In the article What is Obsessive-Compulsive Disorder?, we discussed intrusive and repetitive thoughts. However, the second part of obsessive-compulsive disorder, "compulsion," refers to the behavior or mental activity that a person performs to reduce the anxiety caused by those thoughts.

What is Compulsion?

Compulsion refers to a repetitive behavior or action that an individual feels compelled to perform according to a strict rule; the goal is usually to reduce anxiety caused by an obsessive thought or to prevent a perceived negative event. This behavior can be external and observable (such as repeated hand washing) or completely mental and hidden (such as counting in one's mind).

Common Examples of Compulsion

  • Repeated hand or body washing, beyond normal hygiene needs
  • Frequent checking of door locks, gas valves, or electric stoves
  • Arranging or organizing objects until a sense of "rightness" is achieved
  • Counting, repeating specific words or phrases in one's mind
  • Seeking frequent reassurance from others about a specific concern
Close-up of a shiny metal door handle under natural light from a window

The Vicious Cycle: Why Do These Behaviors Make the Problem Worse?

Compulsion usually reduces anxiety in the short term, which leads the brain to learn that the behavior was "effective." However, this reduction is temporary, and in the long term, a vicious cycle forms: intrusive thought ← anxiety ← compulsive behavior ← temporary reduction of anxiety ← stronger return of intrusive thought. For this reason, effective treatments such as exposure and response prevention approaches specifically target this cycle. This issue is closely related to generalized anxiety, as both are intertwined with repetitive patterns of attempting to control anxiety.

Overhead view of two hands arranging several small objects neatly on a table

Is Every Repetitive Behavior a Compulsion?

No, not necessarily. Daily habits or personal rituals (such as a fixed morning routine) are usually not concerning if they do not cause distress and are flexible. What matters is the feeling of compulsion, distress when resisting the behavior, and its impact on the individual's time and daily functioning.

What is the Treatment Path?

A specialized assessment can determine whether these patterns fall within the framework of obsessive-compulsive disorder. For more information about treatment options, read the article How is Obsessive-Compulsive Disorder Treated?.

Close-up of a simple wall clock on an empty wall with soft lighting

Summary for Patients

Compulsion is a repetitive behavior or mental action performed to reduce anxiety but reinforces the anxiety cycle in the long term. Recognizing this pattern is the first step in breaking the cycle, and with specialized help, one can follow the path to improvement.

Sources

  • International OCD Foundation — Compulsions
  • Mayo Clinic — Obsessive-compulsive disorder (OCD)
  • National Institute of Mental Health — Obsessive-Compulsive Disorder
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