As the name indicates, OCD consists of two major components: obsessions and compulsions. The obsessions include thoughts, images and urges that trigger feelings of fear that something bad will happen—that harm will come to us or someone else, or that we will forget something important, or perhaps that something is inherently wrong with us. When we suffer from OCD the feelings that invade our brains are intensely uncomfortable, unwelcome, highly intrusive, and seemingly uncontrollable. People experiencing these obsessions are left feeling a sense of fear, dread, or disgust, or sometimes simply perceiving that something is “not right.”
Some common obsessions include:
- fears of contamination (dirt, germs, disease)
- fears related to safety (of harming someone or being harmed)
- a need for symmetry or order
- inappropriate thoughts or urges
Compulsions are the second element of the disorder. They are either physical or mental responses to the obsessions. They are the things we do to avoid a consequence we dread, a worry or fear, or to “set things right.” They are intended to bring feelings of relief and safety, but there is a problem with that, which we will get into later.
Some common compulsions include:
- repeatedly washing or cleaning
- checking things like whether appliances are turned off or doors are locked
- ordering or arranging items
The list above consists of compulsions that can be observed, but there are some that are not so obvious, like saying a prayer to drive away a disturbing thought or image in your mind. Others might be rumination on past events, scanning their memories for information to reassure themselves about whether they picked up that toy from the stairs or turned the burner off, or perhaps whether something they said to the last person they saw was not totally inappropriate.
Striving for inner reassurance is not often considered by people to be a compulsion, compared to the more outward forms of repetition and less-than-preferable engagement. Just because the OCD cycle is not engaging a person in physical activity that we can be seen, it is still sapping valuable time and energy from their lives, and it can affect others directly. People suffering from OCD do not always keep their reassurance-seeking behaviors bottled up—they go looking for it from outside sources, such as talking with a specialist, conducting their own research, or engaging with a trusted relative or friend. That last behavior is especially common in children with OCD and is often how family members get pulled into the OCD experience. The OCD can become almost like another family member that is setting the rules for everyone, telling them all where they can’t go and what they can’t do and why.
