I Can’t Help Checking to See Whether I Dropped Something

Reader’s Question

Every time I leave someplace I feel like I have dropped or lost something important. I will worry myself to death until I finally go back and retrace my steps to check and see if I did indeed drop something, even though I know that I didn’t. It has gotten so bad lately that I don’t even want to leave the house. Most of the time when I go back and check to see if I dropped something and see that I didn’t, I will still wonder whether I did, even though I just checked. What can I do to stop worrying?

Psychologist’s Reply

What you’re experiencing is the typical cycle that characterizes obsessive-compulsive disorder (OCD). A primary theory about the cause of OCD is that some people’s brains are too easily triggered to feel a sense that something is wrong or dangerous. We humans have a tremendous need and capacity to try to figure out why we feel the way we do, so we naturally try to find the cause of the uneasy feeling. Accordingly, each person with OCD may answer that question differently. Still, the anxiety associated with OCD is frequently attributed to germs/contamination or having done something (or failed to do something) which will result in a dangerous outcome.

The anxiety inherent in the faulty brain chemistry of OCD fuels thoughts (worries) as to the cause of the anxiety. Because the individual has little control over the anxiety, and hence the thoughts, the intrusive thoughts are referred to as obsessions. The nature of the obsessive worries implies an action the person should take to get rid of the worry — the resulting behavior is referred to as the compulsion. For example, if the individual with OCD attributes his or her anxiety to having unclean hands, the compulsion is to wash them. After all, if the problem is germs, the solution is cleaning. In reality, however, the problem isn’t germs, but rather faulty brain functioning.

In your case, the worry is that you’ve dropped or lost something, so it makes sense that you’d check to ensure you hadn’t. However, as you noted, the checking doesn’t resolve the worry. It might provide a brief instant of relief, but the worries soon pop up again. Because the root of the problem is assumed to be biological, medication is typically the first step in treatment. Such medication may not always eliminate the underlying anxiety and worry entirely, but after some trial and error as to the specific medication and dosage, most people experience tremendous relief. Then, the behavioral component of treatment is possible and success within reach.

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Behaviorally, the compulsive behavior (checking) is reinforced and thus becomes stronger (more likely) over time. Each time you check and receive even a bit of relief, the checking behavior is strengthened. The behavioral aspect of treatment for OCD involves resisting the urge to engage in the compulsion, and doing so will get easier with practice. At first you may need to distract yourself, or talk to yourself, or exert sheer will to go on to the next activity without going back to check. It will be tempting to think, “but if I just go back and quickly check, then I can go about my business.” Of course that hasn’t helped in the past, and it won’t help now either. Reminding yourself of that fact can help you to resist the compulsion.

I strongly encourage you to seek treatment from a qualified mental health professional. Successful treatment involves some combination of medication and behavioral intervention as briefly described here. The sooner you get started, the sooner you’ll be free of the obsessive-compulsive cycle you described.