What are Common Obsessional Themes of OCD?


This subtype of OCD is characterized by extreme discomfort with fears of contamination. Contamination fears can focus on germs, body parts, bodily fluids or substances, dirt, chemicals, or other toxins. Some people with contamination OCD can fear becoming contaminated by other people’s experiences, emotions, or traits. Fears of this nature will generally lead the individual to engage in laborious and ritualistic efforts to cleanse themselves and their environment in order to rid themselves of the feared contaminant, or to avoid people, places, objects, or activities associated with their fears in an effort to eliminate the chances of coming into contact with the feared contaminant.

Harm and Sexual Obsessions

For individuals experiencing this subtype of OCD, obsessive and intense thoughts about potential harm to themselves or other people are intense, disabling, and cause incredible feelings of shame, fear, and anxiety, and can also be focused on distressing sexual themes. Individuals suffering from this form of OCD may fear that they could harm or kill others, cause something terrible to happen through negligence, such as a house fire, run someone over with their car or otherwise cause a terrible accident, sexually harm or assault another person, or could kill or harm themselves. People who suffer from Harm or Sexual OCD will often seek reassurance from friends or family members about their potential to cause harm to others, mentally review their actions to ensure that nothing terrible has happened, check to ensure that they have turned off appliances or locked doors, engage in other checking behaviors such as watching the news for evidence that their fears are true, will avoid people, places, or objects that could cause harm, and will stop engaging in activities in which they fear they could harm someone, such as driving or cooking or spending time with children or family members.

Sexual Orientation and Relationship Obsessions

OCD can assume the form of fears related to one’s sexuality and whether the individual is gay, straight, or otherwise has a sexual orientation that is contrary to what they have always believed or known to be true. Other individuals may experience obsessions related to their relationship and whether it is the right relationship for them, is healthy and fulfilling, or if they are truly attracted to their partner. People suffering from these forms of OCD will often compulsively and repetitively seek information from the internet or books to help them answer these questions, seek reassurance from others, check their emotional and physical reactions to other people or to their partner to monitor or assess their feelings or level of attraction, or will avoid people, places, or activities that prompt these fears.

Religious and Scrupulosity Obsessions

This subtype of OCD is related to unwanted obsessions around religious or moral fears and can occur even in people who would not ordinarily consider themselves to be religious. Individuals suffering from scrupulosity obsessions may fear that they have sinned (or will sin) or otherwise offend God or the tenets of their religion and are therefore at risk of damnation or other terrible consequences now or in the afterlife. Common compulsions often experienced for those with this subtype of OCD include repetitive or ritualistic prayer, seeking reassurance from family members or religious leaders such as pastors, priests, imams, or rabbis, compulsively reading (or avoiding) holy scriptures, or compulsive attendance at (or complete avoidance of) churches, mosques, synagogues, or other places of worship. Additionally, some individuals suffer from existential obsessional themes, in which they are fearful of, and preoccupied by the meaning of life or the nature of existence, and engage in frantic efforts to find answers to and feelings of certainty about these questions.

Symmetry/Just Right OCD

People with this subtype of OCD feel a very strong need to arrange items or engage in specific movements until they are perfect or feel just right. In some cases, this obsessive need to move in a certain way or to organize objects and spaces may be accompanied by “magical thinking,” in which case these efforts are executed as a way to prevent something bad from happening. People with this subtype of OCD will often find themselves repeating actions, movements, or behaviors or compulsively rearranging items over and over again in order to attain a sense of perfection or a feeling of being “just right,” and may find it hard to leave their home or transition to desired or necessary activities due to the degree of time and energy that their compulsions consume.