Everyday Health: What are some common obsessions and compulsions of people living with OCD?
Jeff Szymanski, PhD (ocfoundation.org)
Obsessions: Thoughts, images, or impulses that occur over and over again and feel out of the person's control. The person does not want to have these ideas. He or she finds them disturbing and unwanted, and usually knows that they don't make sense. They come with uncomfortable feelings, such as fear, disgust, doubt, or a feeling that things have to be done in a way that is "just right." They take a lot of time and get in the way of important activities the person values. Compulsions: Repetitive behaviors or thoughts that a person engages in to neutralize, counteract, or make their obsessions go away. People with OCD realize this is only a temporary solution, but without a better way to cope, they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Compulsions are time consuming and get in the way of important activities the person values.
Common Obsessions in OCD
Contamination:
- Body fluids (examples: urine, feces)
- Germs/disease (examples: herpes, HIV)
- Environmental contaminants (examples: asbestos, radiation)
- Household chemicals (examples: cleaners, solvents)
- Dirt
Losing Control:
- Fear of acting on an impulse to harm oneself
- Fear of acting on an impulse to harm others
- Fear of violent or horrific images in one’s mind
- Fear of blurting out obscenities or insults
- Fear of stealing things
Harm:
- Fear of being responsible for something terrible happening (examples: fire, burglary)
- Fear of harming others because of not being careful enough (example: dropping something on the ground that might cause someone to slip and hurt him/herself)
Perfectionism:
- Concern about evenness or exactness
- Concern with a need to know or remember
- Fear of losing or forgetting important information when throwing something out
- Inability to decide whether to keep or to discard things
- Fear of losing things
Unwanted Sexual Thoughts:
- Forbidden or perverse sexual thoughts or images
- Forbidden or perverse sexual impulses about others
- Obsessions about homosexuality
- Sexual obsessions that involve children or incest
- Obsessions about aggressive sexual behavior towards others
Religious Obsessions (Scrupulosity):
- Concern with offending God, or concern about blasphemy
- Excessive concern with right/wrong or morality
Other Obsessions:
- Concern with getting a physical illness or disease (not by contamination, e.g., cancer)
- Superstitious ideas about lucky/unlucky numbers, certain colors
Common Compulsions in OCD
Washing and Cleaning:
- Washing hands excessively or in a certain way
- Excessive showering, bathing, tooth brushing, grooming or toilet routines
- Cleaning household items or other objects excessively
- Doing other things to prevent or remove contact with contaminants
Checking:
- Checking that you did not/will not harm others
- Checking that you did not/will not harm yourself
- Checking that nothing terrible happened
- Checking that you did not make a mistake
- Checking some parts of your physical condition or body
Repeating:
- Rereading or rewriting
- Repeating routine activities (examples: going in or out doors, getting up or down from chairs)
- Repeating body movements (example: tapping, touching, blinking)
- Repeating activities in "multiples" (examples: doing a task three times because three is a "good," "right," "safe" number)
Mental Compulsions:
- Mental review of events to prevent harm (to oneself, others, to prevent terrible consequences)
- Praying to prevent harm (to oneself, others, to prevent terrible consequences)
- Counting while performing a task to end on a "good," "right," or "safe" number
- "Cancelling" or "Undoing" (example: replacing a "bad" word with a "good" word to cancel it out)
Other Compulsions:
- Collecting items that results in significant clutter in the home (also called hoarding)
- Putting things in order or arranging things until it "feels right"
- Telling, asking, or confessing to get reassurance
- Avoiding situations that might trigger your obsessions
Jonathan Abramowitz, PhD (jabramowitz.com)
Common obsessions include: fears of contamination/germs, causing harm (perhaps by hitting someone with a car that you don’t mean to), making mistakes (leaving the door unlocked), disasters (causing a fire), certain numbers (such as 13 and 666), unwanted violent thoughts (thought of harming a loved one), blasphemous thoughts (cursing God), sexual thought (what if I’m a child molester, gay, or want to have sex with my mother?), need for symmetry and exactness, and thoughts that something is terribly wrong with your body (what if I have cancer?). A general theme is that obsessions concern situations where there is some degree of uncertainty (what if "X" happens and I didn’t do enough to prevent it?) Compulsive rituals are all about trying to get reassurance and certainty. For example, washing to remove germs, praying to counter blasphemous or sacrilegious thoughts that could result in going to hell, checking for assurances that doors are locked or people are OK, putting things in order (arranging), repeating other behaviors to get rid of a thought (turning a light off and on until a bad thought goes away). Also common are mental rituals that take place purely in the person’s mind.
