People with obsessive-compulsive disorder (OCD) experience frequent, distressing thoughts, ideas or images, known as obsessions. They also feel compelled to repeatedly perform activities or rituals, known as compulsions, in response to the obsessions. Compulsions are repetitive behaviors or mental acts that a person with OCD feels driven to perform, either to try to prevent or avoid some dreaded event or situation, or to ‘neutralize’ the obsessive thoughts. Examples of compulsions include excessive cleaning, checking locks, repeating phrases, ordering objects and retracing steps. People with OCD often know their compulsions are excessive or unreasonable but feel powerless to stop the thoughts or actions.
Ignoring compulsions may seem like an easy way to combat OCD symptoms, but it’s not that simple. When compulsions are ignored, anxiety can spike dramatically in the short term. However, resisting compulsions is an important part of evidence-based treatment approaches for OCD. With guidance, people with OCD can learn to gradually face their fears and resist performing compulsive rituals through a process called exposure and response prevention (ERP) therapy. Successfully resisting compulsions over time can lead to decreased anxiety and reduced OCD symptoms in the long run.
What happens in the short term
In the short term, anxiety levels typically spike when people with OCD first start trying to ignore or resist a compulsion. Compulsions are performed to decrease anxiety and distress linked to obsessions. So when compulsions are avoided, the anxiety doesn’t get released and may continue to build. This is incredibly uncomfortable and accounts for why compulsions are so difficult to resist. People with OCD may experience increased heart rate, sweating, shaking and feeling on edge when they first start trying to cut out compulsive behaviors. The urge to perform the compulsion can become overpowering. Ignoring compulsions in the short term takes huge mental effort. People with OCD often liken it to holding your breath underwater – you can only resist so long before you desperately need to come up for air and perform the compulsion.
The main short term effect of resisting a compulsion is a dramatic increase in anxiety. The level of anxiety depends on the person and the type of compulsion. For example, someone who always washes their hands for exactly one minute may experience more intense anxiety resisting that compulsion compared to resisting a lower stakes compulsion like having to line up all objects “just right”. The longer someone tries to ignore the compulsive urge, the more their anxiety is likely to increase. In the short term, anxiety continues to rise until the person gives in and performs the compulsion or is forced to face natural consequences.
With high anxiety levels, resisting compulsions also often causes difficulty concentrating in the short term. Intrusive obsessive thoughts may keep bombarding the mind, making it hard to focus on anything else. The urge to perform the compulsion can be distracting and make it difficult to think about or do other tasks. People with OCD may find their productivity and performance decreases in the short term when they first start trying to cut out compulsions. Basic tasks become much harder when battling intense anxiety.
Other short term effects
Other short term effects that may occur when resisting compulsions include:
- Insomnia or fatigue from anxiety disrupting sleep
- Irritability or lashing out at loved ones
- Avoiding social activities or situations that could trigger anxiety
- Feeling depressed or hopeless due to the intensity of anxiety
In the short term, trying to ignore compulsions can be extremely challenging. Support from a mental health professional trained in exposure therapy can help make resisting compulsions more manageable.
What happens in the long term
While ignoring compulsions causes anxiety to spike at first, if someone sticks with it, the anxiety will gradually diminish over time. This is the principle behind exposure and response prevention therapy for OCD. By continually resisting the urge to perform compulsions in a structured way, anxiety triggered by obsessions begins to decrease through habituation. Eventually, the obsessions and compulsions cause less distress and occur less frequently. Here’s an overview of the long term effects that occur when compulsions are consistently resisted over time:
Decreased anxiety and stress
After the initial spike, anxiety levels gradually decline and stabilize at a lower level the more times someone resists a compulsion. The obsessive thoughts tend to trigger less anxiety overall after repeated exposures. Resisting compulsions becomes easier and requires less mental effort over time. Overall anxiety and stress levels decrease as fewer mental resources are spent on obsessive thoughts and compulsive rituals.
Improved daily functioning
With reduced OCD symptoms, people report improved concentration, focus, productivity and performance of daily tasks. Sleep often improves too. Relationships, work life and social activities suffer less interference from OCD symptoms that have decreased in frequency and intensity. More time is freed up to enjoy life when not as crippled by obsessions and compulsions.
Increased confidence and self-efficacy
As OCD symptoms improve, the person gains confidence they can manage their anxiety without relying on compulsions. They have evidence that feared consequences linked to obsessions (like harm or contamination) won’t happen even if they stop rituals. Their self-efficacy improves – they feel empowered that they can tolerate anxiety without compulsions. This motivates them to keep resisting urges.
Possible complete remission
With continued exposure therapy practice, OCD symptoms may fade away completely in the long term. For some people, resisting compulsions leads to full remission with no remaining signs of OCD. The principles behind exposure therapy align with findings that neurological pathways linked to compulsions weaken with disuse over time. Of course, remission depends on the individual and type of OCD. But many people do achieve full recovery after committed exposure therapy.
Ignoring compulsions is very difficult initially but gets easier with consistent practice. While anxiety worsens in the short term, exposure therapy helps retrain the brain over time to habituate to triggers. Resisting compulsions gradually strengthens one’s ability to tolerate uncomfortable thoughts and feelings without ritualizing. Long term effects of resisting compulsions include reduced OCD symptoms, less anxiety, healthier functioning and greater self-efficacy. For many with OCD, facing fears is the pathway to recovery.