Rituals are repetitive actions done in a specific manner or order, like checking and re-checking that you’ve locked your doors, or engaging in a specific bedtime routine. While performing rituals is not always detrimental to your health, ritualistic behaviors meant to calm anxiety can become compulsive, and may be a sign of obsessive-compulsive disorder.
Most of us have some sort of routine we rely on. Maybe you go to sleep at the same time everyday, or prefer to start work once you’ve made a cup of coffee according to a specific recipe. There’s nothing wrong with identifying regular habits that feel good, but sometimes our routines can become too ritualistic, and may actually interfere with our daily functioning.
But, how can you know? “Plenty of people have routines that make them feel good,” explains Tracie Ibrahim, LMFT, CST, Chief Compliance Officer at NOCD. If these routines start to take hours, however, wasting significant amounts of time, or producing results that are counter to their intention, it’s important to reassess.
While rituals—from religious practices to wellness routines—can make life feel fulfilling and easier, compulsive behaviors can indicate a mental health condition, like obsessive-compulsive disorder (OCD). Read on to understand when rituals become unhealthy, how to know if you’re dealing with a mental health condition, and how to get help.
Defining ritualistic behavior
Ritualistic behaviors are repetitive actions done in a specific manner or order. These behaviors may carry religious or cultural meaning, and can center on specific objects, activities, words, phrases, or gestures. Sometimes, rituals are a basic way to simplify tasks. For example, you might create a routine around showering that helps you remember all the steps you want to complete, or gives you more time to allow a hair or skincare product to soak in. Or, you may designate a specific time each week to meal prep and listen to a favorite podcast, to ease the task of cooking throughout the week. Completing daily chores in a routine, regular way can often make them feel more manageable.
Sometimes, however, rituals can become compulsive. This usually happens when the behaviors involved in your routine start to feel uncontrollable, or necessary to calm feelings of anxiety, discomfort, or other difficult emotions. You might feel like your rituals are a way to regain control over areas of life that feel threatened by uncertainty. For example, a showering ritual can be nourishing and calming, but if adhering to every step of the routine feels essential to neutralize obsessive concerns about contamination or germs, the behavior may no longer be serving you.
In some cases, the link between your fears and the ritual you perform in response may be less obvious, making the compulsive behavior harder to identify. A good way to tell is to consider how it would feel to break with your routine.
If deep discomfort arises, it’s worth considering whether your ritual is still serving you.
For example, a bedtime routine can be helpful, but if you feel intense distress that something bad will happen if you deviate from it, it’s probably worth exploring whether you’re dealing with a mental health condition.
What mental health conditions cause unhealthy rituals?
Mental health conditions including OCD, eating disorders, and general anxiety disorder (GAD) can result in unhealthy ritualistic behaviors. For example, if you have an eating disorder, you might ritualistically arrange food on your plate, or feel a need to chew for a certain amount of time before you swallow.
If you’re dealing with an anxiety disorder, rituals will usually show up as safety-seeking behaviors, meant to prevent any perceived potential threats. So, if you fear fires, for example, Ibrahim says you might feel the need to triple-check safety hazards in your home, or ask reassurance-seeking questions like, “ Are you sure that I shut off my curling iron before I left? Could you check for me?”
For OCD, ritualistic behaviors show up as compulsions—repetitive mental or physical actions done to prevent a feared event from happening, or relieve distress from obsessions. While these behaviors can overlap with anxiety-fueled safety seeking behaviors, they differ in that they are a direct response to obsessions—intrusive thoughts, sensations, images, feelings, or urges. OCD compulsions can offer temporary relief, but ultimately only serve to prolong a cycle of symptoms, if left untreated.
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Understanding OCD rituals
Engaging in rituals doesn’t necessarily mean you have OCD, according to Ibrahim—even if you experience the occasional obsession or compulsion. For your rituals to be considered OCD compulsions, you have to meet certain diagnostic standards, such as engaging in these behaviors for over an hour each day, and/or experiencing an impairment to your daily functioning as a result. People with OCD typically feel significant distress about their symptoms, and often have trouble functioning at school, work, or in social settings.
It can be tricky to tell if your ritualistic routines warrant a diagnosis, but one way to understand what’s going on is to consider whether your behaviors seem related to one specific stressful life setback, or are latching onto a variety of things. For example, Ibrahim has a friend who recently found a mass in her breast. Since the discovery, this friend has been compulsively researching potential related health issues.
While this friend’s behavior may not be entirely healthy, it’s limited to this one (hopefully short-term) life event. She isn’t excessively researching health issues beyond this issue, and she isn’t engaging in any other compulsions. “ She does not have OCD,” Ibrahim clarifies. “She has a medical situation that came up, which has clearly made ritualistic behaviors flare.”
OCD rituals can latch onto specific themes, like health anxieties, but these behaviors stem from persistent intrusive thoughts—not a one-off life event—and feel inescapable. OCD rituals also don’t provide long-term relief. While someone dealing with a cancer scare might be able to feel satisfied after researching online, if you have OCD, you’re unlikely to ever feel comfortably certain. In fact, you might even feel the need to restart your rituals if they’re disrupted in any way, making your search for satisfaction endless.
Common OCD compulsions
- Needing to eat (or cook/prep) food in a specific order or manner, in order to feel comfortable consuming it.
- Compulsively washing your hands, or engaging in specific showering/washing rituals.
- Compulsively cleaning.
- Nighttime or bedtime routines that are excessive in nature (i.e. having to organize your pillows perfectly in order to sleep).
- Excessively checking for danger before leaving the house, by repeatedly confirming that you’ve locked up, and that any appliances, like stoves are turned off.
- Tapping or touching objects repetitively.
- Mentally reviewing situations or conversations in your head over and over again to make sure you didn’t do or say anything wrong.
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How to break free from OCD rituals
The best way to stop engaging in time-consuming rituals that are no longer serving you is to reach out to a therapist trained in exposure and response prevention (ERP) therapy—a specialized form of cognitive behavioral therapy (CBT) designed to help reduce OCD symptoms.
In ERP, you’ll work with a therapist to intentionally and gradually expose yourself to situations that trigger your obsessions, and make you want to perform compulsions. Instead of engaging in these ritualistic behaviors, however, you’ll learn to practice new techniques—like sitting with discomfort, and accepting uncertainty.
For example, if you feel the urge to intensely clean your home every single night, your ERP therapist might start off by helping you eliminate a few steps of this routine, so you’re only doing a light nightly clean. From there, you might reduce your cleaning ritual to every other day. Or, you might try switching up the order of your cleaning tasks, so you are forced to incorporate more flexibility. By delaying, shortening, or disrupting these behaviors, you can slowly learn to rely on them less. This helps teach your brain that the rituals aren’t necessary to survive the feelings of anxiety that drive them.
In time, your obsessions will lessen, allowing you to reclaim the time you once spent on these routines.
Key takeaways
- Rituals and routines can be helpful to your daily functioning and happiness, but these behaviors are usually unhealthy if they take up extreme amounts of time or feel essential to calm anxiety.
- Not all rituals are OCD compulsions, and not all OCD compulsions resemble rituals, but many OCD compulsions are ritualistic in nature.
- Ritualistic OCD compulsions can be successfully treated with ERP therapy, which teaches you new ways of handling anxiety, distress, and uncertainty.