Neurotic disorders: Compulsive actions (compulsions)

Although compulsions are formally under conscious control, people who feel the need to make them actually do not have much choice. They believe that if you do not carry out these actions, there will be something terrible. At the same time, most of these people realize that their behavior is irrational.

After performing compulsive acts they are usually for a while feel relieved. Some people make this action into a detailed and often elaborate compulsive ritual. They must perform a ritual every time the same way, obeying to certain rules. Sometimes the performance of these rituals quite is painful, and people seek psychological help and psychotherapy.

As with obsessions, compulsions can take many forms. Very common compulsions are associated with purification. People with such disorders feel they have to constantly clean themselves, their clothes, their home. Cleaning and brushing can follow the rules of ritual and repeated dozens or even hundreds of times a day. People suffering from obsessive actions related to verification, check the same things over and over again, such as door locks, gas valve, an ashtray, important papers. Another common type of obsessive actions manifests at people who are constantly searching for the procedure or the proportionality of their actions and that surrounds them. They can lay out the objects (such as clothing, books, products) in the exact order in accordance with strict rules.

Compulsive rituals is a detailed, often carefully thought out sequence of actions, which, man feels he has to perform, always in the same way.

Obsessive cleaning action are common compulsive actions taken by people who feel the need to constantly clean themselves, their clothes, their home.

Obsessive verification steps are intrusive actions done by people who feel the need to check the same things over and over again.

Thirteen years old Paul was sent for examination to a psychiatrist because of “meaningless rituals and attention to detail.” He could spend three hours having a roll of toilet paper holder strictly at the center or adjusting the bed and other items in his room. He shifted several times the book or tying his shoelaces until he was convinced that they are “exactly.” Being generally peaceful, he argued with his family as they tried to come to his room, for fear that they would move or break a thing. While in school, Paul was worried that people may disturb the order in his room. Sometimes he had to be forcibly separated from routine activities, in order that the boy could even eat. Last year, he hid his wardrobe items around the house, because they did not want to lie flat in its box. Furthermore, Paul often said to himself: “That’s fine, you’re done.”

Other common compulsions are touching (repeated touching or avoiding touching certain things), verbal rituals (repetition of expressions, or humming motifs) or account (repeated counting of objects encountered during the day).

Although some people with obsessive - compulsive disorder, have only obsessions or compulsions, most of them suffers from that and also from the other. In fact, compulsive actions are often a response to obsessions. One study in psychoanalysis has shown that in most cases, compulsive actions are a kind of concession to the obsessive doubts, ideas or motives.

A woman who constantly questions if her house is safe, may give it an obsessive doubts, frequently checking the locks and gas valves. A man with an obsessive fear of contamination can make a concession to this fear, carrying out the rituals of purification. In some cases, it seems that the compulsive actions help to control obsessions. Below is a description of a girl - a teenager trying to control her obsessive fears of infection by enforcing accounting and verbal rituals:

Patient: As soon as I heard something that had to do with germs or disease, I started to feel bad and I had to do something in mind in order that all was well again.
Psychologist: What is it you had to do?
Patient: Talking to myself of numbers or words that are like protection.
Psychologist: What numbers and words?
Patient: Three and in order numbers divisible by three, the word “soap and water” or something like that, and then the numbers divisible by three, it became very much, I had to count to 124 and more. Then it became really bad.

Many people with obsessive-compulsive disorder worry that they can implement their own obsessions. A man with haunting images of injured ones, may fear that is close to committing murder, or a woman with an obsessive desire to swear in the church may worry that one day she succumbs to this desire and wind up in a ridiculous position. These disturbances are mostly unfounded. Although many obsessions lead to compulsive actions - in particular, the cleaning and verification compulsions – they usually do not lead to violent or immoral acts.