OCDTYPES

Obsessive-compulsive disorder comes in many forms

Covert Symptoms in OCD

Mental Compulsions

Although obsessions without overt rituals are now considered relatively common among people with OCD, this OCD symptoms has generally been understudied and until recently has been considered resistant treatment. Beliefs regarding the importance of thoughts and the need to control them are common in people with this type of OCD. The meanings associated with unwanted thoughts may be related to views of self, for example, the ideaa that "Having a bad thought means I am a bad person."

People with mental compulsions are usually coping with thoughts are that are unacceptable or taboo in nature (sexual, harming, religious thoughts), or worries about illness and health. Rather than perform an overt ritual, such people will engage in these covert rituals and mental neutralizing. This might include repeating silent prayers, replacing "bad" thoughts with "good" thoughts, or erasing unpleasant mental images. They might also engage in excessive silent prayer or confession, perform some form of mental checking (e.g., reviewing one's behaviors), or engage in excessive self-reassurance (e.g., "I have never done that bad thing before so I won't do it now.") These mental compulsions result in the same temporary relief from anxiety, and are thus are thus equivalent to more overt rituals.

Looking out the window and drinking coffee, while wrestling with thoughts.

People with OCD tend to be introspective and may spend a great deal of time and effort ruminating about the origins of their disorder. In fact, this sort of rumination can also be a mental compulsion.

Common mental rituals

  • Special words, images, numbers, repeated mentally to neutralize anxiety
  • Special prayers (short or long) repeated in a set manner
  • Mental counting
  • Mental list-making
  • Mental reviewing (e.g. reviewing conversations or actions)
  • Mental erasing of unwanted mental images
  • Mental un-doing
  • Self-reassurance

Pure-O

Sometimes people who have primarily mental compulsions are called "pure-o" or "pure OCD". This actually means "pure obsessional" — someone with only obsessions and no compulsions. But this person does have compulsions, they just go unseen.

New Book for Treating OCD

Sexual Obsessions in OCDTreating sexual obsessions in OCD differs from treating of other forms of OCD due to greater feelings of shame surrounding symptoms, widespread misdiagnosis from professionals, and the covert nature of ritualizing behaviors. Written by a team of international experts on OCD, this book provides clinicians with the tools needed to successfully help clients suffering from unwanted, intrusive thoughts of a sexual nature. Learn more...

The Impact of OCD

It is estimated that between 2 and 3 million people are suffering from obsessive-compulsive disorder in the United States. About one in fifty people have had symptoms of OCD at some point in their lives, with 1% suffering within the last year. OCD strikes people of all races, faiths, nationalities, and ethnic groups. This disorder causes great suffering to patients and their families, as up to ten hours per day may be devoted to performing rituals. OCD has been classified by the World Health Organization as one the leading causes of disability worldwide.

Therapy Going Nowhere?

Although any medical doctor can take your blood pressure, only a few can do heart surgery. Likewise, any therapist can help someone who is feeling a bit blue, but only a few can effectively treat OCD.

OCD treatment is a type of therapy that requires a specialized protocol called Exposure and Ritual Prevention (ERP or EX/RP).

Learn about the Top Mistakes Made by OCD Therapists.

Top Seven Myths About OCD

One stereotype is that people with OCD are neat and tidy to a fault. Actually, nothing could be further from the truth. Although many people with OCD wash because they are concerned about dirt and germs, being tidy is actually not a typical symptom of the disorder. Almost two-thirds of people with OCD are also hoarders...

Learn more about the Top Myths about OCD.

 
Mental rituals are a covert type of compulsion performed by people with OCD to help manage anxiety. People with mental compulsions are usually coping with thoughts are that are unacceptable or taboo in nature, like sexual, religious, or health concerns. People with OCD might also engage in excessive prayer or confession, perform some form of mental checking, reviewing their behaviors, or seeking excessive reassurance from others.