Obsessive-compulsive disorder (OCD) involves intrusive thoughts, images, feelings, urges, or sensations (obsessions) and the mental or physical behaviors (compulsions) a person uses to relieve the resulting anxiety or prevent something bad from happening. OCD can affect anyone, but the specific fears and compulsions it targets often follow recognizable patterns—known as OCD subtypes.
Below is an overview of several of the most common OCD subtypes, including their characteristics and treatment options.
What is an OCD subtype?
An OCD subtype is a pattern of obsessions and compulsions centered around a specific fear or theme. Some subtypes focus on harm, relationships, contamination, or the need for things to feel “just right.”
Everyone with OCD experiences obsessions and compulsions, but how those symptoms appear can vary dramatically. While subtypes don’t represent official diagnoses, they help people recognize that they’re not alone—and that effective treatment exists for every subtype.
1.Checking OCD
Checking OCD involves repetitive behaviors or mental rituals aimed at preventing harm, mistakes, or catastrophes. These checks are driven by doubt and fear—not forgetfulness or carelessness.
Common obsessions:
- What if I left the stove on?
- Did I lock the door?
- What if I made a mistake and someone gets hurt?
Common compulsions:
- Repeatedly checking locks, appliances, or messages
- Mentally reviewing tasks or past events
- Seeking reassurance (Are you sure I didn’t mess that up?)
2.Contamination OCD
Contamination OCD involves fear of being harmed or harming others by germs, dirt, chemicals, or other forms of “contamination.” These fears are not limited to hygiene—many people also fear emotional or moral contamination.
Common obsessions:
- What if I get sick from touching that?
- What if I infect my family?
- What if this space is toxic or unclean?
Common compulsions:
3.Counting OCD
Counting OCD involves an obsession with specific numbers or counting rituals that feel necessary to prevent harm. The counting may need to be done in a particular pattern or number to feel “safe” or “right.”
Common obsessions:
- If I don’t count to 8, something bad will happen.
- Odd numbers make me feel anxious.
- I have to do this the right number of times.
Common compulsions:
- Repeating actions a certain number of times
- Mental counting during everyday tasks
- Trying to avoid numbers that don’t feel “right”
4.Existential OCD
Existential OCD involves intrusive thoughts about life’s big questions—like the nature of reality, death, or free will—that trigger intense anxiety and obsessive rumination.
Common obsessions:
- What if none of this is real?
- Why do I exist?
- What happens after death?
Common compulsions:
- Excessive online research to find the “truth”
- Engaging in actions to confirm your existence, such as checking your reflection in the mirror
- Reassurance-seeking from others
5.False memory OCD
False memory OCD causes a person to become convinced they did something bad—even when there’s no real evidence. These false memories can feel vivid, triggering guilt, shame, or fear of consequences.
Common obsessions:
- What if I cheated and forgot?
- What if I committed a crime years ago?
- What if that memory is real and I’m a terrible person?
Common compulsions:
- Mentally reviewing past events
- Seeking reassurance or confessing
- Steering clear of people or places that trigger the memory
6.Harm OCD
Harm OCD involves fears of causing harm to others or oneself, either accidentally or on purpose. These fears are deeply distressing and don’t reflect a person’s desires or values.
Common obsessions:
- What if I stab someone with this knife?
- What if I push someone into traffic?
- What if I lose control and hurt someone?
Common compulsions:
- Avoiding sharp objects or people
- Mentally reviewing behavior for signs of danger
- Asking for reassurance (I wouldn’t actually do that, right?)
7.Hoarding OCD
Hoarding OCD involves the compulsive need to keep objects, often out of fear that discarding them will cause harm or regret. It differs from a hoarding disorder when it’s driven by intrusive fears and compulsions.
Common obsessions:
- What if I need this later?
- Throwing this away might cause something bad to happen.
- Getting rid of this feels morally wrong.
