OCD Obsessions and Compulsions
Obsessions and compulsions can take numerous forms and are unique to each individual. Below are a few common examples.
- Fear of contamination, including body fluids, germs, and dirt, which may be related to fear of disease, illness, or death.
- Fear of harming a loved one or others due to carelessness.
- Fear of purposefully hurting someone. People with these fears may have no history of aggression and no desire to hurt others, but they obsess about losing control and acting impulsively (i.e. stabbing someone with a kitchen knife for no reason or pushing someone they know or a stranger into an oncoming train).
- Sexual obsessions, including a fear about sexual orientation or unwanted sexual thoughts about family members, animals or other taboo subjects.
- Religious obsessions, including excessive concern about committing a sin or blasphemy, also called scrupulosity.
- Symmetry and exactness, often related to the way items are arranged or ordered. People with these obsessions may believe that something bad will happen if something is uneven or out of order.
Washing and cleaning– People with contamination fears may engage in excessive washing to remove dirt or germs or to feel clean. Wearing gloves or repeated hand washing, including cleaning each finger and under each fingernail, is common. People may also shower, bathe, brush their teeth or do other self-grooming rituals to the point of damaging their skin. They may also spend an inordinate amount of time cleaning their house, cell phone, or shoes and even avoid touching surfaces like doorknobs.
Checking – Stemming from a fear of being responsible for someone being hurt, people with OCD may repeatedly check appliances, doors and windows for signs of being unlocked, damaged, leaking, and so on. Checking may extend to people – they may check their own bodies for signs of disease or injury, or constantly scan their environment for signs of reassurance that they haven’t caused harm to others.
Repeating – Repeating behaviors such as going in and out of a door multiple times, rereading the same passage in a book to make sure they didn’t miss anything, or feeling the need to say the same word again and again, are all types of repetitive behavior associated with OCD. Repeating body movements can include tapping, touching or blinking.
Ordering, arranging and counting – Instilling order and exactness to objects, or obsessively counting steps or floor tiles when walking, either out loud or internally, are signs of OCD. People may also have fears of certain numbers, such as a number on a clock or an address on a building. This is more than feeling a bit superstitious about Friday the 13th or deciding “8” is your lucky number. Number obsessions lead people to believe terrible things will happen if they don’t obey their rules about numbers –for example, if they don’t eat at a certain time or wash a certain body part a set number of times, they feel extreme anxiety that something bad will happen.
According to the National Alliance on Mental Illness, people living with OCD have obsessions and compulsions that last more than one hour per day. Further, their need to perform certain compulsions lead to disruption of daily life. Finally, the act of completing the compulsions do not give the person pleasure. Instead, performing the compulsions offers a brief reprieve from the anxiety associated with the obsessions.
The intensity of these intrusive and unwanted thoughts as well as the feeling of needing to act out certain rituals or behaviors in order to cope can cause people to experience suicidal thoughts or compulsions regarding self-harm.