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The Many Faces of OCD: A Closer Look at Its Subtypes and How Therapy Can Help 

Obsessive-Compulsive Disorder (OCD) is a mental health condition where people have ongoing, unwanted thoughts that cause them a lot of stress and anxiety, leading them to repeat certain behaviors over and over. OCD can manifest in many ways, and it affects everyone differently. At Love This Therapy, we understand the unique struggles that come with OCD, and we are here to provide specialized and compassionate support to help individuals handle and overcome these challenges. 

The Spectrum of OCD 

Many people associate OCD with repetitive hand-washing or constant cleaning, and while these are indeed manifestations of the disorder, they represent just one aspect of it. OCD varies widely from person to person. It manifests in different forms, each with distinct characteristics, demonstrating the diverse nature of this condition: 

  • Contamination and Washing: Fear of contamination often leads to excessive cleaning and washing rituals. This subtype revolves around the dread of being contaminated by germs or getting sick (Fontenelle, L. F., & Hasler, G., 2008). 
  • Symmetry and Ordering: Individuals with this subtype are preoccupied with alignment and order. They may spend hours arranging objects to satisfy their need for symmetry and exactness, which they believe prevents discomfort or disaster (Summerfeldt, L. J., 2004). 
  • Harm and Checking: This involves fears of causing harm to oneself or others inadvertently, leading to compulsive behaviors such as checking locks, appliances, and repeatedly ensuring that no harm has occurred (Coles, M. E., et al., 2005). 
  • Hoarding: Previously considered a part of OCD, hoarding is now recognized as a separate disorder in the DSM-5. It involves the compulsive gathering and saving of items that others may view as worthless (Pertusa, A., et al., 2010). 
  • Ruminative/Intrusive Thoughts: This subtype is dominated by intrusive and unwanted thoughts that are violent, religious, or sexual in nature, often without visible compulsions but with significant mental rituals (Clark, D. A., 2004). 

Each subtype of OCD involves a cycle of obsessions and compulsions that can be immensely distressing and significantly impair daily functioning. 

Understanding The Obsessions and Compulsions of OCD 

Obsessive-Compulsive Disorder (OCD) is characterized by two main components: obsessions and compulsions, each with distinct symptoms: 

Obsessions are intrusive and unwanted thoughts, images, or urges that cause significant anxiety or distress. These are not simply excessive worries about real-life problems but often involve fears that the sufferer recognizes as irrational. Common symptoms of obsessions include: 

  • Fear of contamination or dirt 
  • Needing things orderly and symmetrical 
  • Aggressive or horrific thoughts about harming oneself or others 
  • Unwanted thoughts, including aggression, or sexual or religious subjects (Abramowitz, J. S., Taylor, S., & McKay, D., 2009). 

Compulsions are behaviors that an individual feels compelled to perform in response to an obsession or according to rules that must be applied rigidly. The behaviors are aimed at preventing or reducing distress or a feared situation; however, they are not connected in a realistic way with what they are designed to neutralize or prevent, or they are clearly excessive. Symptoms of compulsions include: 

  • Washing and cleaning 
  • Checking 
  • Counting 
  • Orderliness 
  • Following a strict routine 
  • Demanding reassurances  

These compulsive behaviors and obsessive thoughts can significantly interfere with daily functioning and are typically recognized by the person as excessive or unreasonable. This recognition, however, does not alleviate the compulsion to engage in them, which is a hallmark of the disorder’s disruptive impact on mental health. 

The Importance of Diagnosis and Assessment 

Accurate diagnosis and assessment are critical components of effectively treating OCD. Misdiagnosis can lead to treatments that are not only ineffective but also potentially exacerbating the disorder. At Love This Therapy, we have experts like Dr. Nicole Gevaux who specialize in the assessment and diagnosis of OCD. Utilizing a combination of clinical interviews, symptom assessment tools, and behavioral observations, we ensure a comprehensive understanding of everyone’s experience with OCD. 

