Checking rituals can be a result of many types of obsessions, such as fears of harming accidentally, sexual obsessions, or perfectionism. The underlying reason of compulsive checking is for the sufferer to reduce his distress, associated with the uncertainty over feared consequences for themselves or others. One of the most common examples is a person who worries that harm will occur if he/she is too careless, and so many repeatedly check that the door is locked, for instance, to reassure him or herself that no break-in will be able to happen.

Some checking is cued by specific scenarios, such as when the person leaves their house, while in other cases it happens as a result of random thoughts that just pop into the mind, which are considered dangerous. People with these types of obsessions, may believe that if they think of a bad event, it becomes more likely to happen. Counting rituals is often a compulsion with many suffering from OCD. This is also closely related to feeling that everything needs to be symmetrical, counting a certain number of times until it feels right, or the inability to walk through a door threshold until it feels safe to do so.