Common Under-Recognized OCD Compulsions
Because the symptoms of obsessive-compulsive disorder are so specific to each individual, there are many symptoms that do not fit neatly within any particular category. Below are some typical compulsive behaviors that have not been the focus of much discussion or research, but are nonetheless quite common. Compulsions are any behavior performed by someone with OCD to quell the obsessions. They do not work in the long run as the relief is only temporary, and the person with OCD does not learn that the compulsions are unnecessary.
- Excessive list-making
- Urges to tell, confess, or gain reassurance
- Need to touch, tap, or rub
- Rituals involving blinking or staring
- Self-damaging behaviors to fix an imperfection
- Ritualized eating behaviors
Excessive list-making
People with OCD often fear they will forget something important, so they may make excessive lists to remind them to do daily routine activities (i.e. brush teeth, make breakfast, etc.) However, research has shown that people with OCD do not have memory problems, so the lists are actually unnecessary. List-making would be considered a compulsion because the list reassures the person with OCD and helps them to feel temporarily better, thus they never learn that they do not need the list to remember things. People with OCD may also make lists to remember things that may be contaminated to later wash or avoid, which also contributes to the OCD process. List-making can be in writing or verbalized aloud.
Urges to tell or confess
People with OCD may constantly wonder if they have done something wrong or made a mistake. One way they often try to cope with this fear is by telling every detail of their actions to another person. This behavior can be particularly troublesome in relationships, as for example, a husband may have an urge to tell his wife every time he notices an attractive woman, to assure her she does not think he is looking at her in an improper manner. Likewise, Catholics may feel compelled to confess every small sin to the priest to be sure that they have not accidentally omitted a cardinal sin to prevent damnation. People with OCD may even stress their therapists as they may feel the need to disclose every detail of their past mental health history to be sure that the therapist will have all the information needed to render a proper diagnosis and treatment plan. As a result people often get tired and frustrated listening to the person with OCD confess or explain things to an extreme degree. The need to tell or confess is often coupled by the need to obtain reassurance (see below).
Excessive reassurance seeking
People with OCD often seek reassurance from others as a way of reducing anxiety from obsessions. Research has shown that people plagued by obsessions about sex, religion, morality, and bodily concerns tend to be the most likely to use reassurance to cope with their distress. Requests for reassurance can come in the form of demands or can be elicited more subtly. People with concerns about illness may visit a doctor repeatedly to be reassured that they have not contracted an illness. People who worry about having said the wrong thing, may seek reassurance from others to ensure that have not caused offense. People who use reassurance to cope can be very skilled at eliciting reassuring feedback from others, and neither party may even be aware that the obsessive-compulsive process is occurring. Therapists often provide reassurance to clients as part of the treatment process, but people with OCD should not be reassured as this only perpetuates the OCD cycle.
Other Compulsions
Individuals with OCD can sometimes be very superstitious. Since OCD is the great “what if,” a person with OCD might walk under a ladder, and despite knowing it’s just a superstition they don’t believe in, may say “let’s undo this just in case.” Ultimately OCD is unwanted thoughts. So, while someone with harm OCD might see someone on the sidewalk, and momentarily have an unwanted thought pop in of pushing them into traffic, someone else may have the same thought with a superstitious ritual, whereby something bad may happen if a superstitious act is not carried out. Since ultimately the fear in OCD can often be causing harm by not being careful enough, so it is very easy to latch on to superstition.
Many other disorders are often similar to OCD or misdiagnosed as something else. An example of this would be self damaging behaviors. Someone may misinterpret someone with a nail biting or skin picking obsession, as doing self harming behavior, without knowing the reasoning behind the action. People with OCD can be very symmetrical, and so hate having uneven nails and then keep biting them down to make them feel right, and then obsessing they are not even, and continuing to bite or trim until they are so trimmed too much has been taken off.
Unusual Compulsions
Some OCD symptoms may seem unusual or strange. One person with OCD had the need to rewind videos he watched on social media back 15 seconds until he felt satisfied. Here are a few other unusual compulsions. Ultimately what all OCD obsessions have in common, is a feeling of discomfort and anxiety, and while a person with OCD often feels there is some reason or logic to their obsessions, some obsessions are more about not feeling “right.” Sometimes a person may re-read a passage of a book over and over because they fear they missed something. But sometimes it may because it just doesn’t feel right. Ultimately though the reason doesn’t matter, as the feeling of anxiety and stress is causes is the same.
Some people may touch one finger, and then the other finger doesn’t feel “right until it is tapped in the same way to feel symmetrical, or even just a touching ritual that feel better. This can also apply in the same way to blinking, or staring and forcing ones eyes to stay open. It can even manifest in eating behaviors; for example, having to eat foods a certain way or in a specific order for things to be just right. People with OCD may not want their foods to touch.
The Impact of OCD
How Can the New England Institute Help?
Our group of caring clinicians can offer the Gold Standard in treating OCD, Exposure and Response Prevention (ERP). Reach out to one of our client intake coordinators to learn more about how this may help you!
Lasting Relief
At the New England OCD Institute, our approach is simple: to provide strategies which can be used lifelong. This means that after your initial treatment, we will continue to provide follow-up care, but will also strive for you to be empowered within your own care and life.