How Therapy Can Help 

Therapy can be a powerful tool in managing obsessive-compulsive disorder (OCD). Psychologists and counsellors utilize effective therapeutic methods like Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) to help you tackle the irrational beliefs that drive your obsessions and compulsions. In therapy, you’ll learn strategies to face these anxieties directly, without falling back on compulsive behaviors, which gradually diminishes their influence over your life. Psychologists and counsellors also provide essential ongoing support, teaching you how to handle stress and anxiety and deal with feelings of shame or embarrassment associated with OCD. By addressing both the mental and practical challenges of OCD, this comprehensive treatment fosters resilience and aids in recovery, helping you regain control and improve your quality of life. 

Therapeutic Modalities that Make a Difference 

At Love This Therapy, we embrace evidence-based approaches proven effective in managing and treating OCD: 

  • Cognitive Behavioral Therapy (CBT): Recognized as the gold standard for OCD treatment, CBT focuses on identifying and transforming distorted thinking patterns. 
  • Exposure and Response Prevention (ERP): As a critical component of CBT, ERP involves controlled exposure to fear sources while learning to refrain from compulsive behaviors. Jeffrey M. Schwartz’s “Brain Lock” emphasizes this method, advocating a four-step process to change brain behavior: relabeling the obsession, reattributing the cause, refocusing on new activities, and revaluing it as merely another symptom that can be managed (Schwartz, 1997). 
  • Mindfulness and Relaxation Techniques: These methods are helpful for controlling anxiety and stress, which can exacerbate OCD symptoms. Techniques such as meditation and yoga are beneficial for maintaining mental balance and well-being (Hofmann, S. G., & Gómez, A. F., 2017). 
  • Medication: For some, therapy alone might not suffice. Selective Serotonin Reuptake Inhibitors (SSRIs) are often prescribed to mitigate symptoms, complementing therapeutic efforts (Pittenger, C., et al., 2018). 

Each of these modalities contributes uniquely to the comprehensive treatment of OCD, offering you a variety of tools to combat the disorder and improve your quality of life. 


OCD is a complex condition that needs a thoughtful and personalized approach to treatment. With the right kind of help and support, people with OCD can manage their thoughts and behaviors better and enjoy a more fulfilling life. Here at Love This Therapy, we’re dedicated to offering kind and effective care that meets the specific needs of each person we work with. Dr. Catalina Zilveti, one of our psychologists, has 20+ years of experience treating OCD and is here to support you every step of the way as you work toward recovery. 

If you or someone you know is struggling with symptoms of OCD, consider reaching out to our clinic. We are here to help you navigate the complexities of this disorder and support you through every step of your treatment. 

If you would like to book a session with Dr. Catalina Zilveti or are interested in an OCD assessment and diagnosis with Dr. Nicole Gevaux, please give us a call at 604-229-4887 or email us at


  • Clark, D. A. (2004). Cognitive-behavioral therapy for OCD. Guilford Press. 
  • Coles, M. E., Frost, R. O., Heimberg, R. G., & Rheaume, J. (2005). Hoarding behaviors in a large college sample. Behaviour Research and Therapy, 43(7), 897-911. 
  • Fontenelle, L. F., & Hasler, G. (2008). The analytical epidemiology of obsessive-compulsive disorder: Risk factors and correlates. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 32(1), 1-15. 
  • Hofmann, S. G., & Gómez, A. F. (2017). Mindfulness-based interventions for anxiety and depression. Psychiatric Clinics of North America, 40(4), 739-749. 
  • Pertusa, A., Frost, R. O., Fullana, M. A., Samuels, J., Steketee, G., Tolin, D., Saxena, S., Leckman, J. F., & Mataix-Cols, D. (2010). Refining the diagnostic boundaries of compulsive hoarding: A critical review. Clinical Psychology Review, 30(4), 371-386. 
  • Pittenger, C., Bloch, M. H., & Williams, K. (2018). Glutamate abnormalities in obsessive-compulsive disorder: Neurobiology, pathophysiology, and treatment. Pharmacology & Therapeutics, 132(3), 314-332. 
  • Schwartz, J. M. (1997). Brain Lock: Free Yourself from Obsessive-Compulsive Behavior. Harper Perennial. 
  • Summerfeldt, L. J. (2004). Understanding and treating incompleteness in obsessive-compulsive disorder. Journal of Clinical Psychology, 60(11), 1155-1168. 
  • Abramowitz, J. S., Taylor, S., & McKay, D. (2009). Obsessive-compulsive disorder. Lancet, 374(9688), 491-499. 

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