Common OCD Themes and How TMS Therapy Can Help

Obsessive-compulsive disorder, or OCD, is a common mental health condition that affects around 2.5 million people in the U.S. alone. 

You may have heard that there are different “subtypes” of OCD. This is a common misunderstanding. Everyone with OCD has the same diagnosis, and the disorder isn’t separated into different types.

However, there are different themes that OCD obsessions can revolve around. People with OCD usually experience obsessions and compulsions that are related to one specific idea. These are sometimes referred to as OCD subtypes or OCD themes.

In this article, we’ll go over the most common OCD themes, and how TMS therapy may be able to help you no matter what OCD theme you face.

What is OCD?

First, what is OCD and what are its most common symptoms?

OCD is a serious mental health condition that’s defined by two specific symptoms: obsessions and compulsions. Obsessions are intrusive, unwanted thoughts that cause an intense amount of anxiety. Obsessions lead people with OCD to perform compulsions, or repetitive behaviors that are meant to reduce anxiety and fear.

As we’ll go over, people with OCD can have obsessions about anything, from dirtiness to whether or not they’re a murderer. 

OCD differs from generalized anxiety because obsessions are often much more severe and persistent than anxious thoughts. People with generalized anxiety also don’t perform compulsions. The presence of obsessions and compulsions keep people with OCD locked in a cycle; compulsions may make them feel better temporarily, but soon the obsession comes back stronger than ever.

Many people with OCD lose hours of their time to performing compulsions. When left untreated, OCD can make it extremely difficult to function in daily life.

Common OCD themes

People with OCD often have obsessions that revolve around a specific theme. This is another way in which it differs from generalized anxiety — people with anxiety tend to have anxious thoughts about many things in life, while obsessions are the same general thought that people have over and over.

Here, we’ll go over some of the most common OCD themes. But, by no means, is this a comprehensive list of everything someone with OCD can have obsessions about. OCD can latch itself onto anything, especially the things that you value.

Contamination OCD

If you don’t know much about OCD, contamination OCD might be what you imagine when you think of a person with OCD. People with contamination OCD get obsessions around dirtiness, illness, or contamination. For example, they could have obsessions like, “If I don’t wash my hands, then I could get my children sick and they could die.”

Common compulsions that come with contamination OCD include repeated hand-washing, showering, and avoidance (refusing to touch anything that they view as “dirty”).

Just right OCD

This is another OCD theme that’s commonly known. People with “just right” themes of OCD have a need to objects, plans, or other aspects of life “perfect.” This is different from perfectionism because with OCD, there is an obsession that comes along with this compulsion. People with just-right OCD don’t enjoy things being “perfect,” but their obsessions cause them to engage in these compulsive behaviors.

For example, someone may have the thought, “If these pencils don’t line up exactly right, then something really terrible will happen and it’ll be my fault.” They may spend hours of their time trying to adjust their pencils to be “just right.”

Harm OCD

People with harm themes of OCD have obsessions about intentionally or unintentionally hurting themselves or others. For example, many people with OCD have the obsession that they will run someone over while driving. Another frequent harm OCD obsession is to worry that you will suddenly become violent and injure the people you love.

Many people with harm OCD use avoidance as a compulsion. For example, they might hide all the knives in their house because they worry that if they see a knife, they will pick it up and stab someone.

Sexual orientation OCD

People with sexual orientation themes of OCD have obsessions about whether they truly identify with the sexual orientation that they’ve identified with their whole lives. For example, a straight person might obsess about whether they’re gay, and a gay person might obsess about whether they’re straight. Having these obsessions has nothing to do with someone’s true sexual orientation.

Compulsions that can come along with sexual orientation OCD usually revolve around checking. For example, someone could compulsively ask other people about when and how they knew they were gay (or straight), and compare their own experience against others’.

Pedophilia OCD

This is an OCD theme that is rarely talked about, because the people who live with it experience a lot of shame about having these thoughts. People with pedophilia have obsessions that they may have a sexual attraction to children. People with pedophilia OCD are not pedophiles. The thought of being a pedophile is so revolting to them that they worry incessantly about it.

Compulsions with pedophilia OCD can include checking groinal responses when around children and reading compulsively about pedophiles and checking their own experiences against others’. People with pedophilia OCD may also compulsively seek reassurance that they aren’t a pedophile.


There are many effective treatment options for OCD, including a type of therapy called Exposure and Response Prevention (ERP) and psychiatric medications. In general, the goal of treatment for OCD is to reduce the amount of time someone spends on doing compulsions, and  lessen the severity of the anxiety that obsessions bring.

But for some, these treatment options don’t work. Others may not be able to commit to years of therapy or find the side effects of OCD medication too uncomfortable to be able to continue taking it.

Transcranial magnetic stimulation, also known as TMS therapy, is a safe and effective treatment option for OCD that could be a great option for people in these situations. 

TMS is a brain stimulation therapy. This may sound scary at first, because “brain stimulation therapy” often makes people think of electroconvulsive therapy (ECT). But TMS is much less invasive than ECT. You don’t need to go under any anesthesia at all to receive TMS, and sessions last less than an hour. You can drive yourself home directly afterward.

TMS therapy uses electromagnetic technology to stimulate certain areas of the brain that are affected by OCD. It’s been proven to be safe and well-tolerated by most people, and it’s approved by the Food and Drug Administration (FDA) for treatment-resistant depression. 

On top of that, there are very few side effects with TMS. The side effects you could experience are generally mild, like fatigue and scalp pain directly following a session. Unlike ECT, TMS therapy does not cause seizures.

A few different deep TMS devices, including the BrainsWay and MagVenture coils, have been approved by the FDA for the treatment of OCD. TMS is best for people who’ve tried firstline OCD treatments like therapy and medication — and have ound no relief.

If you live with OCD, then you may feel like life is hell.  But it doesn’t have to be. TMS is an innovative treatment that could help you overcome OCD obsessions and compulsions for good. 

Southern Colorado TMS is the premier TMS provider in the area. Get in touch with us to learn more about TMS, whether you’re eligible, and how you can get started.

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