OCD & Checking: Part 2 (Mental Checking)
Mental checking can involve mentally analyzing whether or not a behavior was completed properly.
Behavioral Checking (Overt Checking)
Many examples of compulsive checking rituals in OCD involve direct inspection of a target stimulus by sight, sound, or feel.
Common OCD checking behaviors include relocking doors, visually examining the position of one’s parking brake, or holding one’s hands above stove burners in order to detect warmth.
Behavioral checking is often accompanied by the thought, “Did I do it the right way?”
These checking behaviors are often referred to as behavioral checks, manual checks, or overt checks. Overt rituals (by definition) are visible behaviors that can be perceived by external observers. However, in some cases, overt rituals may be subtle or purposefully hidden in order to avoid embarrassment.
Mental Checking (Covert Checking)
In contrast, other compulsive checking rituals can only be perceived by the individual engaging in the behavior. These types of OCD rituals are thought-based and are sometimes referred to as mental checking or covert checking rituals.
Mental checks are often accompanied by thoughts such as, “Did I do it the right way?”, “Am I feeling the right way?”, or “Did I do this for the right reason?”
Mental checking is the cognitive counterpart of behavioral checking, and many covert checking rituals overlap extensively with the mental rituals that characterize Pure-O OCD.
Whereas overt checking involves obtaining evidence directly from the current physical environment (i.e., obtaining visual, auditory, or tactile feedback from physical objects or behaviors), mental checking typically involves an evaluation (or reevaluation) of information already obtained. This information may exist in the form of memories, feelings, motivations, or other internal states of being.
Mental checks can occur both in the presence and absence of a given target stimulus. Individuals may engage in mental checking rituals shortly after an event, but covert checking is not bound by time or space. Some people with OCD continue to check hours, days, or even years after the original event. For example, some individuals may review or check the content of conversations that occurred many years ago.
Let’s identify some examples of mental checking. This list is not exhaustive but is intended to illustrate the diversity of situations in which mental checking might be present.
Examples of Mental Checking
1. Memory Checking Rituals – Reviewing one’s memory to “make sure” or verify that a behavior was completed properly.
Did I lock the door? Was the stove really off? Was the “H” on the faucet handle facing the way it normally does when it’s off? I know the answer was “B”, but did I circle “A”? Was that sound similar to the sound of a stick hitting the underside of my car, or did it sound “wet”?
This mental ritual involves retrieving memories or trying to recreate mental pictures of past events. These images are then mentally examined, checked, or scrutinized to determine if a specific criterion has been met. For example, one might try to remember the exact angle of a stovetop dial in order to obtain reassurance that the gas valve has been closed. Memories in any sensory modality can be mentally retrieved and checked – sights, sounds, or physical sensations. Because there is often OCD doubt about whether these mental images do, in fact, represent what one has actually seen, mental checks often fuel additional behavioral checks.
Other memory checking rituals involve categorization and probability estimation, which are more complicated processes than when one evaluates a simple dichotomy. With these more complex rituals, multiple possible outcomes are considered, each of which differs with regard to its undesirability. These checks occur in nearly all forms of OCD, including contamination OCD and hit-and-run OCD.
2. Feeling Checking Rituals – Comparing current feelings to how they “should” feel.
Do I feel as secure in my relationship with God as I should? Did my prayer feel genuine?
This mental checking ritual is based around comparing one’s current emotions to an idealized version of how they should be. This desired feeling state may be based on history (i.e., previous feeling states) or on aspirational feeling states. These symptoms often characterize scrupulosity, ROCD, and HOCD. For example, scrupulosity often involves a discrepancy between how “close” or “connected” one should feel in their relationship with God vs. how they actually feel at a given moment. There may also be perceived discrepancies related to feelings of “genuineness” about one’s prayers.
3. Relationship Checking Rituals – Comparing current relationships to how they “should” be.
Am I still in love with my partner? Does the fact that I found that other person attractive or had that dream mean that I should end my current relationship? Do doubts about my current relationship mean that there’s somebody better out there for me?
These checking rituals are often based around the premise that if one is in the “right relationship,” one shouldn’t experience any doubts about their relationship or their partner. Individuals with these types of OCD checking rituals compare current relationships to past relationships or to potential idealized future relationships. They often experience significant doubt and distress about their personal relationships and may have a history of relationship “ping pong.” They may worry about “missing out,” hurting their partner’s feelings, or not “being on the right path.”
