Obsessive compulsive disorder (OCD) is an anxiety disorder marked by obsessions (recurring intrusive thoughts) and compulsions (repetitive behaviours). The compulsions are meant to relieve the anxiety generated by the obsessions. Although the anxiety triggered by the obsessions are temporarily reduced by the compulsions, the anxiety in the long run becomes worse, in the form of worsening and continued obsessions, worsening anxiety, and the compensatory compulsions. The person afflicted with OCD is compelled to carry out the compulsions in reaction to the obsessions, and the person knows that this is excessive and unreasonable. Below are the top 15 things people are OCD over (Goodman et al., 1989):
- Mental rituals
- Compulsion to tell, ask, confess
- Compulsion to touch, tab, rub
- Measures to prevent harm to self or others
- Eating rituals
- Superstitious behaviors
- Hair pulling
The compulsion to hoard is the top thing that people are OCD over, as illustrated by the popularity of the TV show Hoarders. A person with compulsive hoarding literally buries themselves in the stuff they collect. There is no mistaking a person with compulsive hoarding…you can SEE it. People with compulsive hoarding have obsessive thoughts about collecting or saving things, however useless or trivial. They may be worried that if they throw something away, they may need it in the future.
Cleaning and washing compulsions stem from germ contamination fears. If they touch a contaminated object, they may do excessive washing, multiple times a day. They may also compulsively clean themselves by excessive grooming or showering that may last for hours. If their cleaning routine sequence is interrupted, then they may have to start the whole routine over again, wasting even more time on the compulsion.
Checking compulsions involve repeatedly checking things to make sure they are turned off or closed, like checking doors, locks, stoves/ovens, switches, etc. They can spend many hours on checking, and they are never reassured despite numerous checking. Some may have the fear that they harmed someone, like the person who repeatedly circled the neighborhood and retracing their path that they drove, to make sure they did not run someone over. Others may be fearful that something terrible will occur, and spend much time scouring the news about a catastrophe one may have caused, and also ask people for reassurance that one did not cause it. Still, others with checking compulsions may have a fear that they have some illness, and seek repeated reassurance from doctors, friends or family that they don’t have such problems.
People with counting compulsions have a need to count and recount. They may count objects, like tiles on the floor. They may also count when performing checking rituals. When their counting is interrupted, they may have to start over and restart the counting, further obligating them to time spent on compulsions.
Ordering/arranging compulsions stem from the need to arrange and order things. This compulsion can also take up many hours, and may lead one to be upset if this order is disturbed. If the process is interrupted, the routine is restarted from the beginning.
Re-reading/re-writing is a common repeating compulsion. People afflicted with this compulsion have a need to re-read, as they may worry that they may be missing something that may have been overlooked. Or re-writing something as they may be missing the perfect word or idea.
People with this compulsion may have a need to pray to undo any ‘sinning’ they may have done. They may also think ‘good’ thoughts to undo any ‘bad’ thoughts. These compulsive thought are different from obsessive thoughts in that the compulsive thoughts are performed to undo the anxiety induced by the obsessive thoughts.
People with this compulsion have the need to tell, ask, or confess. For example, they may have to repeatedly ask reassurance from someone, making sure they didn’t do anything wrong. Or they may repeatedly confess to something they never did. This compulsion catches the attention of others, as the compulsion targets others, who are the unwilling co-conspirators of the compulsions.
People with this compulsion have the need to touch, tab, or rub. They may give in to their urges and touch other people. They may also give in to the need to touch objects. They may also touch things to prevent something bad from happening.
People may have obsessions that they may harm themselves or others. They may actively try to stay away from sharp objects or potential weapons, for fear of harming self or others.
People with eating rituals have specific routines when eating. They may arrange eating utensils in a certain way, or are only able to commence at certain times or situations. They end up spending inordinate amounts of time on eating rituals.
People with superstitious rituals may have a problem with certain number, like the number thirteen, and avoid anything associated with that number. They may also do other behaviors like throwing away the clothes they wore each time they pass a cemetery.
People with these compulsions have an urge to pull their hair. They may pluck their eyebrows, eyelashes, hair, pubic hair. They may spend many hours pulling their hair, to the point where bald spots occur, and may be quite obvious to others. Hair pulling is also called trichotillomania.
In summary, obsessive compulsive disorder is recognized by the compulsive behaviors listed above. People with OCD spend much time engaged in compulsive behaviors, in an attempt to reduce the anxiety generated by their obsessive thoughts. Fortunately, there is treatment for this disabling mental illness, which is covered in other articles.