Other Obsessions
Table of Contents
Racist Obsessions
Racism and Racist Themed OCD
Some people with OCD experience unwanted, repetitive, racist thoughts.
In the wake of global Black Lives Matter protests there have been increasing discussions of obsessive thoughts in the area of racism and racist behavior. Despite a lack of representation in the scientific literature, there is evidence that intrusive thoughts about racism do plague a certain number of people with obsessive-compulsive disorder (OCD).
OCD is a condition that presents in many different ways, so it is no surprise that there are still specific obsessions that are less well known. Some people who suffer from OCD experience unwanted, repetitive, racist thoughts that may be accompanied by fears of being a racist.
Racism and OCD
Racism is rooted in the belief that group of people is superior in humanity than another, based on race. The unfavored group is then viewed as inferior and less than human. People who are racist will often display their racism through discriminatory actions that can be blatant or subtle. In most of the Western world, people recognize racism as negative and will adamantly deny engaging in racist behavior. But the main difference between people partaking in racist actions and people who are suffering from intrusive thoughts about racism, is that racists will falsely deny being racist or take pride in it, while those suffering from OCD will overthink and worry. People with OCD will convince themselves, regardless of any overt racist activity, that they are morally flawed.
OCD is like an overwhelming, repetitive voice in your head trying to convince you that your self worth is tied to your thought patterns and actions, most of which are inadvertent. This voice is a continuous source of anxiety and paranoia and leads to questions such as: Am I racist? Did I do something racist? Do other people know that I am like this? These intrusive thoughts can be followed by compulsive behaviors that appear to help combat the thoughts, but in reality only worsen the symptoms in the long run.
Worries about racial issues may include:
- Fear of using a racial slur
- Fear of accidentally or purposefully causing emotional harm to people of color
- Fear of inability to discern own behavior as racist or not
- Fear/thoughts of being racist and being perceived as racist
These thoughts and fears will cause a person with OCD to obsess that they are racist. There were several experiences described on OCD forums which show how these types of thoughts can be a hindrance to everyday life. One person reported feeling disturbed about typing a word beginning with ‘n’ in fear of potentially typing out a racial slur. They then sat in front of their computer paralyzed by the thought. Another person reported experiencing racist thoughts about their own family and fear about running over their brother with a car due to the color of his skin. Additionally, they explained discomfort at the idea of touching their mother because she was “too dark.” These thoughts gave the person immense emotional discomfort.
Not much research has been done on the obsessions surrounding the ideas of being racist or committing racist actions. There are only two publications in the scientific literature linking racism and OCD and neither discuss obsessive thoughts about being racist. Discussions with those who specialize in treating people with OCD and a review of OCD forums, however, reveal that these thoughts do exist and can plague the people who have them. Some of the obsessive thoughts relating to racism as well as the compulsive actions taken to mitigate those thoughts do, however, resemble discriminatory behavior.
Intrusive discriminatory thoughts may include:
- Fear of being around or of touching people of color
- Afraid to be related to a person of color
- Thoughts that people of color are “evil” or “out to get me”
- Thoughts of harming people of color
- Thoughts of racist stereotypes
A person who has the repetitive thought that they cannot touch people of color might stay away from them for this reason. Avoiding a person due to skin color in its own would be a racist act, but in the case of this type of obsession it is the OCD which is driving the behavior, and not the person’s morals.
Some people experiencing these thoughts may instead feel a need to be kinder to people of color or speak to more people of color to convince themselves they are not racist. One person online also described feeling the need to watch atrocities happening to people of color in order to “cure” themselves of the thoughts. Although some behaviors may seem positive or even helpful, others may manifest as pathological. In either case, giving into any obsession only strengthens the disorders hold, such behavior will worsen the OCD if performed ritualistically.
While the responses and thoughts may differ from person to person, one thing seems common for each experience — there is self-loathing and discomfort caused by the intrusive racist thoughts that a sufferer cannot stop thinking about.