These types of symptoms often characterize ROCD. In addition to the symptoms described above, ROCD may also involve making faulty inferences about one’s future behavior on the basis of their current doubts (see Intention Checking rituals below). For example, one might infer that having doubts about one’s current relationship might mean that they secretly want to cheat (or will cheat) on their partner (despite having no desire to do so). Parallel symptoms can also characterize scrupulosity, in which individuals may worry that they secretly want to reject God and/or worship the devil.
4. Intention Checking Rituals – Examining one’s own motivation for engaging in particular behaviors.
Am I changing my child’s diaper because I thought it was really soiled or because I wanted to look at my child’s private parts (postpartum OCD)? Does the fact that I noticed that person’s attractiveness mean that I want to have a relationship with them? Does the fact that I’m clenching my fists in anger mean that I want to punch or harm that person? Does the fact that I’m having suicidal thoughts mean that I want to kill myself (suicide obsessions)? What kind of person would be having these kinds of thoughts?
These checking rituals cause one to question their own motivations for engaging in certain behaviors which commonly results in extreme guilt, shame, or confusion. These types of checking rituals are often present in OCD characterized by harm, sexual, or suicide obsessions, as well as in cases of HOCD, ROCD, and scrupulosity.
Individuals with these types of rituals often assume that their thoughts have significant meaning. They might think that all thoughts are purposeful or may reflect one’s “true” character or desires. This is problematic in that these types of rituals often involve morally taboo topics or unwanted thoughts.
These rituals are sometimes called “figuring out” rituals, as they involve trying to understand the “real” reason for doing something. They also are frequently accompanied by reassurance seeking rituals. Reassurance seeking rituals may involve other people (“Do you think I could ever do that?”) or may consist of personal attempts to convince oneself that one’s behavior is motivated by sound reasons.
5. Sensation Checking Rituals – Attempting to understand the meaning of physical sensations in one’s body.
Does that tingling sensation in my groin mean that I want to have a sexual relationship with that person? Does that fluttering in my chest mean that I’m about to lose control and scream something inappropriate?
This type of mental ritual involves trying to figure out the meaning of specific bodily sensations. Individuals with these types of compulsions often become hyper-attuned to small changes in their own physiology. Sensations associated with this type of ritual are often sexual, violent, or frightening in nature.
6. People Checking Rituals – Mentally reviewing the meaning of other people’s behaviors, words, or facial expressions.
Did his expression indicate that I insulted him? Did she invite me to lunch because she really wanted to see me, or because she thinks I’m pathetic? If I hadn’t locked the door, wouldn’t my spouse have said something? If I had left the gas stove on, wouldn’t my kids have commented on the smell?
These rituals involve reviewing other people’s actions, words, or facial expressions in order to better understand their reactions or intentions. These rituals can also involve establishing the safety of current situations by reducing doubt and uncertainty through reassurance or diffusion of responsibility. For example, “If that person wasn’t concerned, then I shouldn’t be concerned either” or “If this situation is really dangerous, then that person would have taken proper precautions.”
7. Understanding/Information Checking Rituals – Mentally replaying conversations or reviewing written materials to check their content.
Did I really understand their advice? Did I express myself properly? Did I leave any important information out that could cause something bad to happen? Did I understand what I just read?
These rituals involve a fear of misunderstanding and/or miscommunicating information. Individuals with these types of rituals may fear that they have misunderstood something that was said to them, or they may be afraid of mispeaking or leaving out essential details when talking to others. This fear is based around the idea that something important might be missed, or that there is a moral imperative to avoid misleading other people.
Common forms of OCD that are based around this ritual include OCD perfectionism (rereading, rewriting rituals), and moral OCD based around the fear of unintentionally lying to others. Many individuals with these types of compulsions do not recognize that they have OCD.
As you can see, covert checking is incredibly diverse and can be easily overlooked. Whether behavioral or mental, checking rituals provide short-lived reassurance that ultimately backfires and reinforces OCD. The most effective treatment for OCD is exposure and response prevention (ERP). In my South Florida psychological practice, I treat individuals with OCD by helping them learn to recognize and resist their behavioral and mental checking rituals.
Questions? Comments? Do you engage in covert checking rituals? Sound off below.
Related posts:
Hit-and-Run OCD vs. Other Driving Fears
Imaginal Exposure vs. In Vivo Exposure for OCD
Relationship OCD (rOCD) – Unwanted Impulses & Images
ERP Tip of the Day #2
ERP Tip of the Day #1
“Pure-O” OCD: Common Obsessions & Mental Rituals
ROCD – Relationship OCD
Checking & OCD: Part 1 (Checking for Safety)
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Dr. Steven Seay is a licensed psychologist in Florida & Missouri. He is the Director of the Center for Psychological & Behavioral Science and provides treatment & therapy throughout South Florida, including Palm Beach Gardens, Jupiter, West Palm Beach, Boca Raton, Boynton Beach, Fort Lauderdale, & Miami.
