Common Obsessions and Compulsions Among People With OCD

A key symptom of obsessive-compulsive disorder (OCD) is compulsions. Compulsions are behaviors done in response to an obsessive thought. A person with OCD may repeat these behaviors over and over again, possibly for hours on end, in order to try and relieve anxiety. In OCD, examples of compulsions include repeated handwashing or counting, but everyone with OCD is different and may display different behaviors.

Even though people with OCD feel driven to engage in these behaviors, they probably don't want to. Though the behaviors do lessen the negative feelings of anxiety, guilt, or fear, they do so only temporarily, and they take a lot of time. Obsessive behavior may significantly impact quality of life.

Common Compulsions in OCD

A compulsion can be a physical act or a mental one. Examples of common compulsions among people with OCD include:

• Repeatedly checking to make sure that doors and windows are locked or that appliances are turned off; some individuals with OCD have to check their neighborhood to make sure they have not hit someone with their car or assaulted someone
• Excessive cleaning of the house, clothes, and/or body
• Counting objects, letters, words, or actions
• Doing routine activities repeatedly, like standing up or going up and down stairs
• Requesting or demanding reassurance from family members or health care providers, such as "My hands should be clean now, right?"
• Repeating phrases or sequences of words either out loud or mentally
• Rearranging objects to ensure a specific order and/or symmetry
• Doing things in multiples; for instance, turning the light on and off five times because five is a "good" number

Sometimes, compulsive behavior is present in other conditions, such as addiction, binge-eating disorder, or hoarding disorder. These are not the same as obsessive-compulsive disorder, although there are overlapping symptoms.

Common Obsessions in OCD

Obsessions are the other half of obsessive-compulsive disorder, the experience that causes compulsive behaviors. Obsessions involve thoughts, feelings, and mental images that can seem like they are taking over. They may cause people with OCD to feel a terrible lack of control, as well as significant anxiety, fear, disgust, shame, or guilt. Common obsessions among people with OCD include:

• A fear of contamination, such as germs, viruses, body fluids, animals, diseases, chemicals, or dirt
• Fear of losing control of yourself by acting on thoughts or impulses, such as harming someone, stealing, blurting out swear words, or becoming violent
• Fear of accidentally hurting someone else because of something you did or forgot to do, such as not cleaning up water that you spilled and causing someone to slip and fall
• Unwanted sexual obsessions, thoughts, or images about children, incest, and/or aggressiveness
• Worry about living a moral enough life
• Fear of losing or forgetting something important
• Worry about how straight or even objects are
• An inability to make decisions on what to keep and what to throw away
• A fixation on certain numbers and/or colors being good/correct or bad/incorrect

Treatment for Obsessive Behaviors

Treatment for OCD is available. Obsessive thoughts and compulsive behaviors can often be dramatically reduced using behavior therapy, such as cognitive-behavioral therapy (CBT) or exposure and response prevention therapy (ERP).

Some people also benefit from medications. Selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine hydrochloride), or Zoloft (sertraline) may be helpful in treating OCD.