When I'm attempting to discern whether or not someone is struggling with or suffering from OCD, I ask a simple question so not to complicate the issue: "Do you find that you worry often? And to what degree do you worry?" So I often use the word worry to help narrow down their focus and pay attention to the more clinical word of rumination. When you're looking at OCD, you're looking at it in two contexts: you're looking at in thoughts, there's the obsessive part of it, and compulsion, which is the behavior part of it. So, obsessive thinking is about ruminating, thinking certain thoughts over and over again, repeatedly, not having success for any length of time with interrupting or distracting yourself from those thoughts. And so that's why I sometimes capture it as worrying, because people can relate to worrying, as opposed to: "Do you have obsessive thoughts?" "No." "Do you worry a lot?" "Oh absolutely. I worry about everything." Then I ask, "Can we identify some of those things you worry about? How often do you worry? Are there certain things that you find you worry about daily and others that you worry about sporadically?"
Typically with the compulsive part of OCD, an individual engages in repetitive behavior. Just like the obsessive part is thinking repetitive thoughts, the same thought over and over, the compulsion is to engage in a specific behavior or behaviors repeatedly in an effort to get relief. The function of obsessive thinking and compulsive doing are similar in that the brain is trying desperately to get relief about a particular matter, and it's thinking it to death in an effort to come up with a solution. The behaving part is the brain says "if I will do this repeatedly, then I will experience some form of relief or calm". And the behavior that one engages in repeatedly may not in any way be related to the actual thing that the person is worried about.
So for example, I may be ruminating about the loss of a relationship, and I may spend hours and hours thinking about this particular individual that I was in a relationship with and how I'm going to see them again, and what I'm gonna do in an effort to get them back, including calling other people to get information about them, calling other people to talk to them about my thoughts and feelings related to the fear of losing or the actual losing of this individual from my life. So if I'm ruminating and obsessed and thinking repetitively about this individual, I'm feeling very powerless and out of control. Then what I might do compulsively, that appears to be completely unrelated, is I may engage in compulsive cleaning. This would be an effort to feel some sense of control or power over my life, since it feels out of control because this person is leaving me. Some people may engage in compulsive spending. They're feeling very sad, a deep sense of sadness or maybe even becoming depressed over the loss of this individual, the loss of this relationship. And they go out and they spend a significant amount of money on things that they don't need. The very act of spending feels good to them. It's self-soothing, just like cleaning the house, cleaning the base boards, scrubbing the floor. That would probably be an example of more severe action. Often we hear people talk about engaging in hand washing, or another form of compulsive behavior is picking at skin, pulling hair, those are both separate and individually diagnosed forms of OCD. So, cleaning, hand-washing, skin-picking, pulling hair, pulling eyebrows, pulling eyelashes, pulling patches of hair off your arm or off your leg, these can be considered compulsive behaviors. Or it can be as minimal but nonetheless disruptive as certain checking behaviors, checking doors, checking windows, checking to see if I unplugged the iron, checking to see if I unplugged a curling iron. What's interesting about OCD is that we find it us almost always rooted in some significant fear or trauma that left the individual feeling extremely powerless. So any compulsive behavior is an attempt to engage in a form of behavior which leaves me feeling as though I have some power and control over it.