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Oh, yes, I engage in this type of checking. Some of this sounds like me!
Understanding information checking leads me to reread passages in books and sometimes makes it hard to finish a book. I guess it’s this type of checking that also causes me to overexplain what I meant when I said something. I get so anxious about whether or not the other person understood exactly what I meant and that I didn’t say something I really didn’t mean.
When I was in the throes of feeling checking, I closely examined my feelings for/about God and was constantly trying to figure out if I prayed “right.” It was all based on how I felt.
What you said under the subheading of intention checking really hit home for me: we assume that our thoughts have significance. It’s hard to remember sometimes that we are not our thoughts.
Thanks for a great explanation and post!
Hi Tina,
Rereading rituals can be some of the worst. I know many brilliant young college students whose OCD made school virtually impossible before they began treatment. Writing/re-writing can also present unique challenges, which is why I sometimes ask patients to start blogging as a form of exposure. 🙂 On a related note, I’ve really been enjoying your posts. Keep up the good work.
Thank you so much!
Blogging has been good for me, because OCD affects my writing too.
My son Dan engaged in lots of mental checking, probably mostly under the categories of Intention Checking Rituals and People Checking Rituals. Now that I understand OCD more, I have an inking of what he was dealing with. At the time, though, all I knew was that he often seemed far away in thought, as if he were daydreaming. I’d get annoyed with him because he seemed to “not listen” to me.
Because Dan had almost all mental compulsions, we had no idea he had OCD, or that there was even a serious problem, for quite a while……covert checking makes it so much easier for those with OCD to hide their disorder. It still makes me so sad to think of how much he was suffering in silence.
Thanks for a great post!
Thanks Janet,
You make an important point. Although covert compulsions may be hidden; increased distractibility, daydreaming, and “spaciness” may be signs that mental compulsions are present. Unfortunately, these non-classic symptoms can be hard to detect. I’m so glad that Dan was ultimately able to get the help he needed.
All the Best!
I do a lot of these! Its kinda funny because I usually do not realize what I’m doing is checking. When I do these types of behaviors I usually think “if I think about this long enough, maybe I’ll remember something and I wont have to worry anymore”! The one compulsion I’m currently caught up in is the the intention checking, but I was wondering can this compulsion also involve past experiences? I am constantly ruminating about things I did in middle school and high school and constantly questioning if I was being genuine.
Hi Gabi,
Yes, intention checking often involves analyzing/re-analyzing previous experiences in order to figure out their meaning. This happens with scrupulosity, ROCD, HOCD, harm obsessions, and many other forms of OCD.
I got an appointment call today and I am pretty sure the rendez-vous is fixed for 6 septembre, but I keep recalling the appointment call: was it for 4th, or was it for 5th. I am even planning to personally go tomorrow just to confirm the date. I was googling this “self doubt” situation when I came across this page.
Isn’t there a data base on “how real these doubts are?”. This brings up perhaps “calculating the probability” thingy, but won’t such stats be reassuring?
Thanks doc.
I’m a mental checker. I can spend hours and hours in my head ruminating about my health, or existence, or – quite literally – whatever. However, there does tend to be a massive amount of rumination regarding my health (at one point I had a blood sugar monitor [I’m not diabetic] and was testing myself 40-50 times a day). Other times I’m testing my heart rate, or my blood pressure, etc. Now the psychiatrist up’d my SSRI medication, and I’ve started self-monitoring to see if I am getting serotonin syndrome. It’s horrible, non-stop and disrupting.
As a child I was afraid of contracting AIDS. I was afraid of literally everything I heard about. I would sit and fear these things and ruminate about them and constantly, do reassurance seeking from everyone in my family. In addition, I would have these fears that if I didn’t do something right, my mother or my father would die.
I understand all of these things are covered under the OCD spectrum of diseases, and I know I tend towards the “Pure-O” side of the spectrum. But I was wondering if you had insight into the sorts of ERP techniques that work for those who spend most of our time in our own heads. I’m seeing a counselor at the moment, and the things we’re trying are related to thought-interruption (engaging in other behaviors when these thoughts occur). They help. I’m hoping the new dose of medication will help too (though I’m terrified of getting serotonin syndrome). thoughts?
Hi Ben, in these types of situations, it is sometimes helpful to utilize imaginal exposure techniques. This involves sitting with uncomfortable thoughts without ritualizing, neutralizing, or avoiding until the worry thoughts become boring. This can be very scary at first, but you eventually habituate and become less bothered by the thoughts.
