May 8, 2025

Have you ever had a thought that shook you so much, you couldn’t stop thinking about it?

Maybe it felt random, disturbing, or totally unlike you, but your brain kept looping it anyway.

Like… Why can’t I stop thinking about that one thing? What if that random thought means something awful about who I am? Maybe I should Google it just one more time, just to be sure?

If you’ve ever been haunted by thoughts like these—thoughts you don’t want, thoughts that feel confusing or out of character—you’re not alone. These experiences can be a sign of obsessive-compulsive disorder (OCD), even if they don’t look like the symptoms of OCD most people know.

So, What is Obsessive-Compulsive Disorder (OCD)?

OCD is a repetitive pattern of thoughts and behaviours that the person feels trapped in. The OCD cycle begins with an intrusive mental process. It could be a thought, image, fear, or worry deemed as “dangerous” by the brain. When the feared mental process develops into an obsession, the individual experiences distress and begins to engage in compulsions as a means of alleviating the anxiety from their obsession(s). Compulsions are any behaviours (physical or mental) that the individual engages in to reduce their anxiety. Even though the compulsions want to reassure you everything is or is going to be ok, that’s short-lived, so you have to check again, wash again, organize again. The cycle goes on and is self-reinforcing.

Do I have OCD?

We all have some thoughts or behaviours that might resemble OCD; however, people who have OCD feel a clear negative impact on their lives. They usually spend a considerable amount of time on repetitive behaviours and often feel consumed by intrusive thoughts they can’t shake. If that’s what happens to you, talk with a trained professional who can help you determine if you have OCD.

In the meantime, I want to share with you some lesser-known forms of OCD to help you think about your own experience.

More Than Just Handwashing - The Different Faces of OCD

When people hear the term “OCD,” they often think of excessive handwashing, neatness, sorting, or checking locks and the stove repeatedly. While these are authentic and valid forms of OCD, they represent only a small fraction of a much broader, complex and debilitating disorder. For example, some people contend with lesser-known OCD themes such as harm, relationships, or health. Others struggle with Purely Obsessional OCD, or “Pure O,” which is a lot more common (and treatable!) than most people realize. Read on to learn more.

OCD Themes You Might Not Know About

Some lesser-known OCD themes aren’t often discussed, yet they can be just as distressing. Here are a few examples:

Harm OCD

Obsessions: Fears of accidentally or intentionally harming others.
Compulsions: Mentally reviewing past actions, avoidance of sharp objects or vulnerable people who are more “at risk,” reassurance seeking.

Sexual Intrusive Thoughts

Obsessions: Unwanted thoughts about taboo sexual content
Compulsions: Mental checking, avoidance of triggers, reassurance seeking from others.

Relationship OCD (ROCD)

Obsessions: Doubts about one’s love for their partner or constant questioning if they are with the “right person”.
Compulsions: Reassurance, checking “feelings,” comparing relationships.

Religious Scrupulosity OCD

Obsessions: Fear of being immoral, unethical, or offensive to God.
Compulsions: Confessing to self or others, mental review, excessive prayer.

Health OCD (Hypochondriasis)

Obsessions: Fear of having or developing a serious illness.
Compulsions: Frequent doctor visits, booking scans/physicals, body checking, Googling symptoms, reassurance seeking.

Somatic OCD

Obsessions: Preoccupation and hyperawareness of automatic bodily processes (i.e. blinking, breathing, swallowing). A fear that you are doing them wrong, or that you will never go back to doing them automatically.
Compulsions: Checking, mental review, distraction.

Pure O

The compulsion (observable behaviour) part of OCD is what people usually see or focus on. For example, checking, sorting, etc. However, Purely Obsessional OCD, or “Pure O”, is completely invisible to the outside world. In Pure O, individuals struggle with compulsions that happen inside the mind, such as rumination, mental checking, or avoidance. Pure O might be more difficult to recognize because our thoughts happen so automatically and fast that at times we don’t even notice them, let alone others who are not inside our minds! All we feel is the intense discomfort and a sense of helplessness to face it.

What Makes OCD So Debilitating?

What makes OCD a top 10 debilitating disorder, according to the World Health Organization, is how deeply the intrusive thoughts often conflict with a person’s values. This is why we refer to OCD’s intrusive thoughts as ego-dystonic or inconsistent with one’s core beliefs and values.

Someone with Harm OCD, for example, might be terrified of hurting someone, not because they want to but because their worst fear is the possibility that they could. This inner struggle can lead to significant shame, isolation and stigma, which impacts their ability to get help. On average, it takes 5-10 years for someone with OCD to seek proper treatment.

Why Recognizing OCD Matters

People may go years without a diagnosis, especially if their OCD doesn’t fit the stereotypical mould. They may also feel ashamed to tell anyone about their thoughts, especially if they are taboo or distressing (i.e. thoughts of harm, unwanted sexual thoughts, etc). OCD can also present as generalized anxiety, depression, or even personality disorders, making proper treatment challenging.

But there is hope—and help.

The Good News: OCD Is Treatable

The gold standard treatment for any form of OCD is Exposure and Response Prevention (ERP). ERP therapy is a form of Cognitive Behavioural Therapy (CBT) that helps people gradually confront their obsessional fears, while simultaneously resisting compulsions. Exposures are typically planned, values-based (i.e. exposing yourself to things that matter), and hierarchical (easier exposures are planned first). Acceptance and Commitment Therapy (ACT) and Inference-Based CBT (I-CBT) are other treatment approaches that may be helpful for individuals with OCD. In some cases, medication can also play an important role in treatment. At PRISMA, our nurse practitioner offers medical consultations and can collaborate with your therapist to help you explore whether medication could be a beneficial part of your treatment plan.

You are Not Alone

Whatever shape your OCD takes, you're not alone—and it’s treatable. If you are interested in learning more about therapy for OCD or OCD treatment, or if you have any questions about starting your therapy journey, contact us at PRISMA for more information on the next steps.

Disclosure

This article is for informational purposes only and should not replace professional psychological or medical advice. We encourage you to discuss any treatment options with your mental healthcare provider to fully understand the potential risks and benefits. For Emergencies, call 911, 988 or go to the nearest hospital. For specific Crisis Services, please visit our Resources page.

**About PRISMA**

PRISMA is a boutique psychology practice located in downtown Toronto, offering treatment for various mental health concerns, including OCD and anxiety disorders. Our experienced team of clinicians provides compassionate, individualized care using gold-standard approaches to help clients break free from the cycle of OCD.
Whether you are dealing with intrusive thoughts, compulsive behaviours, or uncertainty about your experiences, we are here to help you.

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