You’re laying in bed, just beginning to doze. Your sheets are soft, your alarm is set, your white noise machine is on, your pillow is cool, and your front door is absolutely locked. Isn’t it?
You’re sure you remember locking it. Or at least, pretty sure. But how sure are you, really? You should probably check, just to be extra sure. So you get out of your cozy cocoon and drag yourself to the front door, which you relock, just to really be sure. And now you’re laying in bed once again, just beginning to doze—but how sure are you that the door is locked, really? And if you’re wrong, what kinds of horrible consequences might follow? How can you just lay there when suddenly your brain is bombarding you with visions of home invasions? Better check just one more time.
If you have obsessive-compulsive disorder (OCD), this can go on for hours until you’re frustrated, overwhelmed, and completely exhausted. Checking OCD is a subtype that creates persistent doubts and fears, which fuel the urge to check certain things, even when there’s no logical reason to do so. And scientific data shows that each time you check actually reduces your confidence that the door is, in fact, locked. In other words—as is always the case with OCD—the pursuit of certainty only makes you less certain. Here’s what the research says about the effects of repeated checking, and how exposure and response prevention (ERP) therapy can help.
Checking as a compulsion
Checking OCD can make you feel like you’re constantly on the verge of making a grievous mistake or causing harm to yourself, someone you love, or an innocent stranger. In order to manage the distress, you might feel compelled to check your past actions.
The compulsion to check can be both physical and mental. While some common examples are repeatedly checking that doors are locked, windows are shut, and lights and appliances are turned off, you might also repeatedly check your phone to make sure you haven’t somehow sent an inappropriate message to your boss or posted embarrassing photos of yourself. You might also replay past events in your mind over and over, analyzing your behavior or a sequence of events in an attempt to be sure that nothing bad has happened.
Mental compulsions, or repetitive mental actions you perform in an attempt to soothe the distress of obsessions, can sometimes be more difficult to notice because their impact is less visible from the outside. However, that doesn’t mean they’re less impactful. If you don’t actually get out of bed to check whether you locked the door, but you still stay up all night replaying your memory of doing so, the urge to check is still hijacking your good night’s sleep. You might also be compelled to check by asking someone else to confirm that your memories are accurate, which can also be compulsive and can quickly bleed into reassurance seeking.
What the research shows: The more you check, the more you feel the need to check
It’s a perfect manifestation of the OCD cycle: When the distress of obsessions drives you to engage in compulsions, which provide temporary relief but ultimately just teach your brain that your distress is justified and only more compulsive behavior can assuage it.
Each time you engage in the compulsion to check, research shows that you are impacting your memory processes by muddying the very memories you’re trying to access or confirm. A study from Cambridge University Press found that “distrust in one’s memory is both a cause and a consequence of repeated checking.” Participants in a study at Concordia University who were asked to repeatedly check a stove experienced a decline in not only how confident they were about their memories, but also in how vivid and detailed those memories were.
Checking makes you less certain in the long run, but memory is imperfect even without it. OCD pushes you to chase absolute certainty about what you remember, but you can’t catch something that doesn’t exist—you can only stress yourself out trying.
Sometimes, OCD feels like it boosts your memory—in ways that create more anxiety
While checking can create a bias that makes your memory worse, OCD can also create a bias that makes you more confident in your memory. If your OCD drives you to check whether you’ve turned the stove off, it may also overemphasize your memory of the one time you left it on to “prove” that the possibility is always there. Those with contamination OCD have been shown to have a bias toward remembering objects they understand to be dirty. Rather than protecting you from harm, however, this bias is more likely to reinforce an urge to avoid these objects, or other substances, people, or environments you perceive as threatening due to contamination, even if they don’t actually pose a true threat. This avoidance can be a compulsion as well.
A heightened sense of responsibility can also influence your memory
Many people with OCD experience a sense of hyper-responsibility, which can feel like being absolutely certain that the well-being and safety of everyone in the world depends entirely on your behavior, even if there’s no logical connection between your behavior and the outcome you fear. When participants in one study were made to feel more responsible for the consequences of their actions, the perceived threat of that responsibility created a memory bias in favor of threatening information. In other words, if you’re reminded that a home invasion would affect everyone in your household, it can make checking feel even more important, and over-emphasize memories that reinforce your fears, like a time you did forget to lock the door.
One important thing to note: The researchers also found that “responsibility appears to have had a greater impact on confidence in memory than on memory itself in OCD.” Basically, while it might feel to some like obsessively checking your memories and past actions has made you meticulous and honed your recall, it’s more likely that feelings of hyper-responsibility are helping to reinforce these harmful habits without actually improving memory at all.
How ERP can help reduce the urge to check
OCD is all about chasing an unattainable level of certainty. But memory is inherently fallible, and one of the key goals of exposure and response prevention (ERP) therapy if you have checking OCD or a checking compulsion will be increasing your ability to sit with the discomfort of that fact.
ERP is a proven, evidence-based form of therapy designed specifically to help those with OCD gradually learn to resist compulsions when confronted with their fears. Research demonstrates that ERP is “the therapy that has shown the most empirical evidence of its efficacy,” with 80% of recipients experiencing relief from OCD symptoms. A peer-reviewed study led by NOCD also found that ERP teletherapy, which can be more accessible for many people, is effective across all OCD subtypes, with an average 43.4% reduction in OCD symptoms and a 62.9% treatment response rate.
If you can’t sleep because of your compulsive need to make sure the door is locked, your therapist might guide you to practice going to bed without checking on the door. To work toward this point, you might start by noticing the compulsion to check and delaying the behavior, or reducing the number of times you check. This gives you the chance to build your tolerance for the discomfort OCD causes, and teach your brain that you don’t need compulsions to keep you safe. In this situation, they will also work with you to address how the unease you are learning to sit with might affect your ability to fall asleep.
Checking rituals can take up your time and mental energy, disrupt your sleep and daily schedule, and undermine your faith in yourself and what you recall. By learning to accept uncertainty, you can break out of this cycle—and you’ll likely feel a bit more confident about your memory, too.
