What are Examples of Mental Compulsions? Here’s a list from an OCD Therapist in San Francisco
Obsessive-Compulsive Disorder (OCD) is often depicted by repetitive physical behaviors that seem excessive: frequent handwashing, constant checking of the locks, and precise organization. But OCD is much more than that. One of the unseen struggles is the experience of mental compulsions, also known as mental rituals. In this blog, I’ll provide examples of mental compulsions that are commonly seen to help you better understand this often misunderstood and overlooked aspect of OCD.
Let’s start with the basics: What is a mental compulsion or a mental ritual?
Mental compulsions are unobservable mental behaviors that individuals engage in to reduce the anxiety or distress caused by their obsessions. They may also be done to prevent a perceived negative consequence from occurring. These mental rituals can be just as time-consuming and distressing as physical compulsions. Some people with OCD do not experience any physical compulsions at all, their OCD is all mental. This particular OCD subtype with only mental compulsions is sometimes referred to as Pure Obsessional OCD or ‘Pure O’.
So now, what are some examples of mental compulsions?
Below, is a list of mental compulsions commonly seen with OCD. You’ll also see an example of how these can appear with different OCD subtypes.
Mental reviewing
This involves replaying and reviewing past situations. It could include a past conversation, an event, a memory, etc. Individuals may engage in this behavior to figure out the meaning of something, ensure that they remember how something played out, confirm whether something did/did not happen, etc.
Harm OCD Example:
“You probably caused an accident while driving home.”
You spend hours mentally replaying the entire route you drove earlier. You try and remember specific moments to ensure you didn’t accidentally hit something, miss a traffic signal, etc.
Mental checking
Checking can be physical (i.e. checking to see if a door is locked, if an appliance is unplugged, if the light is turned off, etc.) Checking can also include mental monitoring or scanning. Some examples include checking feelings, memories, bodily sensations, signs of arousal, etc.
Contamination OCD Example:
“What if that fork that I ate with was dirty?”
You mentally scan your body for signs of illness and try to recall if the fork looked clean or if anything felt ‘off’ when using it.
Mental prayer
Prayer can be a healthy practice and a way to connect with one’s religion and faith. Prayer as a mental compulsion is not done with this intention. It is driven by anxiety, guilt, shame, or another distressing emotion. It may be used to prevent a feared outcome from occurring or to reduce uncomfortable feelings.
Religious Scrupulosity OCD Example:
“One of your past mistakes has upset God.”
You compulsively pray for forgiveness and repeat the prayer every time you have this obsession.
Counting
Counting can happen out loud or mentally. It can include counting numbers, patterns, objects, or actions. For example, doing everything is 4’s, counting how many times you chew before you swallow, counting patterns, etc. Some individuals have unique counting rituals that must be performed a certain way.
Magical Thinking OCD Example:
“Something bad might happen to my family if I don’t do things in even numbers”
You mentally count throughout the day to ensure that everything is done in even numbers (number of steps before stopping, number of chews before swallowing, number of items in your shopping cart, number of toilet paper squares used, etc.)
Mental comparison
This involves finding similarities or differences between their thoughts, behaviors, or lives, compared to others. This could also include comparing current emotions, thoughts, sensations, and situations, with past ones. The purpose is usually to prove something is true or untrue, or to gain certainty around something.
Suicidal OCD Example:
“What if I’m suicidal and I don’t know it?”
You compare yourself and your life to stories of others on social media, the news, or celebrities, who have died by suicide. You look for similarities/differences that could provide a clearer answer.
Self-reassurance
This is internally reassuring yourself that your obsession is not true or that your feared outcome won’t come true. One might mentally justify by coming up with a list of reasons why their obsession cannot be true.
Moral Scrupulosity OCD Example:
“I might suddenly blurt out something racist or obscene in the middle of my work meeting.”
You mentally repeat to yourself “I’m a good person, I would never say that” throughout the work meeting.
Mental ruminating
This is compulsively analyzing situations and trying to ‘figure it out.’ It could be overanalyzing past situations, future possibilities, getting overly caught up in what-if questions, etc. There is usually no new insight developed and the questions are typically unanswerable. Individuals usually become more doubtful and confused.
