Obsessions & Compulsions

Obsessive-compulsive disorder (OCD) inquinates a mental

illness that affects people of all ages and walks of life, occurs
when a person gets caught in a cycle of obsessions and
compulsions and involves persistent, unwanted obsessions
and compulsions.

With OCD, obsessive thoughts usually trigger compulsive

actions meant to help dispel the thoughts and reduce distress.
But this usually only provides short-term relief and doesn’t make
the obsession go away.

Obsessions and Compulsions can become a cycle that’s

difficult to stop. The time one spends on compulsions might
begin to take up so much of their day that one finds it hard to get
anything else done. This can affect one’s school, work, or
personal life, leading to even more distress.

Obsessions are involuntary thoughts, images, or impulses

that occur over and over again in your mind. You don’t want to
have these ideas, but you can’t stop them. Unfortunately, these
obsessive thoughts are often disturbing and distracting. While
on the contrary compulsions are behaviors or rituals that you
feel driven to act out again and again. Usually, compulsions are
performed in an attempt to make obsessions go away.
For instance:

If you’re petrified of contamination, you might develop elaborate

cleaning rituals. However, the relief never lasts. In fact, the
obsessive thoughts usually come back stronger. And the
compulsive rituals and behaviors often end up causing anxiety
themselves as they become more demanding and time-
consuming. This is the vicious cycle of OCD.

OBSESSIONS:

 Recurrent and persistent thoughts, impulses or images that

are experienced at some time during the disturbance as
 intrusive and inappropriate that causes marked anxiety and
distress.
 The thoughts, impulses or images aren’t simply excessive
worries about life problems.
 The person attempts to ignore or suppress such thoughts,
impulses or images or to neutralize them with some other
thought or action.
 The person recognizes that the obsessional thoughts,
impulses or images are a product of his/her own mind.
(Not imposed from without as in thought insertion)

Obsessive thoughts can interrupt one’s daily life, upsetting one

and making it hard to do things you want to do. Even if one is
aware, they aren’t real and know you won’t act on them, one may
still feel distressed and worry one could act on them. As a result,
one might try to avoid everything that triggers these thoughts.
They come with uncomfortable feelings, such as fear, disgust,
doubt, or a feeling that things have to be done in a way that is
"just right." They take a lot of time and get in the way of
important activities the person values.

In the context of OCD, obsessions are time-consuming and

get in the way of important activities the person values. This last
part is indelibly significant to keep in mind as it, in part determines
whether someone has OCD a psychological disorder rather
than an obsessive personality trait.

Common Obsessions in OCD

Obsession % of sample (N-200)

Contamination 45
Pathological doubt 42
Somatic 36
Symmetry 31
Aggressive 28
Sexual 26
Multiple obsession 60

Common Obsessions in OCD

The most prevalent and recurrent obsessions in OCD are as follows:

Contamination

 Body fluids (examples: urine, feces)

 Germs/disease (examples: herpes, HIV)

 Environmental contaminants (examples: asbestos, radiation)

 Household chemicals (examples: cleaners, solvents)

 Dirt

Losing Control
  Fear of acting on an impulse to harm oneself

 Fear of acting on an impulse to harm others

 Fear of violent or horrific images in one’s mind

 Fear of blurting out obscenities or insults

 Fear of stealing things

Harm

 Fear of being responsible for something terrible happening

(examples: fire, burglary)

 Fear of harming others because of not being careful enough

(example: dropping something on the ground that might cause
someone to slip and hurt him/herself)

Unwanted Sexual Thoughts

 Forbidden or perverse sexual thoughts or images

 Forbidden or perverse sexual impulses about others

 Sexual obsessions that involve children or incest

 Obsessions about aggressive sexual behavior towards others

Religious Obsessions (Scrupulosity)

 Concern with offending God, or concern about blasphemy

 Excessive concern with right/wrong or morality

Obsessions Related to Perfectionism

 Concern about evenness or exactness

 Concern with a need to know or remember
  Fear of losing or forgetting important information when throwing
something out
 Inability to decide whether to keep or to discard things
 Fear of losing things

Other Obsessions

 Obsessions about one’s sexual orientation.

