Compulsive Behaviour

When you hear the phrase ‘compulsive behaviour’, you may immediately think about Obsessive Compulsive Disorder (OCD). Whilst compulsive behaviours are a large part of this condition, there may be other instances where individuals deal with compulsive behaviours whilst not fitting the criteria for this diagnosis. Individuals with addictions commonly experience compulsive behaviour. This is the case for individuals dealing with both behavioural addictions and substance use disorders. But what is the link between these types of behaviour and compulsive addiction? How do you recognise that you are dealing with compulsive behaviours, and what is the best way to manage them?

What is compulsive behaviour?

One research team defines compulsive behaviours as something that is seen ‘in many psychiatric or psychopathological disorders’ where ‘patients repetitively engage in behaviours that are disruptive for themselves and their environment.’ An essential part of understanding compulsive behaviours is noting that a lot of the time, the individuals engaging with them can realise ‘the nonsensical nature of their compulsions,’ but may still feel that they need to carry them out. A lot of people may not be able to explain why their compulsions occur and are able to identify that the behaviours can have a negative effect on their lives. This indicates, crucially, that compulsive behaviours do not feel like conscious decisions but rather ingrained routines and acts that feel innate, required, natural, or soothing.

Compulsive behaviour is seen most prominently in Obsessive-Compulsive Disorder (OCD). OCD is an anxiety-based condition which, according to OCD UK, affects around 1.2% of the population. OCD is often characterised by a series of rituals that involve specific compulsive behaviours in order to manage ‘intrusive and unwelcome obsessional thoughts.’

But compulsive behaviours can be developed in the absence of OCD. This typically happens in instances of anxiety, chronic stress or other forms of emotional distress. In these instances, compulsive behaviours can be established as a way of seeking alleviation. However, the behaviours associated with compulsivity can often increase risk and lead to secondary harm. This can either exacerbate distress or lead to the development of a comorbid condition, such as a substance use disorder or behavioural addiction.

Types of compulsive behaviour

A compulsive behaviour can take different shapes for each individual. Some of the common forms of compulsive behaviour can manifest in the following activities:

• Shopping
• Spending 
• Gambling 
• Hoarding 
• Ordering and arranging 
• Eating 
• Washing 
• Skin-picking 
• Hair-pulling 
• Checking behaviours 

Common compulsive behaviours associated with OCD include things like frequent handwashing, counting, ordering, or repeating words or phrases. However, compulsions are not limited to these behaviours specifically – they can be much more broad. 

Signs and symptoms

It can be more difficult to identify compulsive behaviours in some cases than in others. Some of the ways you can identify a compulsive behaviour is by thinking about the presence of the following actions, feelings or behaviours:

• Finding it difficult to avoid thinking about compulsive behaviour 
• Spending lots of time each day thinking about compulsive behaviour 
• Compulsions do not bring pleasure  but instead bring relief 
• Compulsions are taking over the ability to engage with daily life 
• Avoiding certain situations when it may not be possible to engage in compulsive behaviour 
• Spending time alone (or at home) in order to engage with compulsive behaviour
• Spending more time thinking about or engaging with a compulsion when more stressed or anxious 

The psychology of compulsive behaviour

The American Psychological Association explain that a compulsion is:

‘a type of behaviour […] or a mental act […] engaged in to reduce anxiety or distress. Typically, the individual feels driven or compelled to perform a compulsion to reduce the distress associated with an obsession or to prevent a dreaded event or situation.’ The APA also states that compulsion does not always provide pleasure – rather, it acts to ‘neutralise’ difficult thoughts, feelings or distress. This means that compulsive behaviours may be more likely to be experienced by individuals dealing with chronic stress – either due to a life event or because of a mental health condition. These types of behaviours may be particularly linked with:

• Anxiety 
• Panic disorder 
• Depression 

They can also be commonly experienced by autistic individuals. 

Clinicians have indicated that risk factors for the development of compulsive behaviours include:

• Genetics (having a close family member with OCD)
• Individuals with a more reserved temperament 
• Individuals with a tendency towards low mood 
• Individuals with an experience of childhood trauma 

Some psychologists theorise that compulsive behaviours can develop as a result of an unconscious perceived lack of control, explaining that this lack can lead to anxiety and hopelessness, with the behaviour appearing as a potential tool for regaining agency. [12] However, the reasons underlying compulsive behaviours are complex and plural. The catalyst for such experiences is very individual and will change from person to person.

Compulsive behaviour and addiction: What’s the link?

Compulsion and an addiction is not the same thing. However, compulsions can play a key role in the development – and maintenance – of an addiction cycle. One researcher suggests that addictions are a result of ‘compromise formations,’ where compulsions can be seen as coming from ‘a forbidden unconscious drive and of an opposing force.’  This indicates that for many people, the reasons for engaging in a specific behaviour can be unknown. However, as the behaviour becomes more and more common, our brains can remap our reward systems to recognise the behaviour as a positive action. This can lead to us developing a behavioural addiction. 

In the case of a substance use disorder, compulsive drinking and use of drugs can act in a similar way. Individuals with compulsive behaviours may also find themselves turning to substances as a way of coping with these behaviours. However, this can act to mask the underlying issue and risk the development of a secondary condition – an addiction. 

Managing compulsive behaviour

Managing compulsive behaviour will look different for each person. But some more general ways you can try and regulate these behaviours include:

• Trying to ‘sit’ in your feelings without actively trying to soothe them
• Remember feelings are transient 
• Focus on your breathing 
• Use distraction techniques
• Exposure yourself to fear without engaging in compulsions (as a kind of exposure therapy)
• Delay engaging in compulsive behaviours 
• Try to notice your thoughts rather than challenging them 
• Trust that you can cope without the behaviours 

This can be a very difficult process – where possible, it can be helpful to work through compulsions with the help of a specialist.

Compulsive behaviours in addiction recovery

During addiction recovery, you may find that compulsive behaviours may feel stronger. This can occur when one of our previous coping mechanisms (such as an addiction stimulus) is removed, and we struggle to cope in its absence. But in order for rehab to combat both addiction and ingrained compulsions on a deeper level, it is necessary to avoid, challenge and control our engagement with these behaviours with the help of specialist therapists. If you are struggling with compulsive behaviour and also cope with comorbid addiction, you may find the following forms of support particularly useful:

• Addiction counselling 
• Cognitive behavioural therapy (CBT)
• Exposure and response prevention (ERP)
• Group therapy 
• Antidepressant medication  

To find out more, contact us today.