Which OCD Brain Pattern Do You Have?

Which OCD Brain Pattern Do You Have

When you think of OCD (obsessive compulsive disorder), what comes to your mind? Visions of someone cleaning furiously or washing their hands multiple times? That’s the image most people have regarding this condition, which affects about 1 in 40 adults and 1 in 200 children. But OCD isn’t just one thing. There are different types of OCD, and brain SPECT imaging reveals different patterns in the brain associated with those types.


OCD is a condition that is characterized by obsessions and compulsions. Obsessions are recurring thoughts, impulses, or mental images that are intrusive, usually senseless, sometimes frightening, and often repulsive. Compulsions involve repetitive behaviors that are performed in response to obsessions and the anxiety they cause.

These obsessions and compulsions can take on many forms, although most tend to fall into the following 5 types.

  • Contamination and cleaning: This type typically involves obsessive worries about being contaminated or coming into contact with contaminants that might make you or a loved one ill. This leads to compulsions, such as excessive cleaning, washing, or showering. An Amen Clinics patient named Gail used to clean her house for hours every night after work, but she derived no pleasure or sense of satisfaction from making the house gleam. She was also fixated on making her husband and kids wash their hands more than 10 times a day (and this was long before pandemic hand-washing practices took over). She also stopped having sex with her husband because she couldn’t stand the feeling of being messy. The couple was on the verge of divorce.
  • Checking: With this type of OCD, you are likely to be wracked with fears about some type of harm that may come to you or someone you love. For example, you may be afraid of an armed intruder hurting you or a fire destroying your home. In response, you may compulsively check that doors are locked or that you turned off the stove.
  • Symmetry and order: Some people have feelings of dread that if everything isn’t “just so” in perfect symmetrical order will lead to some form of harm. This type is tied to spending inordinate amounts of time trying to keep everything in order.
  • Forbidden thoughts: This involves obsessing over unwanted, disturbing, and repulsive thoughts. At Amen Clinics, an 83-year-old patient named Sylvia had intrusive sexual thoughts that made her feel dirty. She was so disgusted by them that she would lock all her doors, draw the curtains, turn off the lights, and sit in the middle of a dark room in an effort to stop the abhorrent sexual thoughts that came into her mind.
  • Hoarding: Considered a type of OCD, this type causes distressing thoughts whenever you think about discarding something due to a perceived need to retain it. This may lead to compulsive shopping, stockpiling items, or piles of “important” things piling up. As an example, look at Bill, a high-powered attorney who visited Amen Clinics for symptoms of OCD and hoarding. He refused to let anyone ride in his car and would always say there wasn’t enough room for passengers even though he drove a large sedan. It turned out that about 70% of the space in his car was filled with trash and piles of work papers that he couldn’t part with.


1. Overactive Brains

SPECT scans show that in most OCD types—contamination and cleaning, checking, symmetry and order, and forbidden thoughts—the brain’s frontal lobes are overactive. The scans light up so much, it’s like the brain is on fire.

Take Gail, for instance. Her SPECT study showed marked increased activity in her frontal lobes and an area called the anterior cingulate gyrus. This area is involved in shifting from one idea to another or from one action to another. When there is too much activity here, people like Gail tend to get “stuck” on thoughts and behaviors, even if they get no pleasure from them. Seeing this helped find the right treatment plan for Gail, who within 6 weeks, felt significantly more relaxed. Her ritualistic behavior diminished, and she stopped forcing her husband and children to wash their hands every time they turned around.

Other findings on SPECT scans in people with these types of OCD include heightened brain activity in a region called the basal ganglia. This area helps set the body’s anxiety level and plays a role in habit formation.

2. Sleepy Brains

People who are hoarders sometimes have a different brain pattern. For example, Bill’s SPECT scans didn’t reveal the classic OCD patterns, but rather it showed that his brain was “sleepy,” or underactive in some areas involved in organization. This helped explain why he ended up with a car full of useless stuff that he felt powerless to discard.

Without looking at his brain scans, Bill might have been given medications for classic OCD, which likely would have exacerbated his condition. Seeing his brain patterns helped find the right treatment protocol for him. Over time, he was able to clean out his car without being overwhelmed by distressing thoughts, and he was finally able to keep things more organized at work, so he no longer piled important papers in his car.