Getting Help for Racially-Themed OCD
As stated prior, while there is a dearth of information on this burgeoning form of the OCD, it is increasingly obvious to clinicians who see people day to day, that this obsession is increasing in light of worldwide events. OCD has a tendency to latch on to things that people most care about, so it can manifest in many different forms, even if the underlying mechanisms of each obsession is the same.
It has only been in the last ten years that sexual obsessions have gained any kind of widespread acknowledgement, so in light of racism and discrimination being more prevalent in the news, this form of OCD is likely to grow and become better recognized. OCD in any form is easy for a trained expert to recognize, but sadly these lesser known obsessions are often widely misunderstood, even by mental health professionals.
Monnica Williams, Ph.D., & Imani Faber
Transgender Obsessions
What is TOCD?
About Transgender OCD (or Trans OCD)
With the recent media attention and ongoing conversations regarding gender identity, many people with OCD are now struggling with intrusive thoughts and uncertainty in how they identify their gender. This form of OCD is called Transgender OCD (TOCD).
TOCD is not limited to cisgender people. Transgender people can also have obsessions relating to whether they are cisgender, although this is less common.
The core fear behind TOCD is not whether being transgender is bad, but rather, the confusion and questioning behind the thoughts and obsessions. The worry that they aren’t who they thought they were. The worry of what friends and family will think.
Obsessive-compulsive disorder (OCD) is a brain-based anxiety-related mental health disorder that causes a great deal of suffering and impairment.
What are common TOCD symptoms?
Common obsessive thoughts and intrusive images in TOCD:
- Being afraid that they are trans/cisgender
- Constantly questioning their sexuality
- Fear of sending out unintentional signals that they are trans/cisgender
- Ruminating on what it might mean to be trans/cisgender
- Playing out scenarios from their past (for example, a young boy dressed up in his older sisters’ dress, and wondering if he liked it at the time)
- Being worried about finding more intrusive thoughts or triggers (for example, hearing a transgender person share their story on TV, or in a magazine, and wonder if they are transgender, too).
Obsessive-compulsive disorder (OCD) is a brain-based anxiety-related mental health condition that causes a great deal of suffering and impairment.
People struggling with TOCD may have some of the following compulsions and rituals:
- Searching online: “Am I transgender?” “How to know if you are trans?”
- Asking for reassurance from family and friends
- Trying on clothes of the opposite gender
- Avoiding social events
- Using logic to reassure themselves
- Looking through old journals and photographs and asking their family and friends if they ever noticed anything earlier in their life that may confirm that they are transgender
- Looking online for communities of people expressing the same symptoms
- Examining some of their own body parts and try to determine if they are masculine or feminine (e.g., a male looking at his calves and wondering if they look feminine)
How does TOCD impact a person’s daily life?
The impact TOCD has on an individuals’ day to day life is much like the impact that people who suffer from other forms of OCD deal with on a day-to-day basis.
Obsessive thoughts and compulsion rituals can take up large chunks of time in a person’s day and cause severe anxiety and stress.
Over time people that struggle with TOCD may isolate themselves and avoid social gatherings. They may constantly ask and need reassurance that they are not transgender/cisgender.
Case Example of Trans OCD
Doctors at Stanford University described the case of a queer 20-year old college student who did not know he had TOCD. He presented for an evaluation for sexual reassignment surgery due to severe, anxiety-producing doubts about his gender identity. His worries started abruptly after the use of marijuana, at which point he began to question whether or not he was happy being a male. He suffered from paralyzing obsessions of being transgender that caused him great distress, and as a result he engaged in mental and behavioral compulsions such as “testing” his reactions to certain thoughts or images and reassurance seeking. He also experienced problems in school, depression, and even suicidal thoughts (Safer, Bullock, & Safer, 2016).
There is hope!
To a person struggling with TOCD, it may seem hopeless. But there are treatments that can give people relief.
ERP, the gold standard treatment for OCD, is the most effective way to combat obsessions, intrusive thoughts, and compulsions.
Are you struggling with TOCD? Contact us today to find a therapist to help you.
