Contamination Obsessive Compulsive Disorder
Contamination OCD can take on a variety of forms in individuals. Most patients report an overwhelming anxiety or fear that they can be contaminated or accidently spread their contamination to other people. Most of the fear of contamination are grossly out of proportion to the actual risk. Patient symptoms may differ as some may present with fears of being contaminated by germs of other physical contaminants and others may present with fears of being contaminated by other unlikely sources that most people wouldn’t typically consider to be contaminated. Other OCD suffers report a general sense of feeling dirty and often become anxious of their emotional reaction to the feeling. Contamination OCD isn’t always typically associated with over washing and cleaning. An assessment will be done to determine if perfectionism OCD or other compulsions may play a factor in maintaining the behaviour.
One of the major goals of treatment is to highlight the irrational thoughts that the individual sufferer experiences. We challenge the OCD by identifying how their OCD patterns and thinking don’t make sense. Some of these challenges include helping patients understand that germs don’t survive hours even days on chairs or germs cannot jump if you get too close to them. Of course, these are just some examples of irrational thoughts and not every patient will identify with them. But, the goal still remains the same- challenge the irrational thinking and help them identify how they are already breaking their OCD rules that they have created for themselves. For example, we may highlight that they may not want to hold or touch inside a garbage can, but at the same time it may be easy for them to take a wrapper off a sandwich and touch the garbage can flap when throwing it away and continue eating. The flap may just be as dirty as the insides of the garbage can, but most people continue to carry on with their day (including OCD sufferers) without a second thought. This unawareness and inconsistency is what’s highlighted during our cognitive work.
Of more importance, we help our clients live with the risk and maintain some level of acceptance that nothing is certain in life.
Some of the irrational thoughts we challenge:
Mental pollution is a term used to describe a sense of internal dirtiness that can be brought on by certain thoughts, words, or memories. Mental pollution are typically brought on by thoughts of a potential threat, it’s also associated with emotions such as shame and responsibility.
Sympathetic Magic is a term used to describe the implausible belief about the nature of getting contaminated. This can manifest in many ways, but two irrational thoughts most often thought by OCD suffers are ‘once in contact, always in contact’ and if one object touches another contaminated object, it too can contaminate many other objects (a pencil touching a toilet seat and the pencil now contaminating many other objects it comes in contact with)
How we Challenge the Unnecessary Behaviours
We work with each patient to recognize and challenge their avoidance behaviours maintaining their fear reactions. This may look like helping the patient recognize that compulsive washing and cleaning may be a form of active avoidance, which only creates more anxiety. Passive avoidance is also addressed in session.