An obsession diagnosis requires that four criteria be met. First, the obsession is defined as a persistent and repetitive thought, impulse, or image that, according to the DSM-IV-TR (2000), is intrusive and inappropriate and causes significant anxiety and distress. Next, the obsession must not be just worries about real life problems. Things that most people would reasonably worry about do not count as an obsession, the concern must go beyond what we would normally expect, such as washing your very dirty laundry one time on an extended cycle versus washing all of your laundry four times before you wear it again, just to be sure that it is clean. Third, the person either must try to ignore or suppress the obsession or must try to neutralize it with another thought or action (a compulsive behavior). Finally, the person must recognize that the obsession is a product of his or her own mind, it is not a psychotic experience such as a hallucination of hearing voices telling you to fear something. A person must be able to say that he or she recognizes that he or she is having obsessive thoughts, but is having trouble dealing with them.