Obsessive-Compulsive Disorder (OCD) is more than a fear of germs or a need for order. It can take many forms, often centered around themes that are deeply personal and distressing. Each subtype involves intrusive thoughts (obsessions)and compulsions (behaviors or mental rituals) performed to reduce anxiety. Below are some of the most common types of OCD we treat through ERP therapy at our practice in New York and Massachusetts.

🔪 Harm OCD

"What if I hurt someone without meaning to?"

Harm OCD involves intrusive fears of causing physical, emotional, or accidental harm to others—or to oneself. These thoughts are deeply distressing and go against the person's values, often leaving them feeling unsafe or ashamed.

Examples of Harm OCD:

• Avoiding knives, driving, or being alone with others

• Constantly replaying memories to check for harm

• Asking for reassurance: “Would I ever snap?”

Despite how convincing the thoughts may feel, people with Harm OCD are not dangerous. The fear lies in not wantingthe thought to be true, which ERP therapy helps address by building tolerance to uncertainty and separating thought from action.

🧼 Contamination OCD

"What if I get sick or spread illness to others?"

Contamination OCD centers around fears of germs, illness, chemicals, bodily fluids, or even "spiritual" contamination. It often results in compulsive washing, cleaning, or avoiding people, places, and objects.

Examples of Contamination OCD:

• Washing hands excessively or using disinfectant after every interaction

• Avoiding public spaces, pets, hospitals, or “dirty” areas

• Changing clothes multiple times a day

ERP therapy for contamination OCD helps individuals gradually confront feared situations and learn that anxiety can fade without performing rituals—restoring freedom and flexibility in everyday life.

🔁 Checking OCD

"Did I leave the door unlocked? What if I caused a fire?"

Checking OCD is fueled by the fear of making a mistake that could lead to harm or catastrophe. This leads to compulsions like repeatedly checking locks, appliances, or one’s own memory.

Examples of Checking OCD:

• Repeatedly checking the stove, car, or front door

• Mentally reviewing situations to “make sure nothing bad happened”

• Seeking reassurance from others: “Are you sure I didn’t mess that up?”

Through ERP therapy, clients learn to face uncertainty without needing to check—freeing up time, energy, and peace of mind.

✝️ Scrupulosity OCD

"What if I'm sinning without realizing it?"

Scrupulosity involves obsessions related to morality, ethics, or religious devotion. People may fear being a bad person, offending a higher power, or making immoral decisions—even if their behavior is well within normal bounds.

Examples of Scrupulosity OCD:

• Compulsive prayer, confession, or rule-following

• Excessive concern with being “good,” honest, or righteous

• Avoiding media, people, or situations deemed “morally risky”

ERP for scrupulosity involves challenging black-and-white thinking and gradually confronting feared moral uncertainties—helping individuals reconnect with their values without OCD calling the shots.

❤️ Relationship OCD (ROCD)

"Do I really love my partner—or am I lying to myself?"

Relationship OCD causes intrusive doubts about one’s relationship, often focused on compatibility, attraction, or feelings of certainty. The thoughts may center around romantic partners, friends, or even family.

Examples of ROCD:

• Constantly analyzing feelings about a partner

• Mentally comparing current or past relationships

• Seeking reassurance from others or the partner themselves

ERP helps individuals disengage from obsessive mental loops and tolerate uncertainty—so they can connect to their relationships with more clarity and less anxiety.

🌈 Sexual Orientation & Gender Identity OCD

"What if I'm not the identity I thought I was?"

This form of OCD involves distressing thoughts about one’s sexual orientation or gender identity, often paired with compulsive checking, avoidance, or mental reviewing. These fears are not explorations of identity—they’re rooted in fear and doubt.

Examples:

• Avoiding LGBTQ+ media or communities due to fear of being triggered

• Excessively checking physical sensations or attraction

• Replaying conversations or memories for “proof” of identity

ERP helps individuals separate OCD-driven doubt from true identity, allowing space for self-trust and authentic exploration without fear.

🔄 Just-Right OCD / Symmetry OCD

"It doesn't feel right—I need to fix it."

Just-Right OCD involves a need for things to feel balanced, even, symmetrical, or “just right.” This can involve organizing, repeating, or mentally “correcting” until the sensation of wrongness disappears.

Examples:

• Arranging or tapping objects symmetrically

• Repeating actions until they feel “perfect”

• Avoiding certain numbers, words, or movements

ERP for Just-Right OCD focuses on building distress tolerance and helping individuals break free from rituals that steal time and energy.

🧩 “Pure O” / Mental Compulsions

"No one can see it—but it's nonstop in my head."

Many people with OCD experience internal compulsions—repetitive mental acts like analyzing, reviewing, or mentally reassuring themselves. Although there may be no visible behaviors, the mental rituals are just as exhausting.

Examples of Mental Compulsions:

• Replaying conversations or thoughts

• “Neutralizing” bad thoughts with good ones

• Mentally solving “what if” questions to feel safe

ERP helps clients face intrusive thoughts without engaging in mental compulsions—allowing the brain to unlearn OCD’s false alarms.

You’re Not Alone, and You’re Not Your Thoughts

OCD is a highly treatable condition, no matter how it shows up. At my practice, I offer evidence-based, affirming ERP therapy to teens and adults in New York and Massachusetts through secure telehealth sessions. Whether you’re struggling with contamination fears, harm thoughts, or doubts about your identity, I provide personalized, culturally responsive care grounded in compassion and clinical expertise.

I work with teens and adults across New York and Massachusetts through secure telehealth, offering compassionate, identity-affirming care that meets you where you are. Whether you're dealing with harm OCD, contamination fears, or mental rituals that won't stop, I bring clinical expertise, lived empathy, and a direct but supportive approach to help you break free from the OCD cycle.