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• Obsessions are thoughts, images or impulses that occur repeatedly, are intrusive and distressing and can't be supressed or neutralised
• Compulsions are repetitive behaviours used to control or neutralise the obsessions and prevent the harm and reduce the anxiety, but which are excessive and disabling

• Education about the nature of the disorder
• Advice to resist carrying out compulsions
• Specialist referral to a cognitive behavioural program is recommended.

A 40-year-old man presented with a long history of checking behaviour that was significantly interfering with his life. He checked on "dangerous" items repeatedly before being able to leave his home because of recurring thoughts that something terrible -- like an appliance staring a fire -- might happen and that he may inadvertently be responsible for harm befalling others. He performed his checking in a ritualised manner, ensuring that all electrical items were switched off and unplugged, at times having to count to four as he stared at each item. If interrupted during these behaviours or if feeling under pressure, he had to restart his checking rituals. Similarly, if the thought that some appliance might have been left on occurred during his checking behaviour, the time spent checking each item was lengthened considerably. He reported that he was consistently late in getting out of the house because of his checking, and frequently had to leave work during the day to go home and check items again. He had been asked to resign from two previous jobs because of his constant lateness and absences from work.

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