Key Takeaways
People with obsessive-compulsive disorder (OCD) may experience a strong desire to control their thoughts but have less control over their fears and urges.
Unmanaged OCD obsessions and compulsions can impact your relationships, well-being, and quality of life.
Exposure and response prevention (ERP) therapy can help people control the way they respond to obsessive thoughts and compulsive behaviors.
Research shows that approximately 1 in 40 adults in the U.S. will experience obsessive-compulsive disorder [1] (OCD) at some point in their lives. Characterized by a cycle of unwanted, intrusive thoughts and compulsive behaviors, OCD can be extremely distressing. You might realize that your obsessions and compulsions are irrational but feel powerless to break the cycle.
Below, we review the link between OCD and control so that you can feel more empowered to manage its effect on your life.
Exploring the link between OCD and control
If you have OCD, you know that it can be difficult to manage certain thoughts and behaviors. People with OCD may have a greater desire to control their thoughts [2] than people without OCD. However, people with OCD also tend to have a lower sense of control over their thoughts. Research suggests that this “control mismatch” [3] is one of the reasons people with OCD engage in compulsions.
After experiencing a distressing thought, compulsive behaviors can help restore a sense of order or safety. They can alleviate the anxiety caused by intrusive thoughts and help you feel more in control of your emotions. Most people don’t want to engage in compulsions but feel like it’s the only way to manage their distress [4].
What control issues look like with OCD
OCD can present in different ways, but everyone with the condition experiences some type of unwanted and intrusive thoughts. These obsessions may relate to a lack of perceived control [5] or fear of losing control.
Here are a few examples of how obsessions and compulsions may relate to control:
Symmetry and ordering OCD: People with symmetry and ordering OCD have an intense fixation on balance and symmetry. When things aren’t perfect or you don't feel in control of your surroundings, it can cause significant distress. For example, maybe you can’t start work until the items on your desk are arranged in a very specific way.
Checking OCD: Checking OCD involves obsessive thoughts about making mistakes or causing unintentional harm. This leads to compulsive behaviors like repeatedly checking locks, appliances, or doors. Research shows that checking behaviors are a response to the possibility of losing control [6]. But once you engage in these behaviors, you no longer feel that same desire for control.
Harm OCD: With harm OCD, you experience intrusive thoughts about hurting yourself or others. Most people have no real desire to do harm, but the thoughts can feel impossible to control. For example, you might obsess over the idea of hitting someone with your car. As a result, you avoid places or situations that might trigger those thoughts. For example, you might get to a point where driving causes extreme anxiety and you avoid it as much as possible.
Eventually, these control issues can impact your relationships, well-being, and quality of life. You might find that symptoms interfere with your productivity at work or ability to collaborate with colleagues. You might struggle with spontaneity or turn down opportunities where you don’t feel in control.
Reshaping your relationship with control and OCD
For many people, unmanaged OCD can contribute to anxiety, helplessness, and low self-esteem. Managing OCD is often an ongoing effort [7], but it’s possible to navigate control issues and other distressing symptoms. While you can't control everything, you can focus on how you respond to your thoughts and the anxiety they bring.
Treatment typically includes some combination of therapy, medication, and self-management strategies. Exposure and response prevention (ERP) is considered a first-choice approach for treating OCD [8]. With the support of your therapist, you’ll learn to confront your triggers in a safe environment.
Other strategies for improving your relationship with control include:
Focusing on what you can control: When you're finding it difficult to cope with OCD symptoms, it can be helpful to focus on what’s in your control. For example, you can choose to prioritize sleep, physical activity, and your favorite hobbies. These acts of self-care can support both your mental and physical well-being.
Remembering that not everything has meaning: Not all of your thoughts and feelings are significant or even true. For example, if you have relationship OCD, you might wonder if your partner really loves you. Instead of replacing or disputing the thought, choose to accept it. You don’t need to agree, but do your best to let it pass without reacting.
Clinician's take
When control behaviors start affecting relationships, I remind clients that the goal isn’t to eliminate uncertainty but to learn to tolerate it. This takes practice and patience. Talking openly about what feels hard can help loved ones understand the difference between offering support and giving reassurance.
Find care with Rula
OCD symptoms can affect the way you approach certain situations and how you act. You may experience a strong desire to control your environment or have a hard time managing certain thoughts and behaviors. If this sounds familiar, know that support is available.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 21,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.
About the clinical reviewer
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
