Checking and reassurance-seeking: why the relief is so short-lived

The key is already in your pocket, you are already on the stairs, and then it comes: “Did I really lock up?” You know you did. You remember the movement. And still you go back, press the handle, the door is shut, and for a moment there is calm in your chest. As far as the car. There a new question arrives: “What about the iron?”

Almost everyone has at some point gone back to check the door or the cooker, and for most people it happens a few times a year, when they are tired or distracted. For some, though, checking becomes part of every departure from home, every sent message, every evening. Once is not enough, nor is three times, and when your own eyes no longer suffice, the question goes to someone else: “Did you see me lock it? Are you sure?”

In this post I explain why the relief after checking is so short-lived, why reassurance from a loved one works in a similar way, and what the research knows about it. Excessive checking is one of the common forms of obsessive-compulsive disorder (OCD), but not all checking is OCD. That disorder is assessed and treated by a psychiatrist or a clinical psychologist; I do not diagnose or treat it. The post is meant for understanding the mechanism, not for giving yourself a diagnosis.

Checking is a solution that works too quickly

First, something that is easily overlooked: checking works. If it were ineffective, people would not repeat it. When you press the handle and the door is shut, the anxiety drops within seconds. No breathing exercise, no conversation and no medication works that fast. From the nervous system’s point of view it is an excellent solution.

The trouble is the price that comes later. Checking removes the anxiety, but it does not remove what produces it: the feeling that you must be completely certain, and the belief that any accident would be your fault. Those two remain untouched and within minutes they find a new question.

How widespread such experiences are is shown by a large American study of a representative sample of adults: more than a quarter of respondents said they had experienced obsessions or compulsions at some point in their lives, while only a small share of them met the criteria for the disorder (Ruscio et al., 2010). An occasional urge to check is therefore something very human. We speak of a disorder only when it takes up a lot of time, causes severe distress or gets in the way of life. What OCD is and how the field defines it, I explain in Obsessive-compulsive disorder: more than tidiness and cleanliness, and there is also a short description in the knowledge base under obsessive-compulsive disorder.

Negative reinforcement: why what relieves gets repeated

The psychology of learning has a dry name for this: negative reinforcement. “Negative” here does not mean bad; it means that something is taken away. A behaviour after which an unpleasant feeling disappears becomes more likely. You take a tablet, the headache goes, next time you take it sooner. You open an umbrella, you stop getting wet, next time you open it at the first drop.

With checking, the unpleasant feeling is anxiety and the behaviour is a look at the cooker. Because the relief comes at once, the learning is very strong. The brain does not remember “the cooker was off”; it remembers “when I checked, it felt easier”. At the same time it fails to learn something else: that the anxiety would have eased without checking too. The British psychologist Stanley Rachman and his colleagues were already observing people with OCD in the 1970s who, by agreement, refrained from their ritual, and found that the urge and the discomfort decline over time by themselves. Someone who always checks never gets that experience.

The same mechanism sits behind all avoidance; I describe it in more detail in Anxiety and avoidance: why avoiding helps you today and harms you tomorrow. Checking is in fact a particular form of avoidance: what you avoid is not a place or a person but the feeling of uncertainty.

The more you check, the less you trust your memory

The second reason the relief does not last is less well known and more surprising. It seems obvious that people who check a lot do so because they have a poor memory. Research shows almost the opposite: poor trust in memory is to a large extent a consequence of checking, not its cause.

In 2003 the Dutch psychologists Marcel van den Hout and Merel Kindt asked healthy volunteers to check a virtual cooker on a computer again and again. Their memory of the last check stayed accurate. Something else changed: the memory became less vivid and less detailed, and the participants trusted it considerably less. The Canadian researcher Adam Radomsky and colleagues later showed the same effect with a real kitchen cooker.

The explanation is simple. The first check is an event: you see the knob, feel it under your fingers, hear the click. The twentieth is the same as the nineteenth and the eighteenth. The memories blur into a fog, and when you later ask yourself “Did I really check?”, all you find is a vague sense of having done something at the cooker. That vagueness feels like a reason to check again. Rachman called this a self-perpetuating mechanism: checking increases the sense of responsibility, lowers confidence in memory and so prepares the ground for the next check.

