This is an overview on the types of obsessions/compulsions that a sufferer of OCD may face.

Avoidance

  • Avoiding everyday activities because they cause anxiety
  • Avoiding experiencing new things
  • Avoiding certain triggers obsessively


  • The more you avoid, the worse things get.

    Even those who do not suffer from OCD avoid certain things as it is only natural. The problem with avoidance in regards to OCD, however, is that seemingly inconsequential situations become ever more threatening as the sufferer begins performing the necessary rituals to ease the anxiety. For example: A person without OCD washes their hands a few times a day, only when obviously necessary, whereas someone who suffers from OCD will wash their hands dozens, even over a hundred times a day depening on how far in the cycle of repititve-brain-training they have come. Touching any surface could bring up a bombardment of intrusive and agitating thoughts about the possibility of harming their health because of their now-supposedly dirty hands. They avoid not washing their hands.

    Avoiding things becomes the driving force behind a sufferer's obsession. It continually reinforces their corrupted mindset. To that person, the avoidance is a measure necessary to keep them away from harm. But not only does this practice repeatedly make things worse, it also makes life extremely stressful, especially when a particular obsession is about something part of daily life, i.e. worrying about leaving the house because something bad will happen while they are away. OCD can lead to severe Agorophobia where someone avoids leaving the house for as long as humanly possible. The obsessions and subsequent compulsion rituals become their new school. They teach their brains to react in particular ways to particular stimuli. Every single time they act out a compulsion, such as avoiding driving a car for just one more day, that is another piece of reinforcement towards the obsession; more reason to continue the cycle.

    There is hope, however. Neuroplasticity allows for retraining the brain. Because avoidance is at the core of OCD, there is a very simple practice that can help in curing it: Unavoidance, or in clinical terms, Exposure Therapy. The person must eventually face their fears, for without such action there is little hope in fighting the affliction. They must expose themselves to these fears that they have inflated and reteach themselves that there is nothing to be afraid of. This is usually done gradually and under the supervision of a doctor, but those who are suffering mildly can approach the practice themselves using various tools such as OCD workbooks and/or guidance videos.


    Contamination

  • Afraid of contamination from all sources
  • Any surface can be deadly
  • Washing hands obsessively
  • Discarding costly items in fear


  • Contamination OCD is simply the fear of ingesting contaminents - poisons, chemicals, bacteria, drugs, etc. Things that a person without OCD would glance over or simply not even contemplate are things that the sufferer obsesses over. Touching surfaces becomes risk assessments. Food in public becomes a gamble. Contamination OCD can lead to a person never leaving a water bottle unattended because if they did they would throw it out immediately upon returning in fear that someone had laced the bottle. It becomes a weird sort of paranoia that can only be quelled by washing or discarding compulsion rituals. This obsession can be unsustainable. It can be harmful to the skin of the hands if the compulsion is to constantly rewash under scolding water.

    Those suffering Contamination OCD have continually reinforced their fear by washing away the supposed contaminents. They repeat the hand-washing until they are completely confident that the contaminent had been cleaned away. This obsession can be very debilitating as it can cause a person to spend hours washing their hands or spend loads of cash replacing discarded items.

    To a person without OCD, they wouldn't think-twice about eating out in public - they already understand how futile it would be to spend psychological effort and time on worrying about such a ridiculous notion. But to the sufferer, it is definitely not ridiculous, but rather very important, and this is only because they have given in to their obsession and have cyclically performed the complusion rituals. Time and time again, they have washed their hands, washed their phones, or keys or avoided fast food and resturants - it is only natural for them to be afraid, for they have gone to such lengths to avoid any possbility of being contaminated.

    But there is still a way to beat this. Gradually exposing themselves to the possbilities will weaken this obsession's hold on them. It is important to remind themselves of how low the risks are. So long as you don't start eating out of a dumpster, you will be fine. Practically no one, in a Western Society of course, will purposefully drug a stranger in public. Any contaminent or drug found in public can be easily traced back. We don't live in the Dark Ages. People can't get away with such things. All that said, think about how long you have lived and all the moments you have eaten in public, ordered food, didn't wash your hands after going outside, etc. etc. and nothing has happened to you. All those years and you were never drugged, never poisoned, all those surfaces you touched and they never harmed you. Remembering this can be very reasurring and helpful in the curing process. The chances of your fears are usually similar to those of being struck by lightning or hit by falling debris, which obviously are so unlikely that worrying about them is pointless. Would you constantly worry about an asteroid impact wiping out the human race? No you wouldn't. You don't have time for it, you understand it is pointless to worry about such a thing.

    That said, it is easy to tell someone to not worry but multitudes harder to cure a sufferer of an obsession. A mixture of mindfulness and exposure therapy will go a long way. Do not be afraid of those impossible scenarios. Relearn that carelessness of such trivial things.


