Obsessive Compulsive Disorder (OCD) is a mental health condition that affects millions of people worldwide. It is characterized by intrusive and distressing thoughts, images, or urges, and repetitive, ritualistic behaviors or mental acts that the individual feels compelled to perform in order to reduce anxiety and prevent harm.

While some OCD symptoms are obvious, such as excessive hand washing or checking, others are more subtle and difficult to detect. We call these “sneaky rituals.”

What do you mean by sneaky rituals?

Great question. Let’s define what we mean by “non-observable” rituals. These are behaviors or mental acts that an individual with OCD may perform in their mind. For example, one might count in their head, repeat a phrase or prayer silently, or mentally review a list of things to do.

These rituals are often, but not always, related to their obsessions – the unwanted thoughts, images, or urges that cause them anxiety. By performing these mental rituals, the person with OCD believes that they are preventing harm or avoiding a negative consequence.

Mental checking

One common type of non-observable ritual in OCD is mental checking. This involves repeatedly reviewing past events or current situations in one’s mind to make sure that everything is OK. For example, one may review conversations they had earlier in the day to make sure they didn’t say anything offensive or embarrassing. They might also mentally check their surroundings to make sure there is nothing dangerous or harmful present. While mental checking might seem harmless, it can be incredibly time-consuming and interfere with daily life. It can also reinforce the belief that one must constantly be vigilant and hyper-aware of potential threats.

Mental counting

Another sneaky ritual that people with OCD might engage in is mental counting. This can take many forms, such as counting to a certain number, counting in multiples of a certain number, or counting until a specific event occurs.

For example, someone with OCD might count to 10 in their head before leaving the house to make sure they haven’t forgotten anything. They might also count the number of steps they take while walking or count the number of times they touch an object. Mental counting can be a way for the person with OCD to feel in control of their environment and prevent bad things from happening.

Rumination

A third type of non-observable ritual in OCD is rumination. This involves mentally going over obsessions and scenarios in great detail, in hopes of “figuring it out.”

Mental rumination refers to the persistent and repetitive thinking about a particular thought, image, or idea that creates significant distress and interferes with daily functioning.

In OCD, the content of the rumination is often related to obsessions. People with OCD engage in rumination as a way of trying to reduce their anxiety or prevent a feared outcome, such as harm to themselves or others.

However, rumination can actually perpetuate OCD symptoms by reinforcing the importance of the obsessional thought or belief, and by preventing the individual from engaging in other, more productive activities. Rumination can also lead to a cycle of increasing anxiety and compulsive behaviors, as individuals try to alleviate their distress.

How can ERP help with sneaky rituals?

So, how can ERP therapy help someone with OCD who engages in these sneaky, non-observable rituals? ERP is a type of cognitive-behavioral therapy that is highly effective in treating OCD. It involves gradually exposing the person to their feared situations or thoughts, while preventing them from engaging in their usual compulsions or rituals. This process is known as “exposure and response prevention,” and it helps the person with OCD learn that they can tolerate anxiety without resorting to compulsive behaviors.

In the case of non-observable rituals, ERP might involve asking the person to stop performing mental checking, counting, or review. This can be challenging, as these rituals often feel automatic and involuntary. However, with practice and guidance from a therapist, the person can learn to resist the urge to perform these mental rituals.

For example, the therapist might ask the person to intentionally expose themselves to a triggering situation, such as walking out of the house without performing their usual mental checking routine. The therapist would then guide the person through the anxiety that arises, without allowing them to perform the mental ritual. This can be uncomfortable at first, but over time the person learns that they can tolerate the anxiety without engaging in the ritual, and the anxiety eventually decreases.

Mindfulness techniques for sneaky rituals

In addition to ERP, mindfulness-based techniques can also be helpful for managing those sneaky rituals. Mindfulness involves paying attention to the present moment, without judgment or reaction. By practicing mindfulness, the person with OCD can learn to observe their thoughts and urges without automatically reacting to them. This can be particularly helpful for managing mental rituals, as it allows the person to recognize when they are engaging in a ritual and choose not to follow through with it.

Remember, as always, you can do this

Sneaky rituals in OCD can difficult to detect by others, but they can still be distressing and impede on daily life. ERP therapy, along with mindfulness-based techniques, can be effective in helping people with OCD learn to resist the urge to engage in these rituals and manage their symptoms. If you or someone you know is struggling with OCD, know that there is help available. With the right treatment and support, it is possible to live a fulfilling life free from the limitations of OCD.

If you are looking to combat those sneaky rituals, sign up for my next workshop: Sneaky Rituals with The OCD Whisperer, Kristina Orlova on April 28. You can join us live, or download it afterward!

I also talk all about this in one of my latest podcast episodes: Sneaky Rituals In OCD.

I’m rooting for you every. single. day.

– Jenna

Remember: this blog is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as mental health or medical advice. The information and education provided here is not intended or implied to supplement or replace professional advice of your own professional mental health or medical treatment, advice, and/or diagnosis. Always check with your own physician or medical or mental health professional before trying or implementing any information read here. I am not acting as your therapist or mental health professional and this is not therapeutic advice. My goal is to provide you with options, resources, and information to make an informed decision regarding your mental health.

© 2023 Jenna Overbaugh, LLC