Real Event OCD Example:
“What if that sexual encounter during my 21st birthday weekend was non-consensual?”
You mentally analyze and replay the situation repetitively, trying to recall specific details. You try to ‘figure out’ whether consent was clear by remembering your behaviors during that incident, the other person’s reactions, etc.
Neutralizing
This is countering or undoing a ‘bad’ thought or image by replacing it with a more pleasant or positive one. An example might be replacing a thought about harming a loved one with the thought of hugging them. “Thinking positive” can become a compulsion when one relies on it too much to negate a distressing obsession.
Relationship OCD (ROCD) Example:
"What if I don’t truly love my partner?"
You repeatedly think of a romantic moment from your last date every time this thought comes up, as a way to ‘cancel out’ that fear.
Self-punishment
This can be a physical behavior or a mental one. When it is mental it can include engaging in negative self-talk, blame, criticism, or denying oneself feelings of happiness or pleasure, etc. This may be done to prevent harm or to rectify/atone for a perceived wrongdoing or moral violation.
Harm OCD Example:
“You could easily push that child on the train tracks”
You mentally berate yourself for having such a horrifying thought with, “Why would you think something so evil? Only a sociopath would think that.” You deny yourself enjoyable activities for the rest of the day to punish yourself for having the thought.
Thought suppression
This is mentally blocking, pushing away, or distracting yourself from unwanted thoughts. It usually has the opposite effect and the thoughts tend to return more intensely. It’s like the pink elephant paradox. When someone tells you “Don’t think about pink elephants!” your mind tends to think about it even more.
Sensorimotor OCD Example:
“What if I never stop noticing how often I blink?”
You repeatedly attempt to push away your awareness of the sensation and mentally say “Stop noticing.”
I engage in some of these, does that mean I have OCD?
We all engage in these mental behaviors to some extent. However, they become problematic if you find yourself engaging in them repeatedly, relying on them too much, or engaging in them in a way that goes against your values. If these mental behaviors are driven by distressing intrusions (obsessions), and impact your normal activities, it could be OCD.
Many individuals with OCD find that these behaviors take up a lot of time and energy, and they find it difficult to move forward without engaging in them. Often, they are exhausted by these compulsions and feel like hostages to their minds. But they do it because it helps them get through that moment. Then the next time an obsession is triggered, they do it all over again, as if they hadn’t already been done an hour ago or five other times that day.
An OCD specialist can help you determine whether your symptoms are OCD and work with you on how to manage them.
How do I know when a behavior has gone into mental ritual territory?
Good question. I’ll leave you with an example that demonstrates how this could happen:
Your normal routine is to pray at night before bed. That’s when you feel most connected to God. You enjoy it because it helps you unwind before bed, reflect on the day, and express gratitude. This practice is important to you and aligns with your values and faith. Let’s imagine that you are experiencing some Religious OCD symptoms. You are having obsessions that are causing you to pray at random times in the middle of the day. You do this because the doubts in your mind feel urgent, they need to be addressed immediately. You stay at your desk longer until you’re done with your prayer and it’s caused you to arrive late to work meetings. You’re stressed and your boss has called you out on your recent lateness. The intention behind the prayer is to get through that intense fear caused by the religious obsession. Your prayer is driven by your obsessions and not your values anymore- it’s jeopardizing your job and you wouldn’t be doing it if you felt like you had the choice. This is an example of how a healthy behavior could cross over into an unhelpful compulsion.
I think I’m experiencing obsessions and mental compulsions, what should my next step be?
It’s always a good idea to start with an evaluation for a proper diagnosis. If you strongly suspect that your symptoms might be related to OCD, seeking help from an OCD specialist would be beneficial. If you do get an OCD diagnosis, you can get started with the right kind of treatment. That could involve medication, therapy like Exposure and Response Prevention therapy (ERP), or a combination of medication with therapy.
I’m an online OCD therapist licensed in California and New York and I’d love to help you get started. You are welcome to reach out to me below.