    Physical Checking

  • Repeated checking of something
  • Mental anxiety if checking isn't satisfied
  • Feeling of impending doom if checking ritual isn't complete
  • Checking the same thing over and over but still doesn't feel the task is complete
  • Constant worry that they didn't finish the task


  • Most OCD sufferers have done this. At some point in time they will find themselves having to repeatedly check something to reconfirm that it was successfully completed. For example: Checking if the car is locked, if the stove is off, if the house door is locked, if the dog gate is closed, if the toilet seat is down, etc. etc. This is done from a couple times to many times, over and over until finally the person eithers gives up out of frustration or takes a stand and walks away. This, just as with all compulsions, is a learned behavior, one strengthened with repitition.

    A person who goes through this compulsion usually is telling themselves subconsciously that there is a possibility that they didn't complete the task and that catastrophe is possible. By checking multiple times, they believe they are lessening the chance of the catastrophe or they simply cannot believe the task to be completeled until the ritual is completed - in a way, there is an error in short term memory, but ultimately it is the obsession that has been strengthened.

    The checking compulsion can be accompanied by a numerical observation, a counting of something. For example when checking if the stove is off the person may count the gas-knobs as they go through each. At some point this counting becomes a part of the ritual itself and not doing it is as if you didn't check the stove at all. This specific example is a good showcasing of the power of the obsessive repitition - not only does the person have to recheck if the stove is off, but they must count the knobs while doing so. The counting may have been just a thoughtless gesture as they initally performed the checking but over time it becomes integral to the ritual, one with it. And who can tell them any different? They've been doing this so long and the desired result has always come true - the house didn't burn down - so why would they suddenly stop now? To them, the counting is just as important as the visual check.

    Those who suffer this particular compulsion may find themselves going out of their way to silence that nagging intrusive thought that "maybe I didn't close the gate!", forcing them to drive back to their house just to check again. Or the checking may cause them to be late to timely events. It is quite an interruptive compulsion to have to continuously check something. Where someone without OCD can walk away from the car pressing the lock button once, the sufferer may have to do it multiple times and even check, physically, if the doors are locked.

    As with all compulsions, simply being told to stop doing it is hardly the answer. Not only is this barely likely to solve anything but it diminshes the severity of the condition, plays down the hold it has over the sufferer, and ultimately insults them. "How easy it is to just do something once and walk away" the outside observer ponders. But it is not so easy. Not completing the ritual is the same as leaping into a dark pit, an abyss of agonizing stress. Upon walking away, leaving the act undone, the anxiety will intesify for them. It will scratch at their inner thoughts. The obsession doesn't simply go away, it grows larger now as the worry grows. The intrusive thoughts such as "what ifs" attack the consciousness. Walking away, to the non-sufferer, is trivial and the thought almost instantly discarded, but to one strangled by OCD it is an intense battle. The worry bombards their mental state. This can eventually lead to a panic attack which completely morphs the situation into something incredibly worse. Where one can forget the other can only remember, and that memory haunts them. To a person with OCD, the future is as true as the present, in times of anxiety. Those futures are futures of doom, regret, shame, catastrophe, death, pain, guilt, anger, and all possible negative emotions. Continuously checking removes these possible futures from reality.

    The most important thing to realize about this particular compulsion is that it is built over time. The more and more one gives in to the obsession, the stronger and stronger it becomes. Where at first someone turns the knob once to feel its locked state, the more they continue to do this while obsessing over it and subconsciously thinking of all the horrible potentialities if they didn't, the more forceful the thought will become. One check may become two, a third check might have to happen even though they walked away but suddenly thought about "what if". All of it is unique to the person, but the general idea is there. The more energy you give in to the obsession the more control it has over you.


    Mental Checking

  • Constant Intrusive thoughts that cause anxiety
  • Reviewing past events to make sure they played out as they remember
  • Random obscene thoughts are obsessed over
  • Bad thoughts are countered with a neutralizing effort


  • Just as serious as the cyclical, physical check, the mental check is another interruptive process that those with OCD will sometimes go through. Firstly, the mental check accompanies the physical check as the person will conjure up the images of the things they locked or made sure were off, in their head. They do this in order to completely make sure that the task was completed, because if they could not visually remember it then how could it possibly have occured.

