What Is an Obsession?
Medically reviewed by Melissa Bronstein, LICSW
Obsessions are persistent and often intrusive thoughts, ideas, or impulses. People with and without obsessive-compulsive disorder (OCD) can experience obsessions, but those with OCD experience more distress, guilt, negative emotion, and interference in daily life compared to the general population.
Most people know their obsessions are excessive but feel unable to control them. Because they are unwanted and disturbing, obsessions usually cause anxiety.
This article will discuss obsessions, including types, causes, coping methods, and treatment options.
FS-Stock / Getty Images
What Is an Obsession?
Obsessions are repeated thoughts, urges, or mental images that are intrusive and unwanted. For people with obsessive-compulsive disorder (OCD), obsessions make them very anxious. To relieve that anxiety, they are driven to perform compulsions.
Compulsions are rituals or behaviors that temporarily “neutralize” someone’s distress about an unwanted obsession. People with OCD may have obsessions, compulsions, or both.
Most people experience some degree of obsessive symptoms, such as intrusive thoughts, at some point in their life. Recurring, unwanted thoughts are especially common during times of stress. However, most people who have occasional intrusive thoughts don’t develop obsessions or OCD.
Types of Obsession
Obsessions and their accompanying compulsions are typically time-consuming and overwhelming. People with obsessions may seek to relieve their inner tension by performing a certain action compulsively, such as washing their hands, “checking” (doors, locks, ovens, etc.), counting, or asking repetitive questions.
Obsessions typically fall along certain anxiety-inducing themes, such as fears of harm, sickness, and bad luck, as well as things that are inappropriate or wrong.
The five most common types of obsessions can be categorized as perfectionism, relational, contamination, causing harm, and intrusive thoughts. All obsessions can cause significant emotional distress, lower self-esteem, and interfere with the ability to function normally in relationships, work, or school.
How Common Is OCD?
Obsessive-compulsive disorder is a relatively common mental health condition. Over the course of their lives, about 2.3% of U.S. adults will meet the criteria for OCD.
Perfectionism
People with perfectionistic obsessions are overwhelmed by a fear of making mistakes, doing something wrong, or leaving things out of place. Perfectionistic OCD may involve obsessions with:
Order, symmetry, and organization
Neatness
Following specific rules, directions, and routines
Feeling that things are “in their place” or “just right”
Completing tasks at work or school perfectly
Contrary to popular belief, perfectionistic obsessions aren’t always about organization, neatness, or arranging household items. Some people with OCD also exhibit scrupulosity, a type of moral perfectionism. Scrupulosity often involves rigidly adhering to strict religious, ethical, and/or moral beliefs.
Relational
Relationship-focused obsessions involve overwhelming doubts and worries about the “rightness” of a romantic relationship or partner. Some researchers refer to this kind of obsession as relationship obsessive-compulsive disorder (ROCD).
People who have obsessive thoughts or worries about a particular romantic partner often have an intense fear of abandonment. Many people with relationship-focused obsessions experienced childhood trauma or rejection, leading them to develop an insecure attachment style. Others may have experienced betrayal, such as cheating, in a past relationship.
People with ROCD may experience symptoms such as:
Constantly questioning their feelings or their partner’s feelings
Wondering if their partner is their soulmate or “the one”
Frequently comparing their current partner to previous partners
Preoccupation with their partner’s perceived moral, emotional, or physical flaws
Worrying that their partner will cheat or leave the relationship
Many people with relationship-focused obsessions attempt to relieve their anxiety by asking constantly for reassurance of their partner’s love or loyalty. They may also fantasize excessively about finding their ideal soulmate or developing the perfect relationship to manage their distress.
Contamination
Contamination obsessions may involve fears of physical contamination (such as with dirt, bacteria, germs, chemicals, or illness) or moral contamination (such as with a person, place, or idea that is perceived as “bad” or distasteful).
When confronted with the possibility (or even sometimes the thought) of contamination, people with contamination obsessions often feel overwhelmed.
To feel “pure” or “clean” again, people with contamination-related obsessions may:
Engage in excessive and sometimes ritualized hand-washing
Disinfect or sterilize things
Throw things away
Change clothes frequently
Create clean areas off-limits to others
Avoid certain places or touching things
Causing Harm
Some people with OCD experience obsessions related to causing harm to themselves or others. Common examples of obsessive fears related to causing harm include:
Forgetting to turn off household appliances
Getting into a car accident
Getting someone sick
Accidentally dropping a baby
Many people with OCD feel an “over-responsibility for harm,” meaning that they feel their everyday actions can cause bad things to happen even when it’s unlikely or impossible.
Common compulsions for harm obsessions include:
Avoidance of certain people, objects, or locations
Reassurance seeking from others, self, and online sources
Mental rituals, such as excessive prayer to prevent violence; neutralizing bad thoughts with good ones; rationalizations about why they wouldn't do harm; and playing out how they would handle fearful scenarios
Intrusive Thoughts
Intrusive thoughts are typically related to something frightening, dangerous, inappropriate, or repulsive, such as:
Unwanted sexual imagery
Unwanted violent imagery
Aggressive impulses
Religious blasphemy
About 80%–90% of the general population experiences intrusive thoughts. However, for some people—such as those with OCD—those obsessive thoughts are persistent and anxiety-inducing enough to interfere with daily functioning. It’s important to remember that having intrusive thoughts doesn’t mean you’ll act on them.
