1, 2, 3: Counting and OCD
Ernie is a young man with OCD. He has a constant sense that something is wrong, that something terrible is about to happen. To ward this sense of danger off, he makes sure to perform every task in even numbers – because he feels that odd numbers are bad luck. He brushes his teeth for an even number of seconds, ends his steps on an even number, and counts up to 22 in his head constantly.
Ernie knows that his behaviors don’t really make any sense, but the urge to stick to even numbers is so strong that he can’t help himself.
For someone with OCD like Ernie, anything can become the object of obsessions and compulsions. Some people with OCD become attached to compulsive counting as a way to soothe themselves or ward off imagined danger.
So what exactly is OCD counting, and why do people do it? Here is everything you need to know.
What is Counting OCD?
First, we have to get this out of the way. There is a misconception that there are a limited number of officially classified OCD “subtypes”, and anything outside of these isn’t OCD. This is a myth; there is no official classification of OCD subtypes, and there are as many themes of OCD obsessions and compulsions as there are people with OCD. However, some symptoms and fears are more common among people with OCD, which is why experts have defined them.
A Quick Recap of OCD
OCD, or Obsessive-Compulsive Disorder, is a psychiatric disorder which is characterized by the presence of obsessions and compulsions. An obsession is an intrusive and unwanted thought or urge that causes anxiety or distress for the person experiencing it. A compulsion quickly follows – any sort of ritualistic or repetitive behavior that the person believes will ease their anxiety.
At face value, that doesn’t seem to be a problem. Someone feels anxiety, and does something to stop it, right?
Not so simple for someone with OCD. Compulsions only work to ease anxiety for a very short time. OCD has been called “the doubting disease” – people who suffer from it are plagued with “But what if…” thoughts. The obsessions rise up again and again, which causes the person to get locked in compulsive behaviors that start to take over their lives.
Is Counting a Subtype of OCD?
Remember that there are no officially established subtypes of OCD, and that themes of obsessions and compulsions are limitless. With that said, “Counting OCD” isn’t usually talked about as its own subtype – more commonly, the act of compulsive counting is associated with other subtypes of OCD, especially “just right” or “symmetry” subtypes.
In these subtypes of OCD, a person has a perpetual sense of “wrongness” and compulsively arranges, mentally reviews, or fixes things in order to achieve a sense that everything is okay. The person may count to try to achieve that feeling of “just-rightness”.
OCD counting can, though, be associated with other subtypes of the disorder. Some people with OCD may compulsively count because of contamination obsessions or harm obsessions. We’ll talk more about this in detail later on.
Sometimes, people with OCD count repetitively in their heads, to themselves. Sometimes, people accompany their counting with physical movements, and others may even count out loud. It doesn’t matter how the counting happens – what matters is the intention behind it.
The important thing to remember is that OCD is OCD is OCD. What do we mean by that? We mean that OCD is a singular disorder, in which the sufferer experiences obsessions and then the subsequent need to perform compulsions. To put it simply, OCD counting is just OCD. It is not its own, separate disorder.
At the end of the day, someone with OCD who compulsively counts has the same disorder as someone who has hand-washing OCD, or pedophile OCD. You’ll see why this matters when we start talking about treatment.
Why Do People Develop OCD?
Unfortunately, the exact cause of OCD is still not fully understood – but scientists are working on it.
What we’ve found out so far is that there does seem to be a genetic component to the development of OCD. Both familial aggregation studies and twin studies conducted in the past have suggested that there is a hereditary factor at play here, although none of the results have been conclusive.
There are also theories that environment plays a factor in the development of OCD. For example, traumatic or significant life events might lead to the person developing ritualistic behaviors to prevent the event from happening again – a life-threatening illness, for example.
Some people might learn these behaviors from a parent with OCD. Compulsions also are a learned behavior in themselves – by performing them, we teach our brains (inaccurately) that compulsions are an appropriate and effective way to ease anxiety.
There’s research that shows that there is a biological component to OCD, too. The brains of people with OCD seem to work in different ways than non-OCD brains, including in the interactions between the orbitofrontal cortex and the thalamus. This causes people with OCD to have a harder time than usual stopping urges and impulses to perform compulsions.
As with most other mental illnesses, what we can guess is that OCD is caused by a combination of “nature” and “nurture”. Just because your parent or someone else in your family has OCD, doesn’t mean you will, by default, have it too. However, it does seem to make it more likely – along with a multitude of other factors that increase your risk.
As for why some people with OCD count while others wash their hands, pray, or repeat certain words is anyone’s guess. Some significant life events might play a factor – for example, perhaps something traumatic happened in your life which you feel like you could have prevented if you’d just counted accurately. Perhaps you learned the counting rituals from a parent with a similar type of OCD.
