A person with OCD often has a strong need to be responsible for their actions, and even certain events that they have no control over. They often doubt if they have carried out an important task properly, or if they have done it at all. In return, their major compulsion is to check repeatedly. Obsessive-compulsive disorder is often called “the disease of doubt” for that reason.Repetitive checking is a behavior the person feels driven to perform as a reaction to an obsession. If the patient’s primary obsession falls within this category, he or she will experience intrusive thoughts, images, urges, and fears connected to the possibility of harming other people or themselves because of negligence or failing to something the right way. These harming fears include the fear of forgetting to turn off the stove that could lead to the death of a loved one or fear of accidentally hitting another person while driving. There’s an intense feeling of doubt that accompanies the fear of harm. These people may also experience severe obsessional doubt that they tend to question their recollection of their actions, and there have been cases where people who repeatedly check, do have some memory problems. Research studies confirms that most OCD patients who check are not very confident of their own memories and may perform poorly on certain types of memory tasks. It is still not clear whether this is caused by high levels of anxiety or if it’s an actual brain issue.
There could be an instance where an OCD patient sees someone on the side of the rode as he passes by. While driving, he may start to worry that the little bump he felt while driving was the body of the pedestrian. This person knows deep-down that his thoughts are too far-fetched and that he didn’t really hit the pedestrian. But his mind will continue making “what if...” scenarios and invent elaborate possibilities, eventually creating a shred of doubt. The OCD patient will contemplate on the thought until it gets intolerable and that they must drive back to where they last saw the pedestrian, in order to reduce the stress.
Another common and potentially practical fear is leaving on hot equipment that can be a cause of fire. This could include objects like stove, oven, hair dryer, and curling iron. The gravity of the actual obsession is impertinent to a person with OCD. Even though forgetting to turn off the hair dryer is not as serious as hitting a pedestrian, an OCD person may exaggerate it and may feel tortured by the thought of causing harm. A typical person may go back to check on the stove, but a person with OCD will check and re-check, thinking they must have forgotten to correctly switch off the item. They may go back a second time, a third or more depending on the severity of the disorder. If this is the primary obsession, the person with OCD may have this fear every time they leave the house. A common compulsion associated with this is when an OCD sufferer stares at the knobs on the stove - making sure they are turned off before leaving the room – only to come back in, check again and again before leaving the house. There are also times when an OCD patient feels a certain relief when checking things, a certain number of times. For example, such person may look at the knobs three times, then leave the room, and come back to check on the knobs again, three times for each.
Leaving a door or window unlocked that could result in a robbery is also a common doubting fear. This is somewhat similar to the fear of leaving on a hot item causing a fire. If this is the main obsession or the favorite obsession of the time, it can be as torturous as hitting a pedestrian or burning down a house with your loved ones. Again, it is not the severity of the potential disaster that causes distress but the severity of the disorder. Those who worry that they forgot to lock their door may also be worried that they forgot to turn off the stove. People with OCD will often be nagged by doubting fears even when there is no present danger.
Another type of obsession that may upset a person with OCD is worrying about causing harm to others on impulse. Such a person may fear stabbing a friend, pushing a helpless person on the subway, or hurting their children, not out of anger, but just because they can. The main subject of this obsession is usually loved ones, but it can also be anyone – pets, neighbors or strangers. A person not suffering from OCD might have a passing thought of stabbing a loved one with a kitchen knife while they are eating. These are just random thoughts created by the mind and not caused by contemplating on killing the loved one; the person doesn’t have any desire to carry out the act, so they may disregard it as just a silly thought. Others might shudder at the thought but would still know it’s just a random weird thought. On the other hand, a person with harming obsession will ponder on this thought longer than usual and engage in compulsions to the alleviate their fears.
Under this category is also the fear of doing shameful and embarrassing things. It may include, accidentally blurting out obscenities or saying something that is incorrect or not true. Like when the person is in a meeting with important people and worries that they may scream or say something obscene. The mind of the person with OCD will continue to suggest that it can happen or that they have probably done it already without realizing it. These fears may manifest themselves into avoiding the tasks that may cause them to do wrong such as public speaking. Most people are not comfortable talking in front of a big crowd but a person with OCD trembles with anxiety because they are afraid of forgetting their lines or blurting out a swear word. They may have social phobia symptoms, which is often comorbid with the disorder, and might obsess for weeks before the event.A person with this type of obsession might also fear doing something illegal such as stealing. At the grocery store, they might worry about looking at the security guard the wrong way and be suspected of being a thief.