Understanding OCD: Beyond Handwashing and Symmetry

When we hear the term OCD, we often think of handwashing or arranging things in a specific way. While these examples do capture some aspects of OCD, this condition is far more complex and diverse than many people realize. OCD, or Obsessive-Compulsive Disorder, affects between 1 – 2% of Canadians and has a profound impact on their lives and their families. In this article, we will explore OCD beyond its common stereotypes and shed light on its various subtypes and presentations.

Hidden Aspects of OCD

OCD comes in different forms, and each person experiences it uniquely. Unfortunately, mental health professionals often fail to identify OCD during assessments because they primarily focus on questions about handwashing or repetitive checking behaviors. If someone doesn’t exhibit these specific symptoms, OCD can easily go unnoticed unless they voluntarily disclose their struggles.

Intrusive and Dark Thoughts

OCD often manifests as intrusive and unwanted thoughts that may be considered taboo or distressing. For instance, a parent may have thoughts about harming their children, which can be extremely distressing. Sharing such thoughts becomes challenging due to the fear of being judged or seen as dangerous. Without a proper understanding of OCD’s subtypes, mental health professionals may miss these important signs and fail to provide the necessary support.


Subtypes Beyond the Obvious:

Some OCD subtypes may go undetected because they appear as extreme versions of common experiences. For example, individuals may question their sexual identity excessively, leading to excessive rumination about their orientation.

This subtype, known as Sexual Orientation OCD (SOCD), involves overanalyzing feelings and attractions, testing one’s attraction, and avoiding stimuli that trigger turmoil. Although seemingly harmless, SOCD can cause significant distress. Mental health professionals unfamiliar with this subtype may unintentionally worsen the situation by focusing on exploring the client’s sexuality, rather than employing the most effective treatment approach called Exposure and Response Prevention (ERP). ERP aims to help clients cope with uncertainty and doubt rather than finding definitive answers or delving into the content of their obsessions.

Self-Unawareness and Mental Rituals:

Interestingly, some individuals may be unaware that they have OCD because they don’t engage in the typical rituals associated with the condition, such as checking or washing. Instead, they may engage in subtle mental rituals that provide temporary relief or ward off perceived threats. These mental compulsions can be so ingrained that the person may not even notice them. Examples of mental rituals include thought suppression, thought swapping, mental distraction, reassurance-seeking, mental checking, and endless analyzing and rationalizing. Engaging in these rituals can lead to hours of mental distress and futile attempts to answer unanswerable questions.

The Extensive Range of OCD Subtypes:

OCD encompasses a wide range of subtypes, including Pedophilia OCD (POCD), Relationship OCD (ROCD), Existential OCD, Contamination (Physical and Emotional), Sexual Orientation OCD (SOCD), Order & Symmetry, Harm OCD, Religiosity/Scrupulosity, and checking, to name a few. Furthermore, some individuals may experience obsessions that don’t neatly fit into any subtype category. This extensive variety highlights the complexity and diversity of OCD.


OCD is far more than just handwashing or symmetry. It is a complex and diverse condition that affects individuals in various ways. Unfortunately, due to misconceptions and lack of awareness, OCD often goes undetected, causing significant distress to those who experience it. By understanding the different subtypes and presentations of OCD, we can provide better support and help individuals find effective treatment approaches. Let’s work together to raise awareness about the true nature of OCD and promote a more compassionate and informed understanding of this condition.

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