checking (n)

the process of making sure that something is correct or satisfactory

When stress builds up in our lives we are prone to low mood and anxiety. We might be dealing with daily pressures and then something else will happen, like a birth, a death, career change or a house move.  This event on top of everything else could trigger a range of issues, including the symptoms Obsessive Compulsive Disorder.

You might already know enough about OCD to know that it is NOT the desire to have a tidy home! Obsessive Compulsive Disorder causes significant levels of distress and often people with OCD know that their behaviours aren’t really helpful and are exhausted by having to perform them. 

There are four main types of OCD: contamination, ordering (symmetry), Intrusive thoughts and checking. This blog takes a brief look at checking.

The trademark of OCD is that an unwanted and often unpleasant intrusion (usually a thought or image) causes distress which is reduced or neutralised by performing a ‘ritual’ (compulsion). Maybe this is to keep ourselves or a loved one safe or because we ‘just don’t feel right’ unless we do it.

An example might look like this:

Obsession: Having a thought that my son will crash his car on the way home.

My anxiety starts to rise until it’s pretty unbearable and I decide that if I check the front door is locked it keeps him safe.

Compulsion: I check the door is locked 10 times and my anxiety reduces in the short term.

My son comes home from work without having crashed and I tell myself that the door checking kept him safe.

I have to keep up this unwanted and unhelpful behaviour in order to keep my family safe and now every time I pass the front door I have to check it is locked. The more I do this, the more I believe I need to do it.

Even though deep down I know that you can’t keep someone safe by checking a door handle, I can’t afford to take the risk. I’m stuck with this long-winded and distressing behaviour and what’s more, I seem to be developing new rituals, like checking the windows and the back door. The irony is that instead of becoming less anxious, my compulsive behaviours seem to be making me feel increasingly anxious as I spend the day trying to find short term fixes to my worry.

Increase checking = increased certainty?

Surely the more I check something, the more certain I am it’s done? Well, this isn’t actually the case. The paradox is that checking something more often reduces your certainty and makes you feel less confident about whether you have in fact shut the door, locked the window, turned off the gas hob or the straighteners. In other words, increased checking = increased doubt= increased anxiety.

Help for OCD

If you would like some help with checking behaviours or other OCD behaviours, you can access talking therapy either privately or through your GP. You can self-refer online too through your local IAPT service. Cognitive Behavioural Therapy (using exposure work) can be a helpful way to explore what has triggered and maintained OCD behaviours and it might also be helpful to look at whether you have an inflated sense of responsibility  – check out my previous blog here.

Treatment will include Exposure and Response Prevention (ERP). This involves not responding to the distressing thought by performing an unhelpful behaviour but building a tolerance to the anxiety symptoms until they naturally reduce.  Initially this can be tricky, and so it is important to rank the behaviours from least to most challenging and gradually move up the list.

At the same time, you are reducing the belief that the ritual has any influence over what may or may not occur. In other words, just thinking about something, doesn’t make it more likely to happen.