OCD Compulsions: Types, Examples, and Treatment [2026]

You wash your hands, dry them carefully, and reach for the door handle. Before your fingers touch it, a thought flashes: What if they are not clean enough? You know you just washed. You watched the soap run over every finger. But the doubt is louder than the logic, so you turn back to the sink and start again. Three washes later, your skin is raw and you are running late, but walking away still feels impossible. Something inside insists that one more time will finally make it right.

If a pattern like this feels familiar, whether it involves washing, checking, counting, or something less visible, you may be experiencing OCD compulsions. Compulsions are one half of the cycle that defines obsessive-compulsive disorder (OCD), and understanding how they work is an important step toward learning how to respond to them differently. In this article, we will look at what OCD compulsions are, why they develop, what forms they take, and what treatment approaches can help.

What Are OCD Compulsions?

Compulsions in obsessive-compulsive disorder (OCD) are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsessive thought. The purpose of a compulsion, from the brain's perspective, is to reduce the anxiety an obsession creates or to prevent a feared outcome from happening. Compulsions can be physical actions you can see from the outside, like hand-washing or checking a lock, or they can be entirely internal, like silently counting or mentally replaying a conversation to make sure you did not say something harmful.

Compulsions are the second part of the OCD cycle. The cycle typically follows a predictable pattern: an obsession appears, it triggers distress, the person performs a compulsion to get relief, and the relief fades, which causes the obsession to return. Each time the compulsion provides that brief window of calm, it teaches the brain that the ritual was necessary. Over time, this loop becomes deeply ingrained, and the compulsions can grow more frequent, more elaborate, or more time-consuming.

It is worth emphasizing that compulsions are not habits a person enjoys or chooses freely. Most people with OCD recognize, at least on some level, that their compulsions are excessive or do not make logical sense. The problem is that the emotional pull, the urgent sense that something bad will happen if the compulsion is not performed, can overpower that rational awareness.

How OCD Compulsions Develop

Compulsions develop through a process called negative reinforcement. As the International OCD Foundation explains, each time you perform a compulsion and feel temporary relief from anxiety, your brain registers the compulsion as the thing that kept you safe. The next time the obsessive thought appears, the brain pushes you toward the same action, because it "worked" before.

The trouble is that the relief does not last. The anxiety comes back, often stronger or sooner than the last time, and the brain's conclusion is that you need to do the compulsion again, perhaps more thoroughly or more times. This is how compulsions can escalate. A person who started by checking the stove once before leaving the house may eventually need to check it five times, then ten, then develop a specific ritual around how they check, all because the brain keeps raising the bar for what counts as "enough."

Over time, compulsions can become automatic. What begins as a deliberate attempt to manage a specific fear can turn into a reflexive response that fires before the person even recognizes what triggered it. This is part of what makes OCD so frustrating: the compulsions start to feel like something happening to you rather than something you are choosing to do.

Types of OCD Compulsions

OCD compulsions generally fall into two broad categories: physical compulsions and mental compulsions. Both serve the same function within the OCD cycle, but they look very different from the outside, and mental compulsions are often harder for others to notice.

Physical Compulsions

Physical compulsions are the observable behaviors most people associate with OCD. They involve actions you can see, such as:

• Checking: Repeatedly verifying that doors are locked, appliances are off, emails were sent correctly, or that you did not make a mistake.
• Washing and cleaning: Excessive hand-washing, showering for extended periods, or sanitizing surfaces and objects far beyond what hygiene requires.
• Repeating: Performing an action a set number of times, re-entering a room until it feels "right," or re-reading a sentence over and over.
• Ordering and arranging: Adjusting objects until they are symmetrical, aligned, or arranged in a specific pattern that satisfies an internal sense of balance.
• Tapping and touching: Needing to touch certain objects or surfaces in a particular sequence or a particular number of times.
• Hoarding: Difficulty discarding items due to a fear that throwing them away will lead to something bad, or a sense that the item might be needed someday despite evidence to the contrary.

Mental Compulsions

Mental compulsions happen inside a person's mind. They are invisible to others but can be just as time-consuming and exhausting as physical rituals. Common mental compulsions include:

• Counting: Repeating numbers or counting in specific patterns (for example, counting to a "safe" number) to neutralize anxiety.
• Mental reviewing: Replaying past events, conversations, or actions in your mind to confirm that nothing bad happened or that you did not do something wrong.
• Praying or repeating phrases: Silently reciting prayers, mantras, or specific words to "cancel out" a disturbing thought or to prevent a feared outcome.
• Thought replacement: Deliberately trying to substitute a "bad" thought with a "good" one, or picturing a positive image to counteract a distressing one.
• Mental reassurance: Internally arguing with the obsessive thought, trying to reason your way to certainty that everything is fine.
• Analyzing: Endlessly examining your own feelings, motivations, or reactions to determine whether an intrusive thought "means something."

Mental compulsions are particularly important to recognize because they can lead people to believe they do not have "real" compulsions. The term "Pure O" is sometimes used to describe OCD that appears to involve only obsessions, but in most cases, the person is performing mental compulsions that are simply not visible to anyone else. The compulsions are there. They are just happening internally.

Physical vs. Mental Compulsions at a Glance

Common OCD Compulsions and Examples

The specific form a compulsion takes often depends on the theme of the obsession driving it. Below are some of the more frequently seen compulsion patterns, organized by the type of fear they are connected to.

