Constraints have many faces

Constraints have many faces

In many mental and physical illnesses, those affected suffer from similar symptoms, unlike obsessive-compulsive disorder. The differences between the various forms of compulsion can be so significant that those affected do not believe they suffer from the same disorder. What connects them, however, is that they all experience uncontrollable thoughts and impulses in some form. The number of symptoms also varies from person to person: while some suffer from one OCD, others struggle with a variety of different  OCDs. The most common forms are briefly presented below, with the so-called cleaning and washing compulsions comprising the most significant proportion.

Cleaning and washing compulsions

Those affected feel panicky or disgusted with dirt, bacteria, viruses, bodily fluids, or excretions. The associated discomfort leads to extensive washing and cleaning rituals. The hands, the entire body, the apartment or soiled objects are cleaned and disinfected for hours. The sequence of the rituals is precisely defined. If interruptions occur, the person concerned has to start all over again.


control compulsions

The second largest group of obsessive-compulsive disorders are the so-called control obsessions. In this case, those affected fear triggering a catastrophe through carelessness and omissions. For this reason, technical household appliances, doors and windows, and routes just driven are checked repeatedly. But even after repeated checks, the obsessive-compulsive patient does not get the feeling that everything is all right. Those affected often ask family members or neighbours to help them with the control. This way, they can hand over responsibility and complete their patrols more quickly.

Repetition and counting compulsions

The so-called repetition compulsions cause those affected to repeat everyday actions – such as brushing their teeth or shaking out the bedclothes – for a certain number of times. If he didn’t follow his rules, he feared something terrible could happen to himself or someone close to him. With compulsive counting, the obsessive-compulsive sufferer feels the urge to count certain things, such as books on the shelf, paving stones, or bathroom tiles, over and over again.


collection compulsions

Collectors are afraid of accidentally throwing away something valuable or important to them. They need help distinguishing between memorabilia that is important to everyone and worthless rubbish. Many also collect discarded items such as old car parts or broken household appliances to “one day” repair them. The so-called messages have been increasingly reported in the media for some time. Those affected are characterized by the so-called “neglect syndrome”. A large number of them also suffer from the compulsion to collect.

order constraints

Those affected have subjected themselves to stringent regulatory criteria and standards. They spend a corresponding amount of time every day meticulously restoring their order. For example, they always put the cans on the shelf in a certain way or ensure that the laundry in the cupboard lies precisely on each other.

Compulsive slowness

Since compulsive rituals take up a lot of time, any obsessive-compulsive disorder slows down the lives of those affected accordingly. However, for a small subgroup, slowness itself is the problem. They need hours for everyday activities such as eating or dressing. When combing hair, for example, each hair must be brushed individually. If the person concerned gets confused, they must start over again.


Obsessive thoughts without compulsive actions

Intrusive thoughts play a central role in most obsessive-compulsive disorders. However, in a subset of sufferers, the compulsion consists solely of intrusive thoughts. These usually have aggressive (“I could hit my wife”), sexual (“I could sexually abuse the neighbour’s child” or “I’m homosexual”) or religious (“I could make blasphemous statements during the service”) content. The greatest fear of those affected is that their thoughts could eventually become reality. So far, no case has become known where an obsessive-compulsive disorder has turned his frightening obsessions into reality.


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