Exploring the Seen and Unseen: Compulsions & Mental Rituals in OCD
Imagine you are hiking on a beautiful trail in your favorite national park. You reach a series of stepping stones across a flowing stream. Each stone represents a thought in your mind. For some people, stepping on the stones is a straightforward task. They can move on without much concern. However, if you have OCD, it is not so straightforward. You feel an intense need to step on each stone in a very specific way. Maybe you have to tap it a certain number of times or arrange them in a particular order.
A part of you knows that how you step on the stones doesn't affect the outcome of your hike. But emotion trumps logic. You feel an overwhelming sense of discomfort and anxiety if you don't follow the ritual precisely. Your mind insists that something terrible might happen if you do anything different. The compulsion feels like a relentless urge. It's a demand that must be met to stop the anxiety, even though it might not make logical sense to anyone else. If you can relate to this, you may experience Obsessive Compulsive Disorder (OCD). OCD is a powerful force in your mind that tells you what to think or how to behave. In this blog, you will learn more about compulsions, mental rituals and ERP therapy that can help you break the cycle.
What is OCD?
The term "OCD" is often misused in our society. This contributes to misconceptions about the disorder. Have you ever heard of someone using the term "OCD" as an adjective to describe an organized person? Maybe someone has claimed to have "a little bit of OCD" because they prefer order or cleanliness in certain aspects of their lives. These are misrepresentations of OCD and oversimplifies the complexity of the actual condition. OCD is also not anxiety! OCD can cause anxiety but it is not the same as anxiety.
OCD is a mental health condition that affects 1 out of every 40 adults and 1 out of every 100 children. That means if you know 40 adults, you know someone living with OCD. It also means that if you have OCD, you are not alone. OCD is a combination of obsessions and compulsions. Obsessions are persistent, intrusive thoughts. These are the type of thoughts that no matter how hard you try, they won't go away. It's like playing the most annoying song on repeat in your head. Compulsions are repetitive behaviors or mental acts that stem from obsessions. Compulsions are not choices. They are urges that you cannot control and create a lot of stress and anxiety. If you don't act on the OCD compulsion, your anxiety increases. The problem is that OCD is a double edge sword. Acting on a compulsion reduces anxiety in the short term but ultimately strengthens the obsession. As a result, you feel trapped in a cycle of anxiety and compulsive behaviors.
Types of OCD Compulsions
There are many different types of compulsions with OCD. Below we will explore 4 common ritualistic behaviors and how they can manifest. It's important to note that these examples are just a few manifestations of OCD. If your compulsion is not on this list, there isn't anything wrong with you. You are not beyond help! It can be helpful to recognize your compulsions. While providing temporary relief, they can significantly impact daily life. They take up a lot of time and result in problems at work or school. Compulsions can feel more urgent or important than completing a work project or studying. Your relationships can also suffer. You might struggle to be fully present with others because of your compulsive behaviors.
Washing and Cleaning:
Washing and cleaning compulsions are ritualistic behaviors driven by obsessive fears of contamination. As a result, you repeatedly engage in excessive cleaning or washing routines.
Example: Washing hands repetitively throughout the day. People tell you are doing it more than what is considered "normal hygiene." Your hands are raw and cracked but you can't stop. Even when they are not visibly dirty, you can't help but wash them. You have to do the "right" way, with soap and water exactly seven times. There is a strict routine of scrubbing that you hate when people get in the way of.
Checking:
Checking compulsions involve repetitive behaviors or rituals driven by obsessive fears. This leads you to repeatedly verify or inspect certain things to reduce anxiety or prevent perceived harm.
Example: When you leave the house for work, you feel the urge to check if the door is lock. You turn the doorknob three times to the right and then three times to the left. You walk away from the door, return, and check the lock again. You create a mental checklist of the locked doors in the house. Despite trying to resist the urge, you go through each one multiple times before feeling okay. You are never completely satisfied. This happens on a daily basis.
Ordering and Arranging:
This compulsion compels you to arrange and organize items in a specific way to stop anxiety and create a sense of control.
Example: When you walk into your house, you have to arrange the shoes in the hallway in a specific order. They have to be perfectly aligned with the toes pointing outward. Throughout the day, you check and rearrange the shoes multiple times, even if they were already arranged correctly. If you don't do this, something terrible with happen to someone you love.
Hoarding:
Hoarding compulsions involve the persistent difficulty discarding possessions, regardless of their value. As a result, you excessively save items, often resulting in cluttered living spaces and significant distress.
Example: There’s a piles of magazines around your apartment. Even though you haven't read them in years, you can't throw them out. What if you need them later? Wasn't there an article you wanted to keep? There is a fear if you get rid of the magazines, clothes, containers, etc something bad will happen. You can't put your finger on what exactly that bad thing is, but you know it will be bad. Every time you think about throwing something away (or recycling it) you get anxious.
