, or the misfortunes of others. Often this can lead to a sufferer displaying the very common behavioural compulsion of hand washing although this is but the tip of the iceberg. Other behaviours can include avoiding certain places which may ‘feel’ contaminated, mentally ruminating about events, washing the entire body time and time again, asking others for reassurance. The list can go on and on.

Checking and counting

Checking rituals can be a result of all types of obsessions, including fears of harming accidentally, fears of harming impulsively, or sexual obsessions. The purpose of compulsive checking is to reduce distress associated with uncertainty or doubt over feared consequences for oneself or others. For example, a person who worries about causing harm by not being careful enough, may have the thought that if they check that the door is locked, they will be assured that no one will break in. Whereas some checking is cued by specific situations (e.g. leaving the house) and reminders (e.g. light switches), in other instances it is performed in response to random thoughts that just pop into the mind and are considered dangerous. People with these types of obsessions, may believe that if they think of a bad event, it is more likely to happen. Counting rituals is often a compulsion with many suffering from OCD. This is also closely related to feeling that everything needs to be symmetrical, counting a certain number of times until it feels right, or the inability to walk through a door threshold until it feels safe enough to do so.

Scrupulosity

Those suffering with Scrupulosity hold strict standards of religious, moral, and ethical perfection. For example, if held in a black and white view, certain passages in the Bible and other religious texts may carry with them intense burdens of condemnation. In holding a strict view of these religious verses, the Scrupulosity sufferer experiences not just intense guilt, but also anxiety about the threat of eternal punishment for having violated religious precepts. Without having chosen to experience these obsessions (OCD thoughts being both intrusive and unwanted), the individual experiencing Scrupulosity feels an overwhelming urge to take whatever compulsive action offers the promise of relief.

Perfectionism

Perfectionism is one of the most common personality traits in OCD. Indeed, some researchers have described obsessive-compulsives as the ultimate perfectionists. Perfectionism can be, and is often theme relating to most forms of OCD. Here, the sufferer believes that everything has to be 'perfect' or feel 'just right' before they can carry on with their day. The belief that everything has to be 'perfect' or the sufferer themselves have to be 'perfect' in order to simply be accepted. This form of OCD can lead to sufferers checking academic work, checking their reflections in the mirror, ruminating to make sure they havent upset another person and generally avoiding any situation or circumstance that they feel may make them a 'bad' person.

Magical thinking

This form of OCD can manifest from an irrational belief that one has the power to control and prevent dangerous situation’s from happening. People partaking in 'magical thinking' are holding the distorted belief that one can control and prevent outcomes by doing safety seeking behaviours to prevent the imagined scenario from happening.

False memory OCD

The imagination can play a great role in this type of OCD. The sufferer may have a fearful image pop in to their minds, and they become worried that the image may have happened. They struggle to separate imagination from reality. This is also where thought-action fusion can take place, that is, when a sufferer becomes confused and believes that the thought of doing something is tantamount to the very act of doing it.

Health Anxiety OCD

A common form of OCD is health obsessions. The sufferer cannot find the reassurance they so desire and so obsess they may have an illness that is life threatening. No matter how much reassurance they have they always doubt it.

Symmetry OCD

Some people with OCD have obsessions surrounding the way objects are arranged. These people may feel very uncomfortable when confronted with situations where objects are misaligned or in disarray. On a related note, some people may be made uncomfortable when something does not appear perfect. They may not be able to tolerate having written something where the letters may be shaped imperfectly. Individuals with obsessions about symmetry and exactness may have magical thinking associated with their concerns. For example, they may worry that their mother will have an accident unless things are in the right place. In other cases, the need for symmetry may just “feel right” and ease any feelings of anxiety or despair.

Pure O type OCD (Purely Obsessional)

This form of OCD is driven by the need to find the right answer. Pure 'O' tends to manifest as a question followed by the need for certainty that leads to obsessional mental rumination. Like any compulsion, rumination can take up many hours of an OCD sufferers day. People with Pure 'O' are likely to spend alot of their day in their heads, rather than living in the moment via their senses.

Don't start your day with the broken pieces of yesterday. Every morning we wake up is the first day of the rest of our life.

Neurons that fire together, wire together

There is evidence to suggest that an OCD sufferer has different levels of serotonin in the brain, as well as accelerated levels of brain activity in the thinking part of the brain (known as the orbitofrontal cortex). However, the brain can change simply from changing your behaviour.

The way your body is wired has an impact on OCD

Your sympathetic nervous system, brain chemistry and susceptibility to autonomic overload play a pivotal role in the management of OCD.

The type of OCD you develop depends on the environment

The processes behind OCD are always extremely similar. However, the type of OCD that you develop is largely influenced by external cues.

Biological
Physiological
Environmental