Mental Compulsions: What They Are and How to Recognize Them
When most people think about Obsessive-Compulsive Disorder (OCD), they imagine someone repeatedly washing their hands, checking locks, or arranging items in a specific way. These are visible, outward behaviors we typically associate with the disorder. But OCD doesn’t always look like this. For many people, the compulsions happen entirely inside the mind. These are called mental compulsions—and they can be just as distressing and disruptive as the physical ones.
What Are Mental Compulsions?
Mental compulsions are internal behaviors or thought patterns that someone with OCD performs to reduce anxiety, neutralize a distressing thought, or “undo” a feared outcome. Unlike physical compulsions, they’re invisible to others—but they serve the same function: temporarily relieving discomfort caused by obsessive thoughts.
Common Mental Compulsions (with Everyday Metaphors)
Mental reviewing – replaying events or conversations in your head to make sure you didn’t say or do something wrong, offend someone, or miss a key detail
Like hitting “rewind” on a conversation over and over, trying to find a moment where you “messed up”—as if you’re editing a movie frame by frame, hoping to catch and fix a scene that might not even be there.
Mental reassurance – thinking things like “I would never do that” or “That’s not who I am”
Like being your own defense attorney, constantly presenting arguments and evidence to convince yourself you're a good person and nothing bad will happen.
Counting, praying, or repeating words/phrases silently
Like tapping a lucky charm in your pocket, except it’s all in your head—repeating a word or prayer in just the right way to prevent something bad from happening.
Thought neutralizing – replacing a “bad” or distressing thought with a “good” one
Like trying to “cancel out” a dark thought by immediately forcing in a bright one—imagining you can balance the emotional scales if you think the “right” thing fast enough.
Mentally checking – scanning your body, feelings, or memories for evidence of safety, certainty, or “rightness”
Like being stuck in an internal security check—constantly scanning for signs that everything is okay, even though nothing has actually changed since the last time you checked.
Why Are Mental Compulsions So Hard to Recognize?
People often describe their mental compulsions in ways that make them sound logical or even helpful. Over time, these mental behaviors become automatic—a go-to habit whenever uncertainty or distress shows up. They feel like problem-solving, but if you find yourself doing them on a loop without real resolution, they’re likely reinforcing the OCD cycle.
You might catch yourself thinking:
“I’m just thinking things through.”
“I need to be sure.”
“I’m reminding myself of what’s true.”
“I’m fixing my thoughts so they’re correct.”
These mental habits can feel like you're doing something productive, trying to solve a problem, make sense of your thoughts, or calm your anxiety. But the more you engage with them, the more stuck you often feel. They offer a temporary sense of relief or control, but they don’t lead to lasting clarity or peace of mind. Instead, they strengthen the pattern and make your brain believe these loops are necessary.
How Mental Compulsions Maintain the OCD Cycle
Here’s the trap: every time you engage in a mental compulsion, you teach your brain that the intrusive thought is dangerous and needs to be managed or “fixed.” This keeps the obsession alive and strengthens the belief that you can’t tolerate uncertainty. Over time, the brain becomes more sensitized, and the compulsions become more frequent or elaborate.
This cycle looks like:
Intrusive thought
Spike in anxiety or distress
Mental compulsion to reduce discomfort
Temporary relief
The obsession returns—and usually with more intensity
How to Break the Cycle
The good news: you can learn to recognize and reduce mental compulsions with the right approach. Treatment for OCD, especially Exposure and Response Prevention (ERP), helps you do just that.
Here’s where to start:
Build awareness. Begin noticing when you’re doing something in your head to feel better or safer. It might feel automatic at first, but with practice, you’ll start to catch it.
Label it. Instead of justifying the mental action, try labeling it: “That’s a mental compulsion.” This step helps you create space between the urge and the action.
Allow uncertainty. This is the heart of OCD treatment. Practice letting the thought be there without trying to resolve it. Say to yourself, “Maybe that’s true, maybe it’s not. I can tolerate not knowing.”
Work with a trained therapist. ERP therapy is the gold standard for OCD. A therapist trained in ERP can help you identify your mental compulsions and develop strategies to reduce them gradually and effectively.
Final Thoughts
Mental compulsions are tricky—they’re quiet, hidden, and often mistaken for helpful thinking. But recognizing them is a powerful step in changing your relationship with OCD. You don’t have to do it perfectly, and you don’t have to do it alone.
By Andrea Born-Horowitz, LCSW
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