OCD Therapy in Massachusetts: Exploring the Many Forms of OCD
When most people hear the term Obsessive-Compulsive Disorder (OCD), their minds often go to the classic image: someone who washes their hands repeatedly, checks the stove or door locks over and over, or arranges items until they feel “just right.” These are indeed common forms of OCD, but they represent only part of the story.
The truth is, OCD can show up in many ways that aren’t as visible. Some of these forms are deeply misunderstood, often misdiagnosed, and can leave people suffering silently for years. At Whole Mind Therapy and Counseling, we provide online therapy for individuals struggling with the many subtypes of OCD—helping them understand what’s happening and assisting them with reducing OCD symptoms that are often misdiagnosed.
In this article, we’ll look at what most people think of as “classic” OCD, then explore some of the lesser-known subtypes such as Responsibility OCD, Scrupulosity (Moral) OCD, and Pure O, and discuss why OCD so often goes unrecognized.
The Classic Picture of OCD
The most recognizable forms of OCD involve observable compulsions—behaviors that someone feels compelled to repeat in order to reduce anxiety or prevent a feared outcome. Examples include:
Checking locks, stoves, or appliances repeatedly to be sure nothing bad will happen.
Excessive cleaning or handwashing due to fear of contamination.
Arranging items or repeating actions until things feel “just right.”
These rituals can take up hours of a person’s day and cause significant distress. While these presentations are real and serious, they’ve become so strongly associated with OCD that many people don’t realize the disorder can look very different.
Responsibility OCD
Responsibility OCD is one of the less obvious subtypes. People with this form of OCD carry a heavy sense of responsibility for preventing a mad outcome or mistakes. Even when nothing bad has happened, they feel overwhelming guilt or fear that they’ve overlooked something.
Examples include:
Replaying conversations in their mind to make sure they didn’t say something offensive.
Rechecking emails endlessly before sending them, terrified of making an error.
Worrying that forgetting a small task will have disastrous consequences.
This type of OCD often involves mental compulsions such as reassurance-seeking, reviewing memories, or mentally checking whether they have offended or hurt someone’s feelings.
Scrupulosity or Moral OCD
Scrupulosity OCD, sometimes called moral OCD, centers on fears about morality, ethics, or religious values. People with this subtype are consumed with doubts about whether they are “good enough” or whether they’ve sinned, lied, or acted immorally in some way.
Examples include:
Excessive prayer or confession to make sure they are morally pure.
Obsessing over whether they accidentally lied or misled someone.
Reviewing past behaviors to ensure they didn’t commit a moral mistake.
This can be exhausting and deeply distressing, especially when religious or cultural values are at the core of someone’s identity.
Pure O: The “Invisible” OCD
Many people have heard of Pure O (short for “purely obsessional” OCD). The term can be a little misleading, because while individuals may not engage in visible rituals like checking or washing, they often perform mental compulsions that are just as disruptive.
Examples include:
Mentally reviewing past events to be sure nothing bad happened.
Silently repeating phrases or prayers for reassurance.
Constantly analyzing thoughts to make sure they “don’t mean anything.”
Pure O can be especially difficult because it’s invisible to others. Someone may look calm on the outside while battling relentless intrusive thoughts on the inside.
Why OCD Is Often Misunderstood and Underdiagnosed
Despite being a well-known disorder, OCD is frequently misunderstood. Many people assume it’s only about cleaning or organizing, which leaves those with less visible symptoms feeling confused or overlooked.
Common reasons for underdiagnosis include:
Mental compulsions aren’t obvious: Without outward rituals, it’s easy for both the individual and professionals to miss the signs.
Shame and stigma: Intrusive thoughts can feel embarrassing or frightening, so people often hide them.
Overlap with anxiety: Because OCD involves worry and rumination, it’s sometimes mistaken for generalized anxiety disorder.
This misunderstanding means that many people don’t get the right treatment until years after symptoms begin. At Whole Mind Therapy and Counseling, we aim to change that by educating clients about the many subtypes of OCD and providing therapy that truly addresses the underlying patterns.
Living with OCD: You’re Not Alone
OCD can make daily life feel overwhelming, but with the right support, it’s possible to build a healthier, more balanced life. Many clients are relieved to learn that what they’re experiencing has a name—and that there are proven strategies for managing it.
At Whole Mind Therapy and Counseling, we specialize in helping individuals navigate the many faces of OCD. We provide online therapy in Massachusetts, making it easier to access treatment from home. If you’ve been struggling with intrusive thoughts, compulsions, or doubts that never seem to end, you don’t have to face it alone.
Take the First Step
If you recognize yourself in these descriptions—whether it’s responsibility OCD, scrupulosity, Pure O, or another misunderstood OCD subtype—know that help is available. OCD isn’t just about rituals or visible behaviors; it can take many forms, and each one is valid and worthy of care.
At Whole Mind Therapy and Counseling, we offer OCD therapy in Massachusetts and provide online OCD therapy across the state. Together, we’ll work to understand your symptoms, reduce their hold on your life, and help you find relief.
Reach out today to learn more about how we can support you.