Counting OCD: Types, Causes, & Treatment

What Is Counting OCD?

An individual with counting OCD may have obsessions about symmetry or exactness. Additionally, they may experience an ongoing urge to count to stop a feared outcome or block an intrusive thought. Someone with this type of OCD feels driven to perform compulsions involving counting or numbers. Counting OCD falls under the subtype of perfection and symmetry.¹

Someone with counting OCD may be unable to complete a task due to compulsions involving numbers, such as waiting to leave the house until a specific time they see on the clock, performing an activity a certain amount of times, or having to count to a number repetitively. All of these behaviors impact a person’s ability to get through the day and can be disruptive and time-consuming.

Examples of OCD Counting Rituals

Common types of counting OCD are:

• Counting items
• Counting footsteps when walking or running
• Waiting until a specific time on the clock to do an activity
• Performing actions in sets of a specific number
• Favoring a particular number (also called magic numbers)
• Counting words in a sentence or on a page

Counting OCD & Magic Numbers

Magic numbers are numbers someone with counting OCD has assigned special meaning to. Some individuals may repetitively perform an action until they reach this magic number, for example, tapping something three times if their magic number is 3. Magic numbers often accompany the idea of magical thinking or the belief that specific thoughts or behaviors have a causal effect on unrelated events.²

Not everyone with counting OCD will have magic numbers, and how they choose the numbers varies from person to person. Some connect numbers to superstitious beliefs, such as the lucky number 7 or unlucky 13. Other magic numbers may be based on life events that an individual has experienced or developed due to compulsive behaviors.

What Triggers Counting OCD?

OCD counting can be triggered in a variety of ways. For some individuals, a counting compulsion may come up in response to an obsessive thought or in response to block out an intrusive thought. These thoughts may focus on potential harm to themselves or a loved one.³ To keep these intrusive thoughts at bay, someone with counting OCD uses counting compulsions to keep the thoughts away or to keep their loved one safe from harm.

Someone with counting OCD may also feel the urge to count until they feel it is “just right.” With this type of OCD, counting itself may trigger an obsession, such as the thought that they may never be able to stop counting. Triggers vary from person to person, but the core theme with counting OCD is an urge to focus on counting numbers.

Common triggers for counting OCD include:

• Thoughts of harm occurring to self or loved ones
• Attempting to block out an intrusive thought
• Organizing or lining up items
• Looking at the clock, waiting for a specific time
• A feeling of “wrongness” that leads to counting until they achieve the “right” feeling
• Thoughts that counting may never stop

Symptoms of Counting OCD

Symptoms of OCD include unwanted and intrusive thoughts, known as obsessions, and urges to engage in repetitive behaviors, known as compulsions. In counting OCD specifically, many compulsions focus on numbers and counting. Obsessions may focus on perfection, symmetry, or avoiding a feared outcome, such as harm to themselves or a loved one.³

Common compulsions in counting OCD include:

• Repeatedly counting floor or ceiling tiles
• Counting steps while walking
• Counting until a specific number
• Repeating an action a set number of times
• Counting items, ex. books on a bookcase
• Waiting until a specific time on the clock to perform an action
• Repeatedly counting out loud
• Counting until the “right” feeling is achieved

What Causes Counting OCD?

There is little research currently focused on what causes counting OCD in particular. For OCD as a whole, multiple factors have been studied as potential causes. Genetics plays a role in OCD, particularly if you have a parent or sibling with OCD.⁴ Environmental factors, such as exposure to traumatic or stressful events, may also contribute. Because counting OCD falls under the umbrella of perfection OCD, traits of perfectionism have been linked to this type of OCD as well.

Possible causes of counting OCD include:

• Genetics: Genes have been shown to play a role in OCD, especially if a parent or sibling has it. Although genetics have an influence, they are not the sole cause of OCD.
• Environmental factors: Various environmental factors have been correlated with OCD, such as experiencing traumatic events or experiencing many life stressors all at once.
• Perfectionism: Counting OCD falls under the subtype of perfection OCD. Perfectionistic traits are highly common in individuals with OCD.⁵

Impacts of Counting OCD

Counting OCD can be debilitating and interfere with a person’s ability to function at work, at home, socially, and more. Performing repetitive compulsions can be time-consuming and interfere with daily activities and routines. Individuals with OCD, particularly with more moderate or severe symptoms, often spend much of their time consumed by intrusive thoughts that cause distress and an ongoing urge that drives them to perform counting compulsions repeatedly.