Contamination-Related Compulsions

• Washing hands repeatedly until the skin cracks or bleeds.
• Avoiding public surfaces like door handles, handrails, or shared equipment.
• Changing clothes or showering immediately after being in a space perceived as contaminated.
• Using excessive amounts of hand sanitizer, disinfectant, or soap throughout the day.

Harm-Related Compulsions

• Hiding or avoiding knives, scissors, or other sharp objects.
• Mentally reviewing interactions to confirm you did not hurt someone.
• Seeking reassurance from loved ones: "You know I would not do something like that, right?"
• Avoiding being alone with certain people, such as children or elderly family members, out of fear that a harm-related intrusive thought might come true.

Symmetry and "Just Right" Compulsions

• Rearranging items on a desk, shelf, or table until they feel perfectly balanced.
• Re-writing a sentence or re-typing a word until it looks or feels correct.
• Needing to perform an action with both hands or both sides of the body equally.
• Walking through a doorway multiple times until the experience feels "complete."

Doubt and Checking Compulsions

• Returning home multiple times to verify the stove is off or the front door is locked.
• Re-reading emails, texts, or forms dozens of times before sending to make sure nothing is wrong.
• Driving back along a route to check whether you might have hit someone or something without noticing.

Reassurance-Seeking Compulsions

• Repeatedly asking a partner, friend, or family member for confirmation that a feared scenario will not happen.
• Searching the internet for hours looking for evidence that a worry is unfounded.
• Consulting multiple professionals or sources looking for the "right" answer that will finally settle the anxiety.

Why OCD Compulsions Feel So Hard to Resist

If you have experienced OCD compulsions, you know that resisting them is not as simple as "just stop doing that." The urge to perform a compulsion is driven by a powerful combination of anxiety, emotional discomfort, and a deep need for certainty.

When an obsessive thought appears, the brain interprets it as a genuine threat. It sends alarm signals, the kind designed to help you respond to real danger, even though the situation does not call for that level of response. The compulsion becomes the brain's proposed solution: do this thing, and the danger goes away. In that moment, the pull toward the compulsion can feel as urgent as pulling your hand away from a hot surface.

There is also a tolerance component. As with many anxiety-driven behaviors, the more you rely on a compulsion to manage distress, the less effective it becomes over time. The brain needs more: more repetitions, more thoroughness, more certainty. This is why compulsions tend to escalate and why they can end up consuming large portions of a person's day.

It is also common for people with OCD to feel a strong sense of personal responsibility. The thought is not just "something bad might happen." It is "something bad might happen, and it will be my fault because I did not do enough to prevent it." That sense of inflated responsibility makes walking away from a compulsion feel like a moral failing, even when the rational mind knows the compulsion is not solving anything.

Struggling with compulsions? Understanding how they work is the first step. The next step is getting the right support. Connect with the Obsessless team to learn about evidence-based treatment options.

How to Manage OCD Compulsions

Treatment for OCD compulsions focuses on breaking the cycle at its core: the automatic link between the obsessive thought and the compulsive response. Because compulsions are the response in that equation, the work centers on response prevention. When you stop performing the compulsion, the brain eventually learns that the feared outcome does not occur and that anxiety fades on its own. That recalibration is what loosens the grip of compulsions over time.

Exposure and Response Prevention (ERP) is the gold-standard therapy for OCD and is especially well suited to compulsions. ERP deliberately exposes you to the thoughts or situations that trigger your obsessions while guiding you to resist the compulsions you would normally use. For physical compulsions, that might mean touching a "contaminated" surface and waiting before washing. For mental compulsions, it might mean sitting with an intrusive thought without counting, reviewing, or neutralizing it. Over time, the brain learns that it can tolerate the discomfort without the ritual. Medication can also help reduce the intensity of obsessive anxiety and may be used alongside therapy, particularly when symptoms are severe. For a fuller picture of understanding OCD and its full range of treatment options, the pillar page offers a comprehensive overview.

When to Seek Help

It can be hard to know when compulsive behaviors cross the line from a quirk or preference into something that calls for professional support. Consider reaching out to a mental health professional who specializes in OCD if:

• You find yourself performing repetitive behaviors or mental rituals that you cannot stop, even when you recognize they are excessive.
• The compulsions are time-consuming, taking up more than an hour a day or making you late for responsibilities.
• You experience temporary relief after a compulsion, but the anxiety or urge returns quickly, often pushing you to repeat the behavior.
• You have started avoiding people, places, objects, or situations because they trigger the cycle.
• The pattern is affecting your relationships, work, school, or overall quality of life.
• You feel stuck in a loop where nothing you do provides lasting relief.

Reaching out for help is not a sign of weakness. OCD is a well-understood condition, and the right treatment can make a meaningful difference. The IOCDF therapist directory can help you find a specialist in your area.

Final Note

Compulsions often feel like the only way to cope. When anxiety spikes, the urge to perform a ritual can feel overwhelming, and the brain insists that skipping it would be dangerous or irresponsible. But that feeling is not the whole story. The brain has learned to rely on compulsions because they provided short-term relief. It can also learn a different response: that the discomfort can be tolerated, that the feared outcome does not materialize, and that the urge itself will pass.

That shift does not happen overnight, and it usually does not happen alone. With the right support, many people find that the compulsions that once felt non-negotiable gradually lose their power. If you are ready to explore what that could look like for you, connecting with a therapist who specializes in OCD is a meaningful next step.