At the end of the day, all OCD compulsions rob us of the ability to live our lives fully with no interruptions – no matter what the type.
Why Do Some People With OCD Count?
Someone on the outside looking into somebody who counts compulsively might wonder, why are they doing that? People with OCD might count for all sorts of different reasons – what makes it an OCD behavior is that they can’t stop doing it, even if they know it’s unreasonable.
Common Obsessions in OCD Counting
Some people with OCD count compulsively without really thinking about it – automatically. It might not be a specific intrusive thought that leads to counting, but more of a rigid ritual that the person performs without having a specific reason, at least not a reason that’s consciously known to them.
Other times, people who suffer from OCD counting experience similar obsessive thoughts as those with the “just-right” subtype of OCD. They find themselves feeling a perpetual sensation of wrongness – they can’t put their finger on it, but something is just not quite right. Just like people order or organize things to try to grasp that “just-right” feeling, people who count compulsively may count to try to bring about the same sensation.
Obsessions Related to Other Subtypes
Other people who count compulsively might experience different types of obsessions that lead to the need to count. Another common intrusive thought that people might have is that harm might come to themselves or someone they love if they don’t perform the compulsion of counting. This is similar to people who suffer from the harm subtype of OCD.
For example, perhaps they feel that if they count up to a certain “lucky” number, then this will somehow protect them. Or perhaps they feel that they can’t make a decision until they perform a certain counting ritual, or else it will lead to them making a “bad” decision that will somehow cause harmful consequences.
Contamination obsessions, in which a person with OCD worries about their bodies or surroundings being contaminated or dirty, can lead to compulsive counting, too. Perhaps someone feels that unless they vacuum the floor for exactly 14 minutes or wash their hands for exactly 62 seconds, then they will be contaminated.
At the end of the day, any obsession could lead to a counting compulsion. The important thing is that obsessions are unwanted and intrusive. The person with OCD usually knows that neither the thought nor the counting behavior make any sense, but the fear of “What if…?” keeps them trapped in the cycle.
OCD Counting is a Compulsion
Of course, not everyone who counts things is doing it compulsively – we’ll talk about this more later – but counting can become a compulsion for people who suffer from OCD.
A compulsion is any repetitive action taken to ease anxiety or try to ward off an imagined danger. Obviously, not everyone with OCD performs this particular compulsion, but counting is a fairly common compulsion observed among people with OCD.
What People With OCD Count
So what do people with OCD count, exactly? Well, this depends greatly on each person, but some of the most common things that people count include:
- Syllables in sentences
- Their own or other people’s steps
- Tiles on the ceiling or wall
- Words on a page
- The number of people who walk past them
- Ordinary bodily functions, like breaths, blinks, chews, etc.
- Anything else in their surroundings
Basically, there is no limit to the “what” of what people with OCD can count – and it isn’t the what that’s important. No matter what they’re counting, if it’s compulsive and ritualistic, it might be a manifestation of OCD.
Good Luck Numbers
Some people may count up until a specific number over and over again. This number may be something that the person with OCD thinks of as “good luck”, like the number 7, for example. They feel safe or protected when they ritualistically and repeatedly count up to 7, whether it’s mentally or while performing certain actions.
Other people might not feel “right” unless certain tasks are performed a certain number of times. Taking the example of the number 7, perhaps they need to brush their teeth for exactly 77 seconds, and not a second more or less. Or perhaps another person feels the compulsive need to reach the front door from their bedroom door in exactly 14 (7 x 2) steps.
It’s not uncommon to see people with these manifestations of OCD attach “goodness” and “badness” to certain numbers. This may be linked to a cultural superstition (like the number 4 being bad luck in Japan), or simply arbitrary – like attaching “goodness” to even numbers and “badness” to odd ones.
Compulsions Get In The Way Of Life
All of these compulsions are related to counting, but it’s not hard to see how all subtypes of OCD are the same exact disease. The person who compulsively washes their hands for exactly 77 seconds may be doing so because they’re afraid that otherwise they will be contaminated; the person who counts until 7 over and over again in their minds may worry that if they don’t, they will be responsible for harm coming to a loved one.
In the end, no matter what “subtype” of OCD you suffer from, compulsions will always keep you from being completely present in your life – and that’s why it’s so important to get treatment for this condition.
Imagine someone who has an urge to count how many stairs there are until the third floor, and needs to keep returning back to the ground floor whenever they lose count. This is just as disruptive as someone who feels the need to wash their hands for hours at a time.
No matter what the exact compulsion is, they get in the way of your life – but you don’t need to live this way.
