This information handout describes the common themes that obsessions can take in OCD. It can be used to validate clients' experiences, illustrate the wide range of obsessions, and highlight their connection to compulsions.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Obsessions are unwanted thoughts, images, urges, or doubts that occur repeatedly and cause significant distress. They can have many different themes including contamination, harm, doubts, and superstitions.
This information handout sets out the broad range of obsessional themes seen in OCD, helping to validate and normalize clients' experiences, and explain how obsessions relate to compulsions.
This resource is designed to help clients by:
Clearly defining obsessions.
Explaining the impact they can have.
Outlining different themes in obsessions.
Developing an understanding of OCD-related experiences.
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Clients experiencing obsessions and compulsions.
Talk about the nature of obsessions.
Review common obsessional themes.
Identify obsessions the client experiences.
Explore the link between obsessions and compulsions.
Combine with other OCD psychoeducational resources as needed.
Obsessions are unwanted thoughts, images, or urges that pop into the client’s mind uninvited. They can also take the form of doubts. They feel ‘wrong’ and are inconsistent with the client’s values. Clients often feel very anxious and distressed when they experience obsessions, so they engage in compulsions to help them feel better.
Therapists and clients are often familiar with the common types of OCD, such as:
Fear of contamination that might lead to excessive washing.
Fear of causing harm that might lead to repetitive, ritualized checking behavior.
Because these are the most commonly discussed forms of OCD, many clients are confused about other types of OCD and might question if they really have OCD. They often think their obsessions are a reflection of them being a ‘mad, bad, or dangerous’ person (Rachman, 1998). Giving clients this handout can help them feel less alone and that their form of OCD is recognized.
Therapists can use this handout to demonstrate the wide range of obsessions. It can also help clients understand that obsessions are linked to compulsions and validate their experiences.
An overview of obsessions and common obsessional themes.
An introduction to OCD and obsessions for therapists.
Suggestions for using the resource with clients.
Key references for learning more about obsessions and OCD.
The resource can help therapists:
Educate clients about obsessions.
Recognize and differentiate obsessions.
Develop case conceptualizations and treatment plans.
Aardema, F. (2020). COVID-19, obsessive-compulsive disorder and invisible life forms that threaten the self. Journal of Obsessive-Compulsive and Related Disorders, 26, 100558.
Abramowitz, J., & Jacoby, R. (2014). Scrupulosity: A cognitive–behavioral analysis and implications for treatment. Journal of Obsessive-compulsive and Related Disorders, 3(2), 140-149.
Abramowitz, J. S., Brigidi, B. D., & Foa, E. B. (1999). Health concerns in patients with obsessive-compulsive disorder. Journal of Anxiety Disorders, 13(5), 529-539.
Abramowitz, J. S., Juel, E. K., Inozu, M., Friedman, J. B., & Myers, N. S. (2026). To Be or Not to Be—That Is the Obsession: The Nature and Treatment of Existential Obsessions and a Call for Research. Journal of Cognitive Psychotherapy, 40(1).
Albert, U., De Cori, D., Barbaro, F., Fernández De La Cruz, L., Nordsletten, A. E., & Mataix-Cols, D. (2015). Hoarding disorder: a new obsessive-compulsive related disorder in DSM-5. Journal of Psychopathology, 21(4), 354-364.
Berrios, G. E. (1989). Obsessive-compulsive disorder: its conceptual history in France during the 19th century. Comprehensive psychiatry, 30(4), 283-295.
Bruce, B. K., & Stevens, V. M. (1992). AIDS-related obsessive compulsive disorder: A treatment dilemma. Journal of Anxiety Disorders, 6(1), 79-88.
Chiang, B., & Purdon, C. (2023). A study of doubt in obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 80, 101753.
Einstein, D. A., & Menzies, R. G. (2004). The presence of magical thinking in obsessive compulsive disorder. Behaviour Research and Therapy, 42(5), 539-549.
Greenberg, D., Huppert, J. D. (2010) Scrupulosity: A unique subtype of obsessive-compulsive disorder. Current Psychiatry Reports,12(4), 282-289.
Hedman, E., Ljotsson, B., Axelsson, E., Andersson, G., Rück, C., & Andersson, E. (2017). Health anxiety in obsessive compulsive disorder and obsessive compulsive symptoms in severe health anxiety: An investigation of symptom profiles. Journal of Anxiety Disorders, 45, 80-86.
Kingdon, B. L., Egan, S. J., & Rees, C. S. (2012). The illusory beliefs inventory: a new measure of magical thinking and its relationship with obsessive compulsive disorder. Behavioural and Cognitive Psychotherapy, 40(1), 39-53.
Lee, H. J., & Kwon, S. M. (2003). Two different types of obsession: autogenous obsessions and reactive obsessions. Behaviour Research and Therapy, 41(1), 11–29.
Moulding, R., & Kyrios, M. (2006). Anxiety disorders and control related beliefs: The exemplar of obsessive–compulsive disorder (OCD). Clinical Psychology Review, 26(5), 573-583.
Pozza, A., Marazziti, D., Mucci, F., Angelo, N. L., Prestia, D., & Dèttore, D. (2021). Sexual response in obsessive–compulsive disorder: the role of obsessive beliefs. CNS spectrums, 26(5), 528-537.
Prasad, S., & Manna, C. (2022). Clinical description of rare phenomenology of obsessive–Compulsive disorder. Indian Journal of Social Psychiatry, 38(3), 304-306.
Rachman, S. (1998). A cognitive theory of obsessions. In: Behavior and cognitive therapy today (pp. 209-222). Pergamon.
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