Common compulsions:
- Saving or stockpiling items
- Keeping items in a drawer because a person has decided they are contaminated
- Excessively organizing possessions
8.“Just right” (perfectionism) OCD
This subtype involves needing things to feel “just right,” symmetrical, or perfect—often to avoid a sense of unease or fear.
Common obsessions:
- That didn’t feel right—redo it.
- Everything must be symmetrical.
- If I don’t fix this, something bad might happen.
Common compulsions:
- Repeating tasks until they feel perfect
- Rewriting or redoing work
- Avoiding decisions due to fear of imperfection
9.Magical thinking OCD
Magical thinking OCD involves beliefs that your thoughts or actions can influence unrelated outcomes. You may feel responsible for preventing tragedies through mental rituals.
Common obsessions:
- If I think this, something bad will happen.
- I must tap this four times or my family will die.
- That number is cursed.
Common compulsions:
- Mental rituals to “undo” evil thoughts
- Counting to a specific number or repeating certain phrases or numbers to prevent potential harm
- Superstitious behaviors
10.Pedophilia OCD (POCD)
POCD is a subtype of OCD involving intrusive, unwanted sexual thoughts about children. These thoughts evoke extreme shame and distress and do not align with the person’s values.
Common obsessions:
- What if I’m attracted to children?
- Did I look at that child the wrong way?
- Am I a danger?
Common compulsions:
- Watching content about pedophiles and comparing yourself to them
- Mentally reviewing interactions
- Seeking reassurance or checking physical reactions
11.Perinatal OCD
Perinatal OCD includes intrusive thoughts about harm coming to a baby during pregnancy, delivery, or early postpartum. This subtype affects individuals of all genders, although it’s often underreported.
Common obsessions:
- What if something I do harms the baby?
- What if I fall down the stairs while pregnant?
- What if I secretly want to hurt the baby?
Common compulsions:
- Excessive research about baby care and safety
- Mental checking or confession
- Reassurance-seeking from healthcare providers
12.Postpartum OCD
Postpartum OCD involves unwanted intrusive thoughts about harming your newborn, paired with overwhelming guilt or fear. These thoughts are ego-dystonic, meaning they contradict your values.
Common obsessions:
- What if I smother my baby in my sleep?
- What if I snap and hurt them?
- Does having this thought mean I’m a bad parent?
Common compulsions:
- Avoiding being alone with the baby
- Hiding dangerous objects
- Mentally repeating prayers or assertions about how much you care for your child
13.Purely obsessional (pure O) OCD
“Pure O” refers to OCD subtypes where compulsions are mostly mental rather than physical. People still perform compulsions—but they’re hidden, like mental review or thought neutralization.
Common obsessions:
- Fear of being immoral, violent, or dishonest
- Intrusive sexual or blasphemous thoughts
- Doubts about identity, memory, or reality
Common compulsions:
- Rumination and mental checking
- Neutralizing a “bad” thought with a “good” one
- Seeking reassurance or researching
14.Real event OCD
Real event OCD involves obsessive guilt or shame over something that actually happened in the past. The event is typically minor, but becomes the focus of intense rumination and self-blame.
Common obsessions:
- What if I’m a bad person for doing that?
- What if others find out what I did?
- What if this means I’m dangerous?
Common compulsions:
- Reassurance-seeking or confessing
- Mental review of the event
- Avoiding reminders or triggers
15.Relationship OCD (ROCD)
ROCD centers around doubts or fears about your romantic relationship—even when it’s healthy and loving. These thoughts feel intrusive and distressing, not natural forms of questioning.
Common obsessions:
- Do I really love my partner?
- What if I’m not attracted to them?
- What if this relationship isn’t right?
Common compulsions:
- Comparing your relationship to others
- Mental review or reassurance-seeking
- Testing feelings or avoiding intimacy
16.Responsibility OCD
Responsibility OCD involves excessive concern over being responsible for harm, mistakes, or wrongdoing—especially if it affects others. Even everyday decisions can feel dangerous or morally weighted.
Common obsessions:
- What if I cause an accident due to carelessness?
