A Guide to Recognizing and Conquering Mental Compulsions

Often, when we consider compulsions that occur with OCD, we think of those we can see like handwashing, checking locks, or rearranging. However, compulsions can also be invisible or “mental” and be more difficult for even the sufferer to identify

Common mental compulsions include 

• Self-reassurance: Trying to reassure yourself by finding evidence against anxious thoughts (spoiler alert: OCD only cares about possibly, not probability)
• Mentally reviewing or replaying situations or interactions with others 
• Checking reactions: for example, in moral OCD, to make sure you’re a “good person” 
• Body scanning: checking for physical sensations or symptoms
• Thought neutralizing: replacing “bad” thoughts with “good” ones

So how can we be more aware of these? Pay attention to your intentions. Engaging with thoughts in any way with the intention of reducing anxiety or trying to find certainty is likely a compulsion. 

Why is it important to identify these? 

Mental compulsions keep you in OCD’s cycle. Even if you’re working on reducing other compulsions through Exposure and Response Prevention (ERP) therapy, continuing to let mental compulsions fly under the radar could be keeping you stuck. The goal of exposures is often to learn that you do not have to engage in compulsions or safety behaviors to get through an anxious or uncertain situation. Therefore, if mental compulsions are still occurring, you’re missing a key component that makes ERP so effective.

But they feel automatic 

While it’s true that we cannot control our thoughts, we can control our thinking and what we choose to do about those thoughts. The goal is not to be free of intrusive thoughts (most people have them) but rather to allow them to come without engaging with them. You can actively make the choice not to ruminate. 

Alternate responses to distressing thoughts

Use cognitive diffusion – insert “I’m having the thought that” in front of the thought. This provides separation from thoughts and reality.

Use non-engagement responses like “I’m having the urge to (insert mental compulsion here) but I know that doing so will only keep me stuck.”

Use humor – “good one OCD” or “what will you come up with next, brain?” 

Engage in a values-based activity – take the uncomfortable thoughts with you as you do something you enjoy or value (we’re not letting OCD rob us of any more time). 

If you want to start working toward freedom today, start noticing mental compulsions when they occur. If you don’t feel ready to start resisting them yet, that’s ok, awareness is an important first step. Use the data that you acquire and share it with your therapist if you have one. If you don’t have one yet, we’d love to hear from you.