Hello Dr!
Can you gave us tips to resist these mental checking …? Because some ERP therapist ask you to tell yourself ( fear harm someone ) ”Im gonna harm someone” some says ”I MIGht harm someone” others therapist ask you to tell yourself” I might harm someone but probably not” other says ”Accept the tought without giving any signifiance..” others say like in brain lock ” Its just ocd not you”
Whats the right way to react / resist
Thanks
Having read this I thought it was extremely informative.
I appreciate you spending some time and energy to put this article together.
I once again find myself spending a significant amount of time both reading and leaving comments.
But so what, it was still worth it!
Hi Dr,
I am constantly stuck on wanting my feelings to be either how I thought they were before OCD or mostly how I would like them to be. Mostly Im just numb. I avoid kissing my partner as I cant feel the connection or the desire. I now avoid any sexual contact because I cant engage in the activity without being spiked with loss of feelings (ie no anxiety and enjoying the moment and passion). I feel like I have been either in denial or im just avoiding reality that I have loss interest and I suspect this has been growing for some time I have just pushed it under the carpet… Fact is I do have a good relationship Im just stuck on not being able to feel what i want to feel and I have no idea how to combat / treat this – I would value your feedback your website is probably the best source on the internet. Thanks again
Hi Dr. Seay!
First of all, your website has truly been a Godsend, and I have found answers to many of my questions, as well as knowing I’m not alone.
I’m certain I have the anxiety disorder and, I would say, a severe form of Scrupulosity.
My Scrupulosity is reflected in these actions;
repeating prayers if I didn’t concentrate on them 100%, imagining “good” pictures of jesus whenever I call His name or have the word God in my head, rereading a sentence where something insulting was said (for example “Jesus was phony”) and while rereading it imagining a picture of Jesus and praising him, and rereading it until the whole sentence is physically “covered” in a good picture of God and His praises, to “neutralize” the bad things sad in the sentence.
I also have extremely elaborate rituals when praying (I’m Roman Catholic and I’m sure 90% of them are not usual in my, or any other religion).
Since I was a kid, I used to pray for hours at a time, or “promise” God that I would repeat a prayer 100 times till the end of the day, so that something bad wouldn’t happen.
However, my Scrupulosity is related to my anxiety disorder, and I experience physical symptoms and am especially afraid for the health of my heart as I’m nervous most of the time. Therefore, my main question is:
I’m too afraid to try the ERP you so neatly outlined. My train of thought is; if I pray and instead of saying for ex. ..because You God are great, I think ..You Satan are great, or think of an image so sacrilegious I don’t even want to write about it, and I DON’T “repair” it by repeating a prayer where everything is “as it should be”, I will experience my physical symptoms which frighten me the most. I don’t have the courage to let my intrusive thoughts just come and go, I have to “repair” them for fear of God’s punishment in the form of immediate physical illness.
How should I go about performing the ERP in this case?
Also, I’d like to know if you could categorize my other obsession;
I have an obsession that I call obsession with time running out. It started when I was a kid (I’m 20 now) and I would, for example, push the downstair door slightly and then run up the stairs and feel elated if I could run up to the first floor before I heard the door closing. Sorry if my English is not good, it’s not my first language.
These seemingly harmless rituals have grown over the years and what prompted me to write this addition was something that happened just a few minutes ago; I’ve been heating my lunch in the microwave, and my microwave is a bit faulty; sometimes it will start but sometimes not. As I reached for the TURN ON button, my thought was:
If it doesn’t start this time, something terrible will happen to me or the others I love.
This amy sound funny, but I could write dozens of examples like this.
I guess I’m troubled by COMPLETELY RANDOM stuff that I, unfortunately, truly believe will have an impact on my life or lives of those I love.
What do you think this is?
I’m sorry for writing such long posts, but I really need help, so thanks in advance for your thoughtful answers!
First of all, I would like to say thanks for all that you’ve put up on this website. It’s really helped me out a lot. I had no idea that I was affected by OCD so harshly and that it has had such a strong impact on my life.
At first, I was 10, and I had a terrible case of emetophobia that I didn’t get over for years. I had compulsions of things that would spark my anxiety like crazy. I would continuously look for new ways that could make me sick or gag. I would repeatedly try these things to see if they still would do the same thing, but they kept making me more anxious of it. I went to a psychiatrist and they told me that I had a “chemical imbalance”; an anxiety disorder. I got over that at around 12 and I’ve never had any problems with it since. I always felt like my compulsions had just made me weird and they made me feel stupid.
