Checking OCD

What is Checking OCD?

Obsessive-compulsive disorder (OCD) can involve intrusive thoughts and repetitive behaviors about at preventing harm or avoiding mistakes. People with this condition often experience overwhelming doubt and anxiety about whether they have caused harm, made an error, or failed to prevent a disaster. These worries lead to compulsive checking behaviors as a way to reduce anxiety or create certainty.

Sequence of Checking OCD

Triggers:

Some triggers can include:

Leaving the house (e.g., worries about leaving appliances on, doors unlocked, or windows left open).
Driving (e.g., concerns about hitting someone or damaging property)
Sending emails or texts (e.g., fear of sending incorrect or offensive information)
Health concerns (e.g., checking for physical symptoms or reassurance about medical conditions)

Core Fears:

Causing harm to oneself or others by not being thorough enough
Making a critical mistake that ruins one’s life or someone else’s
Fear of unbearable suffering due the consequences that may follow a mistake

Compulsions / Safety Behaviors: Compulsions are actions people with OCD perform to try to reduce their anxiety or prevent their fears from coming true. These may include:

Physically inspecting appliances, locks, or switches multiple times
Re-reading emails or text messages repeatedly before sending
Mentally reviewing events or actions to ensure no harm occurred
Seeking reassurance from others about whether actions were performed correctly
Avoiding situations that might trigger uncertainty or responsibility

What Causes Checking OCD?

While the exact cause of Checking OCD is not fully understood, research suggests it arises from a combination of factors:

Genetics: OCD often runs in families, suggesting a hereditary component.
Neurobiology: Brain imaging studies show differences in areas involved in decision-making and error detection.
Environmental Influences: Childhood trauma, stressful life events, and overprotective parenting may contribute to the development of OCD.
Learned Behaviors: Observing others engaging in repetitive checking or developing habits to cope with anxiety can reinforce compulsive behaviors.

How Do You Treat Checking OCD?

The most effective treatment for Checking OCD is Exposure and Response Prevention (ERP), a type of Cognitive Behavioral Therapy (CBT).

How ERP Works:

Exposure: The person intentionally faces their fear by triggering situations that cause anxiety without performing the compulsive behavior. For example, leaving the house without double-checking locks.
Response Prevention: The person resists the urge to check, allowing anxiety to rise temporarily and then naturally decrease without relying on compulsions.
Cognitive Restructuring: Patients learn to challenge their beliefs about certainty, responsibility, and the need for perfection.

Example:

Jennifer, who fears leaving appliances on, might work with a therapist to gradually reduce her checking behaviors. She could start by leaving the house without checking the stove more than once and then building up to leaving without checking at all.

Over time, Jennifer would learn that she can tolerate uncertainty without relying on compulsions.

Medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) may also help reduce symptoms when used alongside therapy.

Summary

People with Checking OCD experience intense fears about making mistakes or causing harm, leading to repetitive checking behaviors to reduce anxiety and seek certainty. However, these compulsions often worsen the cycle of doubt and distress. Treatments like ERP help individuals face their fears, reduce compulsions, and learn to tolerate uncertainty. With proper therapy and support, people with Checking OCD can reclaim their lives and reduce the burden of anxiety-driven behaviors.

OCD Clinic
Sydney