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  • Writer's pictureJennifer Zare

Beyond Cleanliness: Unraveling the Complexity of OCD

Jennifer Zare, LISW-CP

Pathways Counseling Center, LLC

When you hear the term OCD (Obsessive-Compulsive Disorder), what thoughts come to mind? Most likely, images of an excessively clean and organized space or someone repeatedly washing their hands. These common associations are the result of prevailing stereotypes perpetuated by media and popular culture. However, OCD is far more varied and complex than these simplified depictions suggest.

OCD is a prevalent mental health condition that impacts millions of people worldwide. It is characterized by the presence of recurring, intrusive thoughts and/or images known as obsessions, which provoke anxiety (such as the fear of becoming ill). Individuals with OCD frequently engage in repetitive behaviors or mental acts called compulsions, as a means to alleviate their anxiety (such as hand washing, eating or avoiding certain foods, or even going through mental rituals repeatedly). Over time, these obsessions and compulsions become excessive, consuming a significant amount of time and interfering with daily life.

Left untreated, OCD can cause considerable distress. It is important to note that OCD is a complex and varied disorder, manifesting in various forms.

Let's look at the different ways OCD can present:

  1. Contamination OCD: Excessive fear of germs, dirt, or contamination. This leads to compulsive cleaning, hand washing, or avoiding certain places or objects.

  2. Checking OCD: Persistent doubts and fears about safety or harm. This results in compulsive checking behaviors, such as repeatedly checking locks, appliances, personal belonging, or asking for reassurance from a trusted person.

  3. Symmetry and Ordering OCD: A strong need for things to be arranged in a specific order, requiring precise alignment and/or rearranging objects until they feel "just right."

  4. Hoarding OCD: Persistent difficulty discarding or parting with possessions, regardless of their value, leading to extreme clutter and difficulty maintaining a functional living space.

  5. Intrusive Thoughts OCD: Unwanted, distressing, and often taboo thoughts or mental images that are recurrent and difficult to control. These thoughts can be violent, sexual, or blasphemous in nature.

  6. Counting and Numbers OCD: An obsession with specific numbers or a compulsion to count objects or perform actions a certain number of times, even when it seems unnecessary or irrational.

  7. Magical Thinking OCD: Believing that specific actions, words, or thoughts have the power to bring about desired outcomes or prevent harm. Rituals or compulsions are performed to ward off perceived threats or bad luck.

  8. Religious or Scrupulosity OCD: Excessive preoccupation with religious or moral thoughts, often involving fears of committing sinful or morally wrong acts. Individuals may engage in excessive prayer, confession, or rituals to alleviate guilt or anxiety.

  9. Just-Right OCD: The need for a specific feeling of completeness or exactness when performing tasks, such as writing, arranging objects, or completing routines. Discomfort arises if things don't feel just right.

  10. Sensory OCD: Hyperawareness or extreme sensitivity to sensory experiences, such as textures, sounds, or bodily sensations, leading to compulsive behaviors or avoidance strategies to manage the discomfort.

OCD can present differently for each individual, and it's possible to experience a combination of these forms or have symptoms that don't fit neatly into a single category. Consulting with a mental health professional who specializes in OCD is recommended for an accurate diagnosis and appropriate treatment.

Recommended Treatment:

Cognitive-Behavioral Therapy (CBT) is considered the most effective form of psychotherapy for OCD. Exposure and Response Prevention (ERP) is a specific type of CBT that is often used to treat OCD. It involves gradually exposing individuals to their feared obsessions and preventing the accompanying compulsive behaviors. Look for mental health professionals, such as clinical social workers, psychologists or licensed counselors, who specialize in OCD and offer evidence-based treatments like CBT and ERP.

EMDR (Eye Movement Desensitization and Reprocessing) therapy is not typically recommended as a first-line treatment for OCD (Obsessive-Compulsive Disorder). However, EMDR therapy may be used as an adjunct to traditional OCD treatment approaches, such as cognitive-behavioral therapy (CBT / ERP) and medication management.


International OCD Foundation (IOCDF): The IOCDF is a renowned organization dedicated to improving the diagnosis and treatment of OCD and related disorders. They provide extensive resources, including information about OCD symptoms, treatment options, and a searchable directory to find specialized OCD treatment providers. Visit their website at for more information.

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