Related: Common Types of OCD
Causes of Obsessions
Obsessions typically don’t have any single root cause. Instead, they are most likely due to a combination of genetic and environmental factors.
Researchers have identified many possible causes of obsessive-compulsive disorder, including:
Genetics: According to twin studies, about 45%–65% of OCD symptoms can be attributed to genetic factors.
Trauma: Experiencing trauma, such as abuse or betrayal, is a significant risk factor for OCD. Additionally, many people with OCD also have post-traumatic stress disorder (PTSD).
Upbringing: There is some correlation between having had an overprotective parent and the development of OCD. Parents who are anxious and/or have obsessions themselves may pass them on to their children, partly through genetics and partly through the home environment and learned behavior.
Stress: Studies suggest that stressful life events, especially during childhood, often play an important role in the development of obsessions.
Brain abnormalities: Imaging studies conducted on people with OCD have revealed hyperactivity in areas of the brain that are involved in impulse control, emotional regulation, and decision-making.
Other conditions: An estimated 69% of people with OCD have one or more comorbid (coexisting) conditions. These include mental health conditions, such as generalized anxiety disorder (GAD) and major depressive disorder (MDD), as well as tic disorders like Tourette’s syndrome (TS).
Obsessive-compulsive disorder is the most common mental health condition that involves obsessions. However, some obsessive symptoms may also be present in other mental health conditions, such as:
Schizophrenia: A mental illness that causes disturbances in thinking, behavior, and perception
Obsessive-compulsive personality disorder (OCPD): A condition that involves a long-lasting, overwhelming preoccupation with orderliness, perfectionism, and control
Related: OCPD vs. OCD: What Are the Differences?
How to Manage Obsession
Obsessions may feel like they’re out of your control, but there are many ways to feel more empowered. Here are some ways to cope with obsessive thoughts:
Find support: Participating in peer support groups for people with OCD or intrusive thoughts can help you feel less alone and connect you to valuable resources.
Avoid drugs and alcohol: Many people with OCD also have a substance use disorder (SUD). In turn, excessive alcohol use worsens OCD symptoms. If you have OCD, it may be best to limit your intake of drugs and alcohol as much as possible.
Practice good sleep habits: Insomnia often exacerbates intrusive thoughts. To improve your sleep quality, practice healthy sleep habits like going to bed at the same time every night and turning off your phone an hour before bedtime.
Exercise regularly: Staying physically active may help you burn off excess energy and keep your mind off of your obsessions. Research suggests that vigorous exercise can even reduce the severity of OCD symptoms.
Use a self-help program: From workbooks and online exercises to smartphone apps, there are plenty of self-help tools you can use to monitor your obsessive thought patterns and learn to stop them in their tracks.
Practice mindfulness: Obsessions may make you feel like you’re not in the driver’s seat when it comes to your thoughts. Mindfulness and mind-body techniques, such as yoga and meditation, can help you stay grounded and present.
Manage stress: Chronic stress can trigger obsessive thoughts or make them worse. If you are prone to obsessive thinking, try to minimize your stress and relax more often by using the above practices.
Related: A Practical Guide to Meditation for OCD
Getting Help
Some people with OCD feel too guilty or embarrassed about their obsessions to seek help. But your obsessions aren’t really “you.” They are part of a health condition that can and should be treated.
Treatment can help to reduce your anxiety and improve your quality of life. Talk to a healthcare provider about your options.
Treatment for OCD typically involves:
Exposure and response prevention therapy (ERP): Exposure and response prevention therapy (ERP) is a type of cognitive behavioral therapy (CBT) that involves confronting your obsessions and resisting the urge to perform compulsive behaviors in response in a clinically supervised setting. Around 50%–60% of people who undergo ERP experience significant and long-term improvements in their OCD symptoms.
Medication: Alongside psychotherapy, medication is sometimes prescribed to treat symptoms of OCD. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are especially effective.
Seek Help
If you or a loved one is struggling with an obsession, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.
Summary
Obsessions are persistent thoughts, ideas, images, or impulses that a person feels unable to control. Typically, obsessions are time-consuming, disturbing, and unwanted. They often cause anxiety and distress and impair functioning.
There are five main types of obsessions: perfectionism (often related to symmetry, organization, or rules), relational (doubts or worries about a relationship, typically a significant other), contamination, causing harm, and unwanted intrusive thoughts (often with sexual or violent themes).
Some people with obsessions have obsessive-compulsive disorder (OCD). Many factors increase the likelihood of developing OCD, including genetics, trauma, stress, parenting style, brain abnormalities, and comorbid medical conditions. OCD is typically treated with psychotherapy—especially exposure and response prevention (ERP) therapy—and/or medication.
Read the original article on Verywell Health.
