Question About Highly Structured and Rule-Based Compulsions in OCD

[eliasParticipant]

I would like to ask a question about compulsions in obsessive-compulsive disorder (OCD).

Can compulsions in OCD also be highly detailed, structured, and rule-based, similar to what I describe in my case? Or do compulsions generally need to be relatively simple and straightforward to be considered compulsions?

To give you some context, I experienced distressing thoughts concerning my family and felt an urge to perform certain compulsive behaviors in order to “prevent” my family from going to hell.

One of my compulsions involved sitting on my bed in my room, taking off my right sock, and placing it next to me. While putting the sock back on, with my eyes open, I imagined myself in a dark environment with several candles burning in front of me, praying, crying, and mentally saying: “God, let my whole family go to hell.” I deliberately stopped just before finishing the sentence, for example: “God, let my whole family go to…” and then immediately mentally reversed the situation by internally expressing regret. This entire imagined process had to take place while I was putting my sock back on, not before or after. Once the sock was fully on and I experienced a certain internal feeling of “rightness,” the compulsion felt complete.

However, since this feeling rarely occurred, I repeated the process many times. It is important to note that the compulsion I had been performing up until that point was relatively straightforward and neither rule-based nor systematic. Since I already knew the content of the compulsion – exactly what I needed to do – I would simply sit on my bed, imagine the process, and perform it directly, without establishing any specific rules beforehand or creating a structured process around it. Eventually, because the compulsion was not relieving my anxiety, I decided to switch to a more structured and rule-based version. I thought that if I established rules in advance, I might feel more in control and more certain, particularly regarding the desired outcome, namely that my family would not go to hell. In this rule-based version, the established rules generally applied exclusively to the compulsion I performed on my bed. This meant that, according to the rules I had established, the compulsion itself would still be considered valid even if I did not perform it thoroughly or completely. Before performing this rule-based behavior, I first prepared the environment in my room accordingly. More specifically, if I had performed this rule-based behavior without preparing the environment beforehand, all the actions and rules would have been considered invalid, and I would essentially have performed them for nothing. Therefore, preparing the environment was an essential part of the entire process.

By preparing the environment, I mean, for example, placing my phone in the bottom-left corner of my pillow and positioning my charger, together with its cable, in a very specific way in the bottom-right corner. I also had to place a pen in the left corner of my desk and position my glasses directly next to it. Then I placed my phone directly above my glasses, with everything arranged in a very specific and precisely defined order. The position of my bedroom door was also predetermined: I had to leave it exactly halfway open. Closing it completely or opening it fully was not permitted. Likewise, I had to leave the window halfway open. In addition, I had to wear certain specific items of clothing that had been determined beforehand. Wearing random or arbitrarily chosen clothes was not acceptable. There were several other requirements of this kind that I had to fulfil before performing the actual compulsion.

First, I positioned myself at a specific distance in front of my wardrobe, with my left foot forward and my right foot behind. I kept both arms straight at my sides. Then, when I placed my right foot next to my left foot so that both feet were parallel, I assumed a posture in which both hands were positioned straight in front of my body. I performed a specific hand movement so that, in the end, my feet remained parallel and my hands were extended straight in front of my body, with my fingertips pointing forward. After assuming this specific position, I looked at a particular spot on my carpet with my eyes open and then began silently reciting the sentences containing the rules internally, without speaking aloud or moving my lips. Internally, I said: “Today, here and in this room, now and later, I will perform a systematic and rule-based obsessive behavior. In order for the systematic and rule-based obsessive behavior to be carried out here, rules will be established.” I then said: “A new rule will be established: (content of the rule)” – followed by many additional rules. Every time I established a new rule internally, I would repeat to myself: “A new rule will be established,” and then formulate the content of that particular rule.

Examples of such rules included:

Regardless of how illogical the rules may be, I am still allowed to establish them.

The systematic and rule-based obsessive behavior performed here will cease to exist, be considered invalid, be terminated, and have no significance whatsoever.

All systematic and rule-based compulsive behaviors performed up until now, regardless of whether they consisted of one or two stages, such as sitting on the bed and looking at the floor, will have no significance, will be terminated, and will cease to exist. The systematic and rule-based obsessive behavior performed here will replace all previous systematic and rule-based compulsive behaviors.” In addition to these, I established many other rules.

My actual question is the following:*

Based on what I have described, is it common in OCD for compulsions to be so highly structured and detailed? For example, is it possible for a person to first prepare their environment, assume a very specific physical position, and then internally establish various rules, where establishing the rules itself is not the actual compulsion, but rather serves the purpose of gaining greater control over the actual compulsion that is subsequently performed? In this way, the actual compulsion becomes much more structured and rule-based.

The reason I am asking is the following: As you probably know, many people with OCD establish rules for their compulsions. However, when people do this, they generally seem to establish these rules in a relatively simple and straightforward way. In other words, they think of the rules and then immediately perform the compulsion, without first establishing the rules in such a highly structured manner as I have described in my case.

I am simply curious about how you guys would interpret this phenomenon and would greatly appreciate it if you guys could share your opinion with me.

[Forum Moderators]

Hi:

Forum moderators here; we’re sorry you haven’t had many replies yet. Please don’t take this personally or ever think you’re alone. It may just be that forum users are taking a bit of  time to consider how to reply and support you.

And please remember that you can also contact the OCD Action Helpline to talk to or email someone who understands OCD.

Our Helpline volunteers provide confidential help, information and support for people with OCD (and anyone who thinks they may have OCD). Most volunteers have personal experience of OCD; all understand how it can impact your entire life. Contact our Helpline by:

• phone: 0300 636 5478 (this is a UK number).
• email: support@ocdaction.org.uk

And please remember that you’re never alone – OCD Action is always here to help and support you.

Best wishes,

Forum Moderators

[Author]

Posts