Many of us occasionally have thoughts about avoiding germs from shaking hands, refraining from using drinking fountains or public bathrooms, or being fearful of getting too close to those who are sick. When we find ourselves constantly thinking about cleanliness or avoiding contagions and can’t get these thoughts out of our minds, when they consume our time or frequently cause us stress, we may have obsessive-compulsive disorder.

Obsessions are thoughts, ideas, images or impulses that we can’t seem to get out of our head and cause us to become anxious. They usually involve repeated doubts and worries, constant thoughts about contamination, distressing images (either horrific or sexually disturbing), and impulses that we fear we might act on or can’t control.

The typical way we try to deal with these obsessions is to push them down into the smallest nooks and crannies of our psyche, pretending they don’t exist, or to escape or avoid anything that creates tension. If we attempt to neutralize this internal tension by repetitive behavior, this could be considered compulsion.

Compulsions are behaviors or actions we continually repeat to relieve tension or discomfort. The most common types of compulsions are repetitive mental or physical behaviors, such as putting things in order, checking things repeatedly, washing hands, counting to oneself or saying certain words – all done with the intention of reducing stress and anxiety.

After unsuccessful attempts to turn off the negative, obsessive thoughts or compulsive acts, we give up trying to resist, letting them rule our day and dominate us. Most of us lack the time and energy to process the daily barrage of impressions, images, drama and problems that face us. Instead of trying to make meaning out of our day through reflection, we turn on the television, have a glass of wine or a beer, or get lost in Facebook.

Obsessive thoughts and compulsive actions, when allowed to run amok, possess us by causing us to think we are prisoners to them. We can instead try something different than ignoring or transferring the pain.

First, we can try getting out into nature. When we’re able to immerse ourselves in our sensations – at the beach, mountains, or in the desert – we start to become more mindful, grounded and relaxed. Another way would be to practice rhythmic, repetitive movements with our breathing, such as running or brisk walking while breathing deeply and swinging our arms.

Doing an evening review of your day through noting thoughts and feelings and letting go of anything upsetting is another way to deal with unresolved issues. Using journaling to write down your inner emotions and negative thoughts is ideal.

Substituting thoughts or actions with a prayer, mantra or positive image works well. Meditation, the quieting of the mind and turning off thoughts, achieves peace and calm. It is only through reflection that we gain insight into our lives.

Meeting with a psychologist to reveal the patterns that have created this anxiety can be helpful. If you feel acutely anxious above and beyond obsessive traits or compulsions, you may need to see a psychiatrist and augment these procedures with medications.

Thomas Conte Manheim is a clinical psychologist specializing in the treatment of anxiety and depression. He practices in Del Mar/Solana Beach and can be reached at tom@moneyandsoul.com