That is why the well-meant advice “check it thoroughly and you’ll feel calm” does not work with excessive checking. Thoroughness is not the cure; it is the fuel.

Reassurance-seeking is checking through another person

When your own checking no longer suffices, it is natural to turn to someone you trust. “Did you see me switch it off?” “Do you think I offended her?” “It’s nothing serious, is it?” The researchers Osamu Kobori and Paul Salkovskis describe reassurance-seeking as a behaviour closely related to checking: the aim is the same, only now the certainty comes from someone else. It has an extra attraction, too. If my partner said it was locked, the responsibility is no longer mine alone.

“Did you see me lock it?”
“I did. I was standing right there.”
“But were you looking at the lock or at me?”
“It’s locked, I promise.”
“Can we turn back anyway? Just this once.”
(a composed dialogue, not a real person)

The answer “it’s locked” works exactly like pressing the handle: the anxiety drops, and because it drops, the question comes back sooner next time. Something else typical happens as well. The answer has to be given in the right way. Too quick, and it sounds as though the partner did not really think; hesitant, and it sounds like doubt. So the question is repeated, phrased a little differently, and the person answering feels they are sitting an exam that cannot be passed.

Reassurance-seeking is not limited to locks. It runs the same way with worries about health, where doctors and the search engine take over the partner’s role (the knowledge base has an entry on health anxiety), and with intrusive thoughts, where a person asks again and again whether they are a bad person. I wrote about those in Intrusive thoughts: why you have thoughts that frighten you — and why they are not your character.

When the whole family adapts to the checking

I want to be especially careful here, because the subject is sensitive for both sides. When someone you love is suffering, you want to help. If your answer calms them, you answer. If it is easier for them when you check the gas, you check it. That is not weakness and not a mistake; it is care. The field has a term for it, family accommodation, and when the American researcher Lisa Calvocoressi and her colleagues first measured it systematically in 1995, it turned out just how ordinary it is: of 34 relatives of people with OCD, 88 per cent were accommodating the disorder in one way or another.

Later reviews of the research, among them a review by Eli Lebowitz and colleagues, showed two things. First, more accommodation is linked with more marked symptoms and a poorer treatment outcome. Second, accommodation wears relatives out: the more of it there is, the greater their burden and the tension in the family. This is an association, not proof that relatives cause the disorder. OCD does not arise because someone answered too patiently. But accommodation can help keep the loop going, through the same mechanism as a person’s own checking: it brings quick relief and so prevents the experience that the anxiety would pass without it.

How to be alongside a loved one with OCD without becoming part of the rituals is the subject of a separate post: When someone you love has OCD: how to help without taking part in the rituals.

What instead of reassurance — and why not overnight

From all this someone might conclude that the solution is simple: stop answering. That is poor advice. If a person in the middle of severe anxiety runs into “I’m not answering you any more”, they do not experience it as help but as rejection, and the distress grows. Researchers who work on accommodation therefore stress that it is reduced gradually, with notice, and together with the person concerned, ideally as part of treatment.

Lebowitz, who developed a programme for parents of anxious children, describes a supportive response as a combination of two messages: acknowledgement that the distress is real, and confidence that the person can bear it. In everyday language it would sound something like this: “I can see you’re really frightened. I believe you can hold on, even without knowing for certain. I’m here.” A sentence like that gives no certainty about the lock, but it does give something the question is really looking for: the sense that you are not alone.

A few things are worth knowing here. Agree on the change in a calm moment, not in the middle of a question. Start with one small thing, not with everything at once. And the person with OCD has to be part of the agreement, otherwise it is just a new argument. How to help without burning out yourself is something I wrote about in How to help someone you love with anxiety — without burning out.

