Ever found yourself regularly counting the number of steps you take, counting and recounting the number of items in your grocery cart, or holding out for the clock to switch to a particular time to perform a certain task? These behaviors could all be a sign of Counting OCD, sometimes referred to as arithmomania.
Counting OCD is a common form of Obsessive-Compulsive Disorder, characterized by a strong urge to engage in repetitive and ritualistic counting behaviors.. People with Counting OCD may count to achieve a state of feeling “right” or “good” and to avoid the anxiety of something feeling “wrong” or “off.”
Common Reasons for Counting OCD
People with Counting OCD count for a variety of reasons. Sometimes the counting is automatic – without thinking about it, a person finds themselves counting random things around them.
Sometimes Counting OCD is driven by attaching meaning to particular numbers where certain numbers will induce anxiety, while others will reduce anxiety. For example, if you assign special meaning to the number three, you might count your steps by threes, or lock and unlock your car three times before driving, or any variety of other actions ruled by this “magic number.” In some cases, people may feel a responsibility to prevent something bad from happening to themselves or to others and they count to try and guarantee safety—even though they know it doesn’t make sense.
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One person I’ve worked with in therapy—let’s call her Annie—saw her Counting OCD triggered when she feared her mother would get in a car accident during her commute home.
In one instance, when she learned that her mother was on her way home from the airport, Annie’s mind shifted to a familiar obsessive thought: “What if mom gets into an accident?”
Annie felt the pit of anxiety in her stomach and noticed her heart beating faster. In response, she started her familiar ritual of mentally counting to seven over and over again. She did things like tap her hand on the armrest of the couch seven times, click her heels together seven times, and move her head to one side and back again seven times.
Annie knew that none of this made sense rationally, but there is nothing rational about OCD. The worry and anxiety that Annie felt in the moment were enough to overwhelm her rational beliefs and understanding.
Common Counting Behaviors
Counting OCD can manifest in a variety of ways. Some common types of counting include:
- Counting to a specific number. This can be done once, or over and over again.
- Counting to whatever number happens to feel “right” at that moment.
- Doing actions in sets of a particular number (e.g., looking at things or performing other behaviors in a specified series, like sets of three).
- Preferring odd or even numbers.
- Adding to or repeating behavior sets as many times as necessary to avoid “bad” numbers.
What might people with OCD compulsively count?
People with Counting OCD might count anything at all, including thoughts, actions, or simply numbers on their own. Common items counted can include:
- Floor or ceiling tiles;
- Road signs;
- Words in a sentence or on a page;
- Steps taken.
- Counting letters in words
- Counting numbers
The counting is not often in response to an obsessive thought. Instead, it can trigger an obsessive fear like: “What if I can’t ever stop counting?” This is similar to obsessive fears people have about being distracted by something like swallowing or blinking, or maybe a ringing in their ears.
More often, counting is a compulsive behavior, meaning that it is in response to an obsession that creates anxiety. The obsessive concern might be that something bad will happen to themselves or to someone they care about. Annie, the girl from the scenario at the beginning of this article was an example of someone with fear-related counting.
Sometimes the obsessive concern is more vague. Instead of fearing that something bad will happen, the person with Counting OCD feels the need for something to be done the “right” amount of times or according to some rigid rules. The concern is that if an action isn’t done in this way they will experience significant distress over the fact that it doesn’t feel “right.”
Is Counting OCD Treatable?
People experiencing Counting OCD sometimes feel like it’s simply part of who they are, and are resigned to living with it the same way for the rest of their lives. Fortunately, that’s just not the case: Counting OCD is no different from any other form of OCD and can all be effectively treated with Exposure and Response Prevention (ERP) therapy.
ERP therapy encourages people to face their fears and teaches them how to respond to OCD thoughts, images, and urges in an effective way. Over time, these obsessions and compulsions can fade in intensity and frequency, allowing the person to regain their life.
When people with Counting OCD are willing to face their fears without giving in to the counting they have the chance to experientially learn some very important things:
- What they fear is very unlikely to happen;
- The anxiety that they feel is likely to eventually go down on its own, without counting;
- They are stronger than they thought—they can tolerate anxiety and uncertainty without having to give in to compulsions.
Examples of ERP for Counting OCD
Let’s return to Annie, our example from earlier. An ERP-trained therapist working with Annie would have her trigger her obsessive thoughts about her mom driving home from anywhere (exposure). Annie would then feel that familiar anxiety but would be instructed not to engage in her counting ritual (response prevention). This could take various forms, such as not counting at all, counting to the “wrong” number or even replacing the mental counting with thoughts like “It’s possible that mom might get into an accident on the way home.”
Were Annie to refrain from her counting ritual, she would have the chance to learn that it really wasn’t the thing that was keeping mom safe. She would also have the chance to learn that her anxiety would go down on its own and that she could tolerate the anxiety and feelings of uncertainty without having to give in to her counting rituals.
How to Find Treatment
If you are struggling with Counting OCD, there is hope. The first step is finding the right help by seeking out a provider trained in treating OCD with Exposure and Response Prevention (ERP) Therapy.
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NOCD has trained ERP specialists who can work with you to reduce your OCD symptoms within just a few weeks of live one-on-one video therapy. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP. If you’d like to get started with a licensed therapist, you can schedule a free call with the NOCD team.
You’ll also be welcomed into our supportive peer community, with 24/7 access to personalized self-management tools built by people who have struggled with OCD and successfully recovered using ERP.