Common OCD Compulsions
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Compulsions are behaviors or mental actions that people with obsessive-compulsive disorder (OCD) perform in an attempt to reduce anxiety or gain certainty about an intrusive thought.
Unfortunately, certainty does not exist, which is why OCD becomes such a painful cycle. The person performs a compulsion hoping to feel relief, but the relief is only temporary. Over time, the brain learns to rely on compulsions more and more.
A compulsion can be any physical behavior or mental thought that the OCD brain believes will neutralize an intrusive thought or prevent a feared outcome.
Because OCD is creative, the list of compulsions could truly be endless. Below are some of the most common compulsions seen in OCD.
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Avoidance
Avoidance is one of the most powerful compulsions in OCD. In fact, avoidance is one of the reasons the term “Pure O OCD” is misleading. Even when compulsions are not visible, avoidance behaviors are usually present.
Avoidance occurs when someone stays away from people, places, objects, or situations that trigger anxiety, fear, guilt, or disgust.
Examples include avoiding:
- Knives or sharp objects (Harm OCD)
- Medical information (Health OCD)
- Children (POCD)
- Relationships (ROCD)
- Certain locations associated with intrusive thoughts
The more someone avoids triggers, the smaller their world becomes, and functioning often decreases over time.
Loved ones may unknowingly participate in avoidance by adjusting routines or helping the person avoid triggers. This is known as family accommodation, which is why we often encourage partners, parents, or other support systems to participate in at least one treatment session.
Reassurance Seeking
Examples include asking:
- “Do you think everything is okay?”
- “You don’t think I did something wrong, right?”
- “Does this look normal to you?”
Reassurance can also happen indirectly. For example, someone might say:
Although reassurance may temporarily relieve anxiety, it ultimately strengthens OCD, causing the person to seek reassurance more frequently over time.
Information Seeking
Common examples include researching:
- Symptoms of illnesses
- Sexual orientation
- Legal consequences of certain behaviors
- Relationship compatibility
- Mental health disorders
Checking
Physical checking may include:
- Checking locks repeatedly
- Checking appliances or heaters
- Checking work for mistakes
- Checking the body for signs of illness (health OCD) or arousal (sexually intrusive thoughts OCD)
- Monitoring emotions or mood
- Checking for signs of attraction or arousal
- Mentally reviewing memories
- Monitoring physical sensations
Talking About the Obsession
This often occurs with health-related OCD, where someone might repeatedly discuss symptoms or physical sensations.
However, it can also occur with other OCD themes. For example:
- Scrupulosity OCD may sound like theological debate
- Existential OCD may sound like philosophical discussion
To others, these conversations may appear intellectual or curious. In reality, they are often a form of compulsive rumination.
Confessing
In some religious traditions, confession is healthy and expected. However, when confession is driven by OCD, it becomes a compulsion that reinforces anxiety rather than relieving it.
Self-Reassurance
- “Everything is okay.”
- “Nothing bad will happen.”
- “I know this isn’t true.”
Although this may feel helpful, it is actually a compulsion. In Exposure and Response Prevention (ERP), individuals often learn to replace self-reassurance with statements such as:
“Maybe, maybe not.”
OCD is fundamentally a fear of uncertainty, and treatment focuses on learning to tolerate that uncertainty.
Washing Rituals
Examples include:
- Repeated hand washing
- Long shower rituals
- Cleaning objects repeatedly
- Washing electronics or personal belongings
Praying
Examples include:
- Repeating prayers until they feel perfect
- Asking for forgiveness repeatedly
- Praying to neutralize intrusive thoughts
Importantly, treatment is not intended to interfere with someone’s faith. Instead, the goal is to reduce OCD-driven rituals so that the person can experience a healthier relationship with their beliefs.
Repeating
Examples include:
- Repeating actions until they feel “just right”
- Repeating words or sentences
- Repeating prayers
- Repeating movements or routines
Perfecting
In perfectionism OCD, individuals may repeatedly redo tasks to eliminate any possible mistake.
Examples include:
- Editing emails or texts repeatedly
- Rewriting work assignments
- Changing clothing or grooming repeatedly
- Rechecking personal appearance
Apologizing
Some individuals apologize repeatedly or provide disclaimers in conversation as a way to reduce anxiety about potentially offending someone.
Mental Compulsions
Common mental compulsions include:
- Rumination
- Analyzing thoughts
- Replaying past events
- Trying to “figure out why”
- Mentally debating intrusive thoughts
Medication can sometimes help reduce the intensity of these mental compulsions, especially when combined with ERP therapy.
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