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A familiar behavior that you will find amongst people with this problem, and quite often in children, is the obsession to perform a behavior a certain number of times. This may even result in counting up until a certain number so that they can now move forward. For these people, this may either stem from something superstitious or maybe a belief. The person will each time before they speak perhaps, have to count until a certain number that makes them feel comfortable.
On other occasions, if someone starts to fear something or someone, they will begin to obsessively count. The counting helps to ease the fear and make them feel safe. The upside to this is that if you want to count because it helps you to feel distracted so that you can get through the fear of climbing stairs, for example, it could actually end up helping you.