The Mental Compulsions You May Be Doing Without Realizing It (A Non-Exhaustive List)
When most people think about OCD compulsions, they usually picture things like hand washing, door checking, cleaning or organizing things a certain way. Those can definitely be compulsions, but they are such a small portion of what compulsions can look like.
For most adults living with OCD, the compulsions are completely invisible, meaning they happen inside one’s mind. They can look like thinking, remembering, communicating, being responsible, planning or preparing and often the person doing them hardly realizes they’re doing them either (especially because it can become so habitual). And, for some adults, they can have a combination of physical and mental compulsions.
It can take the average adult with OCD 14 to 17 years to get the the right diagnosis of OCD and this is part of the reason— clients and even clinicians struggle to recognize these invisible compulsions that maintain the OCD cycle..
So, heres a non-exhaustive list of the most common mental compulsions that I see as a therapist:
1. Mental Reviewing
Going over a past conversation, event, or decision again and again in your head to figure out something (did you embarrass yourself?, did you do something wrong or bad?, did you do something horrible and just not remember it?). The distinguishing feature is that you have already thought about it trying to find the answer to no avail.
2. Rumination
Replaying the same fear, doubt, question, or worst case scenario over and over. It feels like thinking through a problem, planning or, again, trying to figure something out. It’s a compulsion and the difference between this and productive thinking is that productive thinking reaches an ending point or a conclusion, while rumination circles, going over the same question again and again. If you have had the same thought fifteen times and haven’t reached an answer or any new insight, it might be because you’re ruminating.
3. Mental Checking
Scanning your body, thoughts, feelings, or memory to confirm something is okay. For example: Do I still feel love when I look at my partner? Did I actually check the stove? Is that sensation in my chest normal? Am I still the person I think I am? And, the paradox is that research shows that the more you check, the less certain you feel.
4. Reassurance Seeking (or Reassuring Yourself)
Asking the same question to your partner, your friend, your therapist, or yourself in different ways, hoping the answer will finally settle the anxiety. Even if you get some relief from the reassurance seeking the relief usually doesn’t last and the doubt creeps back in again. Most people will think to themselves: Wait, but maybe they’re lying? Or they don’t actually know the answer? And then the cycle repeats itself.
This can also consist of reassuring yourself over and over— repeating things like Everything is okay. You’re okay. You did nothing wrong. Doing this repeatedly, especially in response to an obsessive and/or intrusive thought can be considered a compulsion.
5. Confessing and Over Explaining
Telling people about your thoughts, actions, feelings, sensations or intentions to relieve discomfort. This often looks like explaining yourself more than the situation required or apologizing for things that don’t deserve an apology or that nobody complained about in the first place.
6. Mental Neutralizing
Replacing a bad thought with a good one or picturing a positive outcome to cancel out a negative one. This one can be especially common when someone experiences intrusive thoughts.
7. Subtle Avoidance
The less obvious forms of avoidance, like steering conversations away from certain topics, avoiding places, people, or situations that might trigger an intrusive thought, or canceling plans. Avoidance is one of the sneakiest compulsions because it feels reasonable in the moment and the more you avoid the smaller your world gets.
8. Body Checking
Scanning your body for physical sensations, arousal responses, or symptoms that could be interpreted as meaning something about you. Body checking is common in health OCD, POCD, harm OCD, ROCD and sensorimotor OCD, but can show up in all subtypes.
9. Compulsive Research
Googling symptoms, subtypes, diagnoses, or topics related to your fear. This could be watching hours of content about the specific fear or doubt and reading reddit forums to see if other people experience what you experience. Even though it feels like being well-informed, it can very easily turn into a compulsion.
10. Compulsive Journaling
Journaling can at times be helpful, but it can also be considered ruminating or mental reviewing on paper, especially when it’s used to try and solve an unsolvable question. It consists of endlessly writing about your fears, thoughts, or feelings to try to figure them out.
Why These Compulsions Are So Hard to Spot
All of these compulsions look like they could be something good. That they could be thoughtful and helpful ways to problem solve or process your thoughts and feelings. And, at times, they can be, but when we are doing them repeatedly, a certain way, or in order to solve a question that we can’t solve, it becomes compulsive. And, that’s why it’s so hard for clients and clinicians to spot them! Many of us have been trained to gather information, plan things, prepare, process, but with a brain that is highly anxious or obsessive, we can often swing the pendulum to a point where it’s no longer helpful.
How to Know If Something Is a Compulsion
Sometimes it can be hard to know if it’s a productive coping skill or a compulsion. One way to help you find out is by asking yourself the following: Am I doing this to reduce anxiety or discomfort? Do I feel a sense of urgency around it? Do I feel worse if I do not do it? Is the relief temporary? Does the fear return, sometimes stronger, after I do it? Am I trying to solve an imaginal problem or a fear that hasn’t yet happened?
If the answer to most of those is yes, it is likely a compulsion.
What to Do Instead
The gold standard treatment for OCD is Exposure and Response Prevention (ERP), which works by teaching your brain that you can tolerate the anxiety without doing the compulsion. The way out of any of these compulsions is not through more thinking, more analyzing, or more coping. It is through learning to sit with the discomfort of not knowing, not checking, not fixing, not neutralizing and redirecting your attention to whatever else you would be doing or thinking about if the discomfort wasn’t there (WITH acceptance that it is there).
If This Resonated
If this blog post resonated with you, it may be worth being evaluated by a clinician trained specifically in OCD. Many adults with OCD have spent years in therapy for generalized anxiety without ever being assessed for the compulsions underneath. You are not alone and recovery is possible.
At The Human Collective, we specialize in OCD and anxiety therapy, including health anxiety and health OCD, using ERP, ACT, and CBT. We work with clients online across California and Michigan and we would love to help. Book a free 15-minute consultation to see if we'd be a good fit.
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