When society thinks of OCD, Contamination OCD is typically associated.  If our clinic took 100 people who have gone through the program, we would see five to ten struggling with contamination OCD.  It is not as common as most would think.


Before 1846, nobody knew what contamination was. Ignaz Semmelweis was the first to consider that a doctor’s hands and instruments might be dirty and could cause unnecessary death from infection, especially women giving birth. His belief that doctors should wash their hands received intense scrutiny and ridicule. Decades later, the medical community realized he was right. Once cleanliness became standard in medical practice, people started to live longer. The majority of people in the world are not interested in getting sick. In the last 25 years, we have seen a dramatic increase in cleanliness. Society spends hundreds of millions of dollars on anti-bacterial products to stay safe and clean. Our society has created a strong sentiment that we need to protect our self from germs. Many people take great effort to keep themselves protected against germs. That said, when do you know it is becoming more than just being safe?


I do not like when something gross gets on my hands. Using a scale 0-10 of distress in these moments, I would give myself at most 2 out of 10. If I do not get it off my hands, it is likely I can easily get distracted and move to something else. I may never reflect on my hands being dirty. However, someone struggling with Contamination OCD easily could feel 7 out of 10 or even higher when something gross gets on their hands. The emotion is fear and anxiety. Some describe it as the most disgusting, horrible, awful feeling. Everything inside of them will say, “This is not okay.” They cannot focus on anything until they remove the contamination. Removing the contamination may include washing hands for an extended period of time or more often than necessary. I coined a term with my clients more than a decade ago, “the OCD cuff.” This is a distinguishable line located on their wrist or mid arm. The OCD cuff is a line that is chapped, red and has irritated skin from over washing. A Contamination OCD sufferer may become hyper-vigilant of a possible threat. Assessing risk in everyone and everything is common. Avoidance becomes a way of life. A sufferer must avoid anything that could contaminate, at all costs. A Contamination OCD world gets smaller and smaller. Avoidance or decontamination is the only way to get relief. Unfortunately, this only lasts until the next threat of contamination; then it all starts again with intense fear and concern. Each time a sufferer obeys their “anxiety monster,” they make their tomorrow much more difficult to live. Contamination OCD creates fear slaves of sufferers.


There is another type of Contamination OCD. This type has no connection with getting sick or being at risk. This Contamination OCD can be a thing, a person, a place and even a thought. For example, a sufferer could see a city, a mother or even a sibling as a contaminant. It could be a person who has flaws and they fear they might become that person. Even water, they may feel they could lose their mind if they drink too much. Another example could be a sexual thought they might start to feel it is ruining them and they desire to “clean the mind.” You will see avoidance behaviors and decontamination in all types of this disorder.


It is common for sufferers to rope others into their compulsions and rituals surrounding fears. Sufferers care so much about contamination; they will get others to make accommodation for them. This might include not going into their bedroom, not touching certain items in the house, not going certain places, special products used in the home, where people can sit at the table. As you try to understand Contamination OCD, you must remember the sufferers are plagued with anxiety/terror. The anxiety is so strong it is worth giving up normal life to protect what has become the most important thing in the world. The anxiety they feel becomes confirmation and gives validity to the worry.


Family members or even acquaintances, might try to help the sufferer by trying to talk them out of what they fear. This simply feeds the OCD. Their fear is not in the same realm as a typical person worried about contamination. There is no comparison. One will not talk them out of what they fear. I tried and failed horribly in the beginning of my career. I have since learned better.



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