Summary5 min read

Podcast Summary

Podcast: Get to know OCD
Host: Dr. Patrick McGrath (NOCD Chief Clinical Officer)
Episode: The Types of OCD No One Talks About
Date: November 10, 2025

Episode Overview

In this illuminating episode, Dr. Patrick McGrath debunks common myths about OCD, focusing particularly on the lesser-known, often hidden subtypes of the disorder that aren't discussed in pop culture or mainstream media. He shares real-life, often surprising examples drawn from clinical experience to show OCD’s wide-reaching impact and dispels the idea that OCD is helpful or only about neatness and handwashing. The episode aims to validate the experiences of those struggling in silence and to encourage seeking help.

Key Discussion Points & Insights

1. Misconceptions About OCD

Popular Myths: Many believe OCD is helpful or desirable—associating it only with cleanliness or organization.
- “Wouldn't it be great to have a little OCD? I would get my house cleaned... That shows a level of lack of understanding of OCD...” (00:08)
Reality: Dr. McGrath asserts that OCD is never “helpful” to sufferers and goes far beyond the stereotypes depicted in movies or TV.

2. Uncommon Types/Subtypes of OCD

Beyond the Stereotypes:
- Compulsively checking doors and hands isn’t the full story—Dr. McGrath shares examples of:
  - Repeatedly driving in circles to check for possible hit-and-run victims.
    - “...people with OCD might do things like drive around a block to look for a dead body because they don't know if they hit a pothole or if they ran over a person...” (01:02)
  - Obsessing over relationships and love—doubting one's feelings or their partner's love.
  - Fears around sexual orientation or attraction, leading to intrusive doubts about identity.
  - Worries about harming others through "emotional contamination" or indirect means.
  - Fears of committing taboo acts or sins and relentless ruminations over them.
  - Scrutinizing whether harm was caused unintentionally (e.g., a motorcyclist running off the road).
- These obsessions are usually driven by the intrusive thought: “What if?” followed by catastrophic imaginings.

3. The OCD Playbook – How OCD Works

The Cycle:
- Obsessive “what if” thoughts → worst-case scenarios → urgent compulsions (behaviors) to neutralize distress.
- Quote:
  - “They all start with two words, which is what if? And then are followed by the worst case scenario. And then that's followed by this overwhelming need to do something to neutralize that.” (03:51)
Paradox of Thought Suppression:
- Attempting not to think of something makes the obsession stronger.
  - “If we could get people to just stop thinking things, I'd have a job that I'd meet with people for one session... that's just not how it works, is it?” (11:09)
- The more you avoid or suppress a thought, the more persistent it becomes.

4. Recognizing Hidden OCD

Many listeners may realize, through these examples, that they experience such hidden subtypes—often keeping them secret in shame.
- Quote:
  - “You may also think, wait a minute, I do that all the time. But I didn't know that was obsessive compulsive disorder, and I never told anybody about that. How do you know about that?” (15:12)
- Dr. McGrath normalizes these experiences; they're more common than people think.

5. No One is 'Terminally Unique' with OCD

Commonality is Comfort:
- Dr. McGrath frequently tells clients:
  - “If you tell me something I've never heard in relationship to OCD, I'll give you a dollar. I haven’t given out a dollar in over 10 years.” (17:28)
- This shared experience means there is evidence-based treatment for all types.
- “OCD has one very simple playbook. And that's why in reality, I think it's actually something that's very, very treatable. Because OCD is a one trick pony.” (18:16)

6. Hope and Treatment

Treatment is highly effective; the predictability of OCD’s thinking patterns makes it treatable.
- “You’re just like everybody else with OCD, and there's one cool thing about being just like everybody else... you can get treatment just like everybody else can.” (19:55)
NOCD offers therapy for a variety of related conditions and encourages reaching out.

