Obsessive-compulsive disorder (OCD) is a mental health condition that affects millions of people in the United States. According to the National Institute of Mental Health, about 1 in 100 adults experience OCD at some point in their lives. OCD is often misunderstood, but learning about its different forms can help people understand the condition more clearly.
At Westwind Recovery® in Los Angeles, we support individuals and families affected by mental health conditions, such as the link between OCD and anxiety. Our team provides evidence-based treatment and personalized care to help people manage their related symptoms.
What is Obsessive Compulsive Disorder?
Obsessive-compulsive disorder, or OCD, is a mental health disorder defined by a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts or urges that can cause distress or anxiety. Compulsions are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions.
This cycle of obsessions leading to compulsions can be difficult to interrupt. The National Institute of Mental Health estimates that about 2–3 million adults in the United States live with OCD.
- Obsessions: Unwelcome thoughts, images, or urges that keep coming back and cause discomfort or worry.
- Compulsions: Actions or mental rituals that a person does repeatedly, often in response to obsessions, to try to feel better or prevent something bad from happening.
- The OCD cycle: Obsessions trigger anxiety or discomfort, and compulsions are performed to relieve these feelings temporarily.
OCD can look different for each person, and what OCD feels like can vary widely, with several main types that are commonly recognized.
The 4 Main Categories of OCD
There are four main categories of obsessive-compulsive disorder (OCD) that mental health professionals often use when discussing this condition. These categories describe the patterns of obsessions and compulsions that people may experience. The four types are: contamination and washing, checking and doubt, symmetry and ordering, and intrusive thoughts with mental compulsions.
Many people with OCD experience symptoms from more than one category at the same time, and symptoms can change over time. This classification provides a common language for talking about OCD and helps professionals create targeted treatment plans for each person.
Contamination and Washing OCD
Contamination and washing OCD is a type of obsessive-compulsive disorder where a person has ongoing fears about germs, illness, or being contaminated. These fears lead to repeated cleaning or washing behaviors, even when there is no actual threat present.
Key characteristics:
- Fear of germs: Persistent worry about bacteria, viruses, chemicals, or other sources of contamination.
- Washing rituals: Frequent and repetitive hand washing, showering, or cleaning of personal items or spaces.
- Avoidance behaviors: Refraining from entering places or objects perceived as dirty or contaminated, such as public restrooms or shared surfaces.
Examples include someone who avoids touching doorknobs, frequently uses hand sanitizer, or refuses to shake hands to prevent possible contamination. According to the International OCD Foundation, contamination and washing OCD is one of the most common forms, affecting up to 46% of people with OCD. These symptoms can significantly impact daily routines and take up a considerable amount of time.
Checking and Doubt OCD
Checking and doubt OCD is a form of obsessive-compulsive disorder where a person feels the urge to check things over and over. This pattern often comes from worries about making a mistake or accidentally causing harm to oneself or others.
Common checking behaviors include ensuring doors are locked, appliances are turned off, and safety devices are functioning properly. Doubt is a key part of this type, leading to repeated questions such as “Did I turn off the stove?” or “Did I lock the door?” Even after checking, doubt may remain.
Reassurance seeking is also frequent in this type of OCD. A person might ask someone else to confirm that something was done correctly, like asking a family member if the door was locked or if the lights were turned off.
Examples of checking and doubt OCD include going back to the car several times to ensure it is locked, retracing steps to confirm that no accidents have happened, or repeatedly checking emails for mistakes. This type of OCD is connected to fears about responsibility and the possibility of something going wrong if a task is not checked enough times.
Symmetry and Ordering OCD
Symmetry and ordering OCD is a type of obsessive-compulsive disorder where a person experiences a strong urge for things to be even, balanced, or arranged in a specific way. Individuals with this type of OCD often feel uncomfortable or anxious when objects are not aligned or ordered in a particular fashion.
A person may arrange items until they look or feel symmetrical, such as lining up pencils so they are evenly spaced. Common behaviors include organizing books by height, making sure objects on a desk are perfectly straight, or repeatedly adjusting picture frames until they appear level.
The drive behind these actions is often a feeling that things are not “just right.” A person might repeat certain movements, like tapping or touching items, until a sense of completeness is achieved. These rituals can take up a significant amount of time and may interfere with daily activities when things are out of order. The discomfort experienced when symmetry or order is disrupted goes beyond typical preferences for neatness or organization.
Intrusive Thoughts and Mental Compulsions
Intrusive thoughts and mental compulsions are a form of obsessive-compulsive disorder (OCD) where a person experiences unwanted ideas, images, or urges that feel disturbing or go against their values. These thoughts can focus on topics such as violence, sex, or religion. The presence of these thoughts does not indicate a desire to act on them. Some individuals may also find that persistent obsessions resemble addictive behaviors, showing how obsessions can lead to addiction.
Some individuals may try to reduce their anxiety by performing mental rituals. Mental compulsions can include silently counting, praying, or repeating certain phrases in the mind. These actions are intended to alleviate the distress caused by intrusive thoughts.