Research Articles
Aboujaoude, E. & Starcevic, V. (2021). Case Report: Doubts and pre-occupations about being transgender: Questioning one’s gender identity or a case of obsessive-compulsive disorder? Frontiers in Psychiatry, 12, 644114–. https://doi.org/10.3389/fpsyt.2021.644114
Safer D.L., Bullock K.D., & Safer J.D. (2016). Obsessive-compulsive disorder presenting as gender dysphoria/gender incongruence: a case report and literature review. AACE Clinical Case Reports, 2, e268-e271.
Williams, M. T., & Ching, T. H. W. (2016). Transgender anxiety, cultural issues, and cannabis in obsessive-compulsive disorder. AACE Clinical Case Reports, 2(3), e276-e277. https://doi.org/10.4158/ep161356.co
Symmetry and Exactness
Obsessions with Symmetry in OCD
Reasons behind concerns about symmetry:
- Magical Thinking
- Dysfunctional Protecting
- Need to Feel Right
Some people with OCD have obsessions surrounding the way objects are arranged. These people may feel very uncomfortable when confronted with situations where objects are misaligned or in disarray. On a related note, some people may be made uncomfortable when something does not appear perfect. They may not be able to tolerate having written something where the letters may be shaped imperfectly. The corresponding compulsions would be ordering and arranging or compulsive corrections. When movies attempt to portray OCD, they often throw in seemingly random behaviors. But it is important for outsiders to remember that even if the OCDer is doing something that appears random, or just crazy, that is never the case. There is always some base reason, even if it seems illogical or magical.
It’s Not Just Personality
People with symmetry concerns may be more likely to have other anxiety disorders or obsessive-compulsive personality disorder. People with this type of OCD typically have an earlier age of onset and are are more likely to have close family members with OCD. It is important to note that while OCPD and OCD appear to have some superficial similarities in concerns, the key difference is that those with OCPD are not stressed or bothered by their thoughts, and cannot even really be called obsessions. Whereas a person with symmetry concerns is caused great distress by their obsessions. This is called for OCD ego-dystonic (OCD obsessions are not considered reasonable, and are foreign and unwelcome) versus ego-syntonic (the thoughts are seen as reasonable and part of ones self). So, to an outsider they may appear similar, or even affect a family member or friend in the same way, but OCD always causes the sufferer more distress than even the most traumatized family member.
Magical Thinking
Individuals with obsessions about symmetry and exactness may also have magical thinking associated with their concerns. For example, they may worry that their mother will have an accident unless things are in just the right place. Since the OCD thoughts are almost always ego-dystonic, the person realizes these thoughts are ridiculous. But OCD really is the great “what if” disease, so the obsession may hear the word blind and obsess that if someone doesn’t say “you’re not blind” four times they will go blind. They realize that this is ridiculous, but the person usually thinks “I might as well just in case.” But by giving into the obsession, it is then fed, and comes back more frequently and stronger. What was once just a simple “what if” becomes hundreds of magical obsessions that then lead to compulsions, which start to take more and more time. This is the progressive snowball effect of OCD.
Dysfunctional Protecting
People with most forms of OCD are usually doing compulsions in response to their obsessions to protect themselves or those around them. It feels ridiculous to arrange something just perfectly so a family member doesn’t get cancer, but the OCDer is usually so caring and worried that they don’t want to be the cause by just being lazy. It could even go through their mind that it is some magical karma for not caring enough.
Needs to Feel Right
In other cases, the need for symmetry may just “feel right” and not be accompanied by magical thinking (e.g., just makes the person uncomfortable). For instance, a person may scratch one side of their face, but then the other side will feel weird until scratched the same way for the same amount of time. Some people without OCD may have a preference for symmetry, but the OCD will scream for symmetry and cause great distraction until satisfied. It can be hard for someone without OCD to conceptualize, but if one side of the face has been scratched a good way to understand how distracting it would be to the OCDer is to imagine one sitting on a rock on one side of their body but not the other. This is how much discomfort the nagging need for symmetry can cause.
