What is a compulsion?
In obsessive-compulsive disorders, the action that results directly from obsessive thinking is a compulsion. The distressful nature of the obsession typically forces affected people to make specific gestures to suppress the anxious thinking/condition which is plaguing them. Compulsions may take the form of an external action or a mental ritual. Mental rituals are actions that take place inside one’s head and cannot be observed by others.
What is the Purpose of a Compulsion?
The goal of a compulsion is to eliminate the threat posed by an obsession. Compulsive actions provide temporary relief from the distress, discomfort or disgust caused by an obsession.
Compulsions put an end to or prevent anxiety and discomfort arising from obsessive thinking. For example, wearing gloves to pick up the mail is a compulsion if the action is taken for the purpose of avoiding physical contact that would cause anxiety.
Compulsions may be minor or hard-to-notice actions—e.g., positioning furniture so that particular objects are easy to see without having to approach them; positioning objects so as not to have to clean or move them.
Compulsions may take a verbal form, such as when one repeats certain words or phrases to reassure oneself or be reassured by others.
Compulsions can take the form of a mental strategy, such as when the means of removing the obsession is to replace obsessive thinking with a reassuring image or story, to count or to perform a “magic” ritual. This particular form of compulsion is also known as neutralization.
The Obsessive-Compulsive Cycle
Since the relief it brings is of limited duration, the compulsion is a gesture that has to be repeated and thus becomes a habit. The cycle is as follows:
1. The doubt in which the obsession is rooted persists.
2. The threat of danger arises again in one’s mind.
3. The sense of discomfort recurs.
4. The compulsion has to be repeated to neutralize the danger.
Compulsive Rituals
Since the same action is repeated incessantly, compulsions often take the form of a ritual.
In many cases, this ritual is felt to be annoying, embarrassing and pathetic.
It is often exhaustion that brings the ritual to a halt. The affected individual stops temporarily because of fatigue, not because the actions have provided reassurance.
How can Compulsions Be Identified?
The nature of the compulsion is determined by the obsession that causes it.
One way of identifying the thought causing the compulsion is for the affected person to ask the following questions:
"Why am I performing this action rather than another?"
"What consequences do I have to prevent?"
Typical Obsessions and Compulsions
| Typical Obsessions |
Typical compulsions |
| Fear of contamination by dirt, bacteria, disease, excrement, etc. |
Washing, taking many long showers, incessant cleaning |
| Fear of harming others as a result of carelessness (e.g., fear of causing an accident) |
Repetitive rituals, making sure that nothing terrible has happened |
| Excessive preoccupation with order and symmetry |
Arranging things in a precise order, placing or folding things in the same way |
| Fear of being afflicted by a serious disease such as cancer or AIDS |
Taking excessive measures to eliminate contact with contaminants |
| Perverted impulses, images or thoughts related to sexuality |
Invoking opposing images; reassuring oneself or asking for reassurance in a repetitive manner |
| Exaggerated concern about one or more body parts (e.g., fear that one’s nose is deformed or one’s skin is blemished) |
Spending hours in front of a mirror, putting on excessive amounts of makeup |
| Fear of being responsible for a terrible event |
Checking that doors are locked or that electronic devices are unplugged |
| Preoccupation with sacrilege, blasphemy or morality |
Prayer, performing mental rituals, using special numbers or words |
| Fear of throwing away an object that might be needed later |
Gathering and hoarding useless objects and papers |