Obsessive vs. Compulsive Behavior
Both obsessive and compulsive behaviors are associated with obsessive-compulsive disorder (OCD) and the family of related disorders. OCD is specifically a combination of both obsessive and compulsive thoughts and behaviors, which can impede daily life. Obsessive thoughts and fears lead the individual to practicing compulsive, repetitive behaviors. These intrusive, recurring, and uncontrollable thoughts and behaviors limit a person’s ability to enjoy life.
There are other mental health issues that can lead to either obsessive or compulsive behaviors, both, or OCD. Some of these include:
- Body dysmorphic disorder
- Hoarding disorder
- Trichotillomania (obsessive hair-pulling)
- Excoriation (skin-picking disorder)
- Asperger’s syndrome and autism
- Gambling disorder
- Love addiction or obsessive relationship jealousy
- Post-traumatic stress disorder
- Underlying medical conditions, such as Huntington’s disease
- Substance-induced OCD (from addiction or prescription medications)
Obsessive behaviors stem from obsessive thoughts, persistent urges, intrusive mental images, or an unwanted emotional pull that causes distress, anxiety, and disturbance of a person’s daily routine. Obsessive, intrusive thoughts often include:
- Thoughts about harming oneself or someone else
- Doubts about performing an action, such as turning off the stove
- Unpleasant or disturbing sexual images
- Fear that another person is performing harmful actions against the individual
- Intrusive thoughts about breaking social, religious, or cultural taboos
- Requiring items, personal affects, or people to be in a specific order
- Fear of contamination
These thoughts can manifest in several kinds of actions, including:
- Constant checking doors, locks, stoves, etc., to ensure safety
- Excessive cleaning of oneself, one’s home, or a particular item
- Repeatedly counting
- Making demands of a loved one’s time or specific shows of affection
- Avoiding one or more people due to fears about harm
- Avoiding specific situations, such as shaking hands
- Intense stress in specific situations or due to specific thoughts
- Fear of uncontrollable thoughts of self-harm or harming others
- Unable to think of anything other than a person, object, intoxicating substance, or event like gambling
When a person begins experiencing these obsessive thoughts, they may not feel comfortable talking about them, or they may try to overcome them without professional help. Obsessive thoughts can make a person feel isolated and alone, unusual or frightened, or beyond help. Alone, obsessive thoughts are hard enough to deal with, which is why it is important to get help as soon as possible. These thoughts could be a symptom of OCD or a similar disorder, or they could have an underlying physical cause that requires medical diagnosis and treatment.
Compulsive behaviors are reactions to thoughts or events that a person is unable to stop or control. For people struggling with OCD, for example, compulsive behaviors are the reaction to obsessive thoughts. Someone with obsessive thoughts about infection and disease may take numerous baths over the course of the day. Compulsions can also come in other forms of repetitive behaviors, such as seeking out sexual encounters, or ingesting substances, in order to find relief from obsessive thoughts, without being related specifically to OCD.
Compulsive behaviors often include the following:
- Counting objects over and over
- Washing and cleaning
- Enforcing a specific order for events or objects
- Following a very strict routine or forcing someone else to follow a strict routine
- Demanding reassurance constantly, especially for one perceived flaw
Some compulsive behaviors are physical tics that are subconscious or uncontrolled. These can include:
- Repeating words or phrases
- Sniffing or clearing the throat
- Rapid blinking
- Scratching or twitching
Compulsions can also come in the form of compulsive thoughts. These include repeatedly going over tasks performed or tasks that will be performed. They can also include silently praying to avoid spiritual harm.
Although the person performing compulsive behaviors does so typically due to obsessive thoughts, they do not find emotional or psychological relief from these actions. If they are aware of the actions or able to observe them, they are not able to stop themselves from performing these actions, no matter how detrimental. Sometimes, the person is unaware of their compulsive behavior or tic.
The Link between Obsessive Thoughts, Compulsive Behaviors, and Substance Abuse
People who struggle with obsessive thoughts, compulsive behaviors, or any of the related disorders, such as obsessive-compulsive disorder, PTSD, anxiety disorders, eating disorders, and others, may develop a substance abuse problem in order to self-medicate the severity of the symptoms. This could involve an intoxicating substance like alcohol or heroin, which can calm the mind and slow down the body, or it could be a prescription medication, such as a benzodiazepine, which can be very addictive. In some cases, OCD, obsessive thoughts, or compulsive behaviors are triggered by brain changes from a substance use disorder and may center around acquiring a steady supply of the addictive substance.
Regardless of what mental health issue is linked to substance abuse, people who struggle with mental health problems are at a greater risk of developing substance abuse problems, and vice versa. When both disorders co-occur, appropriate treatment is needed that can effectively address both issues. Many rehabilitation programs offer treatment for co-occurring disorders that can help clients achieve recovery from obsessive thoughts, compulsive behaviors, and substance abuse.