Question : Can we merge two compulsions? "I suck my sprout and cover my ears with my hair. Of course, I seek fullness with my thumb but at the same time I suffer from misophonia".

Answer : Yes, often. "You can even combine many compulsions; the important thing is to distinguish the logic".

Professor Nardone's work shows 3 types of rituals:

• Preventive, control, when you doubt for example that you have cleaned well, turned off the gas, closed the door, which leads to a recheck
• propitiatory:

Here is an illustration of an anecdote by Paul Watzlawick that is called "elephant powder". An old gentleman, traveling by train in the west of France, opened the window every ten minutes to throw a powder that he took in his snuffbox. The other travelers having asked him what it was, he replied: "anti-elephant powder". The other travelers replied: "but there are no elephants here". And the old gentleman said to them: "it's because my powder is effective!".

We are there in the definition of the ritual; one thinks that in fact, by doing such a thing, such and such another thing will not happen. At the risk of perpetuating the difficulty and settling into an increasingly rigid situation.

At the same time, paradoxically, we are not safe. The therapeutic intervention will consist of getting the person to do a little less, to use counter-rituals to reduce the frequency.

• Restorative rituals :

“I have doubts about having been contaminated and so I will clean myself because thanks to this cleaning, I will reassure myself.

The ritual makes it possible to put distance between oneself and one's fear.

Similarly, the avoidance strategy modifies the perception of danger.

The rituals contribute to the construction of a reality, of a protection; we have the feeling that we are safe because that is what it is all about: we need the ritual to tend towards this feeling of security. And we increase the intensity of the ritual or we increase the number of rituals which can take several forms.

In this quest for reassurance, those around you can be solicited; if he participates in the ritual, he makes the situation and the symptoms even more rigid.

If this is indeed the case, it will be necessary to involve the entourage in the therapy; otherwise, the compulsive person will be able to start an arm wrestling match with those around them and pollute them.

Rituals are based on belief, powerful control and the logic of avoidance.