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.
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
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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
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Common Compulsions in OCD1
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)
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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
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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).
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