Compulsion: what is it and why it is so much part of mental health problems

Author and Medical Reviewer
Dr. Jose Toledo

What is compulsion and why it is so much part of mental health problems

Compulsion is defined as having a seemingly uncontrollable urge to do something or behave in a certain way. It plays a huge part in many mental health conditions, including alcoholism, drug addiction, behavioral addiction, and of course obsessive-compulsive disorder (OCD).

In fact, if people could conquer their compulsive behavior they would not have such a problem at all. But to do this means not so much looking at what the compulsive behavior is as to what is behind it.

Or what is driving it. Here it’s interesting to note that the word “compel” derives from the Latin compellere that’s from com– meaning “together” and pellere that means drive”.

For someone who is displaying compulsive behavior, it is exactly what it feels like. Despite their very best thinking and often knowing what they are doing is not healthy, it is as if something bigger than them is driving them to do it, and continue doing it – against their will.

Despite attempts to ignore, control, or be rid of intrusive thoughts and overwhelming urges, sufferers feel powerless. Attempting to stop them usually causes deep despair and anxiety.

So in an attempt to stop their negative feelings, someone with a compulsion feels increasingly compelled to repeat whatever their compulsive behavior is – and this creates a vicious circle. Frequently, people get extremely depressed and everything about it can mean normal daily living becomes harder, sometimes even seeming impossible. 

What compulsions are there?

What are some types of compulsions

There are many types of compulsive behavior. Here are the most common ones:


OCD is defined as having a pattern of unwanted thoughts and fears that compel someone to perform repetitive behaviors. Compulsions include cleaning, repeatedly checking (for instance, to ascertain if a window or door is locked), excessive hand washing, and counting things. Around 50 million people in the world are believed to suffer from some form of OCD. According to the Anxiety and Depression Association of America (ADAA), it affects two million Americans.


Including alcoholism, drug addiction, and behavioral addiction.

Problem gambling

Compulsive gambling is having the desire to gamble – and feeling powerless to resist. A survey from 2013 found that around six million Americans had a gambling problem. Also known as gambling addiction, pathological gambling or gambling disorder, it is classified by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an addictive disorder. As with any addiction, Adverse Childhood Experiences (ACEs) can be a huge factor behind compulsive gambling. It acts as a distraction from negative memories and feelings. As well, it releases a brief high as dopamine and endorphin are released. But because the high does not last long and more distraction is needed the compulsion keeps returning.


Compulsive eating is the inability of someone to be able to limit how much and how often they eat. It is most often a coping mechanism that has developed in an attempt to deal with unresolved histories such as trauma or toxic shame. A compulsive behavior that frequently starts in childhood and teenage years, compulsive eating causes great despair and a great number of physical issues.

Compulsive hoarding

Hoarding is the excessive keeping of possessions – and having problems in ever throwing them away. Things often kept by hoarders include newspapers, containers, junk mail, clothes, and books. A characteristic difference between a collector and a hoarder is that a collector will have things in order.

Skin picking & trichotillomania

Compulsive skin picking also involves scratching, rubbing, or digging the skin. It is to get rid of unwanted skin marks or blemishes that may or may not actually be there. Trichotillomania is the compulsive picking of hair from anywhere on the body. It often results in bald spots.


This is the compulsive and excessive playing of video games. A gaming addict feels to have no control over their gaming compulsion. It can mean not doing much else in life – and that can clearly cause problems at college, home and work.


Just as with almost everything that is done excessively, exercising excessively is unhealthy. It will strain the heart and can damage muscles and joints. As with any compulsion, it means the person is likely to have little time for anything else, which can obviously negatively impact all parts of life.


Compulsive shopping, shopping addiction, or compulsive buying disorder (CBD) is the compulsion to buy things without regard for whether they are needed or if the person can afford them. It is believed that worldwide nearly six percent of people have some issue with this compulsive disorder and that it affects more women than men.

Is compulsive behavior a sign of weak willpower?

Is compulsive behavior a sign of weak willpower

People are compulsive because they are driven by something. If someone doesn’t like the way they feel, then anything that changes the way they feel has got the power to get them to feel compelled to do it.

With compulsions, they are often thinking about the next time they are going to do it, the planning for the next time – and it is all-consuming. It’s not about having weak willpower as many people claim.

Willpower is something we use to pass an exam, get over the line in a race, or reach the top of a mountain. So willpower is a temporary boost and not a state of being that’s sustainable.

In fact, many alcoholics and other addicts have very strong willpower in many aspects of their life. But over a particular thing that they have discovered that seems to alleviate painful and negative feelings, they feel powerless.

The Twelve Steps recovery program – as we can introduce people to at our center –addresses this powerlessness. Devised in the 1930s by AA (Alcoholics Anonymous) co-founders Dr. Bob Smith and Bill Wilson to help alcoholics, the Twelve Steps have since been adapted to help with all addictions.

They are guiding principles for recovery from addiction, compulsion, and other emotional problems. Everyone has choices, but sometimes people do not realize this freedom we all have.

Yet as Jewish psychiatrist Viktor Frankl wrote about in his recovery bestseller Man’s Search For Meaning about how he survived Nazi concentration camps: “Everything can be taken from a man but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.”
Tikvah Lake’s team of professional mental health experts has great experience in treating people with all conditions. Reach out to us today to find out how we can help you or someone you know.

David Hurst - Tikvah Lake Recovery

About David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

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