Mental Rituals: Not All Compulsive Behaviors are Physical

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Not all compulsive OCD behavior is physical. Compulsive, ritualistic behavior to relieve anxiety can also be mental.

An obsession is a repetitive, disturbing thought, image, or attitude that causes distressing anxiety. Compulsions, or compulsive behaviors are rituals performed repeatedly to temporarily relieve obsession anxiety. Compulsions can be physical behaviors such as hand-washing, or mental actions such as counting.

Examples of Mental OCD Rituals

The word “mental” (as in mental ritual) refers to any internal data such as thoughts, physical sensations, feelings, impulses, urges, or images.

Mental Review. Also called replaying, retracing, rewinding, or ruminating, reviewing involves mentally going over and over a past event or interaction. The reviewer hopes to resolve the situation, relieving uncomfortable feelings and thoughts.

Theorizing. To theorize, a person first replays something that happened and then adds a hypothetical element to it—something that could have taken place, but did not. The purpose is to determine if the feared situation can be handled without compromising one's values or morals. This is also called scenario twisting and hypothesizing.

Neutralization. Thought neutralization is silently saying words or entertaining thoughts that are the opposite of intrusive unwanted thoughts. The “good” thoughts are believed to render the “bad” thoughts harmless.

Reverse Rumination. In reverse rumination, an individual imagines a future event to examine it for the possibility of catastrophe. It involves thinking over (and over) a future interaction or performance in the hopes of alleviating distress over what might happen.

Self-Reassurance. By mentally repeating reassuring statements to themselves, people with OCD create a sense of certainty that the negative consequences of a thought will not happen. It is a compulsive use of positive affirmation to dispel anxiety.

Self-Punishment. If someone believes they have committed an unforgivable error and should not be allowed to get away with it, they might compulsively dwell on negative self-talk and guilt feelings to punish themselves. The discomfort of escaping justice is avoided by doing this.

Compulsively Praying. Prayer can be used to block the intrusion of unacceptable thoughts. Instead of praying to spiritually connect with a deity, the person with OCD is avoiding or neutralizing distressing images or ideas.

Treatment

These, and other types of mental rituals, are usually treated using cognitive-behavior therapy (CBT), which helps people examine and change how they think about things. Additionally, the practice of mindfulness allows people with OCD to identify and observe mental urges as they arise, look at them without judgement, and process what is occurring.

Although some people with OCD are diagnosed as purely obsessive, or “Pure O,” some professionals now believe that either mental or behavioral compulsions (or both) are always part of the OCD disorder.

Source: OCD Foundation
Photo credit: Jacob Better (@flickr)

 
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