Compulsive behaviors are repetitive mental or physical acts that people with obsessive-compulsive disorder (OCD) perform to relieve anxiety caused by intrusive thoughts. They are one of the core signs of OCD and can take many forms, from visible actions like washing to mental rituals like rumination. Unlike habits, compulsions are driven by fear or discomfort and can interfere with daily life.
Research shows that OCD affects about 2-3% of the global population, and compulsions are a defining feature of the condition.
Continue reading to gain a deeper understanding of what compulsive behaviors are and how to seek help.
What are compulsive behaviors in OCD?
Compulsive behaviors in OCD are repetitive physical or mental actions carried out to reduce distress caused by obsessions. Obsessions are intrusive thoughts, images, urges, feelings, or sensations that cause significant fear and anxiety. Compulsions are attempts to neutralize those thoughts or prevent a feared outcome.
“People will describe a compulsion as something they feel they have to do—or are drawn to,” says Patrick McGrath, PhD, Chief Clinical Officer at NOCD.
For example, someone who fears a fire might repeatedly check that the stove is turned off. The relief from performing compulsions is temporary, which keeps the OCD cycle going.
What are common examples of compulsive behaviors?
Compulsions vary from person to person, but most fall into recognizable patterns.
Here are the most common types:
Checking compulsions
- Repeatedly checking that doors are locked or appliances are off
- Reviewing work or messages over and over to avoid mistakes
Cleaning and washing compulsions
- Excessive handwashing, showering, or sanitizing
- Cleaning objects or spaces far more than necessary
Repeating compulsions
- Repeating words, phrases, or actions until they feel “just right”
- Rereading or rewriting the exact text multiple times
Mental compulsions
- Silently praying or reciting words to prevent harm
- Mentally reviewing past actions to “prove” nothing bad happened
- Repeatedly seeking reassurance in one’s mind
Ordering and arranging compulsions
- Lining up items until they look symmetrical
- Organizing objects into exact or rigid patterns
Counting compulsions
- Performing actions a certain number of times
- Avoiding unlucky numbers or repeating tasks until a “safe” number is reached
How are compulsions different from habits or routines?
Compulsions differ from habits because they are driven by fear, anxiety, or a sense of danger. Habits and routines are often automatic and helpful—like brushing your teeth before bed. Compulsions, on the other hand, feel urgent, difficult to resist, and provide only temporary relief before the cycle restarts.
How can you recognize the signs of compulsive behavior?
Signs of compulsive behavior include:
- Spending an hour or more per day on rituals
- Feeling unable to resist the urge to perform certain actions
- Performing behaviors to reduce fear, not for enjoyment
- Temporary relief that quickly fades, leading to repetition
When should you seek help for compulsive behaviors?
If compulsive behaviors are interfering with daily functioning, relationships, school, or work, it’s best to seek professional help. If rituals feel uncontrollable, time-consuming, or distressing, getting support from an OCD specialist can provide relief. Early treatment is crucial in preventing symptoms from worsening.
How are compulsive behaviors treated?
The most effective treatment for compulsive behaviors in OCD is exposure and response prevention (ERP) therapy. ERP is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms.
Studies show that ERP therapy is highly effective, with 80% of people with OCD experiencing a significant reduction in their symptoms.
Other approaches that may help include:
- Medication (typically SSRIs)
- Mindfulness-based strategies
- Acceptance and commitment therapy (ACT)
These are typically done in combination with ERP therapy, depending on the individual’s needs.
Severe or treatment-resistant OCD may benefit from the following therapies:
- Intensive outpatient programs (IOPs)
- Partial hospital programs (PHPs)
- Residential treatment centers (RTCs)
- Transcranial magnetic stimulation (TMS)
- Deep brain stimulation (DBS)
- Gamma knife radiosurgery (GKRS)
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Bottom line
Compulsive behaviors are a central feature of OCD, taking many different forms such as cleaning, repeating, or mental rituals. While they may bring short-term relief, they ultimately strengthen OCD over time and can significantly disrupt daily life. Recognizing compulsions and seeking treatment is the first step toward recovery, and proven options like ERP therapy and medication can help people regain control.
Key takeaways
- Compulsions are repetitive actions done to reduce distress caused by intrusive thoughts.
- They differ from habits in that they are driven by fear and are difficult to resist.
- Common compulsions include checking, cleaning, repeating, mental rituals, ordering, and counting.
- Compulsions often interfere with daily life, but effective treatments like ERP and medication are available.