A Guide To Stimming And Its Connection To OCD

Stimming is a repetitive movement or behavior that's often associated with autism. However, people with obsessive-compulsive disorder (OCD) also typically engage in repetitive behaviors. These repetitive behaviors may look different than the stims related to autism, but there may be a connection. Learn more about OCD and autism and the role stimming plays in both conditions.

What is OCD?

Obsessive-compulsive disorder is a mental health condition affecting between two and three million people¹ in the United States. OCD is a common psychiatric disorder that results in a cycle of obsession and compulsions.

Obsessions are unwanted, recurring, distressing thoughts or mental images. Compulsions are repeated behaviors a person with OCD engages in to prevent obsessive thoughts or decrease the anxiety caused by them.

These compulsions often interfere with daily life and may include a range of behaviors, such as excessive hand washing, cleaning, ordering, counting tasks, praying, collecting, hoarding, or checking an item repeatedly. 

How can you tell if you have OCD, autism, or both? 

Research² shows that OCD and autism share similar genetic markers and may stem from similar structural issues affecting the brain. The two conditions share many of the same symptoms, as well, including: 

• Repetitive behaviors

• Severe anxiety 

• Obsessive behaviors

• Difficulties coping with change 

Because of these similarities, it can be difficult for an untrained observer to know if someone has autism or OCD. It's also possible to have both conditions, as around 17%³ of people with autism also have OCD.

However, to determine if you have one or both of these conditions, you'll need to see a doctor who can carefully evaluate and observe your behaviors and offer a diagnosis. 

What is stimming?

Stimming⁴ is self-stimulating repetitive, rhythmic behavior. It might be a specific body movement,  vocalization, or something else. Examples of stimming might include:

• Hand flapping

• Humming

• Repetitive speech

• Skin rubbing

• Finger tapping

• Rocking side to side

• Spinning around

While people with autism and those with OCD tend to engage in repetitive behaviors, the motivations behind the behaviors differ between the two groups.

Why do people with OCD stim? 

People with OCD are unlikely to find the behavior soothing. Instead, they may feel compelled to engage in the behaviors to prevent something terrible from happening. Their repetitive behaviors are driven by fear.

For example, they might wash their hands repeatedly to prevent themselves from getting sick. Or they may lock and unlock a door several times to prevent someone from breaking in. Certain repetitive behaviors may look like the type of stimming more commonly associated with autism.

Why do people with autism stim?

In a person with autism, stimming can provide comfort or help them self-regulate when in an overwhelming environment or experiencing many emotions. In one study, a person with autism said the stim gave him a single point of focus that he could control. That single point of focus helped him block out other overwhelming stimuli in his environment. 

What are the treatment options for stimming?

The treatment to stop stimming will depend on what's causing it. There’s no specific treatment designed to target stimming, and treatments aim to improve the underlying causes.

For those with OCD experiencing disruptive compulsive, repetitive behaviors, treatment options might include:

Cognitive behavior therapy

Through cognitive behavior therapy⁵ (CBT), a therapist can help clients identify unhealthy thought patterns and change them, giving them the tools required to change those thoughts in the future. 

One type of CBT, in particular, exposure-response prevention⁶ (ERP), is commonly used to treat people with OCD. ERP exposes the person with OCD to the triggers that cause obsessive thoughts, then retrains the brain to prevent the resulting compulsions and reduce anxiety. This helps break the cycle between obsession and compulsion.

Medication

Medications such as selective serotonin reuptake inhibitors (SSRIs) can help balance brain chemicals to improve the symptoms of OCD.

When considering treatment options for a person with autism, it's essential to consider whether that behavior needs to stop. There is a movement within the autism community to reclaim stimming as a positive coping mechanism, and many objects to treatment aimed at halting the behavior.

Stimming may sometimes be viewed as socially unacceptable, which may lead to embarrassment in public spaces. Beyond that, some stimming can be harmful, such as pinching or unintentionally hitting others, although this is usually unintentional. 

Stimming can be comforting and valuable, so it may be more beneficial to understand and accept the behavior rather than change it. Stimming can help boost concentration and productivity. Trying to hide or suppress a stim may cause anxiety or increase the desire to stim and can leave a person emotionally and physically exhausted. 

If you need to stop certain stims, try working with a therapist who can help redirect socially unacceptable stims to more discreet ones that are less disruptive. They may also help identify situations when stimming is needed so you can either avoid them or prepare yourself ahead of time. 

The lowdown

Stims are repetitive rhythmic behaviors such as rocking side to side, hand flapping or humming. Stimming is commonly associated with autism, but similar repetitive motions are often present in people with OCD. While both conditions have characteristic repetitive behaviors, the motivation behind the behaviors differs. 

For people with OCD, the repetitive behaviors are fear-based. They are compulsively performed to combat a perceived potential threat. In contrast, people with autism often stim as a self-soothing coping mechanism.

Stimming can help them self-regulate in an overwhelming environment or help them navigate intense emotions. It's possible to reduce the need for stimming through therapy and medication. However, some people with autism are encouraging more public education about the usefulness of stimming, so those with autism can continue to use the coping mechanism without worrying about social stigma.