What’s a compulsion?
When their distress gets overwhelming, people with OCD will often engage in compulsions: repetitive activities aimed at getting rid of distress and regaining a sense of control. Compulsions develop over time, and sometimes they have nothing obvious in common with the content of the obsession. Anything that relieves distress is reinforcing, which means it’s going to seem more appealing the next time that distress shows up.
Eventually, a behavior can become almost automatic because it’s been done so many times; once this happens, and it’s hard to do anything else, it has become a compulsion. This helps us understand why certain “bizarre” compulsions seem to help people feel better short-term even though they have no logical connection to anything else: because this behavior helped the person feel better at one point in the past and developed into a compulsion via reinforcement.
Here are just a few examples of compulsions:
Compulsions: Some Examples
- Excessive hand-washing
- Constantly checking in with people to ensure their safety
- Making sure things are neat and/or symmetrical
- Checking locks, stoves, light switches repeatedly
- Repeatedly counting or saying a word in your head
- Checking trash repeatedly to make sure you aren’t throwing something valuable out
- Looking for mistakes over and over when writing an essay or paying taxes
- Looping back while driving to see if you’ve hit someone
- Google Searching
- Mentally replaying situations to make sure you remember them completely
- Getting reassurance about things from other people
- Visiting different doctors to see if you have an illness
- Repeatedly apologizing to someone or asking if they’re okay
- Keeping yourself away from kitchen knives because you get thoughts about stabbing someone
- Staying away from kids because you get sexual thoughts about them
- Refusing to visit public places because you’re afraid you’ll catch an illness
- Avoiding crowded areas
Compulsions might provide a temporary sense of relief, but the anxiety quickly returns. You can never outrun your own mind, and anything designed to keep a certain thought out of your head is actually, perversely, guaranteed to make that thought pop up more often. This is the part in your psychology lecture when the professor says, “Whatever you do, don’t think of a big pink elephant.” By trying not to think of something, you’re already thinking about it, and the obsession tends to get stronger.
So compulsions only work for a bit, and the distressing thoughts start coming on more often as you try to get keep them away. This process begins to spiral, and the obsessive-compulsive cycle can start to take up the better part of your day. The more you perform compulsions, the less you trust yourself and the more you believe that you should be afraid of your own thoughts. And you never find out what would happen if you didn’t do a compulsion, and just let things happen.
Of course, many people with OCD don’t think about their experience in these terms, and simply feel like they have to do the compulsion for some unknown reason. Others are aware of what’s going on but still feel like the compulsion will either prevent something bad from happening, or help them feel better for a while. Many engage in avoidance of situations that might bring about their obsessions again; this avoidance, too, can become a compulsion.
A common misconception about obsessive-compulsive disorder is that people want to perform their compulsions. We see people washing their hands over and over, or refusing to leave their house, and assume that it’s part of their personality or a reflection of their interests. In reality, most people know that their compulsions don’t make any sense but are still unable to stop doing them. And even the people who don’t know this still aren’t doing the compulsions because they want to, but because they feel completely sure they have to.
In some cases, OCD symptoms can become so severe that people consider suicide. If you ever consider suicide, please call your local emergency number or go directly to a hospital. In the United States, you can also call the Suicide Hotline at 1-800-273-8255.