OCD (regardless of which type you have), and other conditions like anxiety, ADD/ADHD, and depression can’t wait. During these uncertain times, your mental well-being is more important than ever, and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.


  1. AWESOME, you always provide the WHOLE picture.

    Now, it’s convincing doctors to SHARE the BRAIN SCAN with their patients.
    So they are properly advised without inappropriate medication.

    Good Health & Happiness,


    Comment by Linda Turriff — August 3, 2020 @ 5:25 AM

  2. Hello,
    We will be in the Chicagoland area in Dec and am
    Hoping to schedule.

    What is the cost of the brain spect scan and analysis per person?

    Thank you,

    Comment by Andrea — August 4, 2020 @ 8:40 AM

  3. Which is the worse kind out of all mentioned

    Comment by Shirin — August 5, 2020 @ 2:56 AM

  4. Is there a clinic providing this scan in Australia

    Comment by Lyn Clark — August 5, 2020 @ 3:39 AM

  5. Our 20-yr old mostly non-verbal daughter with autism has extreme OCD which has been getting worse in the last few months. While her parents are sleeping or trying to sleep, she prowls around and performs ritualistic behaviors dozens of times. These include: going into the laundry room and opening the door to the garage and organizing shoes just outside the door; opening the refrigerator door and repeatedly organizing nut butters (that she likes) in one of the compartments; going to the kitchen sink and emptying the soap bottles for hand and dish washing; repeatedly going to the bathroom, dumping toilet paper into the bowl and then flushing to create a backed-up toilet which requires a parent to declog with a plunger; moving the living room sofa back and forth thus wearing out the carpet underneath. Parental efforts to interrupt these rituals are usually met by a tantrum that includes banging her head hard with her hand. We have been to the Amen Clinic and attempted to have her submit to a SPECT scan and EEG, but she wouldn’t remain still for either. Would appreciate any advice based on your experience to curtail or reduce these OCD and SIB outbursts.

    Comment by Barry — August 5, 2020 @ 7:47 AM

  6. Hi Dr Amen, I am a huge follower of yours!!! I saw your interview recently with Dr Mark Hyman it amazing!!!! Your deep knowledge and understanding of the brain it’s simply mind blowing. I would like to ask : how do I know if I me or one of my love ones have beginning or manifestation of Alzhymers? I well understand that perhaps loss of memory or confusion it’s a key but I also know it can take up to 20-30 days to manifest . I am 54 years old and I live with some with dementia ( my husbands mother) it is the most devastating disease I ever came across‍♀️It is scary and this is why I like to know if there is a way besides the brain scans( which I wish I could get done and my husband too) but for reasons of finances we can’t at this moment. Is there any way we can do a home test that can indicate signs.? Thank you in advance have a beautiful day!

    Comment by Anna — August 5, 2020 @ 9:27 AM

  7. Sorry I meant to say it takes20-30 years” to manifest .

    Comment by Previous comment correction — August 5, 2020 @ 9:31 AM

  8. Interesting. The “Pure O” form of OCD isn’t on the list, and in my personal experience as someone with OCD, this has been the toughest one to go through. I’m curious if you are able to help people who suffer from Pure O OCD?

    Comment by Minoo — August 5, 2020 @ 10:07 AM

  9. What do you recommend to help with organizing,have slight. OCD

    Comment by Rebeca — August 5, 2020 @ 12:01 PM

  10. I have had ocd since I wa 17. I am now 75. I wa on Prozac for a long period of time about 20 years. I wa off of it for about a year and now back on it. I would like to know if anything new is out there. I do see a psychologist and now I have an appointment at McGrath clinic who deals with ocd. They were the original people who told. Me I had. Ocd. Would appreciate any new news about ocd. I have a few of your books. But want more information . Thank you.

    Comment by Donna kerrigan — August 5, 2020 @ 5:42 PM

  11. Hello Andrea, thank you for reaching out. We look forward to having you at our Bannockburn, IL clinic location: https://amenclinics.com/locations/chicago-metro-area/. For more information about types of evaluations, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/.

    Comment by Amen Clinics — August 20, 2020 @ 10:28 AM

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