    This plays into what is referred to as Reviewing the Past: they will review a past event to make sure it played out a certain way; tap into all the power of the memory to seek out the specific details that confirm their position. This is done in order to quell any anxiety they might be experiencing at that specific moment. An example usually used is that of a driver with OCD who randomly thought about the possibility that they had just run over someone. Normally, this thought would quickly slip away, but to the sufferer it becomes the center of attention. They go back in time and check if they felt a thud at the specific moment. Or maybe they heard a scream? They reassure themselves that if they did run over someone they would have known and tell themselves to calm down and think of something else. The mental check is very important in keeping the anxiety away, for if they just continued on driving without mentally making sure, then they are a murderer on the run, at least in their mind. They could already foresee and even possbily feel the guilt of such an act. To someone with a more severe reaction, they might even drive back to make sure there isn't a body on the road. This is how the mind of somebody with OCD may work. OCD has the power to make the worst possibility as close to reality as possible. This whole checking process - just because of a random thought. Not only is this debilitating, but it is a constant stress on the body and mind.

    The mental check can be considered a sudden paranoia in many ways. Someone can feel weird for a quick second and then go through a whole process to make sure that they are alright. A sudden tiredness might force them to go over the last 24 hours to make sure that the tiredness is naturally occuring due to them being awake for many hours already. There can be a fear of going insane or developing another mental illness which will make them check their sanity. Another aspect of the mental check is Neutralizing. All people have randomly occuring, immoral, sexual, or violent thoughts and they do not ruminate on them but rather forget them quickly. Someone with OCD, the condition specifically called Pure O, will not be able to get these thoughts out of their head once they have occured. They will shame themselves and worry about thinking such a thing. To combat the immoral thoughts, they will attempt to neutralize them by thinking of good things in order to drown the bad ones out.

    And the thing about mental checking and OCD is that these intrusive and stressful thoughts can become a concrete obsession. Although they may be seemingly random and sudden, the anxiety they cause can be long lasting. Someone may fear for their sanity for days at a time until they realize they are fine and find something new to obsess over. The guilt over possibly doing something in the past they are not even remotely sure about is as real as the guilt of a criminal being shown video evidence of their crime. That is the point of their obssessive nature, the thought cannot be rid of so easily. The compulsion is to mentally go over the events, go over the thoughts, and attempt to reassure themselves that everything is alright. It is a seemingly unwinnable battle because they are fighting against themselves. Thoughts are as powerful as visual evidence.

    The different forms of mental checking range vastly; only a couple are mentioned here. The core idea is that of the intrusive thought and subsequent obssession that occurs within those with OCD. The utter most random and seemingly inconsequential of thoughts may inflate to a destructive size and wreak havoc upon the thinker. These intrusive thoughts occur all throughout the day, for days at a time, possibly even months, and some may only find mere moments of relief from them. Think about how hard it is to get something meaningful out of your head - a recent break up for example. Now transfer that feeling of non-relief from the saddening thoughts of your destroyed relationship to any thoughts that you would easily be able to ignore and move on from. A person with OCD feels this way with their intrusive obsessions.

    This is true with any kind of thought for them. One day they might have a random obscene thought about crashing their car on purpose or how easy it would be to kill someone with the knife that's on the table. Instead of just letting the thought occur and then move on, they become attached to it, obsessed with why they had the thought. Some will be afraid and ashamed for having such a thought and begin to attempt to prove to themselves that they are good people. Others will attempt to convince themselves that it was a baseless thought but will have lots of trouble doing so. They may find themselves compulsively praying in order to make up for having such a thought. They might punish themselves because they have escaped actual justice by not being caught for having the thought. The point is that they can't get it out of their heads. Something that hasn't even happened becomes so real to them that they become debilitated by it.


    Hypothesizing

  • Jumping to disastrous conclusions
  • Believing things that aren't concretely true
  • Making things up to complete the picture
  • Obsessing over impressions
  • Being afraid of the unknown


  • This is a form of mental checking but it must be singled out. It can also be called theorizing, scenario bending, jumping to conclusion, etc. The person with OCD will review events, past or future, and will grab certain conclusions out of it only to further their own anxiety and stress. They may believe that a certain person acted in a specific manner because of a supposed reason and they obsess over this. For example, a clerk at a shop has acted weird, according to the sufferer, and this meant that the clerk poisoned them. Or an attractive person, to the sufferer, said something in a specific way that can only mean one thing: that they hate them. You might be thinking "Everbody occasionaly gets the wrong impression", sure they do, but the person with OCD will obsess over that impression. They will bend the implication to cover a wide range of things. If that attractive person hates them, maybe everybody hates them. Maybe their whole self-impression is now completely crumbled. They may have created an entire outside opinion of themselves and believe that every single person they know, thinks of them in this way. And these things aren't taken lightly. It can be ego destroying, self-esteem obliteration.


    Reassurance

  • Constantly seeking the words of friends or family
  • Believing outside opinion to be an integral part to being calm and/or healthy
  • Putting immense trust in their targeted audience


  • One suffering with OCD may occasionally or routinely seek reassurance from a family member or friend about something they are particularly obsessing about at the moment. This can be a very serious compulsion for them and a very annoying action for the person being asked. This leads to friends or family members becoming angry and agitated but it is a simple misunderstanding. This particular compulsion is a good reason why friends and family of the person with OCD should learn about the condition so that they may understand it and not get angry when asked the same question multiple times. The sufferer is only doing this as with any other compulsion, they feel that they need to ask even if they already know the answer. This can be considered the same as physically checking something over and over, but the difference is that they find relief in another's reassurance.

