Checking Behaviours in Obsessive-Compulsive Disorder

Checking behaviours are a common experience for many individuals. They are actions we perform to prevent some danger or to alleviate anxiety about a potential threat or mistake. Whether it's double-checking that the door is locked, or making sure the oven is off, these actions can be a normal part of our routines. For most people, checking can be a simple, quick activity that provides peace of mind. However, for others, it can become a time-consuming and distressing ritual.

When these behaviours become excessive and interfere with daily life, they could be indicative of underlying psychological issues, such as obsessive-compulsive disorder (OCD). 

Obsessive-Compulsive Disorder (OCD) is a chronic mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviours (compulsions) that an individual feels driven to perform. Among the various compulsions in OCD, checking behaviours are particularly common and can significantly impact daily functioning and quality of life. Understanding and addressing these behaviours is crucial for effective management and treatment. 

There are many forms of checking including security-related checks such as locking doors, checking alarms, and windows. Some individuals perform safety checks for instance, ensuring appliances are turned off to prevent fires. Health checks where individuals frequently monitor their own or others’ bodies for signs of illness, are also common. Memory checks can also occur where the individual repeatedly goes over past events to confirm details.

It's important to understand that the checking behaviours we see in individuals with obsessive-compulsive disorder are usually driven by an intense fear of perceived harm or uncertainty. Checking behaviours are often used as a coping mechanism to manage their worry about potential risks or threats and minimise their level of concern. The discomfort experienced by individuals can be extremely overwhelming, and performing the behaviour provides short-lived relief, pushing the person to keep repeating the behaviour. 

The impact of checking behaviours on daily life can be quite profound. Individuals may find themselves becoming overwhelmed by distressing thoughts and spending significant time performing the behaviours. As a result, they might be late to work or miss important appointments. Social interactions and relationships can also suffer, as the individual may avoid certain situations or places that trigger their compulsions. The constant need for reassurance and the associated anxiety can also lead to significant distress and impairment.

Overcoming checking behaviours includes addressing and managing the underlying distress that accompanies it. Coping with this alone can be isolating and frightening, particularly if the anxiety is very strong. A mental health professional can provide a safe space to tolerate distress, and a tailored treatment plan that addresses the specific needs of the individual. 

A combination of therapeutic approaches and self-help strategies have been found as effective in managing and overcoming checking behaviours. Cognitive-Behavioural Therapy (CBT), particularly Exposure and Response Prevention (ERP), is highly effective in treating OCD, and involves addressing checking behaviours. ERP involves gradually exposing individuals to the feared situations without allowing them to engage in checking behaviours, thereby reducing the anxiety associated with those fears over time. Engaging in this therapy can seem daunting, however, Psychologists support the individual through their fear by being present, safe and trustworthy and monitoring their fear throughout. 

Checking behaviours in OCD are a debilitating aspect of the disorder that can significantly impact an individual's daily life. Recognizing these behaviours and seeking appropriate treatment can lead to improved functioning and a better quality of life. By understanding the nature of checking behaviours and implementing effective strategies to manage them, individuals with OCD can take significant steps toward recovery and well-being.