How to Manage Compulsions in OCD
Do you find yourself caught in a cycle where you feel compelled to repeat certain actions, even when you logically know they're not necessary?
Perhaps you check locks multiple times or must rearrange items until they are arranged perfectly. These repetitive behaviors or mental acts are called compulsions and are a key feature of Obsessive-Compulsive Disorder (OCD). In some cases, these compulsions can make your life very challenging and difficult.
While the obsessions (i.e., unwanted or intrusive thoughts or worries) are often the first to appear, it is the compulsions that frequently become the more time-consuming and disruptive for people. Compulsions are performed to help reduce anxiety or prevent a feared outcome associated with the obsession. The relief felt, however, typically is short-lived and leads to a need to repeat the compulsion. This feedback loop creates a reinforcing cycle.
Understanding the Compulsion Cycle
Compulsions are driven by intense anxiety and a strong belief that performing them will neutralize the obsessive thought. This belief creates a powerful, often overwhelming, urge to engage in compulsions. Breaking this cycle requires understanding how it works and how to change the way you respond to urges.
Common types of compulsions include:
Checking: Repeatedly checking locks, appliances, or switches.
Washing or Cleaning: Excessive handwashing, showering, or cleaning objects.
Repeating: Rereading, rewriting, or repeating actions a certain number of times.
Ordering or Arranging: Needing items to be perfectly symmetrical or in a specific order.
Mental Compulsions: Silently reviewing events, praying, counting, or neutralizing "bad" thoughts with "good" ones.
The more you engage in a compulsion, the stronger the connection becomes:
Obsession -> Compulsion -> Temporary Relief -> Stronger Obsession.
Evidence-Based Strategies for Managing Compulsions
A key focus is to disrupt the need to perform compulsions. This process requires courage, practice, and the right tools. Exposure and Response Prevention (ERP) therapy has been found to be one of the most effective evidence-based approaches to treating OCD. Below are some key strategies of ERP.
Identify Your Compulsions and the Obsessions Driving Them:
The Strategy: Recognize the obsessive thoughts and compulsions you are doing.
Implementation Tip: Pay close attention to triggers. When do you feel the urge to perform a compulsion? What thought or fear precedes it? Write these down. For example: "When I touch a doorknob (trigger), I worry about germs (obsession). Then, I feel I must wash my hands for two minutes (compulsion)."
Why it helps: This step shines a light on the automatic patterns that drive your OCD, making them more conscious.
Delay and Resist the Urge:
The Strategy: This is the "Response Prevention" part of ERP. Instead of immediately engaging in the compulsion, you intentionally delay or resist it.
Implementation Tip: Start small. If you normally wash your hands for two minutes, try reducing it to one minute and 50 seconds. Or, if you check the lock five times, try checking it only four times. Gradually increase the delay or reduce the time you spend doing the compulsion. When the urge arises, say to yourself, "I acknowledge this urge, but I'm going to wait 5 minutes before acting on it." Set a timer and engage in a distracting activity. You may find that after distracting yourself, the intensity of the urge decreases.
Why it helps: You begin to learn that the anxiety associated with resisting the compulsion is temporary and will pass. There is no need to perform the ritual. This challenges your brain's automatic connection between the obsession and compulsion.
Mindfulness and Discomfort Tolerance:
The Strategy: Instead of fighting or escaping the anxiety that comes with resisting a compulsion, try to accept the uncomfortableness and be curious to understand it more.
Implementation Tip: As you resist a compulsion, notice the physical sensations of anxiety (e.g., increased heart rate, sweatiness, tension). Try not to judge your feelings; rather, just observe them as temporary. Remind yourself, "This feeling is uncomfortable, but it is not dangerous, This feeling will pass." You can use deep breathing exercises to stay in the present moment while still experiencing the discomfort.
Why it helps: You are learning that you can tolerate the feeling of anxiety (though you may not like it!) and that the feared outcome is not connected to the compulsion. This helps to break the feedback loop.
Seek Counseling if OCD is Holidng You Back
Facing compulsions head on can feel very overwhelming for many people; it’s perfectly normal to seek out professional help. Trained counselors who specialize in OCD treatment can help you create a plan and learn proven strategies and approaches back by years of science.
You don't have to suffer alone. Reach out today for a free 15-minute consultation to learn more about how we can help you reclaim control and live life to the fullest. We offer both in-person and virtual sessions in Las Vegas, NV, and virtual sessions across California, Nevada, Georgia, and Virginia. We look forward to hearing from you.