When the “Compulsion” Is Thinking: The Most Overlooked Form of OCD
Most people think of OCD as a combination of obsessive thoughts coupled with visible rituals—hand-washing, checking locks, lining things up in a very particular order. But there’s a quieter, often-missed presentation where the obsession is followed by a mental ritual: analyzing, problem-solving, “figuring it out,” replaying conversations, and seeking certainty in your head. In other words, the compulsion is rumination.
If you’re someone who gets caught in thought loops—endlessly reviewing “what ifs” “why did I??,” or “what does it mean that I thought or said that?”—this post is for you.
Rumination: the compulsion that spirals
Rumination feels productive—“I’m being responsible by thinking this through.” But in OCD, it becomes a repetitive, sticky mental behavior and pattern performed to reduce distress or gain certainty.
Here’s what it often looks like in real life:
Spiraling into endless “what if” scenarios that endlessly grow darker or with more extreme circumstance
Sliding down rabbit holes of thought, each twist taking you further from where you started.
Self-flagellating with the inner critic—berating yourself for having the intrusive thought in the first place, and then punishing yourself for not being able to stop thinking about it.
Feeling unable to break free from the mental quicksand, no matter how hard you try to “reason” your way out or avoid the mental trap.
Instead of bringing clarity, rumination breeds exhaustion, shame, and paralysis. The harder you think, the more stuck and distressed you become.
Why it’s overlooked
Because there’s no visible ritual, people (and sometimes clinicians) label it “anxiety,” “perfectionism,” or “overthinking.” But the function of the thoughts matters: if the mental activity is done to reduce obsessional distress or silence the critic in your head, it’s a compulsion. And the cycle is pure OCD: obsession → compulsion → temporary relief → stronger obsession.
How the inner critic plays into OCD
For many, rumination doesn’t just chase certainty—it becomes a weapon the inner critic uses. Intrusive thought: What if I hurt someone? Compulsion: spiral through every interaction, berating yourself for being dangerous, irresponsible, or “bad.”
The critic promises control—“If I punish myself enough, I’ll never do it”—but really it keeps the OCD loop alive. Shame and self-attack become their own compulsions, layered on top of rumination.
The broader picture: overlap with eating disorders and addiction
This style of spiraling and self-punishment also shows up in conditions with compulsive behavior patterns:
Eating disorders, where rigid food rules, calorie counting, or body-checking serve as another way to manage intrusive distress in addition to the nearly constant stream of food and body thoughts.
Addiction, where substances can become a way to quiet the critic or check out from the dark and spiraling rabbit holes of thought.
Research supports meaningful comorbidity between OCD, eating disorders, and substance use disorders. While the overlaps are complex, they all share the feature of compulsions—behaviors (or thoughts) meant to reduce distress or give a sense of control, but which ultimately reinforces the obsessive thoughts.
Moving forward
If you recognize yourself in these spirals, the most important shift is this: rumination is not insight, it’s a compulsion. Once you name it that way, you can begin using tools like, mindfulness-based skills and self-compassion practices to step out of the critic’s grip and back into your life.