Is theme important in OCD?
Updated: Jul 28
I see this topic of conversation come up over and over again. Over the past few years there’s been a real increase in talking about the theme of our OCD. Do you have harm-based thoughts? Are you worried about contamination? Or your sexuality? Very often we used acronyms to describe them; HOCD, POCD, SO-OCD etc.
But does this matter?
It’s often argued that themes are irrelevant because “It’s all OCD”, and to some extent that view is correct – it IS all OCD. No matter the current theme of your condition, or the exact nature of your intrusive thoughts, it is all OCD. All forms of OCD deal with obsessions and compulsions which loop together in a downward spiral until the OCD takes up more and more time. They are all treated with Cognitive Behavioural Therapy (CBT) and Exposure Response Prevention (ERP). Some people – irrelevant of theme – respond well to this, others won’t. It’s exactly the same for medication. All types of OCD cause a massive amount of distress and all have a significant impact on our day to day lives.
I think a big argument against using themes to categorise our OCD is that we can hyper-focus on that specific theme. We might seek treatment only for that one type, only to find that another pops up in its place – which of course it often does!
But there is another side to this argument, and it’s a powerful one. As long as we understand that in a more general sense all of our symptoms are OCD, knowing the theme of our OCD can be really helpful because each comes with their very own specific set of challenges and needs. The theme of my OCD after having my son was harm OCD (HOCD). I lived with constant violent intrusive thoughts about harm coming to my son and by the end of it was terrified the person he was most at risk from was me. Believe me, theme mattered then. It was SO much harder for me to get medical support about that. I faced a whole range of obstacles talking to my doctor about those intrusive thoughts and faced the possibility of higher consequences as a result. *1 This is why postpartum OCD support groups are so vital.
I think the trauma impact from OCD is different according to theme. I know from experience that the OCD I dealt with before having my son, which mainly centered around keeping loved ones safe by physically checking locks, switches, plugs, cooker, etc., didn’t compare to the trauma I suffered as a result of the intrusive thoughts that made me believe I wanted to hurt my own child. That’s not to say that other forms of OCD aren’t traumatic – they’re horrendous, I know that. Keeping my parents safe by checking at the window didn’t cause a massive amount of damage to my self-esteem – believing that I was capable of hurting my son obliterated my sense of self. It took years to build up my self-esteem again.
Please believe me here when I say that I totally understand that ALL OCD is horrendous. I don’t mean to create a hierarchy of what hurts the most – because it all does. I just used that as a way of describing some of the differing considerations that come into play with different themes.
Knowing other people with OCD is brilliant – it stops us feeling alone. Knowing other people with the same theme as us is incredibly validating. Identifying your current OCD theme allows you to find peers who have been through very similar situations – you know they totally understand what you’re going through. And sometimes there’s nothing better than that. 😊
Acknowledging the theme might also help you to share recovery strategies that worked or books and resources that have been written specifically for that theme. Jon Hershfield wrote the amazing ‘Overcoming Harm OCD.’ It is an incredible book – so helpful. I’d have never found it unless I knew I was currently dealing with HOCD.
So there you have it, as long as you understand that it is all OCD and that it gets treated in very similar ways, go ahead and call it what you like.*2 And if you see someone criticising others for it – just ignore them. I do. OCD is hard enough – let’s do whatever we can to help ourselves get better.
Loads of love everyone,
Catherine x x
*1 Remember people with OCD are loving, kind and protective. We’re also massive worriers. The chances are, if we are parents, or work with children, our OCD will have through up upsetting intrusive thoughts. This can be terrifying, and you might be worried about talking to a medical professional about it. That’s totally understandable. But there are ways of doing it. Please check out this blog here.
*2 There’s also a whole argument about the use of the term Pure O (purely obsessional) OCD in the UK over here. It is often confusing as the name implies that there are no compulsions – that it only involves obsessions. In reality, Pure O is a term used to describe OCD that has hidden, internal, compulsions. It is often trickier to spot. If being able to identify with the term PURE O helps you, use it! OCD is hard enough. Plus, there’s loads of helpful resources under the heading of Pure O all over the internet. But please be aware that is can cause confusion and medical professionals often won’t know what it is. For some instances, referring to OCD as OCD may be more beneficial.