Obsessions are intrusive, unwanted thoughts that trigger anxiety, distress and uncertainty.  People perform compulsions to neutralize fears or attempt to make obsessions go away.  Compulsions are not pleasurable, but rather behaviors people feel forced against their will to perform in order to avoid a future catastrophe.  There is a sense of loss of control because of the inability to stop engaging in ritualistic behaviors, even if there is some insight that they are irrational and unproductive.

Every human does a small amount of compulsive behavior, but it doesn’t normally get in the way of a happy, healthy, and productive life.  It is a common occurrence to hear someone announce how they are “so OCD!”  Almost 100% of the time if I say I treat OCD for a living at a cocktail party, people respond by asking “Do you have a business card for this one?” gesturing to the person next to them.  It is not immediately clear if they have the fake or the real kind, but real OCD is no joke.  It is a severe and debilitating disorder that makes the sufferer feel imprisoned by simple tasks and experiences most people take for granted.  Diagnosable OCD refers to obsessions and compulsions that take at least 1 hour per day, but most often tend to steal even more time away.  Sufferers often find that compulsions are so time consuming that valued life activities often take a back seat to them.

Why are compulsions important?

Compulsions are the fuel to the fire of OCD.  By continuing to pour gasoline on OCD’s flame by performing compulsions, OCD strengthens and spreads quickly to other areas like a brush fire.  Eliminating compulsions is like placing a cover over the flame, depleting the oxygen OCD needs to continue to thrive.  In OCD treatment, there is a major focus on compulsions because they are normally the most concrete and accessible way to target the disorder.  We can’t always control our thoughts and feelings, but we can control our behavior.  Since thoughts, feelings and behaviors are interrelated, if we change our behavior then our thoughts and feelings follow.  In other words, finding a way to discontinue compulsions is the way to decondition anxiety and have less frequent and intense obsessions.  This must occur in conjunction with repeated exposure to fears using a form of behavioral therapy called Exposure and Response Prevention (ERP).

Disclaimer: The information contained on this site is for informational, educational, and referral purposes only; it is not meant to replace face-to-face counseling, traditional therapy, or serve as medical advice.

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