Areas › Worry and anxiety › Obsessions and compulsions
When the words for feelings are not there, ask for a number instead. How much did the handwashing take over this week, one to ten, is a question someone can answer on a bad day.
A number asks far less of a person than a description, which matters when putting feelings into language is hard for them, and you still end up with something you can both track week to week. It also lets someone report a rough week without handing over the details of it. Keep the wording the same each time so the numbers mean something.
Obsessive thoughts and compulsions respond well to a specific kind of therapy. What is here is for understanding them, not for treating them by yourself.
Qur’an and Sunnah
God does not burden any soul with more than it can bear (Quran 2:286). Asking for a number rather than an account is asking for something a person can actually give today.
لَا يُكَلِّفُ ٱللَّهُ نَفۡسًا إِلَّا وُسۡعَهَاۚ لَهَا مَا كَسَبَتۡ وَعَلَيۡهَا مَا ٱكۡتَسَبَتۡۗ رَبَّنَا لَا تُؤَاخِذۡنَآ إِن نَّسِينَآ أَوۡ أَخۡطَأۡنَاۚ رَبَّنَا وَلَا تَحۡمِلۡ عَلَيۡنَآ إِصۡرࣰ ا كَمَا حَمَلۡتَهُۥ عَلَى ٱلَّذِينَ مِن قَبۡلِنَاۚ رَبَّنَا وَلَا تُحَمِّلۡنَا مَا لَا طَاقَةَ لَنَا بِهِۦۖ وَٱعۡفُ عَنَّا وَٱغۡفِرۡ لَنَا وَٱرۡحَمۡنَآۚ أَنتَ مَوۡلَىٰنَا فَٱنصُرۡنَا عَلَى ٱلۡقَوۡمِ ٱلۡكَٰفِرِينَ
God does not burden any soul with more than it can bear: each gains whatever good it has done, and suffers its bad- ‘ Lord, do not take us to task if we forget or make mistakes. Lord, do not burden us as You burdened those before us. Lord, do not burden us with more than we have strength to bear. Pardon us, forgive us, and have mercy on us. You are our Protector, so help us against the disbelievers.’
Qur’an 2:286read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A meta-analysis pooling randomised trials across all ages found that cognitive behavioural therapy built around exposure and response prevention produces a large reduction in obsessive-compulsive symptoms compared with control conditions. Ratings are one of the ways into that kind of structured work, giving you something to grade steps against. The evidence is for the treatment, not for asking the question this way, which has not been tested on its own.
Reid JE, Laws KR, Drummond L, Vismara M, Grancini B, Mpavaenda D, Fineberg NA. (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials.. Comprehensive psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A number is easier to give than a description, so you get an answer instead of a shrug.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
What the thought is about matters far less than what happens next. Germs, illness, something too silly to say aloud: the machinery running underneath is the same in each case.
If stopping the ritual is out of reach for now, do it differently every time. Different order, different hand, different room, as long as it is never the same twice.
Fears of doing something terrible, of hurting an animal or a person, are not treated by moving closer to the act. Nobody should be walking you up a ladder towards the thing you are terrified of doing.