About Obsessive-Compulsive Disorder

Contamination Fears in OCD

One of the most prevalent obsessions is a fear of contamination, which accounts for approximately a quarter of all obsessive themes in the US and is the most common OCD concern worldwide. Typically the contamination worry is based on a fear of some sort of disease or illness (usually death, but sometimes other concerns such as a fear of blindness or religious concerns are a factor). For example, one might fear developing cancer or disease and so worry about toxic materials to an extreme, such as x-rays, asbestos, or many other numerous carcinogens occurring either naturally or in everyday products.

Clearly, something such as asbestos is dangerous in real life (it is no longer used commonly as it is illegal, but a lot of older homes and building still have things made out of asbestos or other dangers such as lead paint), but a person with contamination OCD would take the fear to the extreme. When walking past a home with asbestos siding, the OCD sufferer might start to imagine that rain water had washed the asbestos particles onto the side walk, and now that it was dry that they might actually be stepping on asbestos particles which were then billowing into the air and attaching onto their clothes. Or even that the asbestos siding had deteriorated (even if it was clearly well encapsulated) so much that it was in the air and attaching to their clothes and indeed infecting everything in proximity. Whereas a regular person would realize that while harmful, the asbestos would really only be dangerous if they were to break it apart and start sniffing in the dust, and that while there are a lot of dangers everyday life, that if everything was so dangerous we would all be sick and dead already (in this case via cancer).

Depending on where the contamination obsession resides in an OCD sufferers' hierarchy or the severity of the OCD, determines the extremes to which these obsessions can manifest. Often times a person with contamination fears will get to the point where virtually everything except a small safe area is contaminated, since the contamination has spread. Since the obsession is in regards to disease or illness one with OCD often feels a sense of responsibility to protect others from the contaminants. This is often where tension is created or stress is caused by those close to an OCD sufferer as they will insist on friends and loved ones avoiding contaminants for fear of them being contaminated or spreading the germs to their safe zones.

While fear of illness or disease is the root of most contamination obsessions, it is not always the case. A good example are people that are bothered by sticky or greasy substances. In cases such as these often the reason for being bothered by the substance can't even be articulated except for a discomfort. Those with OCD often suffer from a heightened sense of symmetry so perhaps getting something sticky on ones hand leads to discomfort.

Common Obsessions

A list of some common concerns:

Dirt and germs. This includes things like HIV, swine flu, Lyme disease, etc. The person might be worried about getting a sickness or disease by touching a public door handle, using a public restroom, or handling money. A person with OCD would ruminate on all the people that may have touched the money and the various contaminants stuck to it received from its travels.

Household items. This includes things like cleaning supplies, bleach, pesticides, hair dye, etc. For many people with OCD, cleansers are the person's best friend, but to others the cleaning supplies are a potential source of danger. Someone with cancer fears might examine every product for toxins or carcinogens. Many products do have trace amounts of carcinogens (such as hair dye or strong household cleaners), so for someone with a cancer fear, this can be overwhelming. Looking at the small print on numerous items at the hardware store can show, "this product is known to cause cancer in mice in the state of California" or other such descriptions. We eat processed foods, things lathered in pesticides, etc. but most people can deal with the small risks. Of course there are people that avoid things such as pesticides or common items with toxins by eating organic since they want to avoid long term exposure to these chemicals, but if they were to handle an orange that was sprayed with pesticides, they would not feel the need to have a shower, wash their clothes and decontaminate everything exposed to the orange. This, of course, is the difference. A regular person realizes one orange covered with pesticides will not cause instant cancer, and while an OCDer would realize this as well, their obsession would cause such distress that the "what if..?" would be impossible to overcome

Environmental contaminants. This includes things like radiation, asbestos, pesticides, toxic waste, radon, mold, lead paint, etc. Most people just accept that we live in a dangerous world that carries risks. Someone with contamination obsessions of sickness or death cannot operate this way, even if they logically can. The nagging and doubt gnaws at the person.

Bodily waste or secretions. This would be things like feces, blood, semen, saliva, etc. An OCD sufferer might worry about getting e. coli from feces, getting HIV/AIDS from blood or accidentally impregnating someone with their semen. If AIDS is the obsession of the week, a spot of red in public may lead an OCD mind to imagine a person with AIDS was cut and left infected blood where the red spot was. Even if obvious it is something else, i.e. dried tomato sauce, the OCD mind would be asking "what if" until the OCD sufferer says okay, I'll clean just to be safe (momentarily quieting the anxiety).

Sticky or greasy substances. This includes things like stickers, glue, butter, cooking oil, etc.

Animals or insects. For many with contamination OCD animals just feel dirty. A big shaggy dog coming in from outside and rubbing up to an OCDer with its thick messy coat or licking with is tongue is an example of something that might just feel dirty to some. Someone with OCD might simply feel disgusted with flies in general and the fact that they land on and feed from disgusting surfaces. If the person is simply afraid of the animal or insect, that would be considered a specific phobia, not OCD.

Going back to asbestos, when walking by a home with asbestos siding, on OCDer with such a fear might see a fly landing on the siding and then worry about the fly landing on them and transferring the contaminants. Someone with more severe OCD might worry about any fly in the area landing on them because it may have touched the siding at some point. An even more extreme example would be someone in the safety of their own home nowhere near any asbestos being touched by a fly and concocting a scenario whereby the fly had been on asbestos siding in some elaborate scenario. The example of the fly is also a good way of showing how the contamination fear spreads.