Steven J. Brodsky, PsyD (OCDHotline.com)
There are thousands of forms of OCD, as unique as each individual. They are not limited to the ones you see on TV with themes of checking, germaphobic cleaning, ordering, perfectionism, hoarding, and hypochondriasis, etc. They can also involve body dysmorphic disorder, scrupulosity, religious OCD, relationship OCD (ROCD) in which people wonder if they love their partner or vice versa, HOCD (homosexuality OCD) in which the sufferer doubts his or her sexual orientation. OCD can even take a nonsense form, with unanswerable metaphysical questions, a song that sticks in your mind, thinking about one's swallowing or blinking, etc.
Charles H. Elliott, PhD, and Laura L. Smith, PhD (psychology4people.com)
Common obsessions include fears about contamination, worries about having left appliances on or doors unlocked, fear of acting in shameful or humiliating ways, discomfort about things being out of order, extreme concerns about superstitions such as unlucky numbers or colors, and excessive worries about keeping objects of all kinds. Common compulsions include excessive cleaning and hand washing; repeatedly checking doors, locks, appliances, and such; rituals designed to ward off contact with superstitious objects; using prayers or chants to prevent bad things from happening; arranging and rearranging objects; and hoarding huge numbers of ordinary objects.
Kenneth Schwarz, PhD (DutchessPsychology.com)
Some common obsessions have to do with becoming contaminated, being or becoming too aggressive, having persistent sexual thoughts, being susceptible to injury or disease. There is also religious scrupulosity, where a person has unwanted, blasphemous thoughts that she must work hard to keep under control, and out of her mind, so she doesn't just blurt them out - which is what makes her so anxious. The common element in all these obsessions are persistent, unwanted thoughts that cause a person considerable anxiety. Common compulsions used to get rid of these obsessions come under the headings of checking, cleaning, decontamination rituals, counting, and putting or keeping things in a certain order.
Charlotte M. Scott (custommovesolutions.com)
Common obsessions and compulsions that many are familiar with include the fear of germs and sickness, constant hand washing, using bleach wipes to handle everyday objects that other people have touched, and an overwhelming compulsion to clean and possibly hoard. A person may be filled with anxiety walking across a soccer field and seeing orange peels, candy wrappers, or empty water bottles and desperately wants to rid the field of the trash and clutter, yet the stronger obsession of not touching the items because of germs and bacteria creates the need to control others to pick up the items. Many people with OCD become hoarders triggered by the death of a loved one and the feeling that they must keep everything to protect the memories.
Barbara Tako (clutterclearingchoices.com)
Someone with OCD might be afraid to throw anything away and have strong emotional attachments to many things they own. On the other end of the scale, someone with OCD might turn down a coffee date or other social activity to stick with their cleaning schedule.
Allen H. Weg, EdD (stressandanxiety.com)
The most common obsessions are worries that something is "contaminated" which results in excessive avoidance or excessive washing. Another common compulsion is checking behavior, which results when a person's obsession makes him not feel sure about something (e.g., "Is it locked?" "Is it turned off?" "Did I leave that thing behind?") Other obsessions may have to do with sexual identity ("Am I gay?") which results in attempts to seek reassurance that one is not gay. Also, fear of loss of impulse control, or a sense that one will act out and do something "crazy," resulting in obsessions such as "maybe I will grab a knife and kill someone before I realize what I am doing," or " maybe I will just fling my body off of a high place and kill myself." These obsessions result in people avoiding sharp objects or knives, or places of perceived danger, such as the kitchen, or high places. Besides Checkers, Hoarders, and Aggressive OCD, as depicted above, there is also ordering OCD, counting OCD, symmetry OCD, and hoarding OCD (though research has of late been demonstrating that this last form may be a different disorder altogether).