Contamination OCD

WHAT IS CONTAMINATION OCD?

Those who struggle with Contamination OCD have concerns related to the idea that they might become contaminated. This is one of the better known subtypes of OCD, and often involves excessive hand-washing or avoidance. People can have concerns related to germs or illness. They might also have fears of being contaminated with cleaning products or other chemicals. Sometimes materials, like asbestos, can also be at the center of this subtype. Whatever the case, when people present to treatment with Contamination OCD, they are often experiencing significant limitation as a result of their symptoms.

Some people with this form of OCD are more concerned with the disgust they feel when they come into contact with contaminants. Therefore they are anxious about the feeling of disgust and, in an attempt to avoid that feeling, they do compulsions.

There are some people who are more concerned with Emotional Contamination. In this form of OCD, certain people, places or things are associated with negative feelings and so are “contaminated.” The fear is that if they come into contact with the person, place or thing, they may feel that unpleasant emotion ongoing.

CONTAMINATION OCD SYMPTOMS

How do you know if you have OCD? Only a licensed practitioner can perform an official assessment and provide a diagnosis. That said, the symptoms of OCD include the presence of obsessions and compulsions that take up a significant amount of time, cause distress and impair social, occupational and other important areas of functioning.

OBSESSIONS

Obsessions are intrusive, upsetting, repetitive, distressing thoughts, images and urges. In Contamination OCD, obsessions can include thoughts like:

• That red spot might be blood. What if I get HIV by touching it?
• I touched that book after touching the doorknob. I must wash my hands for one minute with hot water and Clorox the book.
• My kid touched the counter after playing in the garden. That’s disgusting! I just have to clean it.

You can learn more about obsessions and OCD in general here.

COMPULSIONS

Compulsions are behaviors that people do in order to get rid of the fear, doubt, distress and disgust that often result from obsessions. These actions can be overt or covert. A person might do many types of compulsions. They might wash, check, avoid, seek reassurance, analyze thoughts and more. In Contamination OCD, compulsions can look like:

• Tracking objects that have been touched so that you can clean away any germs later
• Washing hands more than is reasonable or in a specific pattern
• Asking loved ones to clean things or to wash on your behalf

You can learn more about compulsions here.

TREATMENT FOR CONTAMINATION OCD

EXPOSURE AND RESPONSE PREVENTION (ERP)

We approach the treatment of every subtype of OCD in the same way, with Exposure and Response Prevention (ERP). This involves facing the things that trigger thoughts and feelings without giving into compulsions. For instance, with Contamination OCD one might go outside for a walk and make the choice not to shower upon getting home. It is, of course, important to be mindful of CDC guidelines, especially in light of COVID. If CDC guidelines suggest that you wash in certain circumstances, response prevention involves limiting the amount of washing.

The goals of ERP for Contamination OCD are to:

• allow for the presence of doubt thoughts about the potential for contamination
• make space for distress
• accept that one cannot know for certain that they will not come into contact with contaminants

We want to be careful not to focus too much on the content of OCD as the thoughts themselves aren’t important. Still, there are some common roadblocks that people with this subtype face. ⁠If you’re interested in support for this form of OCD, our staff at The Center for the Obsessive Mind have extensive experience working with those who have Contamination OCD. You can learn more about the treatment and services we provide here, or email The Center for the Obsessive Mind here to find out more about working with one of our therapists.

ACCEPTANCE AND COMMITMENT THERAPY (ACT) & MINDFULNESS

While ERP is considered the gold-standard treatment for OCD, Acceptance and Commitment Therapy (ACT) is also an evidence-based treatment for OCD that can be used along with ERP. ACT draws upon mindfulness in order to support people in non-judgmentally witnessing and accepting their thoughts and feelings. By supporting this objective view of these internal experiences, ACT helps people to accept thoughts and feelings while they take actions based on what matters most to them. You can learn more about ACT here.

General Mindfulness as well as Meditation are also helpful approaches that support recovery from Contamination OCD. Meditation can support people in practicing mindfulness. Mindfulness can support individuals in peacefully coexisting with thoughts and feelings.