Compulsions are repetitive, often ritualized behaviors that are intended to suppress the anxiety caused by obsessions. Compulsions common in OCD are the following:
- Asking for assurances
- Avoiding places or situations
- Doing certain tasks slowly and deliberately
- Doubting and checking, e.g., locks, lights, and ovens
- Hoarding possessions
- Ordering or arranging
- Repeating behaviors, including speech and action
- Washing, e.g., excessive hand-washing or bathing
Compulsive washing and cleaning are subsequent to the obsessive fear of germs or contamination. Compulsive people have been known to shower for 4 hours, or to wash their hands until they are raw. Others make sure their bath towels are arranged by some exact design, or that the soap is dry before they leave it. People may check the lock on a door several times an hour, or repetitively return home to make sure the oven is off. Some people count incessantly in an attempt to distract or soothe aggressive thoughts. Others depend on patterned behavior to control anxiety, such as avoiding traffic intersections or avoiding a change in routine.
A general theme of compulsive behavior is adherence to some often elaborate set of rules or routine. People with OCD will go to great lengths to satisfy the requirements of a routine, which often results in patterned, idiosyncratic behavior, e.g., slowly and meticulously preparing a bathroom for a shower that lasts for several hours. People who know OCD sufferers may call them perfectionists, especially if they only get a glimpse of the compulsive behavior.