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Obsessions and Compulsions

Obsessions:

  • Thoughts, images, or impulses that occur over and over again and feel out of the person's control.
  • The person does not want to have these ideas.
  • He or she finds them disturbing and unwanted, and usually know that they don't make sense.
  • 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.

What Obsessions Are Not:

  • It is normal to have occasional thoughts about getting sick or about the safety of loved ones.

Click here for a list of some Common Obsessions in OCD.

Compulsions:

  • Repetitive behaviors or thoughts that a person engages in to neutralize, counteract, or make their obsessions go away.
  • 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.

What Compulsions Are Not:

  • Not all repetitive behaviors or "rituals" are compulsions.  For example, bedtime routines, religious practices, and learning a new skill involve repeating an activity over and over again, but are a welcome part of daily life.
  • Behaviors depend on the context: Arranging and ordering DVDs for eight hours a day isn't a compulsion if the person works in a video store.
Click here for a list of some Common Compulsions in OCD.

Common Obsessions in OCD1

Contamination

  • Body fluids (examples: urine, feces)
  • Germs/disease (examples: herpes, HIV)
  • Environmental contaminants (examples: asbestos, radiation)
  • Household chemicals (examples: cleaners, solvents)
  • Dirt
Losing Control

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)
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
Unwanted Sexual Thoughts

  • Forbidden or perverse sexual thoughts or images
  • Forbidden or perverse sexual impulses about others
  • Obsessions about homosexuality
  • 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.
Other Obsessions

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

Common Compulsions in OCD

   
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

  • Collecting items which results in significant clutter in the home (also called hoarding)
  • 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

  1 Reprinted with permission by New Harbinger Publications, Inc. This is an adaptation of the OC Checklist which appears in S. Wilhelm and G. S. Steketee's, "Cognitive Therapy for Obsessive-Compulsive Disorder: A Guide for Professionals" (2006).  www.newharbinger.com

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