Compulsions are rituals associated with obsessivecompulsive disorder. Behaviors that must be repeated many dozens of times, such as hand-washing, counting, checking door locks or making sure the stove is turned off in order to feel safe or to reduce anxiety are called compulsions.
The lives of individuals with obsessive-compulsive disorder are beset by the need to reduce anxiety or to manage unwanted thoughts through repetitive behaviors such as cleaning, hand-washing, counting or performing activities in a very specific way, e.g., dressing only in a certain order or preparing meals in a very specific way. Compulsive behaviors must be repeated numerous times, sometimes for hours. This can make it very difficult for the person with compulsions to leave the house, to function at school, to sustain personal relationships, or to maintain employment. People with compulsions are generally aware that the behavior does not impact reality, but they feel powerless to stop the behavior without clinical intervention.
Some types of psychotherapy, combined with medications, can be very beneficial in treating compulsions. Two therapies aimed at anxiety reduction through changing thoughts and behaviors associated with compulsions are reported to be particularly effective. They are: cognitive behavioral therapy (CBT), which replaces counterproductive thoughts and behaviors with healthier ones, and exposure and response prevention (ERP), which entails repeated exposure to the anxiety-producing event or situation, either in real life or by imagining the circumstance, and allowing the client to fully experience the anxiety and wait for it to gradually lessen.
A drug class frequently used to treat compulsions is selective serotonin reuptake inhibitor (SSRI). SSRIs prevent the neurotransmitter serotonin from being reabsorbed, allowing it to continue working. Having more circulating serotonin in the brain generally makes people with depression or anxiety feel better. Since compulsions are based on a need for anxiety reduction, using SSRIs may decrease compulsive behavior.
See also Antidepressant Drugs ; Approach versus Avoidance ; Cognitive Behavior Therapy; Conditioning ; Extinction ; Neurotransmitter .
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