You likely recognize obsessions and compulsions as the two key parts of obsessive-compulsive disorder (OCD).
Yet understanding the difference between the two can be somewhat less than straightforward. It’s not always clear where obsessions end and compulsions begin.
How can you tell them apart? Do compulsions come first, or obsessions? Can you experience them on their own or with other mental health conditions besides OCD?
You’ll find answers to your questions in our guide below.
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.) defines a compulsion as a repetitive mental or physical act.
You might feel compelled, in other words, to perform this action when you have an obsessive thought. Even when you recognize these compulsions as irrational or unhelpful, you still have a strong need to do them.
Compulsions might happen physically:
- Before starting work each day, you need to arrange your pens and pencils by height and color.
- You need to wash your hands 3 times for 20 seconds each time you touch something that someone else may have touched.
Compulsions can also happen in your thoughts:
- When you have an upsetting obsessive thought, you counter it with a different thought. Maybe you repeat lines of a favorite song, or a prayer, in your head 10 times, or until the unwanted thought fades.
Types of compulsions
Some compulsions relate to obsessions, but this isn’t always the case.
Main types of compulsions include:
These include specific actions or rituals that involve washing and cleaning your body or your home, workplace, or any other place you spend time.
These might involve repeatedly checking your work for errors, checking your body for changes or signs of illness, or locking doors and turning off appliances and lights again and again.
These refer to thinking patterns. They might involve praying, making lists, constantly reviewing conversations and past events, or countering unwanted thoughts or mental images with “good” images.
These involve repeated behaviors, such as touching belongings in a certain order, tapping different parts of your body in sequence, or repeating gestures or phrases.
Ordering or arranging compulsions
With these, you might make sure your belongings appear in a set pattern or always face a certain direction.
When you experience an obsessive thought, you might repeatedly turn to friends or loved ones for reassurance that your worry won’t become a reality.
Compulsive behaviors often cause more distress, in part because they can take up so much time each day.
They might affect your performance at work or school, create tension in relationships, or keep you from doing the things you’d like to do. You might even begin to avoid situations that could trigger a compulsion.
It’s very common to hear the term “obsession” in casual conversation.
- “K-pop is my new obsession.”
- “I’m obsessed with that new Indian restaurant down the street. I could eat there every single day.”
But an obsession isn’t something you like or enjoy.
An obsession is an intrusive and unwanted thought or image that keeps coming back and causes you great distress.
When you live with conditions that involve obsessions, these obsessive thoughts happen spontaneously. While you may control your response, you might find it challenging to control the thoughts.
Describing positive things as obsessions diminishes the emotional turmoil experienced by people who live with obsessions.
It may be that you find obsessions can leave you feeling anxious, guilty, or even disgusted. You might try to block them out, suppress them, or distract yourself from them.
If you’ve experienced an intrusive thought, you have some understanding of obsessive thoughts. Yet, these are usually more intense and persistent than intrusive thoughts.
Like intrusive thoughts, obsessions might center on taboo, disturbing, or socially unacceptable ideas. They could be violent or sexual in nature.
You don’t want to think them, but you find yourself fixating on them, unable to stop — though compulsive behaviors might offer some temporary relief.
- During a work meeting, you imagine yourself standing up and insulting your boss. You don’t have any reason to do this, but you can’t seem to shake the fear that you will. To banish your anxiety and avoid the thought, you mentally count to 100 over and over until you relieve some of the distress.
- While doing dishes, you worry, “What if I take this knife and drop it on my foot?” You don’t actually want to hurt yourself. Still, the thought keeps returning whenever you see a knife or even enter the kitchen, and you worry you won’t be able to control it.
Types of obsessions
Obsessions tend to fall into the following main categories:
You might worry about touching or encountering something that contains germs, hazardous materials, bodily fluids, or unpleasant but not necessarily harmful substances, like mud.
You might worry about hurting someone else by accidentally putting something toxic in their food, for example. But harm obsessions can also involve fears that your locks don’t work or you left the stove on.
You might fixate on the idea that your behavior has offended God, or that you’ll be punished for what you feel are your sins.
These are of a sexual nature and often involve images or thoughts that you feel uncomfortable having, even if you wouldn’t act on them.
You might experience obsessions related to violence or aggression that might include hurting yourself or others.
Illness or physical and bodily changes
You might worry about being exposed to illness and fixate on physical symptoms, like head pain or stomach distress. You could also be hyperaware of body processes and sensations.
Perfectionism, order, and symmetry
You might fear something bad will happen unless all of your belongings are placed “just right” or your work isn’t completed to exact specifications.
Experiencing an obsession or compulsion doesn’t automatically mean you have OCD.
It’s not uncommon to worry about losing control of your behavior. Many people experience some obsessive thoughts or compulsive behavior on occasion.
Many people experience intrusive thoughts, which might cross your mind briefly and then fade away. They may not cause quite the same distress as obsessions, but they can feel pretty distressing.
Fixating on them, or worrying about acting them out in reality, can prompt a routine of checking, seeking reassurance, or other compulsive behaviors.
Certain compulsions might also develop situationally in response to trauma and other distressing circumstances.
Let’s say you were in the middle of chopping bell peppers on a green cutting board when your mother called to tell you your sister had passed away in the night. You then begin to associate the color green with bad news.
Every time you see or think about something green, you fear something terrible will happen again. In time, you develop techniques that help you cope with these intrusive thoughts. For example, you recite a list of 13 things that aren’t green, and you feel that it counters the threat.
This type of obsessive thought may not always meet the criteria for OCD, but it can still create distress and difficulties for you.
Other mental health conditions can involve thoughts and behaviors that resemble obsessions and compulsions.
- Depression might involve rumination and obsessive thinking that centers on a sense of hopelessness, worthlessness, guilt, or regret.
- Anxiety often involves persistent and repeated worries about mistakes you’ve made and things that could go wrong.
- Body dysmorphic disorder also involves obsessive thoughts and compulsions, but these relate specifically to how you perceive your physical appearance.
- Obsessional jealousy involves persistent worries about your partner cheating on you. These fears can prompt rumination and compulsive behaviors, including invading their privacy or checking up on them repeatedly.
Illness anxiety disorderinvolves frequent and persistent fears of becoming seriously ill. These worries might trigger specific actions, like checking yourself for symptoms and avoiding public places.
- Hair-pulling and skin-picking conditions involve repeated urges to pull at your hair or pick your skin.
- Eating disorders may involve obsessive thinking about food, body shape, and size, or exercise.
Obsessive thoughts and compulsive behaviors can sometimes happen even when you don’t have an underlying mental health condition. However, they are commonly linked to OCD.
There’s plenty left to be discovered about the brain and how it produces certain thoughts. In the meantime, it may help to know that you probably don’t need to worry about these thought patterns unless they affect your daily life or cause lingering distress.
If specific obsessions or compulsions upset you, overwhelm you, or keep coming back, a therapist can offer guidance and support.
A few resources to consider:
- The International OCD Foundation
- American Psychiatric Association’s Find a Psychiatrist tool
- American Psychological Association’s Find a Psychologist tool
- Asian Mental Health Collective’s therapist directory
- Association of Black Psychologists’ Find a Psychologist tool
- Therapy for Latinx’s Therapist Locator
- National Alliance on Mental Illness Helplines and Support Tools
- National Institute of Mental Health’s Helpline Directory
- National Queer and Trans Therapists of Color Network
- Inclusive Therapists