HOCD, ROCD, POCD......I thought I’d discuss the issue of OCD sub-types since for most people, it is absorbing and somewhat addictive. It’s absorbing for clients since they are driven to define their OCD (for some it is one of their obsessions) and it’s absorbing for professionals since they equate a more detailed conceptualisation with greater understanding and skill. For some clients, a large part of their day is spent online, gathering reassurance that they have OCD by scrutinising the various sub-types. The driver behind this compulsion is the need for confirmation that their worst fear isn’t true, i.e., they won’t actually kill someone, they just have OCD (phew!) or their partner isn’t entirely wrong for them, it is just OCD (phew, again!). This offers some relief but it is short-lived and so I steer such clients back to focusing on the solution rather than the problem.
Therapists/professionals might do as well not to concentrate on the significance of sub-type. OCD subtypes are interesting and useful at the beginning of therapy but as work progresses, it becomes clear that commonalities rather than the differences between subtypes are more significant. As a practice, we specialise according to sub-type, e.g., responsibility, pure-O, relationship, religious, etc. and this is helpful early on in the therapeutic process. It reassures our clients that they are understood. It also tackles those miserable thoughts of isolation that no other single human being can identify with what they are going through. Additionally it helps us as therapists set highly specific behaviour work that we know targets that particular sub-type, however, as the client works through this and makes improvements, they realise that their core obsessions are based firmly in self-worth and discomfort.
One of the overriding concerns of the clients attending our group intensive courses is that they might ‘catch’ someone else’s OCD but of course, their core issues are ultimately the same, and you can’t ‘catch’ what you already have! At the outset of the group courses of mixed subtypes, clients are heard to say, ‘I wish I had your OCD, since I would know that wouldn’t happen!’…………..at the end of the group course they are more likely to be nodding in complete empathy and agreement.