OCD and Checking
Hi Everyone,
We’re in the middle of some unusual sunny winter weather here in Oregon. It’s rare we get this many sunny days in January, but I’ll take it! I hope you’re also enjoying some good weather wherever you are. Today’s post is about an almost universal theme in OCD - checking. Most types of OCD have at least some amount of checking as part of the obsession/compulsion cycle. Some forms of checking are easier to spot than others, but whatever type you engage in the goal is the same…to stop checking.
OCD and Checking
When most people think of checking within OCD they think of checking things such as door locks, windows, etc., but checking can cover multiple areas besides locks and windows. I’ve written before about checking. This post is about some of the typical forms of checking and also about some of the less well-recognized types of checking that are actually quite common in OCD. Since it is doing compulsions that perpetuates and maintains OCD, and checking is a compulsion, it is crucial that we identify the compulsions so we know what it is that we’re going to try to change/stop.
When using the exposure and response prevention model (ERP) for treating OCD, it is important that we identify what are obsessions and what are compulsions. The model, as has been explained in numerous previous posts, is to be exposed to the obsession (trigger) and not do the compulsion/checking. When the checking is more obvious, such as literally walking back to check if you closed and locked the front door properly, it may be easier to identify the compulsive behavior. However, when the compulsion is more internal or mental then it’s much trickier to catch it, realize it’s a compulsion, and then stop doing it. While there are multiple types of checking behaviors, I will cover four common types in this post:
Physical checking - As mentioned above, this is often doing things such as returning to the front door to make sure it was closed and locked properly, but can also be things such as driving back to an intersection to make sure that that bump you felt wasn’t a person you hit and left lying bleeding and dying in the road behind you. Other common examples are: reading an email multiple times before hitting send, checking to be sure you didn’t inadvertently say something inappropriate; a student who reads the assigned chapter numerous times checking to be sure she completely understood and can remember everything; and checking that mole on your arm multiple times a day to be sure it hasn’t grown any bigger in case it could be cancer.
Organizational checking - This refers to checking to be sure that everything is where it’s supposed to be and if it’s not then rearranging everything to be sure everything feels just right:
“Have I placed the cushions on the couch in the proper place? Is the couch in the proper spot in the living room?
Are the kitchen table chairs at the proper angle with respect to the table?
Are the curtains closed properly?
Are all the items on my chest of drawers in the bedroom placed in the proper location?
Are my clothes color-coded and arranged properly in my closet?”...you get the idea.
These two types of checking are easier to identify because the client is doing something that can be seen. The solution will sound familiar to any of you who have been reading my previous posts…stop the checking. It is usually easiest to stop the checking gradually rather than all at once, but whether you stop slowly or decide to go cold turkey, the goal is to stop checking.Checking thoughts - This type of checking is often harder to recognize because you don’t see anything, it’s all done in your head. Most of my clients who engage in this type of checking, especially at first, don’t realize that they are checking until it comes up in our sessions. This often involves carefully watching/monitoring thoughts to be sure you’re having the right type of thought. An example is a recent client who had to have the right type of thought as he lifted her coffee cup to take a drink. A “right” thought was thoughts about her loved ones being safe that day and a “bad” thought was about something unpleasant or dangerous happening to her loved ones. If she had a “bad” thought she would have to repeat the behavior and be sure to have a “good” thought. There is some “magical thinking” here as well because she feared that if she didn’t repeat the action with a good thought then something awful would happen (or could happen) to her loved ones because of her thoughts and it would be her fault. Another example is a client who would carefully watch her thoughts as she noticed homeless people on the street. She struggled with scrupulosity OCD and was worried that she wasn’t having the right sympathetic/loving thoughts towards the homeless people she was seeing and, if she wasn’t having the right type of thoughts then she wasn’t being a good Christian.
Checking feelings - Along with checking thoughts, this type of checking is the most subtle and as a result, it is also difficult to detect. And as with checking thoughts, people often don’t even recognize that they’re checking when engaging in this sort of compulsion. It amounts to carefully monitoring/watching one’s feelings to make sure you’re having the “right” type of feelings. In the example above of the Christian woman, in addition to monitoring her thoughts, she also carefully monitored her feelings to see if she was feeling sympathetic enough towards homeless people. Another type of OCD where this comes up is within Pedophilia OCD. Upon seeing a child, they carefully monitor/watch what sort of feelings they are having to see if they’re having the “wrong” kind of thoughts/feelings. They fear noticing signs of arousal. Similarly, individuals with Harm OCD will carefully watch/check their responses when they see someone they fear they could harm in some way - often a loved one. An unfortunate version of this is parents who are afraid of feeling angry or frustrated at their children, fearing that these feelings mean they are about to strike out and hurt their children. Having raised two sons of my own I can certainly attest to the fact that it is quite normal to, at times, feel frustrated by your children, but the OCD makes these parents watch out for these “dangerous” feelings.
What is one to do when these types of checking are noticed? If you’ve been following my posts you may already know the answer…don’t do anything! Recognize how your OCD has tricked you into believing you’re having an inappropriate thought or response and if you dig in to try and figure out what these responses mean then your OCD has already won - you’ve been caught in the “Let’s figure this out” compulsion. I’ve had numerous clients get caught in this particular obsession and, so far, after 35 years not one client has ever been able to resolve their OCD by figuring it out. You can’t think your way out of OCD. Recall the last post and the story of what to do if that rather sketchy guy who just passed you says something really disgusting…”keep on walking”. Treat these thoughts and feelings as if they don’t matter, because they don't. They are just part of OCD’s web. Of course, this is much easier to say than actually do, but knowing this is what you’re shooting for is a good start and gives you some idea of the direction you need to go. You can check some of my earlier posts for more detail.
This post is meant to be educational and not as a substitute for therapy. if you’re struggling with any of the above issues please consult a qualified therapist.
Thanks for reading and I hope you’re finding these posts helpful and, as always, if there are topics you’d like me to cover in future posts, please let me know.
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Stay safe,
Dr Bob