Over the summer, when I was 14, I had developed irrational doubts about what I believed and if I really believed it or not. These doubts had sparked up from what much of modern society believes. I felt like that I absolutely had to have a true proof that I believed it. I do have to say that I’m glad for this for the reason that I took up research in apologetics, but at the same time it had always been a major anxiety for me.
Just recently (after turning 15 a few months ago), I had this very strange dream (that I have hardly any memory of) that made me truly question my sexuality and whether I was really straight or not. For the past few days, these thoughts have been pestering my head and have been involving themselves in everything I do. Every time I see a guy, a thought pop’s into my head like “Do I find him sexually attractive?” Recently these thoughts have been much more broad, like “Do I have feelings for this guy, or do I just think that he’s handsome? And if I think he’s handsome, does that make me gay?” I’ve even had compulsions about checking my compulsions, such as if I were to look at a guy in a particular way, I would think “Did I just look at him because I liked it, or was it because I just want to know if I like it?” even “When I see a gay couple, am I being appropriately disgusted to consider myself straight?” Not only that, but it has been leading me to look for sources on the internet to see if they have the answers. Some of them (very rarely) suggested that HOCD is also a possibility. After seeing your article on HOCD, I felt like it completely described what I was going through. The scariest part was the suggestion of Exposure and Response Prevention. I don’t honestly think I could do that without having frequent anxiety attacks. But I have found out that the more checking I do, eventually it will all stick and I won’t fear it as much anymore, resulting in the drop of the obsession. That’s what happened with my doubts in my belief in God. But sometimes, I have thoughts like “If I continue to check myself, will it ever go away?” or “If I keep performing these checks, will they eventually become a reality?” and especially “Am I scared of being gay because of my religious beliefs, or because I really don’t like guys in that way?” These questions have been the toughest on me, so far. But every day there is a new question being formed. Before this, I’d never had any thoughts like this. Some things in post-pubescence I could consider myself gay for, but then again I think of how hormones are extremely crazy during and shortly after puberty. It seems to be a continuous state of chaos in my mind, but it gets better when I identify some of my thoughts as initiators of anxiety. I still have moments where I feel very anxious about my true sexual identity or not. It seems like a constant checking of my mind, to make sure that I know that I know that I know what is true.
Thank you so much! I’ve read Part 1 & Part 2 and it’s me! What I dismissed as ‘being silly’ seems as if it might be true OCD and my checking is getting worse, longer rituals and more upsetting. I’m going to get help
Thank you. This is exactly what I do. Mental checking in various forms. The need for everything to be ok is how I describe it to myself and my wife. Great article.
Dear Dr. Seay,
I am a long-time OCD sufferer with a diverse and changing bouquet of symptoms. During my adolescence, most of these were overt rituals relating to cleaning, checking, intrusive/obscene thoughts (incestuous/necrophiliac/blasphemous – oh, it ran the gamut) and scrupulosity. I conquered most, if not all of the overt rituals by my early 20s. However, my pure O symptoms and what you call “covert rituals” have waxed in recent years.
Two I want to bring up here:
1) I am an obsessive re-reader. I constantly re-read texts – even ones I read (ostensibly) for pleasure, and take notes in the margins. Copious notes. The notes are partly a way to stop the re-reading. Often I re-read because I fear some part of my brain hasn’t responded in some hard-to-define way and engaged my memory.
2) A lot of my scrupulosity obsessions develop “trigger words” to make sure I cannot forget them. For example – I once told a little white lie to my boss to get out of something, on the advice of a departmental supervisor. Now I feel guilt and a compulsion to think about Bulgaria (where my boss is from). I get so tired of my hindbrain shouting “Bulgaria” at me that I’m tempted just to confess.
I do ERP – probably not enough, but I do it. But the ERP can backfire. For example, one therapist told me to litter. (I still do this, by the way.) One day, I threw a Coke Zero bottle* over a hedge into a backyard. I later found out that this yard belonged to a home for adults with cerebral palsy. Naturally, this triggered more guilt, an urge to somehow retrieve the bottle** and a compulsion to think about Ecuador, as I was reading about that country at the time I realized that the house was a care facility.
My question is – how do I deal with these Pure O obsessions? How do I deal with the urge to think about Ecuador, Bulgaria, Spain, etc – symptoms so esoteric I can’t imagine any therapist knowing how to tackle them specifically? How do I stop the reading thing?
Many thanks,
Ben
*I’m also addicted to Coke Zero. That may be the OCD, or just Coca-Cola’s alliance with Cthulhu and the Elder Ones.
**The Coke Zero bottle is somehow still there in the yard after three months.