Common Obsessions and Compulsions Among People With OCD

The key symptoms of obsessive-compulsive disorder (OCD) are related to unwanted obsessive thoughts, images, and urges, while compulsive behaviors help reduce anxiety related to the obsessions.

Although we often think of someone who is excessively concerned with germs and engaged in compulsive hand washing, that is only one example. There are many different types of obsessions and compulsions that people experience, and you might be surprised by some of them. This article will provide examples of the various types of obsessions and compulsions that can manifest in this disorder.

Obsessions

Obsessions are the first half of obsessive-compulsive disorder, the mental experience that leads to compulsive behaviors. Obsessions involve intrusive thoughts, feelings, and mental images that can seem like they are taking over. They are unwanted, repetitive, and often ego-dystonic, meaning the thoughts are not congruent with the person's character.

Obsessions may cause people with OCD to feel a terrible lack of control, as well as significant anxiety, fear, disgust, shame, or guilt. Oftentimes people know their thoughts are irrational, while other times, they believe their worries are valid.

Common Types of Obsessions

Common obsessions among people with OCD include:

Contamination: A fear of contamination, such as germs, viruses, body fluids, animals, diseases, chemicals, or dirt

Fear of harming someone: Fear of losing control of yourself by acting on thoughts or impulses, such as harming yourself or someone else, being involved in a hit and run, stealing, or becoming violent.

Responsibility: Fear of accidentally hurting someone else because of something you did or forgot to do, such as not turning off the stove and causing a house fire, or forgetting to clean up water that you spilled and causing someone to slip and fall.

Magical thinking: An extreme form of superstition, magical thinking means that you worry that something bad will happen if you don't say a certain word or phrase, wear a certain article of clothing, use a lucky charm, or behave in a certain way. For example, the infamous superstition "step on a crack and break your Mama's back" dates back to ancient folklore where stepping on cracks or openings in the earth invited evil spirits to cause harm to your family members.

Taboo sexual thoughts: Unwanted sexual obsessions, thoughts, or images about children, incest, and/or aggressive sexual behavior. OCD related to pedophilia is extremely upsetting and can make you question whether you are a pedophile.

Moral and religious worry: Worry about being good and living a moral enough life. Some have concerns about blurting out swear words, especially at the wrong time and place (like at a funeral). There can be a preoccupation about blaspheming God, committing sins, and damnation. Real-event OCD refers to having a fixation about events in the past that make you question your morals and character.

Perfectionism: Worry about how straight, symmetrical, or even objects are. Fear of losing or forgetting something important. An inability to make decisions on what to keep and what to throw away. A fixation on certain numbers and/or colors being good/correct or bad/incorrect.

Identity: Many people explore their gender identity and sexual orientation; however, those with this type of OCD develop a preoccupation about it. They experience intrusive and distressing thoughts that are the opposite of their own identity.

Relationships: Doubts and fears that intrude upon your romantic relationships. You may obsess over your partner's flaws, or have excessive concern about finding "the one" that tends to cause strain in your current relationships. On the other hand, you may be obsessing about making your partner happy and worried your partner does not love you anymore.

Compulsions

Compulsions are behaviors done in response to an obsessive thought. A person with OCD may repeat these behaviors over and over again, possibly for hours on end, in order to try and relieve anxiety. In OCD, examples of compulsions include repeated handwashing or counting, but everyone with OCD is different and may display different behaviors.

Even though people with OCD feel driven to engage in these behaviors, they don't want to. Though the behaviors do lessen the negative feelings of anxiety, guilt, or fear, it is only temporary, and they take up a lot of time. Compulsive behaviors may significantly impact the quality of life.

Common Compulsions in OCD

A compulsion can be a physical act or a mental one. Examples of common compulsions among people with OCD include:

• Cleaning: Excessive cleaning of the house, clothes, and/or body
• Checking: Repeatedly checking to make sure that doors and windows are locked or that appliances are turned off. Some individuals with OCD have to check their neighborhood to make sure they have not hit someone with their car or assaulted someone.
• Counting: Counting objects, letters, words, or actions
• Repetition: Repeating phrases or sequences of words either out loud or mentally. Doing routine activities repeatedly, like standing up or going up and down stairs.
• Seeking reassurance: Requesting or demanding reassurance from family members or health care providers, such as "My hands should be clean now, right?" Or with their romantic partners, they make seek reassurance that they are still loved.
• Order and symmetry: Rearranging objects to ensure a specific order and/or symmetry
• Doing things in multiples: For instance, turning the light on and off five times because five is a "good" number or it "feels right." Some tasks may have to be completed with only odd or even numbers.

Sometimes, compulsive behavior is present in other conditions, such as addiction, binge-eating disorder, or hoarding disorder. These are not the same as obsessive-compulsive disorder, although there are overlapping symptoms.

Treatment for Obsessive-Compulsive Disorder

Many people with OCD can learn self-management techniques such as relaxation, mindfulness, distraction, physical activity, and herbal remedies that help them manage their symptoms.

However, OCD can be extremely disabling for some people and more aggressive treatment is necessary. Treatment for OCD includes medications, psychotherapy, brain stimulation therapies, or neurosurgery.

• Psychotherapy: Obsessive thoughts and compulsive behaviors can often be dramatically reduced using behavior therapy, such as cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT) or exposure and response prevention therapy (ERP).
• Medications: Some people also benefit from medications. Selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine hydrochloride), or Zoloft (sertraline) may be helpful in treating OCD.
• Neurotherapy: There are a variety of neurotherapy treatments (such as deep brain stimulation) that have been found to help with OCD, especially if you have not responded well to traditional treatment methods.
• Neurosurgery: Bilateral cingulotomy is a brain surgery that is considered a last resort for people with OCD.

If you recognize some of these symptoms in yourself, you are not alone and help is available. Don't let feelings of embarassment, shame, or guilt hold you back from getting treatmnet. Trained professionals are familiar with these distressing thought patterns and will help you overcome.