When people picture compulsions, one of the main symptoms of obsessive-compulsive disorder (OCD), they often picture visible behaviors, like someone washing their hands over and over, or checking a lock again and again. Those compulsions are common, but they’re only part of the picture. A lot of compulsions happen inside people’s minds, where nobody else can see them, or become so incorporated into daily life that they don’t even register as compulsions.
That’s why these behaviors can be especially hard to stop: you can’t break a pattern that you don’t recognize as a pattern.
In an event for the NOCD Community, NOCD Partner Alegra Kastens, LMFT—a therapist specializing in OCD who also lives with OCD herself—joined us to share more about these sneaky compulsions and how to take back the time they consume.
Below, we’re breaking down what Alegra covered.
Why compulsions backfire
To understand why compulsions backfire, it’s important to understand the OCD cycle—the continuous loop of intrusive thoughts and compulsions that maintains OCD’s grip on a person’s life. Here’s how the OCD cycle works:
- A trigger sets off an intrusive thought, image, feeling, or urge.
- That intrusion—whatever form it takes—provokes distressing and uncomfortable feelings, such as guilt, shame, fear, anxiety, disgust, or embarrassment.
- In response to the discomfort intrusive thoughts cause, people with OCD turn to compulsions—repetitive mental or physical behaviors meant to try to provide relief or prevent a feared outcome.
- Compulsions only bring short-term relief and reinforce the false idea that intrusive thoughts are serious threats requiring urgent attention. Soon, the thoughts return, and the cycle repeats.
This is why it’s so important to learn how to identify compulsions and gradually resist them. The problem is, compulsions aren’t always easy to recognize.
Mental compulsions in OCD
Many OCD compulsions take place inside a person’s mind, which can make them difficult to identify, or to separate from regular thinking. But although they may be invisible to others, mental compulsions are just as distressing as their physical counterparts.
Below are a few common examples of mental compulsions:
- Avoidance: Avoiding people, places, items, or situations that could trigger intrusive thoughts
- Mental rituals (compulsive prayer, compulsive counting, mental review, etc.): Internally repeating prayers or phrases, counting, or reviewing past events or actions to ensure they were “correct” or harmless
- Reassurance-seeking: Repeatedly asking others for reassurance or certainty about fears and doubts
- Rumination: Persistently thinking about and trying to “solve” intrusive thoughts, doubts, or worries
- Thought stopping or neutralization: Trying to “block” unwanted and distressing thoughts, or to “counteract” them by thinking a positive thought
Other sneaky compulsions to know
Mental compulsions can take many different forms in addition to the ones listed above. Here are a few examples of the many varied ways that these behaviors can show up, and why each of them ends up fueling OCD.
Reassurance-seeking through disclosure
Example: Mentioning an intrusive thought to someone, hoping they’ll respond with something like, “That’s ridiculous; you’d never do that.”
Why it fuels OCD: Bringing up the thought signals to your brain that the thought is significant. It also builds dependence on reassurance, preventing you from discovering that you’re able to coexist with intrusive thoughts. This form of reassurance-seeking is similar to compulsive confession, another common but frequently missed compulsion.
Self-reassurance
Example: Repeatedly telling yourself “I’m not the kind of person who would do that,” “This is just OCD,” or similar statements.
Why it fuels OCD: Reassuring yourself signals to your brain that an intrusive thought is important enough to keep revisiting, which tends to make the underlying doubt feel more believable.
“Hypothesizing” and “testing” for physical sensations
Example: Imagining intimacy with a partner of a gender that you aren’t attracted to in an attempt to see whether you experience disgust or arousal, or fixating on a person or body part to test for a reaction.
Why it fuels OCD: These behaviors are both forms of compulsive checking, and vividly imagining or intensely focusing on something can produce a physical response even when you don’t feel any actual desire. That physical response will often get misread as meaningful when it’s actually arousal non-concordance—a term for when your body’s reaction is mismatched from how you actually feel.
Compulsive education
Example: Reading article after article about serial killers because you have unwanted thoughts of causing harm to others and want to find “proof” that you’re different from a serial killer.
Why it fuels OCD: Learning can be valuable, but information-seeking can shift into a compulsion when it’s driven by an urgent need to try to resolve an intrusive thought, fear, or doubt.
Photo hoarding
Example: Snapping a picture of a locked door to try to “prove” to yourself that the door is locked if you have doubts about it later.
Why it fuels OCD: Revisiting that photo is a form of compulsive checking, which research has shown to intensify doubt in the long run.
Compulsive carefulness
Example: Sitting on your hands around a loved one out of fear of acting on an unwanted thought, or sitting with a leg raised to avoid potentially having a groinal response.
Why it fuels OCD: This behavior reinforces thought-action fusion, the belief that having an intrusive thought means that you’re at risk of acting on it (which is untrue).
Self-punishment
Example: Physically hurting yourself every time an unwanted thought appears because you feel like you need to “pay” for having had it.
Why it fuels OCD: Acting like an intrusive thought needs to be punished attaches meaning and judgment to that thought. In reality, intrusive thoughts have no meaning and are no indication of your character, intent, or desires.
Constant distraction and stimulation
Example: Keeping headphones in all day to avoid ever sitting in silence, when there can be more space for intrusive thoughts to show up.
Why it fuels OCD: It sends the message that these thoughts are too uncomfortable to sit with, preventing you from discovering that you’re capable of feeling discomfort without turning to compulsions.
How to recognize and resist compulsions
Exposure and response prevention (ERP) therapy, the most effective treatment for OCD, helps break the OCD cycle by empowering you to coexist with intrusive thoughts without turning to the short-term relief of compulsions. This helps you gradually take back the time and energy that OCD consumes, and put it towards the things that matter to you.
By working with a therapist who has received specialty training in OCD and ERP therapy, you can learn to identify all kinds of compulsions and resist engaging in them on a consistent basis.
At NOCD, all of our therapists complete extensive, expert-led training in OCD and ERP. To learn more and get matched with the right therapist for you, schedule a free 15-minute call with our team.
