Ritualizing

Two key terms—ritual and rumination Opens in new window—are commonly used to describe aspects of obsessive-compulsive disorder Opens in new window. Here in this literature, the term ritual is discussed.

What is a Ritual?

A ritual, in the context of obsessive-compulsive disorder, is a compulsive behavior, either overt or mental.

This implies that the behavior concerned has a rigid, set pattern and a sequence of steps with a clear-cut beginning and end.

Some examples of compulsive behavior are highly ritualized. The following examples illustrates a very elaborate ritual reported by a man in his mid-twenties. This is what he had to do when brushing his teeth and washing his face every morning.

  • Enter bathroom with left foot first.
  • Close door with left hand, then touch door handle with right hand.
  • Take towel from rail and keep it on edge of bath with left hand, then touch it with right hand.
  • Take toothbrush from cabinet and place it on edge of washbasin with left hand, then touch it with right hand.
  • Take toothpaste tube from cabinet with left hand, then touch it with right hand.
  • Unscrew and remove cap with left hand, then touch it with right hand.
  • Squeeze tube to get enough toothpaste on to brush with left hand, then touch tube with right hand.
  • Replace cap of tube with left hand, then touch it with right hand.
  • Put tube back with left hand, then touch it with right hand.
  • Pick up brush with left hand, then start brushing: teeth brushed in twos, from left to right, top row first, bottom row next, outside first, inside next, each set of two eight times; then, repeat whole process with brush in right hand, then again with left hand followed by same again with right hand.
  • Open taps with left hand, then touch them with right hand.
  • Wash brush under hot tap, held in left hand, then touch it with right hand.
  • Put brush back in cabinet with left hand, then touch it with right hand.
  • Rinse mouth, taking water with left hand, then with right hand.
  • Look at self in mirror first with left eye, then with right eye.
  • Begin to wash face, using left hand to splash water on face, then right hand.
  • Rub left side of face with left hand, followed by right side of face with left hand, then rub left side of face with right hand, followed by right side of face with right hand.
  • Apply soap to face, in the same sequence as above.
  • Rinse face, splashing water on face with left hand, then with right hand.
  • Look at self in the mirror, first with left eye, then with right eye.
  • Close taps with left hand, then touch them with right hand.
  • Pick up towel with left hand, then touch it with right hand.
  • Dry face with towel, left side holding towel in left hand, then right side holding towel in left hand, then left side holding towel in right hand, then right side holding towel in right hand.
  • Look at self in mirror, first with left eye, then with right eye.
  • Put towel back on rail with left hand, then touch it with right hand.
  • Open door with left hand, then touch handle with right hand.
  • Leave bathroom, with left foot first.

Most compulsive behavior has a ritualistic quality about it, and for this reason the term ritual is used by many to refer to any compulsive behavior; in this literature, the word ‘ritual’ is used in this broad sense. Similarly, engaging in compulsive behavior is sometimes referred to as ritualizing.

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    The research data for this work have been adapted from:
  1. Obsessive-compulsive Disorder: The Facts By Padmal De Silva, Stanley Rachman