- If I say the wrong thing, someone could get hurt.
- It’s my fault if anything bad happens.
Common compulsions:
- Overchecking or overexplaining yourself
- Avoiding decisions or responsibilities
- Confessing to minor or imagined wrongs
17.Scrupulosity (religious) OCD
Scrupulosity OCD involves fears of moral or religious failure, sin, or punishment. People with this subtype often fear they’ve committed blasphemy or broken religious rules unintentionally.
Common obsessions:
- What if I offended God?
- Did I pray the wrong way?
- Am I going to hell?
Common compulsions:
- Excessive prayer, confession, or ritual
- Repeating spiritual practices until they feel “right”
- Avoiding religious content
18.Sensorimotor (somatic) OCD
Sensorimotor OCD (also called somatic OCD) involves intrusive awareness of automatic bodily functions like breathing, blinking, or swallowing. These sensations can become intensely distressing when they’re no longer automatic but constantly noticed.
Common obsessions:
- What if I never stop noticing my breathing?
- I can’t stop thinking about how often I blink.
- Is my heartbeat normal? I have to pay attention to check.
Common compulsions:
- Trying to “ignore” or suppress the sensation
- Mentally checking for awareness
- Avoiding quiet or still environments where awareness increases
19.Sexual orientation OCD
SO-OCD (formerly known as homosexual OCD) involves obsessive doubts about your sexual orientation, often in direct contradiction to your identity. These fears are unwanted and not part of a healthy exploration of sexuality.
Common obsessions:
- What if I’m secretly gay/straight/bi?
- What if I’ve been lying to myself?
- Did I enjoy that image too much?
Common compulsions:
- Mental reviewing of past attractions
- Avoiding certain people or media
- Testing reactions or seeking reassurance
20.Suicidal OCD
All thoughts of suicide or self-harm should be taken seriously. If you or someone you know has reported thoughts of self-harm, please call 911 or contact your local emergency room number immediately. In the United States, you may also call the National Suicide Prevention Lifeline at 1-800-273-8255. This line is available to you all day, every day.
Suicidal OCD involves intrusive thoughts about ending your life—even though you don’t actually want to die. These thoughts are disturbing and ego-dystonic, meaning they go against your true desires.
Common obsessions:
- What if I jump off this balcony?
- What if I want to die and don’t realize it?
- Am I going to snap and do it?
Common compulsions:
- Avoiding heights, medications, or triggers
- Seeking reassurance (Do I seem okay to you?)
- Mental checking (Do I really want to live?)
How are different OCD subtypes treated?
All types of obsessive-compulsive disorder are treatable, regardless of how your symptoms present. While a different central theme may categorize each subtype, they all involve the same cycle of obsessions and compulsions.
The most effective treatment for all OCD subtypes is exposure and response prevention (ERP) therapy. ERP is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms.
With the support of a specialized therapist, ERP helps you confront your fears and resist performing compulsive behaviors. Over time, you’ll build the skills to manage uncertainty, reduce distress, and regain control over your life.
Studies show that ERP therapy is highly effective, with 80% of people with OCD experiencing a significant reduction in their symptoms.
Other approaches that may help include:
- Medication (typically SSRIs)
- Mindfulness-based strategies
- Acceptance and commitment therapy (ACT)
These are typically done in combination with ERP therapy, depending on the individual’s needs.
Bottom line
OCD can present in many ways, but at its core, it follows the same cycle of obsessions and compulsions. Regardless of how your symptoms show up, your best bet for getting them under control is with ERP therapy.
Key takeaways
- OCD subtypes are themes around which intrusive thoughts and compulsions cluster.
- There are many subtypes, including harm OCD, ROCD, SO-OCD, POCD, scrupulosity, sensorimotor OCD, and more.
- It’s normal for subtypes to overlap or shift over time.
- Several evidence-based treatments exist for managing all OCD subtypes, such as exposure and response prevention (ERP) therapy, medication, ACT, and other approaches.
