OCD is a shape-shifter. Its content often changes, especially with primarily internal obsessions and compulsions (involving thoughts about harm, sexual orientation, and relationships). For many with the disorder, addressing the ever changing obtrusive thoughts is like playing Whack-a-Mole.

The internet is full of articles about “hOCD,”(OCD about sexual orientation), “rOCD,” (OCD about the “rightness” of a relationship) and “Pure O” (obsessions in the absence of compulsions) OCD. Although these designations can be appealing if you’re trying to make sense of distressing thoughts, I find this alphabet-soup approach to OCD problematic for several reasons.

• It places too much emphasis on form over function. OCD isn’t about what it seems to be about. Every subtype of OCD has at its root the inability to tolerate uncertainty.
• It encourages compulsive checking and reassurance-seeking. Many of the forums and sites dedicated to OCD subtypes list the differences between OCD doubting and signs of a genuine issue, such as sexual identity conflicts or relationship problems. Checklists contain generalizations. But individuals don’t necessarily fall into neat categories. So more confusion results, leading to an endless cycle of checking and searching for reassurance.
•  It implies a definitive, black-and-white answer. In reality, OCD won’t accept yes or no. If doubts about a specific content fade, new ones will surface unless the driving mechanism—intolerance of uncertainty—has been addressed.
• In the case of so-called “Pure O” OCD, it’s inaccurate. OCD by definition involves obsessional thoughts and compulsive actions performed to neutralize the distress from the thoughts. The compulsions may not observable to others, as they are with, say,hand-washing; they may involve covert mental rituals, such as reviewing, comparing, or silently repeating prayers, words, or numbers. Rumination and worry in the absence of compulsions do exist but are more likely symptoms of generalized anxiety or depression, not OCD.

Addressing the form OCD takes is important only in designing a treatment plan for ERP (Exposure/Response Prevention).  To keep the OCD from becoming a pattern in which one obsession dissipates only to have another pop up, focus on accepting uncertainty.

Here’s how to begin the process of response-prevention:

1) Refrain from checking and analyzing.

2)Acknowledge that OCD is causing you to doubt yourself and that no amount of research will help you arrive at an answer you’ll believe.

3)Don’t try to categorize your OCD.

4)Give up trying to figure out if your fears are justified.

5)Stop seeking advice from internet forums.

Taking these steps will start you on the path to recovery and keep the moles from lying in wait to ambush you.