 Concern with getting a physical illness or disease (not by
contamination, e.g., cancer)
 Superstitious ideas about lucky/unlucky numbers certain colors

Obsession Examples Associated Compulsive

Behaviors
Contamination Fear of being Washing or cleaning
contaminated or rituals.
contaminating others; fear
of contamination by germs,
infections or environmental
factors, fear of being
contaminated by bad and
immoral people.
Sexual Recurrent thoughts about Avoiding situations.
being a pedophile or
sexually deviant; recurrent
thoughts about acting
sexually inappropriately
towards others.
Religious Thoughts about being Asking forgiveness,
immoral and eternal praying.
 damnation.
Aggressive Fear of harming others,
recurrent violent images.
Control related Fear of making
inappropriate comments in
public.
Pathologic doubt and Recurrent worries about
Monitoring the news for
reports of violent crimes,
asking for reassurance
about being a good
person.
Avoiding being around
others.
Checking excessively,

completeness doing things incorrectly or performing actions in a

incompletely that thereby particular order.
may negatively affect
others or the patient.
Superstation-related Fear of certain bad Counting excessively.
numbers or colors.
Symmetry and Recurrent thoughts of Ordering and arranging.

exactness needing to do things in a

balanced or exact fashion.

COMPULSIONS:

 It denotes unwanted repetitive behavior patterns or mental acts that

are intended to reduce anxiety, not to provide pleasure or
gratification.
 Repetitive behaviors (e.g., hand washing, ordering, checking) or
mental acts (e.g., praying, counting, repeating words silently) that the
person feels driven to perform in response to an obsession or
according to rules that must be applied rigidly.
  The behaviors or mental acts are aimed at preventing or reducing
distress or preventing some dreaded event or situation; However,
these behaviors or mental acts either are not connected in a realistic
way with what they are designed to neutralize, prevent or clearly
excessive.

Carrying out these compulsions brings about a sense of relief from an

obsession, but this feeling is usually short-lived. Sometimes compulsions
are related and relevant to an obsession.

People with OCD realize this is only a temporary solution, but without a

better way to cope, they rely on the compulsion as a temporary escape.
Compulsions can also include avoiding situations that trigger obsessions.
Compulsions are time consuming and get in the way of important activities
the person values.

For example,

 You might check, unlock, and relock your front door seven times
before leaving to prevent a break-in. But in other cases, they
might be totally unrelated.
 You might tap a specific area of a wall before leaving the house
because you feel it helps to prevent getting in a car accident on
your way to work.
 Bedtime routines, religious practices, and learning a new skill all
involve some level of repeating an activity over and over again,
but are usually a positive and functional part of daily life.
Behaviors depend on the context. Arranging and ordering books
for eight hours a day isn’t a compulsion if the person works in a
library.
In OCD, compulsive behavior is done with the intention of trying to
escape or reduce anxiety or the presence of obsessions.

Common Compulsions in OCD

The most prevalent and recurrent compulsions in OCD are as follows:

Washing and Cleaning

 Washing hands excessively or in a certain way

 Excessive showering, bathing, tooth-brushing, grooming ,or toilet
routines
 Cleaning household items or other objects excessively
 Doing other things to prevent or remove contact with contaminants

Checking

 Checking that you did not/will not harm others

 Checking that you did not/will not harm yourself
 Checking that nothing terrible happened
 Checking that you did not make a mistake
 Checking some parts of your physical condition or body

Repeating

 Rereading or rewriting
 Repeating routine activities (examples: going in or out doors, getting
up or down from chairs)
 Repeating body movements (example: tapping, touching, blinking)
 Repeating activities in “multiples” (examples: doing a task three times
because three is a “good,” “right,” “safe” number)

Mental Compulsions
  Mental review of events to prevent harm (to oneself others, to prevent
terrible consequences)
 Praying to prevent harm (to oneself others, to prevent terrible
consequences)
 Counting while performing a task to end on a “good,” “right,” or “safe”
number
 “Cancelling” or “Undoing” (example: replacing a “bad” word with a
“good” word to cancel it out)

Other Compulsions

 Putting things in order or arranging things until it “feels right”

 Telling asking or confessing to get reassurance
 Avoiding situations that might trigger your obsessions