In obsessive-compulsive disorder (OCD), an obsession refers to intrusive and unwanted thoughts, urges, or images that cause significant distress and anxiety. These obsessions are persistent and difficult to control, often leading the person to engage in compulsive behaviours or mental acts in an attempt to reduce the anxiety associated with the obsession. It’s important to note that these obsessions are unwanted and involuntary, and individuals with OCD often recognize them as irrational.
Irrespective of the specific content of these thoughts, they tend to evoke a deep sense of discomfort or unease. Despite recognizing the irrationality of their obsessions, people with OCD struggle to dismiss them because they feel exceedingly real. This internal conflict, characterised by an awareness of the irrationality of their thoughts juxtaposed with an intense belief in their validity, often leads to the conviction that the only way to alleviate anxiety is through engaging in compulsive behaviours.
In certain instances, people may struggle with distinguishing between intrusive thoughts and reality. This confusion can lead them to erroneously believe that merely experiencing these thoughts implies a desire or intent to act on them. However, it’s crucial to comprehend that even in extreme cases, the presence of these intrusive thoughts does not signify an underlying intent or inclination to engage in harmful behaviour.
Here we explore some examples of obsessions in OCD.
Contamination obsessions
One of the most prevalent obsessions in OCD involves fears of contamination or illness. Individuals with this type of obsession may have an excessive fear of germs, dirt, bodily fluids, chemicals, or environmental contaminants, leading to compulsive cleaning or washing rituals. Common obsessive thoughts may include:
Fear of touching surfaces: “If I touch this doorknob, I’ll get contaminated with germs and become seriously ill.”
Concern about bodily fluids: “What if I accidentally come into contact with bodily fluids like blood or saliva and contract a deadly disease?”
Anxiety about food contamination: “I can’t eat this food because it might be contaminated, and I’ll get food poisoning.”
Worry about environmental contamination: “The air around me feels contaminated, and if I breathe it in, I’ll become sick.”
Fear of chemical contamination: “If I come into contact with cleaning products or chemicals, I’ll absorb them through my skin and become poisoned.”
Obsession with personal hygiene: “I must wash my hands repeatedly until they feel clean, or else I’ll spread germs and get sick.”
Anxiety about contamination from animals: “If I touch my pet, I might contract diseases or parasites and become seriously ill.”
Concern about contamination through bodily functions: “If I use a public restroom, I’ll inevitably be exposed to harmful bacteria or viruses.”
Fear of contamination through contact with others: “I can’t shake hands or hug people because they might be carrying germs that will make me sick.”
Obsession with avoiding specific objects: “I can’t touch money because it’s dirty and could make me sick.”
Do you offer OCD therapy near me?
Edinburgh Therapy Service offers both in-person OCD counselling in Edinburgh (United Kingdom), and online therapy accessible worldwide. We specialise in therapy for OCD, offering CBT with ERP as the main treatment option.Â
Harm obsessions
Another common obsession in OCD goes around fears of causing harm to oneself or others, often involving intrusive violent, aggressive, or disturbing thoughts. These thoughts can be deeply distressing and conflict with the person’s values and beliefs. Examples of harm obsessions include:
Fear of losing control: “What if I suddenly lose control and harm someone I love, even though I don’t want to?”
Concern about accidentally causing harm: “What if I accidentally leave something dangerous lying around, and someone gets hurt because of me?”
Anxiety about unintentionally causing harm while driving: “What if I hit someone with my car while driving, even though I’m being careful?”
Worry about harming children: “What if I harm a child by accident or through neglect, even though I would never want to hurt them?”
Fear of acting on violent impulses: “What if I act on the violent thoughts in my head and harm someone, even though I don’t actually want to?”
Obsession with weapons: “What if I’m near a weapon and lose control, using it to harm someone?”
Concern about harming animals: “What if I accidentally harm an animal, even though I love animals and would never want to hurt them?”
Anxiety about causing harm through contamination: “What if I accidentally contaminate something with a harmful substance and someone gets sick because of me?”
Fear of harming oneself: “What if I harm myself intentionally or accidentally, even though I don’t want to?”
Worry about causing harm through neglect: “What if I neglect my responsibilities and someone suffers harm as a result?”
Symmetry and order obsessions
For some people with OCD, obsessions focus on the need for order, symmetry, counting, or a specific arrangement of objects or environments. These obsessions can lead to compulsive behaviours like organising, arranging, or repeating actions a certain number of times. Common thoughts may include:
Fear of asymmetry: “If I don’t arrange these items symmetrically or in a certain pattern, something bad will happen.”
Anxiety about unevenness: “If I don’t balance my actions or behaviours evenly on both sides, I’ll be doomed to face negative consequences.”
Worry about precise alignment: “If I don’t align objects perfectly or keep things in straight lines, I’ll bring chaos or harm into my life.”
Obsession with numerical patterns: “I must perform tasks in sets of specific numbers or multiples, or else I’ll invite misfortune or disaster.”
Concern about organising rituals: “If I don’t follow my rigid organising rituals exactly as planned, I’ll be overwhelmed by anxiety or face punishment.”
Anxiety about uniformity: “If things aren’t uniform or consistent, I’ll be plagued by uncertainty or something terrible will occur.”
Fear of disrupting order: “If I disturb the order of objects or routines, I’ll be unable to cope with the resulting chaos or harm.”
Obsession with perfect arrangements: “If my belongings aren’t arranged perfectly, I’ll be plagued by intrusive thoughts or feelings of dread.”
Anxiety about symmetry in body movements: “If I don’t move my body symmetrically or in a specific pattern, I’ll attract negative energy or harm.”