Memorable Quotes & Moments

On Misconceptions:
- “Not one person with OCD would ever say that OCD has ever been helpful to them in their entire life.” (00:28)
On Relationship OCD:
- “Or is there ever a way to truly 100%...know that your spouse is the absolute right person for you and there will never be anyone else that you will ever be attracted to or interested in whatsoever? I don't think so.” (08:29)
On Paradoxical Thinking:
- “The more we hope not to think of something, the more likely we are to actually think of it.” (13:15)
On Community and Treatment:
- “The best part of OCD being predictable...no topic is off the table...it doesn't mean that you're unique, you're just like everybody else with OCD. And there's one cool thing about being just like everybody else with OCD, and that is you can get treatment just like everybody else with OCD can.” (20:19)

Important Timestamps

[00:08] — Debunking the “desirable” stereotype of OCD
[01:02] — Examples of non-traditional OCD compulsions
[03:51] — Explanation of the “what if-worst case” OCD pattern
[11:09] — Why telling someone to “just stop” doesn’t work
[15:12] — Listeners recognizing themselves in lesser-known OCD subtypes
[17:28] — “If you tell me something I’ve never heard…” anecdote
[18:16] — The ‘OCD playbook’ and why it’s treatable
[20:19] — Assurance that treatment is available and effective for all subtypes

Episode Tone

Dr. McGrath’s tone is empathetic, validating, and gently humorous at times. He provides both clinical insight and real-world encouragement, reducing stigma and offering hope.

Key Takeaways

OCD is much more complex and varied than popular culture suggests.
Obsessive and compulsive patterns often focus on taboo, hidden, or deeply personal fears—typically driven by “what if?” thinking.
No one suffering from OCD is truly alone; these symptoms are widespread and well-understood within clinical practice.
Treatment is available, effective, and everyone with OCD deserves support and relief.

For more information about treatment and support, visit NOCD.com.

