Compulsions
Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. The behaviors are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive. Compulsions are a common feature of Obsessive-Compulsive Disorder (OCD), a disorder characterized by unwanted, intrusive thoughts (obsessions) and repetitive, ritualistic behaviors (compulsions).
Types of Compulsions
Compulsions can vary widely in their nature and intensity. Common types include:
- Cleaning: Repeatedly washing hands, cleaning household items, or other objects.
- Checking: Repeatedly checking things (oven turned off, door locked, etc.) that are associated with safety or fear of harm.
- Repeating: Repeating routine activities (going in and out of doorways, up and down stairs, etc.) a certain number of times or until it feels 'just right.'
- Ordering/Arranging: The need to arrange objects in a specific manner or symmetry.
- Counting: Counting while performing routine tasks to end on a 'good' or 'safe' number.
- Hoarding: Collecting and keeping items with little or no actual value.
Causes
The exact cause of compulsions and Obsessive-Compulsive Disorder is not fully understood, but a combination of genetic, neurological, behavioral, cognitive, and environmental factors are believed to contribute. Abnormalities in the brain, including in the orbitofrontal cortex, anterior cingulate cortex, and striatum, have been associated with OCD.
Treatment
Treatment for compulsions typically involves a combination of psychotherapy and medication. The most effective form of psychotherapy for OCD is Cognitive Behavioral Therapy (CBT), specifically Exposure and Response Prevention (ERP), which involves exposure to the source of fear and refraining from the compulsive behavior. Medications, such as selective serotonin reuptake inhibitors (SSRIs), can also be effective in reducing the symptoms of OCD.
Impact on Life
Compulsions can significantly impact an individual's quality of life, interfering with daily activities, work, and relationships. The time consumed by compulsive behaviors, along with the distress and anxiety associated with trying to resist them, can be overwhelming.
See Also
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Contributors: Prab R. Tumpati, MD