What are obsessions and compulsions?

 
OCD

What are obsessions?

Obsessions are recurring thoughts, urges, or images that are experienced as intrusive and unwanted. They may come to mind spontaneously and can seem to be disconnected from what is happening in the present. Obsessional thoughts typically cause anxiety or distress when they occur.

Obsessions can occur in any of the following domains:

  • Contamination (thoughts about germs and disease, dirt, chemical contamination, fear of getting a physical illness or disease)

  • Losing control (fear of acting on a urge to harm oneself or another person, fear of stealing things or yelling out insults)

  • Perfectionism (extreme desire for things to be even or exact, concern with a need to know or remember something important, inability to decide whether to keep or discard things)

  • Harm (fear of being responsible for something horrible happening or of not protecting others through not being careful enough)

  • Unwanted sexual thoughts (forbidden or unwanted sexual thoughts or images)

  • Religious obsessions (concern with offending god, superstitious ideas about lucky or unlucky numbers or colours)

What are compulsions?

Compulsions refer to repetitive behaviors or mental acts that one feels compelled to do in response to an obsessional thought. They are usually performed to stop the obsessions from happening, to reduce anxiety or distress resulting from the obsession, or to prevent an obsessional thought from becoming a reality.

Common compulsions in OCD might include:

  • Washing and cleaning (hand washing; excessive cleaning or washing to remove or prevent contamination)

  • Checking (checking that you didn’t harm someone, make a mistake, that nothing terrible has happened or checking a part of your body)

  • Repeating (rereading or rewriting; repeating routine activities; repeating body movements e.g. tapping, touching, blinking; repeating activities in multiples of the same number)

  • Mental compulsions (praying, counting, mentally reviewing events to ensure you did things ‘right’ or didn’t do wrong)

  • Avoiding (situations that may trigger obsessions or certain words or numbers that might be ‘unlucky’)

  • Order / symmetry (putting things in order or in a certain place so that it feel ‘right’)

Over time, both obsessions and compulsions usually occur more frequently as the person works harder to stop themselves from having the intrusive thought, or to prevent the intrusive thought from becoming a feared reality.