Obsessions and compulsions in obsessive-compulsive disorder (OCD) vary between people and may focus on one or more themes. The term “taboo OCD” refers to OCD themes that center around socially rejected or forbidden thoughts.

If you have OCD, it means you have obsessions, compulsions, or both. Obsessions are thoughts that are distressing and difficult to manage at will. Compulsions are repetitive behaviors or rituals you engage in to distract yourself from the stress obsessions cause.

The content of obsessive thoughts may vary from individual to individual and sometimes in the same person. Taboo OCD means obsessions frequently involve taboo thoughts or images.

“Taboo” means something that is looked down upon, restricted, penalized, or prohibited in your culture or society.

Taboo OCD isn’t a formal type of OCD. Instead, the term is used when someone with OCD tends to have repetitive and distressing thoughts, images, or urges around themes that are typically forbidden or taboo.

Common taboo OCD themes include:

  • Harm OCD: This includes thoughts, urges, and images about harming yourself or other people. Images may also include violent scenes unrelated to yourself or anyone you know.
  • Sexual OCD: Sexual activity is the main content of intrusive thoughts and images.
  • Scrupulosity OCD: Also known as pure O, this theme focuses on guilt and shame around religious or moral thoughts.

What taboo OCD is not

Taboo OCD thoughts are not pleasurable or something you can turn on and off at will. Thoughts, images, and urges in OCD are unwanted, intrusive, and distressing by nature.

Thoughts of violence and aggression in taboo OCD, for example, do not signal an intention or desire to act them out. Instead, these thoughts are persistent sources of fear, sadness, guilt, and concern.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) has established the following diagnostic criteria for OCD:

  • You have persistent obsessions, compulsions, or both.
    • Obsessions are unwanted and highly distressing thoughts, images, or urges (not observable).
    • Compulsions are physical or mental acts in response to the anxiety caused by obsessions and typically follow a set routine or structure (observable).
  • Obsessions and compulsions take up time from your day, every day, or significantly affect the way you navigate the world (e.g., prevent you from attending school or affect your relationships).
  • Substances, medications, and other health conditions do not cause the obsessions or compulsions.

For taboo OCD specifically, symptoms may include:

  • intense feelings of guilt and shame about the content of your thoughts
  • persistent fear that you’ll act on your thoughts, intentionally or unintentionally
  • shame or fear that your thoughts are morally wrong or could hurt others in any way
  • preoccupation with the meaning behind intrusive sexual thoughts and images
  • constant self-checking or going over your day to ensure you did not harm anyone
  • concern that your thoughts will cause accidents or natural disasters (magical thinking)
  • negative self-opinion deriving from a belief that your obsessions make you a bad person
  • avoiding social interactions or situations out of fear of harming others or acting out obsessions

It’s possible that some people have other types of taboo thoughts and related symptoms not mentioned here. The common core feature of taboo OCD is the intense distress caused by thoughts, urges, and images perceived as socially or morally reproachable.

Examples of obsessions in taboo OCD

Everyone is different. The specific content of obsessions on OCD may vary greatly from one person to another.

Obsessions in taboo OCD may involve images or thoughts of:

  • sexual intercourse with animals
  • masturbating in front of or with religious symbols
  • incest
  • natural disaster or violent tragedies
  • stabbing or severely hurting other people

These thoughts are intrusive, unwanted, and unprompted. They cause intense fear and anxiety to the person with taboo OCD. Taboo OCD symptoms are associated with a higher chance of suicidal thoughts and attempts.

Help is available

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

Depending on individual needs and symptom severity, OCD treatment can include both psychotherapy and medication.

Medications may include antidepressants, anti-anxiety drugs, and antipsychotics, which can help you manage taboo OCD thoughts and related symptoms.

If you have OCD, consider reaching out to a mental health professional. Relief is possible, and support is available. You’re not alone.

Taboo OCD isn’t a formal diagnosis. Instead, it’s used to refer to symptoms of OCD, like obsessions and compulsions, that center around taboo or forbidden thoughts.

Obsessions in taboo OCD may involve urges, images, or thoughts of violence, self-harm, sexual activity, or religion-related content. These obsessions are not a personal choice and are hard to control at will. They do not mean you want to act on those thoughts or carry out those images.