Uncommon Obsessions
Unusual Fears and Worries in OCD
Many Rare Forms of Obsessive-Compulsive Disorder are Unrecognized
Although cleaning and arranging are the most common worries you will hear about when people discuss OCD, there are some lesser known signs and symptoms that are also a part of this challenging disorder. Below we discuss symptoms of OCD that are not unusual, but they are less common, as well as some truly unusual variations.
Some less common forms of OCD:
- Relationship Obsessions
- Somatic (Body-Focused) Obsessions
- Existential Obsessions
- Need to Know Obsessions
Less Common OCD Obsessions
Here we describe some lesser known worries in OCD, followed by some very rare obsessions.
Relationship Obsessions
Relationship worries in OCD, also sometimes called ROCD, is a kind of OCD in which the sufferer experiences intrusive and distressing thoughts about their feelings of attraction or love for their significant other. Obsessions in ROCD include a preoccupation with the relationship or doubting whether their spouse is the right one, or contemplating the overall attractiveness, desirability, or future compatibility of their loved one. Obsessions often arise in otherwise healthy relationships, which can cause new relationships problems of their own.
Somatic Obsessions
Somatic obsessions refer to a hyperawareness of various bodily sensations. These are intrusive thoughts that draw attention to body processes like breathing, blinking, swallowing, body position, ringing in the ears, dull pain in the joints, or awareness of normal occurrences like itching, being full, or heart rate. Somatic obsessions are sometimes called sensorimotor or somatoform obsessions, which can lead to somatic compulsions.
Existential Obsessions
Existential obsessions in OCD occur when a person can’t stop thinking about questions that may be philosophical or spiritual in nature. The questions usually revolve around the meaning or purpose of life, or one’s own existence. Sometimes people with sort of OCD worry that they may not be real or that life might be an illusion. Many people ponder these sort of issues, but most people can stop thinking about these topics when they want and move on to other things. But people with this form of OCD will continue to be distressed as they unable to arrive at permanently satisfying answers.
Need to Know Obsessions
Many people with OCD feel a burning need to know specific information. In these cases, if a person hears part of some information, they can’t move on until they hear the rest. For example, if they see a billboard on the highway, they might drive back to see the rest if they could not read it all when they passed the sign initially. This could also include the need to remember unimportant information, such as names of movies or song lyrics.
Fear of Saying the Wrong Thing
Sometimes people with OCD have a fear of saying certain things. For example, some people with this worry may avoid social situations out of a fear of blurting out something silly, offensive, even racist. These fears can even have a magical quality, and as such they might worry that saying certiain words will make something bad happen. Conversely, some people with OCD have a fear of not saying just the right thing, and then worry about not being perfectly understood by others.
Unusual Worries in OCD
Cell Phone Icons Jiggle
One client came into treatment due to intense anxiety when seeing the icons on his iPhone “jiggle.” He had the sudden thought that the icons were trying to escape from his phone. This happened to him more than once, and each time the client had a surge of panic. He also had the thought that the icons were watching him or looking at him in some way. After the first incident, he also became reactive and anxious upon seeing other clusters of objects, such as the buttons on his TV remote and the holes in blue cheese. Remotes with the highest contrast between buttons and background made him the most anxious.
Other Unusual OCD Obsessions
- Being bothered by certain sounds or noises (e.g., sound of chewing food)
- Intrusive (non-violent) mental images (e.g., cartoons, faces, or clouds)
- Intrusive nonsense sounds, words, or music that pop into a person’s head and won’t go away
- Losing one’s personality or positive qualities
- Fear of losing important things (e.g., keys, wallet, etc.)
- Fear of vomiting (also called emetophobia)
Related Research
Jang, S. J. (2016). Existential Spirituality, Religiosity, and Symptoms of Anxiety-Related Disorders: A Study of Belief in Ultimate Truth and Meaning in Life. Journal of Psychology and Theology, 44(3), 213–229.
The Impact of OCD
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Lasting Relief
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