Recognizing the Signs of Mental Rituals
Mental rituals are tricky little guys. They are a type of compulsive behavior that occur entirely within your mind. As a result, you can't observe them! This makes it harder to notice and identify them. Mental rituals can be by created intrusive thoughts. The compulsions we explored above are all physical actions. Unlike these physical rituals, mental rituals involve repetitive and often distressing thought processes. The purpose of mental rituals is to help reduce anxiety, prevent perceived harm, or neutralize obsessive fears. Even though they can't be seen, that doesn't mean they don't come with consequences. They can be equally as time-consuming, distressing and impactful on your daily life. Examples of mental rituals include:
Mental Reassurance Seeking:
This involves seeking reassurance in one's mind by replaying scenarios or asking oneself questions to alleviate anxiety.
Example: You are driving home and suddenly experience an intrusive, distressing thought. You fear you might have accidentally hit a person at a busy intersection. Immediately you begin to replay the entire scenario in your mind. Every detail of the drive through the intersection is scrutinized. You are desperately seeking reassurance that you did not hit anyone. You repeatedly yourself questions like, "Did I feel a bump", "Did I hear any unusual sounds?" or "Was there any reason to believe I hit someone?" The mental ritual involves a relentless review of the scenario to stop the anxiety associated with the obsessive fear.
Mental Checking:
Mental checking involves repeatedly reviewing thoughts or memories to ensure that nothing harmful or negative happened.
Example: Last week you went to a party with a few close friends. Ever since, you can't stop thinking that you might have said something offensive or inappropriate. You repeat the details of the conversation in your minds. You analyze everything you said to identify any potential harmful remarks. Each conversation is analyzed from every angle, trying to figure out how each word might have been interpreted.
Mental Counting:
Mental counting is the act of counting or recounting mentally to a specific number to ward off anxiety or prevent a perceived negative outcome.
Example: Before you leave a room, you feel compelled to count the number of objects in the room. This could be books on a shelf or tiles on the floor. The count must reach an exact number, let's say 15. If you aren't able to count to 15 before leaving, you are convinced something bad will happen. It doesn't feel right to only count the books once. You have to count them over and over to make sure you didn't make a mistake. When you count, it has to be done in a specific way like in multiples of 3 or in a particular sequence.
Mental Reviewing:
Constantly going over past events or conversations to make sure nothing harmful occurred.
Example: You can't get the conversation you had with your best friend 3 months ago. It's on repeat in your head. With a fine toothed comb, you go through everything ensure you didn't say or do anything wrong. You doubt your own memory and intentions, even though your friend has told you countless times they aren't mad at you. To make sure nothing bad happens in the future, you role play conversations that could happen.
Mental Canceling:
Mental canceling attempts to neutralize distressing thoughts by "canceling" them in your mind or undoing them with positive thoughts or actions.
Example: You have the thought that you might have accidentally wished harm upon someone you love. In an attempt to "cancel" or "undo" the distressing thought, you immediately think a positive or opposite thought. The thought, ""I love them and wish them well" repeats through your mind. You also repeat to yourself, "I would never harm anyone" or "I only wish good things for my loved ones" in an attempt to counteract the distressing thought.
Breaking the Cycle of OCD with ERP Therapy in Detroit
Exposure and Response Prevention (ERP) is one of the most effective treatments for OCD. But what is it? ERP is a type of cognitive-behavioral therapy (CBT). ERP works by exposing you to situations, thoughts, or images that trigger your obsessive fears. This allows you to confront the anxiety-provoking situations without engaging in compulsive behaviors or mental rituals. If you are thinking to yourself, "absolutely not," you are not alone. Please keep reading before you completely rule out this OCD treatment.
There is a reason that you are asked to face your fears and resist the urge to perform compulsive acts. You gradually learn that the anticipated harm or negative outcome does not occur. You learn that if you don't count to a certain number or wash your hands a specific amount, that bad thing won't happen. The goal is to not just learn this cognitively. By now, many people have said to you, "just stop" or questioned why you do what you do. If you could stop, you would have already. You cannot think your way out of a compulsion or mental ritual.
Over time, ERP helps to break the association between the obsessive thoughts and the compulsive rituals. You will be less anxious and no longer have the compulsion to perform rituals. You will no longer fear something bad will happen if you say or do something "incorrect." ERP empowers you to tolerate uncertainty and manage distress. This creates a lasting relief from the grip of OCD.
Start OCD Counseling and ERP Therapy in Detroit, MI Today!
If you recognize signs of compulsions or mental rituals, you have come to the right place. At Embodied Wellness, PLLC, we offer ERP in Detroit via online therapy. Our OCD counselors have specialized training and are here to help you get control over your thoughts and actions. We believe that with the right support, you can break the cycle of OCD. Follow the steps below to get started with us at
Fill out our contact form to schedule a free therapy consultation.
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Life free of mental rituals and compulsions.
Additional Offering at Embodied Wellness throughout Michigan
At Embodied Wellness, PLLC, in addition to traditional OCD treatment and ERP therapy, we offer other forms of counseling as well. We offer holistic therapies including EMDR, Somatic therapy, Internal Family Systems, therapy for empaths, and DBT. We also offer Teen and Adolescent Counseling, Trauma and PTSD treatment, and depression treatment. OCD no longer has to control your life. We are here to help!
About the Author:
Sarah Rollins, LMSW, SEP is the founder of Embodied Wellness, PLLC, a group therapy practice providing online therapy in Michigan. She is passionate about expanding awareness of somatic therapy as way to treat and heal trauma. She incorporates other holistic treatments into her practice including EMDR and IFS.