Compulsive Behavior

When someone engages repeatedly in a behavior that is excessive, and despite the harmful consequences of doing so, it is referred to as compulsive behavior. People who have this experience feel unable to control their behavior, and so it can interfere with their daily activities and relationships.

Compulsive behaviors are usually unwanted, and can cause great distress. As such, it’s not uncommon for people to also experience other mental health concerns like anxiety or depression. However, with the right treatment plan in place, which often includes therapy, it’s possible for people to move on from compulsive behavior.

What is compulsive behavior?

Compulsive behaviors are complex and are conceptualized by researchers in different ways. Some think of it as a type of addiction, while others view it as being linked to difficulties with impulse control. Compulsive behaviors are related to, and sometimes confused with, other mental health conditions. As such, it’s important to see a mental health professional for an assessment. An accurate diagnosis will enable the selection of the appropriate treatment.

Types of compulsive behavior

There are many different types of compulsive behaviors. Some align more closely to addictive behaviors, while others relate more closely to Obsessive-Compulsive Disorder (OCD), or problems with impulse control. Some of the kinds of behaviors that people seek therapy for include:

  • Shopping or buying
  • Eating
  • Gambling
  • Washing
  • Cleaning
  • Counting
  • Checking
  • Skin picking
  • Sexual behavior
  • Hair pulling
  • Exercise

Prevalence of compulsive behavior

Compulsive behaviors appear to be relatively common. For example, one study found that around 10% of students had at least one compulsive behavior (such as gambling, sexual behavior or buying) at some point during their lifetime.

There are many different types of compulsive behavior, as noted above. A review of the research reported the following statistics about the prevalence of some types of compulsive behaviors:

  • Compulsive hair pulling occurs in around 0.5–3.9% of people
  • Skin picking occurs in around 0.2 and 1.4% of people
  • Compulsive buying or shopping occurs in around 5.8% of people

Symptoms of compulsive behavior

Characteristics of compulsive behavior vary and affect people in different ways. That said, some or all of the following symptoms may be experienced:

  • Repetitively engage in a behavior
  • Repeating the behavior despite adverse and harmful consequences to yourself or others
  • Feeling like you can’t control the behavior
  • Experiencing an intense urge, or something that feels a little like a craving, to participate in the behavior
  • A sense of pleasure associated with the behavior

You don’t need to be experiencing all of these symptoms to be faced with a problem that interferes with your life. People with just one or two may have difficulties with compulsive behavior and can benefit from therapy.

What to do if you are struggling with compulsive behavior

The most appropriate treatment plan depends on the type of behavior experienced. In some cases, a combination of medication and therapy may be the most effective way forward. It’s important to work closely with your health care professional to figure out the treatment approach that’s the right fit for you. Common elements of a treatment plan include:

  • Assessment: In some cases, compulsive behaviors can be related to Impulse Control Disorders or Obsessive-Compulsive and Related Disorders, which are groups of diagnosable mental health conditions. These conditions are similar but different, so it’s best to speak with a therapist regarding the specifics of your experience. Receiving an accurate diagnosis will make a big difference to the type of treatment approach taken.
  • Medication: In some cases, medication can be helpful for managing compulsive behaviors or related mental health challenges.
  • Therapy: Psychological talking therapies in both individual and group contexts can help with some symptoms of compulsive behavior and associated challenges. Types of therapy to consider are discussed further, below.
  • Support groups: Many people who struggle with compulsive behavior find support groups to be beneficial. Sharing experiences and learning from people who are further along the treatment journey can be encouraging and helps people to feel that they are not alone. Although compulsive behaviors are not always related to OCD, The International OCD Foundation website can be helpful for finding local support groups and phone support groups. The Smart Recovery website can help you to find support groups in your area.
  • Helplines: If you need immediate support, call 1-800-273-8255, or go the National Suicide Prevention Lifeline website.

Therapy types to consider for compulsive behavior

Many types of therapy are considered helpful for treating symptoms of compulsive behavior and any associated challenges. Therapy types include:

  • Cognitive Behavioral Therapy (CBT): CBT can help change unhelpful thoughts and behaviors. Additionally, it’s not uncommon for people with compulsive behavior to also experience mental health problems such as anxiety, depression, or substance abuse. CBT can also help with this.
  • Exposure and Response Prevention (ERP): This type of therapy is helpful if your experience of compulsive behavior is actually a part of a diagnosis of Obsessive-Compulsive Behavior (OCD). ERP is actually a type of CBT, which people are exposed to the situations that lead to compulsive behaviors, but learn to decrease and stop engaging in them.
  • Mindfulness Practices: Mindfulness helps people to be aware more aware of their bodies and thoughts without automatically acting on them.
  • Acceptance and Commitment Therapy (ACT): ACT involves components of both CBT and mindfulness as well as other strategies to help people take an acceptance approach to urges to engage in compulsive behavior.

What to look for in a therapist for compulsive behavior

The best-fitting type of therapist for you will depend on individual factors, symptoms, your location and finances. When selecting a mental health professional, it can be helpful to consider the following factors:

Personal fit

As is the case when you are seeking therapy for any reason, it’s important to consider the potential for developing a strong working relationship with your therapist. The trusting working relationship with a therapist is called the therapeutic alliance, and it’s the number one indicator of treatment efficacy.

Qualifications and experience

It is important to look for a licensed mental health professional. This ensures that the therapist you work with has undertaken the appropriate education and training. In addition, ask your prospective therapist ahead of time whether they have specialized training and experience in assessment and treatment of compulsive behavior.

Talk in advance

The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call. Most therapists will be happy to oblige. This gives you the opportunity to ask about:

  • Their qualifications
  • Their experience working with people who have compulsive behavior
  • Any ongoing training they are participating in that relates to compulsive behavior
  • What type of therapy they suggest, and what that will be like
  • Their participation in insurance plans and cost of therapy

Try to speak to a few different therapists before making your mind up.

New to therapy? Learn about how to find a therapist here.