The Connection Between Impulsive Behaviors and Compulsions in OCD

Impulse control refers to resisting or inhibiting an impulsive urge or behavior. It is the ability to regulate your emotions and desires so that you can make rational, logical, and thoughtful decisions in any given situation. It’s important to recognize the distinct differences between impulsivity and compulsivity, specifically the ways in which they can be connected to Obsessive Compulsive Disorder (OCD) and the ways in which they are not.

What’s the difference between impulsive and compulsive?

Impulsivity is when you act or make decisions without thinking about the consequences of your actions. It involves behavior that is immediate and based on urges and desires, without accounting for the impact that these decisions may have on the future. This occurs spontaneously and is usually driven by strong emotional reactions and stimuli. Impulsivity often pushes an individual toward something that they find relieving, exciting, or even joyful. 

Compulsivity, on the other hand, can be identified as repetitive behaviors, mental acts that someone feels a drive to perform. These are done in an effort to alleviate an internal urge or anxiety, or as a way to neutralize an obsession. These behaviors are usually rigid and can be very difficult to stop. These are not based on desire, as most people do not want to engage in these actions. In the context of OCD, these behaviors are actually exaggerated responses and attempts to prevent a feared outcome. These behaviors are not wanted and do not bring a sense of joy. They may bring a temporary sense of relief, but this doesn’t last. 

When an individual experiences good impulse control they are able to recognize the long-term consequences of their behaviors. They have the ability to act accordingly in spite of the desires or urges they may be experiencing. In contrast, when an individual has OCD, even if they recognize that their compulsions are illogical, the feelings of discomfort and anxiety driving those behaviors are so strong that it can be difficult to resist performing compulsions meant to alleviate that anxiety.

However, it is important to note that people with OCD do not struggle with impulse control in terms of the obsessions they experience—they are not any more likely to act on their obsessions than anyone else. In fact, they do everything in their power to prevent those feared outcomes. In other words, weak impulse control does not equal someone being more likely to act on their obsessions. This is an extremely important distinction. The obsessions that an individual with OCD has are ego-dystonic, meaning they go against the person’s desires, values, or goals—in effect, the opposite of what they would want to take place.

Is there a connection between impulsivity and compulsivity in OCD?

Although there are distinct differences between impulsivity and compulsivity there is also a connection. Research shows that while OCD sufferers often report having difficulty with impulse control there is no conclusive evidence that they are actually more impulsive than anyone else—though it should be noted that symptoms can vary among individuals. 

When impulsivity is an issue, it can lead to complications with treatment, making it more challenging to engage in response prevention. For someone with OCD, trying to suppress the urge to perform their compulsions can cause intense anxiety and panic. They often feel a sense of overwhelming responsibility and believe that they need to perform these rituals to protect themselves or others from imminent danger. When the individual determines to stop engaging, it can require a great deal of impulse control, which is why improving these skills can have long-lasting and impactful benefits for someone with OCD. 

Reducing the frequency and intensity of obsessions and compulsions can decrease anxiety and free up time for the individual to live a life based on their values and desires. Learning to accept or tolerate distressing feelings without needing to perform compulsions can be very challenging, but it is possible. 

Getting effective treatment

Exposure and Response Prevention (ERP) therapy is a proven treatment approach that can help individuals with OCD to develop and strengthen their control when it comes to engaging in compulsions 
Specialty-trained, qualified, and licensed OCD specialists will never ask you to do things that go against your values or that will cause you or others harm, nor will they ever force you to do anything that you are unwilling to do. Instead, a successful ERP therapist will guide, support, and motivate you. They will come up with reasonable and creative ways for you to gradually face the fears that are holding you back from living the life that you want to live.

If you have any questions about starting ERP therapy or need more information about the treatment, please don’t hesitate to book a free 15-minute call with our care team. On the call, we’ll assist you in either getting started with a licensed therapist at NOCD who has specialty training in OCD and ERP or connect you to other resources that might be helpful.