While individuals with Obsessive-Compulsive-Disorder (OCD) often struggle with obsessions and compulsions in a variety of categories, cleaning and contamination are one of the most well-known and common categories.

Fear of germs can be categorized as part of “contamination” OCD. Coming in contact with contaminants such as dirt, germs, or bodily secretions and then getting an illness, contracting on illness, or spreading germs are examples of contamination OCD.

In regard to coming into contact with contaminants, examples include fear of “cross-contamination” of products due germs, household cleaners, toxins, or being near animals/ animal products. There may be fears of contamination due things such as radiation, asbestos, or lead. Fears of getting a chronic medical condition or infectious disease such as cancer or a sexually transmitted infection are examples. OCD is a disorder of uncertainty. Fears of contamination are not connected in a realistic way; therefore, the individual engages in rituals to neutralize or make the distressing thoughts go away.

Cleaning or washing rituals are time consuming for individuals with OCD (more than an hour a day) or cause impairment to important areas of functioning. There may be avoidance of coming near items such as bleach, food items past their “best by” date, or things not deemed as properly sanitized. Daily routines such as eating, and toileting can become quite ritualized. For example, fears of urine or feces can be rather common and lead to excessive wiping, changing clothes, showering, and/ or handwashing.

Unwelcome and distressing ideas, thoughts, images, or impulses as part of OCD may not make sense. The individual may know that obsessions with germs/ contamination may be excessive but feel compelled to engage in behaviors such as washing, showering cleaning, and sanitation. They may be hyper-focused on researching statistics related to numbers of infection, rates of disease, etc. to find out if something is safe or unsafe. Those with contamination OCD may become extremely protective of their cleaned spaces to where others who are “contaminated” cannot touch or enter their space “decontaminated” space. Living with contamination OCD can be quite distressing–impacting one’s ability to go to work or school or socialize with others.

The use of behavioral therapy such as Exposure and Response Prevention (ERP) in additional to possible medication can help work with patients are they begin to encounter feared situations. Being able to thoroughly identify compulsions while refraining from these rituals of washing, checking, avoiding, etc. will gradually disconfirm erroneous beliefs that fuel OCD and provide long-term relief.

Written By: Charlotte Johnson, MA, LPCC