Contamination OCD: It’s about what the contamination means

Part 1 of Blog Series Focusing on OCD Subtypes

Although OCD can literally be about anything and everything, I thought it would be useful to write a blog series about the different subtypes of OCD that people are most familiar with.

I’ll start the series off with a focus on contamination OCD. Many of us have had the thought that something is dirty or not quite clean enough. We all have thoughts of that nature. Imagine stepping into a publish washroom and noticing urine on the toilet seat. Many people might think – “ugh, that is kind of gross” and responses to this might be different – some might wipe it away first and then use the toilet, others might look for a different stall. But we can all agree that we would have a fleeting though like, “hmmm…not what I was hoping for!”. Now imagine you walk into a stall and you see feces on the toilet seat! I think we can agree that some people would walk away and look for another stall. But some would also wipe it away, use the stall and carry on.

So, we have established that likely most of us in these situations will think – “Kind of gross, but I’ll troubleshoot and use this washroom”. And you would go about your business, wash your hands in a typical manner and go back to whatever else you were doing.

“..the thoughts that follow is where individuals with OCD get stuck and trapped in a never-ending cycle of anxiety, ritualizing, temporary relief and ongoing triggers.”

Now let’s imagine if you are an individual that has contamination OCD. An individual with OCD of this nature, will also experience the same initial thought – “This is gross”, “Not what I had wanted”, “I wish there was another stall free”. However, the thoughts that follow is where individuals with OCD get stuck and trapped in a never-ending cycle of anxiety, ritualizing, temporary relief and ongoing triggers.

An individual with contamination OCD would likely then have many thoughts about the initial thought. These could sound like this: “If I use that toilet seat, I might contract an illness, get sick and die” or “If I use that toilet seat, I might contract an illness, spread it to others and they will die”. Or they might just feel disgusting. Or they might feel that they have now become contaminated just by walking into a dirty washroom stall and want to shower endlessly until they feel clean or “just right”. In order to cope with these thoughts, they might then experience intense urges to ritualize or avoid the situation altogether. Perhaps they would then assume that all stalls are now contaminated and leave the space altogether. And public washrooms might eventually become so dangerous and anxiety-provoking that they stop using them, stop going out for fear of needing to use them and even become housebound.

“In order for the relief to be “enough”, the rituals get longer and more complex and eventually avoidance just might become easier.”

How could this happen – from a drop of urine or feces? Because it isn’t really about the urine or feces. It is about the interpretation of the urine and feces and what that means about them, about what they might do to others by interacting with it and about how it makes them feel. And the engagement in rituals feeds the cycle of doubt. Why? Because in order for the relief to be “enough”, the rituals get longer and more complex and eventually avoidance just might become easier.

So what can be done? I have a feeling you all know what I am going to say! That’s right – you need to lean into your fears and embrace your anxiety. That means using a public washroom when it feels distressing, touching doorknobs without washing hands, washing hands in a typical manner. Interacting with contamination in a manner that feels “wrong” and anything but “just right”. We need to face our fears, expose ourselves to what triggers our OCD and not engage in the rituals and compulsions. Although this work is not easy, it can be done with guidance and support.

“We need to face our fears, expose ourselves to what triggers our OCD and not engage in the rituals and compulsions.”

We hope to see you at Forward Thinking Psychological Services as we help you to face the things that are keeping you from living the life you want!

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