compulsion

Compulsion is a repetitive behavior or mental act that a person feels compelled to perform, usually in response to an obsession or according to rules that must be applied rigidly. The act is intended to reduce distress or prevent a feared event, but it is not realistically connected to what is being prevented and is often excessive or time-consuming.

Common forms include cleaning and washing to reduce perceived contamination, checking doors or appliances, counting, ordering or arranging items, and repeating mental rituals. Compulsions are characteristic of obsessive-compulsive disorder but can occur in other conditions. They differ from obsessions, which are intrusive thoughts, urges, or images; compulsions are the outward behaviors or internal acts used to relieve the anxiety caused by obsessions.

Impact: Compulsions can dominate daily life, lead to avoidance, and cause social or occupational impairment. Some individuals perform compulsions to relieve temporary distress; stopping a compulsive behavior can trigger an anxiety surge or uncomfortable distress.

Diagnosis and treatment: In OCD, compulsions are a core symptom; assessment uses standard diagnostic criteria. Treatment typically includes cognitive-behavioral therapy with exposure and response prevention, and pharmacotherapy with selective serotonin reuptake inhibitors. In severe or treatment-resistant cases, additional approaches such as clomipramine or neuromodulation may be considered.