Obsessions and compulsions are distinct yet related phenomena. Obsessions are anxiety-evoking thoughts, urges, or images that are recurrent, persistent, and intrusive. Common obsessions include fear of contamination, fear of lying, stealing, or making mistakes; visualization of a violent scene (often unrelated to anything the individual has experienced); and urges to act on anxiety-provoking thoughts. Some obsessive thoughts can include graphic and disturbing material such as violence or sexual assault. The intrusive, unwanted nature of obsessions can cause significant distress.

Obsessions occur only in the mind, whereas compulsions can be behaviors or mental acts (such as counting in one’s head). Compulsions are repetitive and performed in response to an obsession, or according to rigid rules. Typically, the compulsion is done to relieve the anxiety or distress associated ...