    The person may ask a friend or family member the same question routinely when the associated obsession is lively in their mind. An example would be someone who is particularly afraid of feelings in their body and have become hyperaware or hypersensitive to even the slightest feelings. They may be obsessing over the possibility of a heart attack and any sensations felt may be a real indicator that a heart attack is actually happening. So what they will do is ask a family member if pain in their left hand can be a sign of the heart attack, get the reassurance, and then feel better because they've completed the compulsion. Over time this will become a routine act and not getting an answer could be very painful. The compulsion is to seek out words from another trusted human, and without the reassurance the fear grows more rapidly. The person becomes attached to the idea that somebody else telling them they're okay will make it so they are actually okay; in a way, the words cure the current affliction.


    Hoarding

  • Keeping things that hold little value
  • Believing these random things to possibly be needed in the future
  • Afraid of the possbility that the trivial objects may be reminisced over in the future
  • A deep fear of letting go


  • Hoarding can be considered a beneficial natural instinct passed on to us by our ancestral lineage. Surely it was useful back then when most moments were a matter of life and death and keeping any tools or food you found was incredibly important, but we've progressed to a point where such self-susitenance isn't readily required and hoarding can become an obsessive problem. Many people keep things from their past that holds some emotional value to them and it is only natural to want to do so, but the hoarder will keep things just for the sake of keeping them. Or they believe they might possibly reference the object in the future and to be able to showcase it physically is very important. This act is very different from collecting. Obsessive Hoarding is about being afraid that you might require the object in the future. Throwing it out can be a very stressful event. This obsession latches on to seemingly trivial objects such as a piece of folded paper or a regular old shirt. The sufferer may say or think "You never know, might want to look at this again!" as they decide to save the object from the garbage bag.

    Obsessive hoarding may relate to the keeping of any or all written or typed out work the person has done in the past. They may have every single notebook and scrap of paper they've used in their life stored in the closet. A collector of books would value every single book in the collection as something of incredible importance. The random pieces of paper the Obsessive Hoarder keeps in the closet probably hold little to no value to them, but they keep it just in case. The difficulty lies within letting go. They may have a sudden thought about the importance, even just slight, and then cling to it. They may question the consequences of throwing out the object and it stresses them.

    Those who hoard memories are afraid of not being able to correctly recall an event to the very last detail because it may be imperative to do so in the future. Being able to recall something as is - is incredibly important to the sufferer, for if they are not totally sure of the details, then they may be enveloped with anxiety. This correlates with other compulsions as for example the fear a person may get when they suddenly think that they might have ran over somebody on the road. They begin to anaylze the past events for every detail and attempt to fully store it. This storing functions as a present reliever of anxiety and a possibly future one when they might recall the event and must retrieve those details once again to reaffirm themselves that they are not guilty of a crime.

    This compulsion intrudes on the everyday and rare experiences of the sufferer. They may be viewing an exceptional event, such as a solar eclipse for example, and be so subconsciously worried about forgetting the experience that they over and re-analyze each moment in order to attempt to fully retain and store them. This, however, only serves to damage the memory itself. Not only is the memory disfigured as the sufferer constantly attempts to access each detail, but the experience itself is muddled with anxiety and unattention. By worrying about such things, the person doesn't experience the moment fully. This compulsion will make it so any experience is left incompleted, not fully appreciated or understood.


    Symmetry

  • Needing things to be symmetrical
  • Actions must be symmetrical and even
  • If things aren't symmetrical they may cause supposed harm to someone else


  • The Symmetry compulsion is about keeping things, objects or actions, symmetrical. A person may touch their left shoulder and then feel overwhelmingly compelled to touch the right shoulder. They may see a stack of paper not properly alligned so they fix it. There may be a group of glasses filled with wine but aren't filled exactly alike so the person will spend great effort to have the exact amount of wine in each glass. The examples go on and on, the exact compulsion is unique to each individual.

    Now, it is important not to downplay the severity of a symmetry compulsion. Uneven objects can truly cause devestation to the sufferer. They "need" it to be right. If it isn't fixed they will feel as if doom has fell upon them. Or they might believe that their inaction may somehow cause harm to someone else. A jumbled stack of books might give their family member cancer. This may seem incredibly childish, outlandish, or what have you, to the outside observer, but to the the person with OCD it is completely real. It may be a simple "what-if" or "you never know" feeling, but that feeling is incredibly powerful. The sufferer has convinced themselves, factually, that if they do not step on each individual tile in the room, something bad will happen.