How Is Counting OCD Diagnosed?

Counting OCD can be diagnosed by a mental health professional, such as a therapist, psychiatrist, or psychologist. It is helpful to seek a professional with prior experience with diagnosing and treating OCD. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is often administered to assess for OCD and is considered the gold standard assessment to use.⁶

Treatment for Counting OCD

OCD treatment typically involves working with a therapist and/or taking medication. Exposure and response prevention (ERP) has been widely studied as an effective treatment for OCD and is typically recommended for counting OCD. Although ERP is the most effective treatment in research thus far, other treatment approaches can also be used, such as EMDR, ACT, and mindfulness-based CBT.

In some instances, the doctor or treating provider may recommend psychiatric medications in combination with therapy to manage symptoms of OCD. Counting OCD can produce high distress, which some individuals may want to manage with medication. A psychiatrist can help recommend medications most effective for your OCD symptoms based on your needs and history.

Treatment options for OCD include:

• Exposure and response prevention (ERP): ERP for OCD involves completing exposures that provoke the feared obsessive thought without engaging in compulsive counting behaviors during the exposure.
• Medications: The medication most effective in managing OCD symptoms is selective serotonin reuptake inhibitors (SSRIs), also known as antidepressants. Various SSRIs treat counting OCD, such as Luvox, Prozac, Paxil, and more.⁷
• Cognitive behavioral therapy (CBT):  CBT for OCD focuses on the link between thoughts, emotions, and behaviors. CBT for counting OCD attempts to break the link between obsessive thoughts and compulsive counting behaviors used to reduce distress caused by these thoughts.
• Eye movement and desensitization reprocessing (EMDR): EMDR for OCD is a particularly helpful approach if the onset of counting OCD symptoms can be traced back to a stressful or traumatic event. EMDR works to decrease distress rooted in prior events contributing to present-day distress, therefore decreasing symptoms of OCD.
• Acceptance and Commitment Therapy (ACT): ACT for OCD is an approach that emphasizes psychological flexibility and explores other ways to respond to distress caused by obsessive thoughts other than compulsive counting. ACT emphasizes letting an obsession pass and choosing a different response aside from counting behaviors.
• Mindfulness-based CBT: Mindfulness-based CBT encourages letting intrusive thoughts come and go, without making judgments or the need to act on them. By taking an observational stance to these thoughts, the drive to engage in counting compulsions can dissipate.

7 Tips for Coping With Counting OCD

Counting OCD can be distracting as you are trying to go through daily life. Rather than feeling you have to give into the compulsion to count continually, there are skills to implement in place of counting compulsions. Developing healthy coping skill for OCD can be incredibly important for managing symptoms. These can help you break the cycle of OCD that compulsions continue to maintain.

Here are seven tips for coping with counting OCD:

1. Practice urge surfing: The urge to count is typically like a wave – it will rise, hit a peak, and then fall as time goes on. Riding out the wave of the urge to count can help reduce this behavior.
2. Delay counting: When you feel the urge to count, try to delay this behavior as long as you can. Engage in a different activity that is distracting instead and can allow you to take your mind off the urge to start counting.
3. Identify triggers: Become aware of what tends to trigger your counting OCD or makes your OCD worse. Each person is unique in their experience – what triggers bring up your counting compulsions?
4. Journal about identified triggers: Keeping track of the triggers you identify can be helpful. Processing the emotions surrounding these triggers in a journal may be beneficial as well.
5. Labeling it as OCD: When the urge to count occurs, recognize and state to yourself “this is my OCD wanting me to count.”
6. Establish “no counting” times: To start decreasing counting compulsions, establish times of the day where you work towards going periods without counting, such as 5 minutes, 10 minutes, and gradually increasing over time. Your therapist may recommend this strategy in ERP treatment as well.
7. Learn new skills to cope: Using skills such as mindfulness or deep breathing in place of counting can be beneficial to calm the anxiety that accompanies counting OCD.

When to Seek Professional Support for Counting OCD

Seeking treatment for counting OCD is typically recommended, particularly if you have noticed your symptoms are time-consuming, impacting your ability to finish tasks, or producing a high amount of distress. Using an online therapist directory can help you search for professionals specializing in OCD. If you prefer to seek treatment in the comfort of your home, seeking OCD treatment through an online therapy platform or an OCD therapy platform may also be a helpful option.