Who treats this

If checking or reassurance-seeking takes up a lot of your time, if it makes you late, makes you avoid leaving home, or causes arguments at home, talk to your GP. They can refer you to a psychiatrist or a clinical psychologist, who will judge whether it is OCD or something else. The best-researched form of help for OCD is cognitive behavioural therapy with exposure and response prevention. Guided by a professional, the person gradually faces what sets off the urge and refrains from checking until they gain the experience that checking never allows: that the anxiety passes this way too. A psychiatrist may also prescribe medication. Reviews of the research on family accommodation also indicate that it makes sense to involve relatives in treatment in an appropriate way.

I do not carry out exposure and response prevention, I do not diagnose OCD and I do not prescribe medication. As a marriage and family therapist in training under supervision, I work with relationships, in person in Ljubljana, in Slovenian or in English. With this topic that means room for what the disorder does between people: the partner’s tiredness, the guilt of the one who asks, arguments about whose fault it is, and agreements that are hard to reach at home. This work does not replace treatment for OCD, but it can run alongside it.

If the distress becomes too much, in Slovenia you can call the Samarijan confidential helpline on 116 123 at any time (24 hours a day) or the mental distress line Klic v duševni stiski on 01 520 99 00 (between 7 pm and 7 am).

An exercise: one check, observed

This exercise is for observing everyday checking and is not treatment for OCD. If you are in treatment, keep to your therapist’s plan. If the distress during the exercise rises quickly to the point where you cannot manage it, that is useful information for a conversation with a doctor, not a defeat.

1. Choose one single check. Something small and everyday: the front door as you leave, or a sent email. Do not start with the one that frightens you most.
2. Check once, and be present. Slowly, with your full attention. Look at what you see and feel the handle in your hand. The point is not a special ritual, but for this to be an event, not an automatic movement.
3. When the urge for a second check comes, rate it. From 0 to 10, and note the number on your phone. Do not chase the urge away or argue with it.
4. For ten minutes, do not check and do not ask. Carry on your way. The question “I did lock up, didn’t I?” counts as checking too.
5. After ten minutes, rate it again. Write down the second number. After a week, look at your notes: how often did the urge drop by itself, and how often did the thing you feared actually happen?

If this kind of note-taking suits you, you can also lean on the worry postponement exercise in the knowledge base, which teaches a similar skill: noticing a thought and not obeying it straight away.

Where this does not apply

All of the above might sound as though checking and reassurance are harmful in themselves. They are not. Checking is one of the most useful human habits: pilots and surgeons use checklists precisely because memory is fallible. Checking the gas once before a holiday is not a symptom; it is common sense.

Reassurance, too, is something people owe one another. A child who wakes frightened in the night needs a hug and “I’m here”, not a lesson in tolerating uncertainty. A partner who has had bad news needs comfort. Someone grieving needs a person who will tell them for the tenth time that it was not their fault. The difference is not whether we reassure, but what the reassurance does. Healthy reassurance brings new information or closeness, and the person then moves on. In the loop I am writing about, the answer brings nothing new, the question returns within minutes, and both people feel they are going round on the spot.

A third limit: excessive checking can have other causes. In generalised anxiety the worries move from topic to topic, which I wrote about in “What if …”: why the brain would rather predict a hundred disasters than one calm day. If an older person newly starts forgetting whether they have done something, that is a matter for a doctor, not for exercises. And sometimes checking is a reasonable response to circumstances: someone who really has been through a burglary or a fire will check more for a while, and that usually passes by itself.

Lastly: the explanation by negative reinforcement is a simplification. It explains well why the loop keeps going, but not why it starts in one person and not in another. Heredity, temperament, life stresses and a good deal else that the field does not fully understand all play a part.

What to remember

• Checking works at once, and that is exactly why it is repeated: a behaviour that takes anxiety away becomes more likely. This is called negative reinforcement.
• Repeating a check does not improve memory; it lowers trust in it, which produces more checking.
• Seeking reassurance from loved ones is checking through another person and works by the same mechanism.
• Family accommodation comes from care and is very common. It is reduced gradually and by agreement, ideally with professional help, not by sudden refusal.
• OCD is assessed and treated by a psychiatrist or clinical psychologist. But not all checking is a disorder, and not all reassurance is harmful.