The symptoms evidenced by persons with obsessive compulsive disorder (OCD) vary, but the categories do not. They report Obsessions and exhibit Compulsions. These symptoms are persistent and long-term, and, even when they appear irrational to the person suffering from OCD, they still seem uncontrollable or irresistible to him.
Compulsions are behaviors that the OCD sufferer feels he must keep repeating in order to quell his anxiety or to keep some unfortunate event from taking place. These actions might be manifested physically (e.g., tapping on a door a certain number of times) or mentally (e.g., silently repeating words). If the compulsion becomes a regular part of the individual’s routine, then it is called a ritual. The number of compulsions and rituals performed by the OCD patient is limitless. Some of the more prevalent ones are excessive hand-washing, counting, checking (locks and other items with safety implications), avoiding sidewalk cracks, touching or knocking on objects, and arranging things in predetermined way.
Compulsions are usually linked to obsessions. That is, if the person has obsessive thoughts about contracting illness from multiple sources of contamination, then he will be compelled to act in ways to prevent the feared contamination—by repeated hand washing, refusal to touch objects or shake hands with anyone, continuous cleaning of the surfaces in his house, etc. If one of his obsessions is with precision, neatness, and order, the compulsions exhibited will be in accordance with the obsession (i.e., straightening, ordering, filing, balancing, etc.). On the other hand, some obsession-compulsion associations are completely illogical. And the OCD patient may realize, for example, that, contrary to his obsession, tapping his fingers on the back on his opposite hand ten times (the compulsion) will not keep his father from having another heart attack. Yet, he is compelled to repeat the action again and again, possibly for hours at a time–to prevent the recurrence of a heart attack for his father. These compulsions are not always voluntary, and they are not enjoyable to the person, but are carried out to relieve his anxiety, fear, distress, and/or apprehension created by the obsessive thoughts.
The obsessions and compulsions of a person with OCD can literally be debilitating. Not only do they cause anxiety within the individual, but they are also time consuming and can interfere with one’s academic or occupational functioning, social activities, and personal relationships, in addition to his normal routine.