Avoidance is another common response. A person may avoid situations, people, or objects that trigger these thoughts. For example, someone may avoid sharp objects or certain conversations because they worry it will bring on unwanted thoughts.
The thoughts experienced in this type of OCD are ego-dystonic. This means the thoughts are the opposite of what the individual wants or believes, and their presence causes significant discomfort. Mental compulsions and avoidance patterns are recognized as valid symptoms of OCD by mental health professionals.
Can You Have Multiple Types of OCD
It is common for a person to experience more than one type of obsessive-compulsive disorder (OCD) at the same time. A person may experience symptoms from multiple categories—such as contamination, checking, symmetry, or intrusive thoughts—either simultaneously or at different times in life.
OCD symptoms can also change over time. For example, someone might have checking rituals during one period, then later develop concerns about contamination or symmetry. PTSD and OCD can also co-occur, highlighting the importance of tailored treatment. Research suggests that up to 60% of people with OCD have symptoms from more than one type.
Treatment plans for OCD are often tailored to address all the types of symptoms a person is experiencing. Therapies and interventions can target multiple forms of OCD in the same individual.
How to Recognize OCD Symptoms
Some behaviors can look similar to OCD but are not the same. OCD symptoms are more intense and disruptive than everyday habits or worries. The table below compares common behaviors with those seen in OCD:
| Normal Behavior | OCD Behavior |
| Checking locks once before bed | Checking locks 10 or more times |
| Preferring things organized | Unable to function if items are not perfectly arranged |
| Occasional worrying thoughts | Intrusive thoughts that cause severe distress |
OCD symptoms are often more time-consuming and cause more distress than typical habits. Patterns that involve obsessions or compulsions for more than an hour each day, disrupt daily life, or feel uncontrollable are common signs of OCD.
A professional assessment can help clarify if symptoms are consistent with OCD. Westwind Recovery® offers support and assessment for mental health disorders.
Treatment Options for Different Types of OCD
There are effective, evidence-based treatments for all types of OCD obsessions and compulsions.
Exposure and Response Prevention (ERP) is a specific type of therapy commonly used for OCD. In ERP, a person is gradually exposed to the thoughts, images, or situations that make them anxious or trigger obsessions. At the same time, they are supported in not performing their usual compulsive behaviors. Over time, this process helps make the anxiety less intense.
Cognitive Behavioral Therapy (CBT) is another widely used treatment for OCD. CBT teaches people to identify and question unhelpful thoughts and beliefs related to their obsessions. It also helps people practice new ways of responding to anxiety and urges, using exercises and activities to change behavior patterns.
Some people with OCD take medication as part of their treatment plan. Selective serotonin reuptake inhibitors (SSRIs) are a common type of medication prescribed for OCD. At Westwind Recovery®, treatment may include therapy, medication, and support for other mental health conditions that occur alongside OCD, such as co-occurring disorders. This approach can cater to the diverse needs of each individual.
Frequently Asked Questions About Types of OCD
Answer: Most mental health professionals talk about four main types of OCD, but some sources list up to 7 subtypes. These may include hoarding, moral or religious obsessions (sometimes referred to as scrupulosity), and somatic concerns (concerns about the body or health). The four main types—contamination/washing, checking/doubt, symmetry/ordering, and intrusive thoughts/mental compulsions—describe the most common ways OCD appears.
Answer: Contamination and washing OCD is often described as the most recognizable type. Checking and doubt OCD is also very common. Many people with OCD experience symptoms from more than one category at the same time.
Answer: OCD symptoms can change over time. A person might experience one type of OCD and later develop symptoms of another type. Some people have more than one type of OCD at the same time.
Answer: OCD thoughts are usually more intense, happen more often, and make it hard to go about daily life. Normal worries do not usually cause severe distress or lead to repeated behaviors. If thoughts are very upsetting or lead to repetitive actions, a mental health professional can help with an evaluation.
Getting help for OCD in Los Angeles, California
Westwind Recovery® provides care for people experiencing mental health issues. Services include partial hospitalization (PHP), intensive outpatient (IOP), and outpatient programs. These options offer varying levels of support, depending on the level of assistance someone requires in their daily life.
The approach at Westwind Recovery® is holistic and client-centered. This means care plans are tailored to each individual and can address mental health conditions someone might have at the same time. Support is available for people at any stage of their recovery process.
To learn about available programs or to ask questions about treatment, contact Westwind Recovery® directly.
Dr. Deena is the Chief Clinical Officer of Westwind Recovery®, an award-winning outpatient treatment center in Los Angeles where she oversees the clinical and administrative program and treatment methods. Dr. Deena is a doctor of psychology and licensed clinical social worker since 1993. LCSW #20628. Originally from the East Coast, Dr. Deena has worked running treatment centers, worked as a therapist in psychiatric hospitals as well as school settings and currently has a thriving private practice in the LA area. Dr. Deena has appeared regularly on the Dr. Phil Show as an expert since 2003. She has also been featured on many other TV shows, podcasts and has contributed to written publications as well as podcasts.