Worry about breaking patterns: “If I deviate from my established patterns or routines, I’ll face consequences or lose control over my life.”
Religious or moral obsessions
OCD can also manifest in the form of obsessions related to religious or moral beliefs. People may experience intrusive thoughts that conflict with their values, leading to intense guilt, anxiety or the need to perform rigid rituals. Examples include:
Fear of blasphemy: “What if I accidentally blaspheme against my religion or say something irreverent about God, leading to divine punishment?”
Anxiety about moral purity: “What if I am morally impure or sinful, and my actions offend my religious beliefs or disgrace myself and my family?”
Worry about moral contamination: “What if I become contaminated by immoral thoughts or actions, making me unworthy or condemned in the eyes of my religion?”
Obsession with scrupulosity: “What if I fail to adhere to every religious ritual or rule perfectly, and I am judged harshly by my religious community or by a higher power?”
Concern about causing harm to others: “What if my actions inadvertently harm others or lead them astray morally, causing them to suffer or sin?”
Anxiety about moral judgement: “What if I am judged harshly for my past mistakes or moral failings, leading to eternal damnation or punishment?”
Fear of committing sacrilege: “What if I accidentally desecrate sacred objects or spaces, bringing divine wrath upon myself or my loved ones?”
Worry about moral responsibility: “What if I am responsible for the suffering or harm of others, either directly or indirectly, because of my actions or choices?”
Obsession with moral perfection: “What if I am unable to live up to the highest moral standards set by my religion, and I am deemed unworthy of salvation or forgiveness?”
Concern about moral contamination through association: “What if I am tainted by the moral impurity of others, even if I have not engaged in sinful behaviour myself?”
Relationship obsessions
In relationship OCD (ROCD) obsessions often involve doubts or fears about commitment, fidelity, or the strength of the relationship. These obsessions may lead to compulsive behaviours like constantly seeking reassurance, checking on the partner, or mentally reviewing the relationship. Common thoughts include:
Fear of not loving your partner: “What if I don’t really love my partner anymore, and I’m just pretending or deceiving myself?”
Anxiety about compatibility: “What if my partner and I aren’t compatible, and our relationship is doomed to fail?”
Worry about finding someone better: “What if there’s someone else out there who’s a better match for me, and I’m making a mistake by staying in this relationship?”
Fear of commitment: “What if I’m not ready for a serious commitment, and I’m just stringing my partner along?”
Obsession with flaws: “What if my partner’s flaws are too much for me to handle, and I’ll never be truly happy with them?”
Concern about attraction: “What if I’m not as attracted to my partner as I should be, and it’s a sign that our relationship is doomed?”
Anxiety about infidelity: “What if I cheat on my partner or they cheat on me, and our relationship is irreparably damaged?”
Worry about the future: “What if my partner and I don’t have a future together, and I’m wasting my time investing in this relationship?”
Fear of missing out: “What if I’m missing out on better opportunities for love or happiness by staying in this relationship?”
Obsession with comparing: “What if my partner isn’t as good as someone else’s partner, and I’m settling for less than I deserve?”
"False" memory obsessions
For others, OCD obsessions involve persistent doubts and intrusive thoughts about vivid imagined events or “false” memories that cause severe distress, such as:
Obsessing over a past event: “I keep replaying this memory in my mind, but I’m not sure if it actually happened or if I’m just imagining it.”
Doubting the authenticity of memories: “I vividly remember saying or doing something, but now I’m questioning whether it really occurred or if I fabricated it.”
Anxiety about misremembering: “What if I’ve completely misremembered a crucial event in my life, and I’ve been living with a false belief all this time?”
Worrying about implanted memories: “I can’t shake the feeling that someone may have planted false memories in my mind, leading me to doubt my own experiences.”
Concern about distorted recollections: “I fear that my memories have been distorted over time, and I can no longer trust my own perception of reality.”
Anxiety about forgetting important details: “I’m terrified that I’ve forgotten important details about a significant event, and now I’m unable to distinguish between what’s real and what’s not.”
Fear of being dishonest with oneself: “I’m scared that I may be lying to myself about past experiences, and I can’t trust my own memories to provide an accurate reflection of reality.”
Sexual orientation obsessions
Sexual orientation obsessions in OCD involve intrusive thoughts, doubts, or uncertainties about one’s sexual orientation. Here are some examples:
Fear of being gay or lesbian: “What if I’m actually gay or lesbian, despite having always identified as straight?”
Doubting one’s sexual attraction: “I keep questioning whether I’m truly attracted to the opposite sex, or if I’m just pretending.”
Anxiety about past experiences: “I had a momentary thought or sensation that felt homosexual, and now I’m worried it means I’m gay or bisexual.”
Concern about sexual arousal: “I experienced arousal in response to something that goes against my perceived sexual orientation, and now I’m questioning my identity.”
Worry about not fitting societal norms: “I don’t feel like I fit the stereotypes of my supposed sexual orientation, leading me to doubt myself.”
Fear of being in denial: “What if I’m in denial about my true sexual orientation, and I’m suppressing my true desires?”
Concern about past relationships: “I had a relationship or encounter with someone of the same sex in the past, and now I’m worried it means I’m not straight.”
Obsession with labels: “I feel pressured to label my sexual orientation, but I’m not sure which label accurately represents me.”
Further reading
Do you offer OCD therapy near me?
Edinburgh Therapy Service offers both in-person OCD counselling in Edinburgh (United Kingdom), and online therapy accessible worldwide. We specialise in therapy for OCD, offering CBT with ERP as the main treatment option.Â