How avoidance fuels the cycle of obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by a cycle of two distinct symptoms: obsessions and compulsions. Obsessions are unwanted, distressing thoughts or images that may cause significant anxiety. In response to obsessions, a person with OCD engages in compulsions — repetitive behaviors or mental acts that are intended to reduce the distress caused by the obsessions. 

For example, a person with OCD may experience distressing, yet irrational, fears related to germs or getting sick. In response, they may compulsively clean all the surfaces in their home multiple times per day. This ritual might reduce their stress, but usually only temporarily. 

This example shows us how OCD might show up in a person’s life on a daily basis. However, it doesn’t illuminate the “why” behind what drives their obsessions and compulsions. While the reasons that someone develops a mental health condition are nuanced, personal, and complex, some experts point to something called pathological or extreme avoidance as a driving force behind OCD. 

What is compulsive avoidance?

Avoidance is a natural, logical human response in many situations. It might protect us from something harmful or simply prevent us from engaging with something we don’t enjoy. Sometimes, the choice is conscious. For example, maybe you don’t want to go to the after-hours office get-together, so you leave work before anyone can invite you. And sometimes, it’s unconscious like when there’s a melted ice cream cone on the sidewalk and you step to the side to avoid it. 

But for some people with OCD, avoidance can become extreme. For these people, it goes beyond the basic acts of avoidance most people perform each day. Keep in mind that people with OCD experience obsessions as cognitive distortions. In other words, they experience their fears as very real, even if they know they’re irrational. 

In response, some people with OCD engage in compulsions to avoid whatever they fear might bring them harm. When viewed in this light, OCD avoidance can be framed as an outsized but reasonable reaction to irrational beliefs and fears.  

Examples of OCD avoidance

There are several types of OCD that share similar symptoms and features. Here’s how OCD avoidance might show up in some of the most common ones:

• In harm OCD, a person constantly fears hurting themselves or someone else either on purpose or by accident. They have an irrational belief in the level of personal responsibility they have to keep everyone safe. For them, OCD avoidance might show up as a refusal to go anywhere where they might be in close contact with other people. This might mean avoiding group activities or refusing to take public transportation. 

• People living with “just right” OCD have an obsession with symmetry and order. They feel significantly distressed if things aren’t arranged in a specific way. So they might avoid anything that they perceive as disorganized or imbalanced. This could include visiting other peoples’ homes, engaging in creative hobbies, or attending events without a strict schedule. 

• Someone with relationship OCD may feel insecure about their relationships and constantly question their partner’s commitment to them without cause. This distress may cause them to avoid relationships altogether or any situation where relationships are portrayed or discussed. 

Harmful effects of OCD avoidance

In the short term, OCD avoidance might seem like it works. After all, why wouldn’t a person want to avoid a thought, place, person, or experience that might cause them distress? 

But over time, untreated OCD can create more significant mental health challenges. It can also make it difficult to keep a job, form healthy relationships, maintain your health, and engage in activities you might otherwise enjoy. Fortunately, you can manage your OCD avoidance with the right support. 

Overcoming compulsive avoidance

Left untreated, OCD is a progressive mental health condition that can become worse as time goes on. But if you’re experiencing compulsive avoidance, know that healing is possible. A therapist who specializes in treating OCD can help you confront your fears, challenge irrational thoughts, and learn to manage stress in new ways. 

The most common treatment for OCD is something called exposure and response prevention (ERP). It’s a form of cognitive-behavioral therapy (CBT) that involves a slow, gradual exposure to obsession triggers under the supervision of a trained therapist. Over time, it can help reduce the stress brought on by obsessions and, in turn, help you overcome the compulsion to rely on avoidance.

If you’re living with OCD or another mental health condition, seeking professional help is one of the best things you can do for yourself. In the meantime, there are some things you can do to manage your OCD avoidance.

• Stick to a routine. Create a daily schedule with activities you enjoy and important tasks you need to complete. A regular routine can make you feel more comfortable and in control and help reduce avoidance.
• Use relaxation techniques. Practice methods like deep breathing or mindfulness to calm yourself when you face things that provoke your OCD. These can help you manage anxiety and resist the urge to avoid things.
• Set small goals. Break down tasks into small and easy steps. Try to celebrate each small success to build confidence and make it easier to tackle bigger challenges.
• Take care of yourself. Focus on activities that support your health, like exercising, eating well, and getting enough sleep. Good self-care can make it a bit easier to handle OCD symptoms.

Find care with Rula

OCD causes unwanted, intrusive thoughts that might seem irrational on the surface. But they create very real fears for the people who experience them. In response, they might engage in a ritual or compulsion to help them avoid whatever might be causing their anxiety. This is called OCD avoidance, and it can negatively affect your well-being, relationships, and daily functioning. 

While this can be a distressing experience, effective OCD care is now just a few clicks away thanks to Rula. With our therapist-matching program, you can connect with a provider who specializes in treating OCD whom you can meet with from the comfort of home. In just a few minutes, you can sift through your in-network options, choose the right therapist for your needs, and schedule your first appointment for as soon as tomorrow.

Find a therapist with Rula