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Transcript1 lines

[00:01]
A
There are times that I talk about obsessive compulsive disorder and people have the joke, oh, I wish I had a little bit of ocd or wouldn't it be great to have a little ocd? I would get my house cleaned, there would be dusting, no one would ever break in. My hands would be washed. And that shows a level of lack of understanding of OCD in a few ways. Number one, that having OCD would actually be helpful, which not one person with OCD would ever say that OCD has ever been helpful to them in their entire life. And number two, that OCD is about the things that we see maybe in some Hollywood movies or some TV shows. So I'd like to break down a few things about OCD and go beyond the typical subtypes that you might think of it as and maybe open some eyes a little bit more to the ways that obsessive compulsive disorder really does interfere in the lives of people. In addition to checking things to make sure that lights are off or on or doors are locked or unlocked, stoves are on or off, hands are clean or not clean, people with OCD might do things like drive around a block to look for a dead body because they don't know if they hit a pothole or if they ran over a person. And even though they didn't see a person fly off their hood, they could worry about. But what if I did hit them? Or they were tiny and therefore they just went under the car instead of over the car. Maybe I should go back and check to see if that body is laying there. Or maybe when they get home, they get out of the car and they lay down on the ground and they stare under their car for minutes to hours to check to see if there's anybody that they dragged home underneath their car. Or maybe it's this idea that I don't love someone quite the way that I'm supposed to, or maybe they don't love me enough. Or what if we're not attracted to each other the right way? Or what if I'm not actually the sexual orientation that I've been my entire life and I've been actually living a lot and I'm. I'm supposed to be something else and. And I didn't know until now, and. And now I'm going to have to leave my spouse and go marry somebody else because I. I might have these different feelings that I just wasn't aware of. Or what if I did something, but I don't remember that I did It. And how can I be 100% confident in the fact that I did or did not do something? Or maybe, just maybe that thing that I touched won't hurt me, but if I touch something else and I leave some kind of physical or even emotional contamination, and emotional contamination would be something along the lines of bad vibes or something like that, and then someone else touches that thing, they could absorb the bad vibes or the contamination, then they would be harmed, all because of me, because I didn't do something to try to neutralize those things whatsoever. Or maybe while I was walking past that family in the mall, my arm moved slightly toward them because I was maybe trying to steal one of their children and take them into the bathroom and take advantage of them and then bring them back to the crib or something before the family even noticed that it were to occur. All of these things are obsessive Compulsive disorder. They're all subtypes of ocd. And they all start with two words, which is what if? And then are followed by the worst case scenario. And then that's followed by this overwhelming need to do something to neutralize that. Because if we don't, A, it could come true because maybe we've manifested it, or, or B, if it did come true, would we be at fault for it? Or C, if it did come true and we didn't do something to stop it, what kind of person are we for not having done so? Now you may hear all those examples and think, well, those, those sound kind of ridiculous and way out there. And sure, OCD is way out there, right? OCD will take whatever is the most important thing to you and get you to doubt it, get you to have uncertainty about it. You love your faith. OCD will say, yeah, but maybe you committed that unpardonable sin and now you're not going to be able to go to the afterlife that you want to. You should probably just do some investigation to try to figure out if you committed that sin or not, and then figure out, even though it's unpardonable and there's no way to do anything about it, still spend thousands upon thousands of hours trying to figure out a way to be pardoned for it, but it is unpardonable. That would be Obsessive Compulsive Disorder, or is there ever a way to truly 100% absolutely, with no doubt whatsoever, know that your spouse is the absolute right person for you and there will never be anyone else that you will ever be attracted to or interested in whatsoever. I Don't think so. How do you know that when you were slightly nodding off last night while driving home, your car didn't veer just a little bit, but there happened to be a motorcycle driver coming up behind you, and because of the veering you did, they veered. But then when they did that, it was while you were approaching a bridge, and maybe the motorcycle went off the road, and now they're at the bottom of the river or the lake. Should you go and get some scuba gear and check just to see, just to make sure that that didn't happen? These are things people with OCD have done, right? And you may say, well, just stop it. Just stop thinking that. And that's as easy as me telling you not to think about what you want for dinner. You probably just thought of it. If we could get people to just stop thinking things, I. I'd have a job that I'd meet with people for one session. It would be like the Bob Newhart stop it skit that's on YouTube. And if you haven't seen it, great one to watch. And I think in watching it, you'll kind of realize, oh, yeah, that's just not how it works, is it? Because we don't have the capability, our brains don't work that way, to just be able to not think of something if we don't want to. In fact, it's quite the opposite. The more we hope not to think of something, the more likely we are to actually think of it. So there's a paradoxical aspect that comes into the treatment that we talk about with obsessive compulsive disorder, and that is, if you want to not be bothered by something, face that thing and learn how to handle it instead of try to figure out a way to never think about that thing ever again for the rest of your life. Because you will be far more successful in learning how to face something and handling it than you ever will be by trying not to think of something. Now, these types of OCD that I've described you, you may be surprised at, but you may also think, wait a minute, I do that all the time. But I didn't know that was obsessive compulsive disorder, and I never told anybody about that. How do you know about that? And the reason I know about that is because we see every one of those themes thousands upon thousands of times every day here at nocd. In all of our therapy sessions that we do on a daily basis, we're talking to people who have fears that they've done something of a taboo nature, that they've harmed someone or are going to be harmed, or that they will harm someone. We've talked to people who are afraid about having not done things absolutely perfectly just right. We talk to people who have issues with being contaminated or contaminating others. And we daily deal with people who think they are, what one of my friends, Clay, once said, terminally unique, that they're the only person in the world who's ever had this thought or image or urge before. And the reality of that is that's just simply not true. I often say to people when I meet with them, if you tell me something I've never heard in relationship to ocd, I'll give you a dollar. I haven't given out a dollar in over 10 years. I think I've heard most things. I'd be happy to give out a dollar if somebody has a new one. That's always of interest to me. But OCD has, has one very simple playbook. And that's why in reality, I think it's actually something that's very, very treatable. Because OCD is a one trick pony. And let me let give you the playbook. What's the worst possible thing you could what if about this scenario or situation? And then what's something that you could do to satisfy it or to neutralize it in a way that will bring you a bit of relief, even if it's only for a few milliseconds? And that's the playbook of ocd, nothing more than that. The most favored compliment I've ever received from anyone is I can't believe you don't have OCD because you think like you do. And the only reason I think like I have OCD is because I know the playbook of OCD and therefore I know the worst case scenario that it can come up with. And when I say that to people I'm working with, they'll say, how did you know I thought that? And I'll say, because I know how to think about worst case scenarios really well. It's what I do. The best part of that, the best part of OCD being predictable. And that no topic is off the table and that we've seen all of the topics here at NOCD is it doesn't mean that you're unique, you're just like everybody else with ocd. And there's one cool thing about being just like everybody else with ocd, and that is you can get treatment just like everybody else with OCD can. And if you're looking for that help. Well, we hope you will. Check us out@nocd.com that's nocd.com where we have clinicians standing by to assist you with ocd body focused repetitive behaviors like hair pulling or skin picking. We work with tics, we work with hoarding, we work with anxiety and mood concerns, trauma, even body dysmorphic disorder in a few states. If that's something that you're interested in, we'd be happy to assist. Check us out nocd.com and start to live the life that you want to live and not the life that OCD wants you to live. We hope to see you soon. Sam.