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 .



Abramowitz, Jonathan S., and Autumn E. Braddock. Hypochondriasis and Health Anxiety. Cambridge, MA: Hogrefe, 2011.

Abramowitz, J.S., B.J. Deacon, and S.P.H.Whiteside. Exposure Therapy for Anxiety. Devon, United Kingdom: Acheron Press, 2012.

Bellenir, Karen. Mental Health Disorders Sourcebook: Basic Consumer Health Information About Healthy Brain Functioning and Mental Illnesses, Including Depression, Bipolar Disorder, Anxiety Disorders, Posttraumatic Stress Disorder, Obsessive-Compulsive Disorder, Psychotic and Personality Disorders, Eating Disorders, Impulse Control Disorders. Detroit, MI: Omnigraphics, 2012.

Bonder, Bette. Psychopathology and Function. Thorofare, NJ: SLACK, 2010.

Hollander, Eric, and Dan J. Stein. Obsessive-Compulsive Disorders Diagnosis, Etiology, Treatment. New York: Dekker, 1997.

Meyer, Robert G., and Christopher M. Weaver. Case Studies in Abnormal Behavior. Boston: Pearson, 2013.

Starcevic, Vladan, and Russell Noyes. Hypochondriasis and Health Anxiety: A Guide for Clinicians. 2014.

Stekel, Wilhelm. Conditions Of Nervous Anxiety And Their Treatment. Hoboken: Taylor and Francis, 2013.

Weeks, Justin W. The Wiley Blackwell Handbook of Social Anxiety Disorder. Hoboken: Wiley, 2014.


Twohig, M.P., et al. “A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder.” Journal of Consulting and Clinical Psychology 78, no. 5 (October 2010): 705–16.


International OCD Foundation. “Obsessions and Compulsions” (accessed September 01, 2014).

Mayo Clinic. “Generalized anxiety disorder.” (accessed October 14, 2014).

Mayo Clinic. “Social anxiety disorder (social phobia).” (accessed October 14, 2014).

National Institute of Mental Health. “Obsessive-Compulsive Disorder, (OCD. What is Obsessive-Compulsive Disorder (OCD)?” (accessed August 23, 2014).