Individuals with a diagnosis of Obsessive-Compulsive Disorder (OCD) typically display some form of compulsive checking, which can include various formats such as checking to see if appliances are turned off, ensuring that doors are locked before going to bed, checking the garbage to be certain that nothing valuable has been accidently discarded, etc.
There are also more subtle forms of compulsive checking, such as mentally reviewing conversations which took place that day; reading the same material over and over again, just to be certain that its content is completely understood; and various forms of reassurance-checking (e.g., “I did a good job on that paper I wrote, right?”).
Both overt (behavioral) and covert (mental) checking serve the primary purpose of confirming that a mistake has not been made, a mistake that compulsive checkers believe could result in some type of catastrophic consequence for oneself, or others.
Thus, self-doubt and obsessive fears become the trigger for compulsive checking. These fears center around three primary categories.
This is perhaps the most common fear associated with compulsive checking, and is seen in countless rituals.
Consider the following individuals: Dan spends up to 2 hours each evening checking over and over again to ensure that all lights in the house are turned off at bedtime, for the purpose of preventing a fire.
He believes that making the mistake of leaving even one light on could lead to catastrophic consequences, such as his home burning to the ground.
Marissa has been fired from several jobs due to arriving late for work. However, she typically arrives for work 1 hour before she is due to begin her job.
The problem is, once Marissa parks her car in her assigned space, she spends more than 45 minutes compulsively checking to see if she has correctly set the emergency parking break.
She will release the break, re-engage it, release it again, etc., just to be certain the car is securely protected.
Fear of Harming Others
Similar to safety fears, the fear of accidently harming others is also associated with making mistakes which could result in harming a friend, family member, or a perfect stranger.
Each night, while preparing dinner for her husband, Nancy becomes extremely anxious. Her anxiety is triggered by thoughts that she may accidently poison her husband, or contaminate the food she is cooking.
Therefore, Nancy spends nearly 3 hours preparing a meal which should normally take 1 hour to cook. Two hours of the cooking process involves compulsively checking every ingredient to ensure that expiration dates have not passed, there are no “unusual” odors emanating from the food, checking that her hands have been properly sanitized, etc.
Fear of Embarrassment
Although this type of fear is seen in all anxiety disorders, it is particularly prevalent for those with Social Anxiety.
These individuals will engage in covert (mental) compulsive checking after nearly every social interaction they have experienced.
A mental review of the entire interaction occurs for the purpose of attempting to remember if any type of mistake may have been made which might result in appearing to others as inept, awkward, or incompetent during the course of the social-interpersonal event.
MEMORY CONFIDENCE LEVELS
Research concerned with the origin of compulsive checking hypothesized that this condition may simply be due to the fact that those who engaged in this type of behavior may possess a deficit with respect to their executive functioning abilities, thus resulting in short-term memory impairment.
Perhaps they repeatedly checked to see if they performed a task correctly because they had difficulty remembering if they had in fact done so.
However, results from these research studies indicated that compulsive checkers did NOT possess any form of memory impairment. Indeed, their short-term memory scores were significantly higher than those who did not engage in compulsive checking.
Follow-up research took a different approach regarding the presence or absence of memory impairment associated with compulsive checking.
A random sample of 2,000 subjects diagnosed with OCD, who performed compulsive checking rituals, were asked the question, “Do you think you have a very good memory — as good or better than most people?”
A statistically significant number of these individuals answered, “NO,” to this question.
Thus, although these subjects demonstrated superior scores on short-term memory tasks, it was their LOW CONFIDENCE LEVELS regarding their own subjective assessment of their memory which maintained their compulsive checking.
In addition to these findings, Part 2 of this series, will take a closer look at two core beliefs which have been found to be the primary factors most consistently correlated with compulsive checking — OVER RESPONSIBILITY and an intolerance for UNCERTAINTY.
Barry C. Barmann, Ph.D., is a Licensed Clinical Psychologist in Nevada and California. His wife, Mary B. Barmann, MFT, is a licensed Marriage and Family Therapist in California. Visit anxietytreatmentinclinevillage.com to learn more.