OCD Symptoms: Obsessions and Compulsions

OCD is a chronic condition with two groups of symptoms. These are unwanted thoughts, or obsessions, and compulsions.

Symptoms of obsessions

Obsessions are intrusive repetitive thoughts, images, or urges that cause intense stress. The one thing obsessions have in common is that they’re unwanted and often distressing.

According the the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), you’re experiencing obsessive symptoms when:

  • you experience stressful thoughts or urges that keep coming back
  • you have methods for trying to make these thoughts go away or calm the stress related to them

Obsessive thoughts can include many focuses. Some common themes in obsessions related to OCD include anxiety about:

  • contamination
  • religion
  • sexuality
  • doing harm to others or yourself
  • losing control
  • sickness or disease
  • perfection or symmetry

OCD obsessions can vary. If you’re experiencing obsessions but don’t see yours listed, it certainly doesn’t mean you don’t have OCD.

Symptoms of compulsions

The more you fight an obsession, the stronger it might seem to get — and that’s enough to make most people anxious. So where do compulsions come in? If you experience obsessions, you might engage in a compulsion to reduce anxiety caused by the obsession.

But what is a compulsion? In short, compulsions are repetitive thoughts or actions you feel a need to act our when you experience an obsessive thought. You might use compulsions to reduce anxiety about an obsessive thought.

Similar to obsessions, compulsions can come in many forms. Some people might have compulsions to do physical actions. Other people act out compulsions with their thoughts.

Here are some examples of compulsions:

  • Excessive praying to prevent harm or ask for forgiveness.
  • Doing things exactly right to prevent harm. For example, not missing a spot while cleaning the table to prevent contamination or sickness.
  • “Canceling” or “undoing” (replacing a negative word with a good word to cancel out the bad vibes).
  • Counting or performing other rituals to prevent harm.
  • Washing, cleaning, showering, and grooming to avoid contamination.
  • Constantly checking if you locked the door or turned off the oven.
  • Arranging objects until it feels “right.”
  • Repeating activities until it feels “right.”
  • Driving back to where you came from to make sure you didn’t hit a pedestrian.
  • Not using, touching, or wearing certain clothes or objects to prevent harm.

Insight and OCD

Very often, people with OCD recognize that their obsessions and compulsions aren’t making any logical sense, but they often feel compelled to do them anyway.

Research suggests that insight plays a large role in how well treatment works for someone with OCD.

When it comes to OCD, insight is defined as the ability to perceive and separate reality from obsessive thoughts.

This can be difficult for many people, as the thoughts and feelings of OCD feel much stronger than their typical thoughts. These obsessions tend to bulldoze over any logical, opposing thoughts.

But having insight about how the condition works rather than getting swept up in what it’s telling you can make treatment easier.

According to the DSM-5, OCD insight is categorized as on a scale from good to absent:

  • Good or fair insight: You know that many of the beliefs that come with your OCD symptoms either aren’t true or probably aren’t true.
  • Poor insight: You think many of your OCD-related beliefs are probably true.
  • Absent insight: You believe the thoughts you have related to OCD represent reality.