What is Arithmomania, and Is It Related to OCD?
It’s important to know that arithmomania is not a classified or diagnosable mental health condition, according to the Diagnostic Statistical Manual. In general, it usually refers to a condition in which people feel compelled to count things in their surroundings. Sometimes, people with arithmomania attach meaning to certain numbers, so that some numbers cause them anxiety while others help them feel safe.
A pop culture figure who is a typical example of someone who suffers from arithmomania is Count Von Count from Sesame Street. We appreciated his condition as children, because he taught us how to do math, but The Count actually could never stop counting – which differentiates it as a disorder rather than a quirk.
Actually, vampires are often depicted as having arithmomania in folklore – hence the old wives’ tale of throwing rice or millet on your doorstep if a vampire tries to enter; the idea is that a vampire with arithmomania wouldn’t be able to suck your blood until they’d finished counting every last grain.
Nowadays, the term “arithmomania” is usually understood to be an expression of OCD. If someone was exhibiting a compulsive need to count everything around them (like The Count), they’d likely be diagnosed with OCD – and quite a severe form of it, at that.
I Count Things. Do I Have OCD?
Of course, counting is a part of life – none of us could get through our everyday without counting things sometimes. Even if you like to be very exact in your counting (for example, while measuring ingredients while cooking), that doesn’t automatically mean that you suffer from OCD.
The DSM-V defines a “compulsion” as being defined by:
- “1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
- 2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.”
Additionally, to meet the diagnostic criteria for OCD, these compulsions must be time-consuming (so – in relation to counting – you must spend over an hour a day counting or performing other rituals and compulsions) or “cause clinically significant distress or impairment in important areas of functioning”.
Obviously, this article cannot tell you whether your counting behaviors qualify as a compulsion. However, if you feel like your counting is causing a disruption in your life – for example, if you are losing significant time to counting or if your counting rituals are damaging your relationships – it’s important that you see a licensed professional for an accurate diagnosis.
How Can You Overcome OCD Counting?
The good news is that there’s effective treatment out there for OCD. And remember, OCD is OCD is OCD – that also means that all types of OCD are treated in generally the same way, and that’s through Exposure and Response Prevention therapy, or ERP.
What is ERP, and How Does It Help With Counting?
ERP is a CBT-based treatment that’s specifically designed to help people with OCD get out of the obsession-compulsion cycle. In a typical ERP treatment period, the therapist and the client work together to build an exposure ladder – a list of activities (in vivo or imaginal) that triggers the client’s OCD anxiety, ordered according to how strong the associated anxiety is.
Beginning with exercises that are lower on the “ladder” (that cause less anxiety), the client is asked to expose themselves to the anxiety – and not react in the compulsive way that they usually do. This is the “response prevention” piece of ERP.
Each person’s ERP process will look differently. But here’s an example of how someone with counting compulsions might move through ERP:
On Ernie’s ladder, stopping his steps on an odd number causes a level 5 of anxiety (on a 1 to 10 scale). He is afraid that if he stops walking on an odd number, terrible things will happen to him. His therapist asks him to stop walking on an odd number and remain with the anxiety that this causes until it starts losing its power. Ernie must resist the intense urge to take one more step to “correct” the number.
ERP is considered the gold standard in OCD treatment, and for good reason. Research has shown that around two-thirds of people with OCD experience improved symptoms with ERP, and about one-third of them recover altogether. Plus, it’s been shown to remain effective across multiple countries, symptom intensities, and treatment settings.
Medications Help With Counting Compulsions
Psychiatric medications, especially a type of antidepressants called SSRIs, have also been shown to be effective in treating OCD, including counting compulsions.
Serotonin is a neurotransmitter that is responsible for your mood, emotions, memory, and sleep. Not enough serotonin is associated with many different mental illnesses, including depression and OCD. SSRI drugs inhibit the reuptake of serotonin in the brain, which increases your overall levels of serotonin.
Scientists don’t know yet exactly how SSRIs work to alleviate OCD symptoms, but the research shows that it does. Some specific SSRIs that have been approved by the FDA to treat OCD are:
Whether or not you decide to take medication to help with OCD symptoms is up to you; talk to your doctor to figure out what your best options are.
Final Words About OCD Counting
Compulsive counting, just like any other OCD compulsion, can cause severe distress and disruption in a person’s life. If you’re finding that your counting rituals and habits are keeping you from living the life you want to live, then it’s important that you seek professional treatment right away from an OCD specialist.
In the meantime, you can check out a self-help program like Impulse Therapy. The techniques used in our program are based on evidence-based practices that have been shown to help reduce symptoms of OCD (including ERP), and can help you get a head start on battling your counting behaviors.