Types of Compulsions

While many different classifications of compulsive behavior have been proposed, two of the most common compulsions are cleaning and checking. Hodgson and Rachman (1977) reported that 52% of OCD patients reported checking compulsions and 48% reported cleaning compulsions. Although cleaning and checking appear to be the most common forms of compulsion, other forms of compulsive behavior are also reported frequently. These include collecting or hoarding useless objects, ordering and arranging objects, repeating actions, and seeking reassurance from others (Foa et al., 1995).

Early definitions of OCD maintained that obsessions were mental events and compulsions were overt behaviors. Under this definition, some OCD patients without overt rituals were labeled "pure obsessives." However, current theories recognize that compulsions can be either actions or thoughts; nearly 80% of OCD patients describe mental compulsions (Foa & Kozak, 1995). Mental compulsions are differentiated from obsessions according to their function: that is, whether they elicit distress or reduce it (Foa et al., 1995). Whereas obsessions elicit anxiety or distress, compulsions are defined as overt (behavioral) or covert (mental) actions that reduce or prevent distress elicited by obsessions. Examples of mental compulsions include attempting to think "good thoughts"; counting objects or counting up to a certain number; saying certain prayers in a rigid, repetitive manner; and mentally reviewing past actions or conversations to hunt for mistakes or other infractions. Thus, it appears that nearly all OCD patients have some form of compulsion, either overt or covert.

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