Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is a neurological disorder that is characterized by recurrent involuntary obsessions (obsessive thoughts) and compulsions (involuntary actions).  It is part of a spectrum of neurobiological anxiety disorders as well as one of a number of regulatory disorders. OCD involves the deregulation of thoughts and actions. A person with OCD experiences worries, doubts, fears or faulty beliefs that are excessive, lack logic and reason, cause distress, interfere with the daily functioning of a routine, and usually take up more than one hour per day.

While many people may at times experience some of these characteristics, the individual is considered OCD when the actions and thoughts become compulsive and interfere with daily normal behaviors. These behaviors can be difficult for outsiders to interpret. As an example, a child may appear to have difficulty reading due to a decoding problem, when actually he is experiencing OCD behavior and is counting all the words that have exactly six letters.

Obsessions consume time, provoke anxiety, and interfere with family, school, and life functioning. They are ideas or feelings that enter the child’s mind and at times are unreasonable, illogical, and experienced as real. Obsessions are intrusive, repetitive, unwanted thoughts, and can provoke profound anxiety and other emotional discomfort.

Common Obsessions:

  • Symmetry and order
  • Doubting and worrying (leads to indecisiveness)
  • Perfectionism with regards to work, words, people, physical environment, or appearance
  • Need to experience sensations (burn, cuts)
  • Issues with dirt, germs, cleanliness, or contamination (fear of germs or infection)
  • Counting or lucky numbers
  • Specific words and phrases
  • Aggressive thoughts or images (sexual or gruesome)
  • Dangerous or terrifying thoughts
  • Religious or moral scrupulosity (perhaps praying excessively)
  • Object placement or arrangment


Compulsions are repetitive, ritualistic behaviors and are frequently associated with an obsession. They frequently appear meaningless and illogical, but a person is driven to do these compulsive behaviors to ease anxiety. Hand washing, which is often considered the most well-known compulsion, may not be present in many OCD individuals. Some OCD individuals do not have both obsessions and compulsions. Compulsions are behaviors that are in direct response to troublesome, obsessive thinking. Compulsive behaviors are done in order to reduce obsessive thoughts.

Common Compulsions:

  • Ordering, counting, arranging, evening up
  • Lining items up
  • Touching, fiddling
  • Correcting or “perfecting” work (e.g. repeatedly erasing, rewriting)
  • Cleaning, sanitizing
  • Smelling objects
  • Superstitions
  • Doing what is forbidden
  • Needing to finish or ask same questions
  • Stuck/perseverating, repeating, erasing, rewriting
  • Exiting, entering, or navigating an area in an exact manner
  • Picking at skin, nail biting
  • Pulling hair out (Trichotillomania)
  • Repeated checking of doors, locks, electrical appliances, or light switches
  • Frequent cleaning/washing of hands or clothes
  • Strict attempts to keep various personal items in careful order
  • Repetitious mental activities, such as counting or praying
  • Washing repeatedly (hands and body)
  • Completing procedures in a rigid order with no deviation (e.g. getting ready for bed)
  • Constantly checking up on things
  • Endlessly rearranging objects
  • Hoarding objects in a work area, home, or vehicle
  • Making something fit, sound, or appear “just right”

“Just Right” Characteristics

  • Keeping pencils sharpened
  • Darkening circles on forms
  • Straightening items on desk
  • Counting objects
  • Straightening pictures
  • Tell me again
  • Just the right food (in terms of type, placement, or amount)
  • Evening up
  • Saying it just right
  • Writing it just right
  • Doing or performing it just rightMaking something feel just right (e.g. sock  seams)