Mental Compulsions in OCD: Compulsions You Can’t See
Obsessive-Compulsive Disorder (OCD) is often misunderstood as merely a condition of visible behaviors like handwashing or checking locks. However, many people with OCD struggle with mental compulsions, which are internal actions just as distressing and impactful as physical ones. In this article, we will explore what OCD is, explain the concept of "Pure O," delve into the various types of mental compulsions, and discuss effective treatments for managing these hidden aspects of OCD.
What is OCD?
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that cause significant anxiety or distress. Compulsions are repetitive behaviors or mental actions performed to alleviate this anxiety or prevent a feared outcome. The OCD cycle starts with a trigger, leading to an obsession, followed by a compulsion to reduce the discomfort. While external compulsions like handwashing or checking are commonly recognized, OCD also involves mental compulsions, which are less visible but equally debilitating.
Explaining "Pure O"
"Pure O" is a term used to describe a form of OCD where the compulsions are primarily mental rather than physical. It stands for "purely obsessional," implying that the individual experiences obsessions without visible compulsions. However, this term is misleading because people with "Pure O" still engage in mental compulsions. These internal actions, such as mental checking or reassurance-seeking, perpetuate the OCD cycle and maintain anxiety.
Types of Mental Compulsions
Mental compulsions are varied and can be complex. Here are some common types:
Thinking/Saying Words, Numbers, or Phrases: Repeating specific words or phrases to neutralize obsessive thoughts. For example, someone might repeatedly say, "I'm safe," to counteract a fear of harm.
Counting: Counting objects, letters, or actions to relieve anxiety. This could involve counting steps, items, or repetitions until a specific "safe" number is reached.
Repeating/Making Lists: Creating mental lists to manage obsessions. This could include listing positive experiences to balance out perceived negative ones.
Replacing an Obsession: Substituting a negative thought with a positive image or word to reduce anxiety.
Saying Prayers: Using prayers repetitively to alleviate anxiety from obsessions, seeking a feeling of completeness or reaching a specific number.
Scanning Thoughts and Feelings: Checking the quality of thoughts and emotions to ensure they are appropriate or "right."
Reviewing and Replaying Past Situations: Mentally reviewing past events to ensure no mistakes were made, often linked with guilt or fear.
Dissecting and Scrutinizing Past Situations: Analyzing past events with hypothetical scenarios to find reassurance.
Anticipating Future Situations: Predicting and mentally preparing for future scenarios to avoid negative outcomes.
Figuring Out the Meaning of Internal Experiences: Analyzing thoughts, images, and feelings to understand their meaning and reduce anxiety.
Figuring Out Major Life Issues or Existential Matters: Reflecting on big life questions to neutralize obsessions about health, death, or existence.
Treatment for Pure O
Effective treatment for "Pure O" and mental compulsions involves recognizing and addressing these internal actions. Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP) therapy, is the gold standard for managing OCD. ERP involves gradually facing fears without performing compulsions, allowing anxiety to diminish naturally. Attention training, which focuses on gently redirecting attention from compulsive thoughts to preferred activities, can also be beneficial. Working with a specialized therapist can help individuals develop strategies to resist mental compulsions and reduce the impact of OCD on their lives.
At Layers Counseling Specialists, we specialize in utilizing ERP and other complementary modalities such as Acceptance & Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) to create an individualized treatment plan to address each client’s unique needs. We work with children, teens, and adults and have in-person therapy options for clients in Plano, Allen, Frisco, Dallas, Prosper, McKinney and surrounding areas. We also offer virtual therapy to clients all over Texas. Schedule a 15-minute consultation with one of our therapists today to discuss your therapy needs.
In Conclusion
Mental compulsions in OCD are hidden yet powerful drivers of anxiety and distress. Understanding the nature of these internal actions and recognizing them as part of the OCD cycle is crucial for effective management. Through therapies like ERP and attention training, individuals can learn to resist mental compulsions, break the cycle of OCD, and improve their overall quality of life. If you or someone you know struggles with mental compulsions, seeking professional help can provide the support and tools needed to reclaim control over thoughts and reduce the burden of OCD.