Shedding Light on Misunderstood OCD Themes: You're Not Alone
Obsessive-Compulsive Disorder (OCD) is one of the most widely misunderstood mental health conditions, especially in the way it’s portrayed in mainstream media. Too often, OCD is reduced to a punchline or depicted only in terms of cleanliness, organization, or repetitive checking behaviors. While those symptoms can certainly be part of the disorder, they only scratch the surface.
As a therapist, I’ve had the privilege of working with clients who have struggled with deeply painful and confusing thoughts and compulsions that don’t fit the stereotypical OCD mold. I wanted to take a moment to shed light on some of these lesser-known OCD themes—ones that are rarely talked about in public but are incredibly common in clinical practice.
My hope in writing this is simple: to help those silently suffering recognize that what they’re going through might be OCD, and more importantly, that they are not alone.
Relationship OCD (ROCD)
ROCD involves intrusive doubts and fears about your romantic relationship. People with ROCD may find themselves obsessing over questions like:
“Do I really love my partner?”
“What if I’m making a mistake?”
“What if I’m not attracted to them enough?”
These questions can be relentless and feel like signs that something is "wrong." In reality, they are often ego-dystonic (meaning they go against the person’s values or desires), and the compulsions (like constantly seeking reassurance or analyzing your feelings) only feed the cycle. ROCD can impact even the healthiest of relationships, and it deserves more recognition and compassion.
Harm OCD
This subtype involves unwanted, intrusive thoughts about causing harm to others—or fear that you could cause harm. Examples include:
Visualizing pushing someone in front of a car or stabbing a loved one.
Worrying you might "snap" and lose control.
Avoiding knives or violent media for fear of triggering yourself.
These thoughts are terrifying not because the person wants to act on them, but precisely because they don’t. Harm OCD often creates deep shame, which leads people to hide their distress instead of seeking help.
Hit-and-Run OCD
Hit-and-Run OCD is a subtype of Harm OCD that centers around the fear of accidentally hitting someone while driving. A person might:
Turn around repeatedly to check for accidents.
Scan the news or traffic reports obsessively.
Reassure themselves they didn’t feel a “bump” in the road.
This can lead to significant driving anxiety and even avoidance of driving altogether. Again, the compulsion to check only reinforces the obsession.
Pedophilic and Sexual OCD (POCD / SO-OCD)
One of the most stigmatized OCD themes, this involves intrusive sexual thoughts or images that are completely unwanted and distressing. This can include:
Fears of being a pedophile.
Intrusive thoughts about inappropriate sexual acts.
Worrying about being sexually attracted to someone you shouldn’t be (e.g., a relative, a child, someone of the same gender if that goes against your orientation).
These thoughts do not reflect actual desires or intentions, but they cause immense anxiety and guilt. Because of the shame involved, people often suffer in silence, terrified to even mention what’s going on inside their head.
Postpartum Harm OCD
New parents—especially new mothers—can experience intrusive thoughts of harming their infant. Examples include:
Visualizing throwing the baby down the stairs.
Fear of accidentally suffocating the baby during sleep.
Avoiding being alone with the infant out of fear of losing control.
These thoughts can be horrifying for parents who love their children deeply. It’s important to know that postpartum OCD is different from postpartum psychosis. In OCD, the thoughts are ego-dystonic and unwanted. The person is usually hyper-aware and overly cautious, not detached from reality.
Why This Matters
Many of these themes are deeply stigmatized or misunderstood, and because of that, people often suffer alone for far too long. They might think they’re "going crazy" or fear being judged if they open up. In reality, they may be dealing with a very treatable condition—OCD.
If anything in this post resonated with you, please know this: You are not broken. You are not dangerous. You are not alone.
OCD takes many forms, and there is effective help out there. Exposure and Response Prevention (ERP) therapy is the gold-standard treatment for OCD and can help you find relief, even from the most distressing themes.
If you're struggling, reach out. Speak to a licensed mental health professional who understands OCD beyond the stereotypes.
Because healing starts with knowing you're not alone.