The rituals of obsessive-compulsive disorder

What do you do when your hands never feel clean, when you’ve made sure you’ve locked the door and yet you doubt it’s still open? For many people with obsessions like these, controlling their life seems to depend on a single action: The rituals of obsessive-compulsive disorder.

This disorder consists of the appearance of obsessions that are relieved with certain actions (compulsions). On average, between 2 and 3% of the world’s population must deal with this type of episode. It is tremendously limiting, and not only because of the uncontrollable and invasive nature of obsessive ideas, but because the rituals can take up the bulk of the patient’s day.

Therefore, in this space we are going to dedicate some time to these rituals and their characteristics. Without them, anxiety is unbearable. With them, the day is filled with carefully crafted stereotypes that seem to calm the discomfort, but only in the short term. Let’s go with it.

What are the rituals of obsessive-compulsive disorder?

Although years ago OCD was classified within anxiety disorders, it is currently considered a nosological entity in itself and is located within an obsessive-compulsive spectrum. This spectrum includes disorders that include obsessive ideas and compulsions that are carried out to alleviate the discomfort they generate.

It is these compulsions that are called “rituals” within obsessive-compulsive disorder. These are acts, physical or mental, that are repeated in a specific way and that the individual sometimes recognizes as irrational.but they help neutralize obsessive thinking.

The complexity and form of compulsions varies with each person. It can range from repeating a thought to complex rituals when getting dressed, washing your hands or closing the door when leaving the house, for example. On many occasions, failing in one of the steps of the ritual means starting again from scratch, which increases the time that the patient must dedicate to it.

The rituals of obsessive-compulsive disorder often get in the way of people’s personal, social, and professional functioning.

Difference between obsessions and compulsions

Sometimes it is difficult to draw the line between obsessive thoughts and the rituals of the disorder. Therefore, let’s define them clearly:

Obsessions: thoughts, ideas or beliefs that appear invasively in the subject’s mind. They are repetitive and cause discomfort, since they persist even when the person recognizes them as irrational or wants to resist them.Compulsions: They are the acts, physical or mental, that are launched after the appearance of the obsession. They also come to be recognized as useless by those patients who have the capacity for introspection intact.

Therefore, both components (obsessions and rituals) of obsessive-compulsive disorder have a repetitive and limiting nature. The fundamental difference is that compulsions aim to neutralize obsessions and are triggered after their appearance.

There is a case where it is more difficult to distinguish between obsessions and compulsions: when both are mental. In this case, it must be taken into account that obsessions produce anxiety and compulsions reduce it, although both types of thoughts are repetitive.

Most common obsessive-compulsive disorder rituals

Compulsions are very varied and depend on each individual.. However, we can group the most common ones into the following categories.

Cleansing rituals

The person carries out exhaustive hygiene and disinfection processes (either on the body itself or on external objects) to avoid dirt or contamination. Among the most frequent actions are repeated hand washing, repeated cleaning of objects before touching them or the use of wipes to pick them up.

Repetition rituals

In this case, the person with OCD repeats strange and seemingly meaningless actions over and over again. Such as, for example, opening and closing the door, turning lights on and off, entering and exiting through a door, and so on. All of them carried out a specific number of times.

Accumulation rituals

It manifests itself in the accumulation or collection of objects that have no obvious value. The person is unable to get rid of them because the act of doing so causes them distress.

Order rituals

It consists of placing and Sort everything by size, color, value, age, etc.. The slightest change in the arrangement of objects generates great anxiety, so they spend much of their time organizing things.

Checking rituals

In this case, the person with OCD repeatedly checks that, in fact, you have performed a specific action. For example, having closed the door, the water tap or having turned off the kitchen burners.

Counting rituals

They are characterized by count the number of elements contained in an object or structure, which can be hundreds or thousands. In this case, they do not rest assured until they know the number and, if they lose the account, they can start over.

Mental rituals

This special case of ritual refers to those that are carried out exclusively mentally.that is, they consist of repeated thoughts or mental operations of a different nature.

They are usually difficult to differentiate from obsessions, since they do not have a visible component to the viewer and the subject experiences them as repetitive in both cases.

Some rituals can take hours to complete, others can be done in a matter of minutes.

How to Treat Obsessive-Compulsive Disorder Rituals

There comes a point in the patient’s life when rituals take over their life. That is why therapy addresses the disorder from different fronts, but, above all, from ending the rituals.. This is usually done gradually, taking into account the patient’s emotional control, while providing therapy for obsessions.

Pharmacological support also provides help in this regard, especially with the use of selective serotonin reuptake inhibitors (SSRIs). For patients who also have tics or whose rituals consist of repetitive movements, the use of anticonvulsants, serotonin receptor blockers or antihypertensives may be recommended.

It is important to keep in mind that obsessive-compulsive disorder can be treated. It usually appears during adolescence and early adulthood, although it is not uncommon for it to take up to a decade for patients to seek help. The faster the latter is done, the less control the rituals of obsessive-compulsive disorder will have over daily life.

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