Guide
Guide
|
Reference
16 Obsessions, Compulsions, and Stuckness
16.1 Summary
- Intrusive thoughts, images, or urges paired with repetitive behaviors or mental rituals that feel hard to resist.
16.2 Patient-Language Phrases
- “I can’t stop thinking about it.”
- “I have to check or repeat things to feel okay.”
- “I get stuck on certain thoughts.”
- “I do it even though I know it doesn’t make sense.”
16.3 Core Features
- Intrusive thoughts or urges that feel unwanted.
- Compulsions, checking, reassurance seeking, or mental rituals.
- Sense of relief followed by return of doubt or distress.
16.4 Boundary Markers
- What it is: repetitive thoughts or behaviors driven by distress or uncertainty.
- What it is not: goal-directed habits or preferences without distress.
16.5 Quick Structure
- Variants / Spectrum
- Checking and reassurance loops.
- Contamination or harm-focused fears.
- Symmetry or “just right” compulsions.
- Body-focused repetitive behaviors (skin, hair).
- Health or illness-focused rumination.
- Severity (0-4)
- 0: No significant intrusive thoughts or rituals.
- 1: Mild, occasional, manageable.
- 2: Moderate, recurring, impacts focus or time use.
- 3: Severe, frequent, time-consuming or impairing.
- 4: Extreme, disabling or unsafe.
- Time-course
- Chronic with fluctuating intensity.
- Trigger-linked spikes.
- Functional impact
- Work/school: reduced focus, time lost to rituals.
- Relationships: reassurance seeking or conflict.
- Self-care: delays or avoidance.
- Developmental expression
- Childhood: rituals or checking that intensify under stress.
- Adolescence: increased rumination and reassurance.
- Late life: health anxiety or checking related to safety.
- Cultural/context notes
- Some rituals are culturally normative; assess distress and impairment.