Classifying Obsessions

Researchers have described two types of obsessions: autogenous and reactive. Autogenous obsessions are experienced as involuntary, guilt-provoking thoughts without an identifiable trigger (e.g., spontaneous unacceptable sexual thoughts). Reactive obsessions are caused by external events and tend to be related to concerns about contamination, accidents (e.g., seeing glass on the floor leads to thoughts of being responsible for someone being injured), and/or a need for perfection. There are many types of OCD that fall within each of these two categories, as shown on the next page, the four kinds of OCD.

About Compulsions

People with OCD engage in repeated behaviors or thoughts, known as compulsions, to try to make the obsessions go away and make themselves feel safer. Compulsions are rituals that the person believes reduce the risk of the obsessions coming true, or at least reduce the anxiety they produce. Compulsions can come in many forms:

• Physical rituals (like washing, or checking the faucet, repeating, or arranging)
• Mental rituals (like praying or mental counting)
• Somatic rituals (like checking the body for signs of illness or sexual arousal)
• Reassurance-seeking (like asking other people if “I’m ok” or finding answers online)

One problem is that the compulsions are not useful, as they do not prevent the feared consequence or are so clearly excessive that they cause other problems. Also, the more the sufferer does compulsions, over time, the stronger the OCD becomes. Compulsions or rituals take up so much time that they get in the way of other important things in life.