Checking compulsions

Checking compulsions are repetitive behaviours, such as repeatedly checking that doors are locked, appliances are switched off, or that no harm has occurred, performed to reduce anxiety or a feared outcome. They are a common feature of obsessive-compulsive disorder (OCD), though checking behaviours can occur at a milder level in people without OCD too. They become a clinical concern when they significantly interfere with daily life.

They typically develop as a response to intrusive, anxiety-provoking thoughts (obsessions) — for example, a fear that leaving the stove on will cause a fire — with checking providing temporary relief from this anxiety. Over time, this relief reinforces the checking behaviour, making it more frequent and harder to resist, even though the underlying fear is rarely realistic. A combination of genetic, psychological and environmental factors is thought to contribute to OCD developing in the first place.

Symptoms include repeated checking behaviours that take up significant time, difficulty stopping despite recognising the checking is excessive, and significant distress or interference with daily life, work, or relationships as a result. Checking is often accompanied by other OCD symptoms such as intrusive thoughts or other compulsions. The behaviours are usually recognised by the person as excessive, even though they feel unable to stop.

They can significantly affect quality of life, relationships and daily functioning when severe, and are a recognised symptom of OCD, a treatable mental health condition. They are not dangerous in themselves, but the associated distress and time consumed can be considerable if untreated. Effective treatments are available and can make a substantial difference.

Yes, cognitive behavioural therapy, particularly a specific technique called exposure and response prevention (ERP), is highly effective for OCD-related checking compulsions, helping people gradually tolerate the anxiety without performing the checking behaviour. Medication, particularly certain antidepressants, can also help, sometimes used alongside therapy. Most people see meaningful improvement with appropriate treatment.

Treatment usually starts with an assessment by a mental health professional to confirm the diagnosis and severity, followed by a course of CBT with ERP, sometimes combined with medication for more significant symptoms. Treatment is often delivered over several weeks to months, with gradual, structured exposure to feared situations without checking. Progress is typically reviewed and adjusted throughout treatment.

If checking behaviours are taking up significant time each day or causing distress, it is worth seeking assessment rather than managing alone. NHS psychological therapy access (such as through IAPT/NHS Talking Therapies) can involve some wait; private psychology or psychiatry consultations are often available within about 1 to 2 weeks for a quicker start.