Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Why do I randomly start counting in my head?

By Andrea Fine

Oct 21, 20223 minute read

Reviewed byTaylor Newendorp

It may be OCD

If you’re concerned about repeatedly counting in your head, it may be a sign that you have OCD. Counting is often a compulsion that someone with OCD uses to decrease distress related to any number of intrusive thoughts. It may be that the numbers themselves have specific significance, like “good” and “bad” numbers. It may be that you count until things feel “just right.” You may also count in your head as a component of a ritual that you feel a need to perform to make sure that things are safe.

Intrusive thoughts and the compulsions that we utilize to decrease distress do not necessarily stem from logical thinking but are the way that we have determined to self-soothe in response to some form of distress. This sounds like a reasonable way to manage our distress, yet this “self-soothing activity” often takes away our freedom to engage in our lives fully, as it starts to take more and more time and energy–and begins to cause frustration and distress of its own.

For example, I may identify the number 8 as a “good” number but the number 5 is a “bad” number. If I have 5 pieces of chocolate I may need to add 3 more, for a total of 8, to relieve my fear that something bad or tragic will happen if I eat only 5. This sounds easy enough in theory. Who doesn’t want 3 extra pieces of chocolate? But what happens when I can’t pull into my driveway until I have gone around the block 8 times, or have to repeat something 8 times before I feel safe?

Another example of engaging in a counting compulsion with OCD is counting until something feels “just right.” I may be looking at a picture and can’t look away until I engage in counting until my distress has lessened and it now feels “just right” to look away. This may involve random counting in my head, or it may involve counting things like ceiling tiles, cars going by, steps I take, etc. Essentially anything is fair game for OCD to attach itself to.

What if my fears are legitimate?

One of the most important things to remember about OCD intrusive thoughts is that they are ego-dystonic. This means that these intrusive thoughts, impulses, and behaviors are in direct opposition to our value system, identity, wants, or intentions. They create illogical feelings of distress because they are inconsistent with our self-concept. We fear that they may be true, and thus we are out of alignment with our beliefs and values, causing distress and frustration.

With the compulsion to count, I may feel that if I don’t do something a certain number of times, or until it feels just right, I hold responsibility for something bad happening to myself or someone else. This is in direct opposition to my value system which is grounded in being kind and protective of others. I cannot allow myself to take the chance that by not completing the counting something terrible will happen to someone else.
If fears about not engaging in counting rituals are causing you to suffer, you can get better. The gold standard treatment for all forms of OCD is Exposure and Response Prevention (ERP) therapy. ERP targets both obsessions and their compulsions. The “E” in ERP is what we use to target a person’s obsessions. Exposures should be developed with a therapist trained in ERP to ensure that they are actually targeting the obsessions. The response prevention (RP) piece of ERP is what targets a person’s compulsions, and what ultimately leads to progress and recovery. Over time, learning to accept uncertainty and sit with distress without engaging in compulsions will allow you to break OCD’s cycle so that your obsessions cause less distress. 

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