OCD (obsessive compulsive disorder) is an anxiety disorder marked by recurrent, intrusive thoughts and uncontrollable rituals to decrease the distress. For a behavioral explanation of what reinforces the thought and ritual in obsessive compulsive disorder, let’s look at an example of a negative cycle of OCD:
Let’s say you have OCD and are driving around a neighborhood. This driving around triggers intrusive thoughts: “I think I ran someone over,” and “I must go back and check.” These intrusive thoughts (obsessions) in turn trigger distressing anxiety symptoms, and you feel the adrenaline rush from the fight or flight response.
The anxiety then compels you to act to reduce the distress associated with the anxiety. So you are compelled to address your intrusive thoughts that you must have run someone over with your car, and you drive back along the path driven to make sure nobody was run over. Then you drive back along the path that you had detoured to check the previous path. You then repeat checking the paths that you had detoured to check the previous path, and this becomes a never-ending loop. And if you get interrupted with the checking, you must start over to make absolutely sure you did not run someone over. Finally, after repeated loops to check your paths driven, you have finally scanned your entire path, and determine that nobody was run over. This checking reassures you, and you get short-term relief from anxiety, until the next round of intrusive thoughts.
Although the compulsive behaviors decrease your anxiety over the short-term, the compulsions actually maintain your overall anxiety from OCD. The compulsions, or acts, are reinforced by the short-term relief from anxiety caused by your obsessions, or thoughts. But when you are driving around a neighborhood again, this may trigger intrusive thoughts that you have run someone over. As a result, the vicious, negative cycle continues, where your thoughts (obsessions) are triggered by a situation, and the thoughts induce anxiety, which compels you to act (compulsions). The only way to short-circuit this never-ending loop is to stop the compensatory compulsions and find other ways to reduce anxiety.