Obsessive Thoughts: A Case Study in Mental Health

Obsessive thinking?

Hello Doctor: About nine months ago, I had diarrhea, and some of the stool accidentally got on my underwear, and a little bit on my outer pants as well.
I only washed the underwear by hand, while the outer pants were accidentally thrown into the washing machine with the rest of the laundry.
After washing, I could still smell something on the outer pants, so I washed them a few more times until the smell was gone.
The other clothes did not have any odor.
I forgot about this incident after a few days.
However, three months ago, I suddenly remembered it and felt that the washing machine was very dirty.
During this time, I felt that everything that had been washed was contaminated, and I worried that I might contaminate others.
This made me feel very down, and I kept thinking about it every day.
I repeatedly asked my family and friends for their opinions several times a day, asking them if they thought it was disgusting.
They usually replied that after such a long time, everything would have been washed away by the washing machine.
They became impatient with my questioning.
Although I have used bleach and washing machine cleaner to clean the machine, I thought it should be clean, but the thought of it being dirty still constantly pops into my mind.
I want to forget about it, but the feeling has become more intense.
For the past three months, I have been very troubled and exhausted by this.
Does this count as a form of obsessive-compulsive disorder (OCD) or obsessive thinking?

Niming, 20~29 year old female. Ask Date: 2016/12/28

Dr. Zhang Gengjia reply Psychiatry

Dear Sir/Madam,
Thank you for your message.
Based on your description, it is clear that you are experiencing discomfort.
The depiction of obsessive-compulsive disorder (OCD) has been notably illustrated in the classic play "Macbeth," where Lady Macbeth is tormented by her compulsive need to wash her hands repeatedly.
Commonly reported compulsive behaviors include checking, washing, counting, asking questions, confessing, creating symmetry and order, and the need for absolute correctness.
Obsessive thoughts and compulsive behaviors are often intertwined, as the attempt to resist obsessive thoughts frequently leads to corresponding compulsive actions (Kong Fan-Chung, 2000).
Therefore, OCD is notoriously difficult to treat (Shear & Frosh, 1986).
You mentioned that you have been suffering from this condition for some time, and I can imagine the pain you have endured during these days.
Our hospital has established a special outpatient clinic for psychosomatic disorders to create a therapeutic environment aimed at alleviating the suffering caused by anxiety disorders and OCD.
We have outpatient registration hours from Monday to Friday, both in the morning and afternoon, with morning hours until 11:30 AM and afternoon hours until 4:30 PM.
The consultation phone number is 06-2795019 ext 1106, 1107.
We welcome your visit and wish you well-being.
Sincerely,
Dr.
Chang Geng-Jia
Department of Psychiatry

Reply Date: 2016/12/28

More Info

It sounds like you are experiencing a significant amount of distress related to obsessive thoughts and compulsive behaviors, which can indeed be indicative of Obsessive-Compulsive Disorder (OCD). Your situation, where a past incident has resurfaced and led to persistent worries about cleanliness and contamination, is a common manifestation of OCD.
OCD is characterized by unwanted, intrusive thoughts (obsessions) that cause significant anxiety, and the compulsive behaviors are often performed in an attempt to alleviate that anxiety. In your case, the initial incident of contamination from your clothing has triggered a cycle of obsessive thinking about cleanliness and the fear of contaminating others. This cycle can be exhausting and can lead to feelings of frustration and helplessness, as you described.

The fact that you have been preoccupied with these thoughts for several months, and that they have begun to interfere with your daily life and relationships, is concerning. It’s common for individuals with OCD to seek reassurance from others, as you have done by repeatedly asking family and friends about their opinions on the cleanliness of your clothes and your home. However, this reassurance often provides only temporary relief and can reinforce the cycle of obsession and compulsion.

It's important to recognize that these thoughts and behaviors are not a reflection of your character or worth; they are symptoms of a mental health condition that can be treated. Cognitive Behavioral Therapy (CBT), particularly a specific type called Exposure and Response Prevention (ERP), is considered one of the most effective treatments for OCD. This therapy involves gradually exposing yourself to the sources of your anxiety (in this case, the thoughts about contamination) and learning to refrain from engaging in compulsive behaviors (like excessive washing or seeking reassurance). Over time, this can help reduce the power of the obsessive thoughts and the compulsive responses.

Additionally, medication, such as selective serotonin reuptake inhibitors (SSRIs), can also be effective in managing OCD symptoms. It’s crucial to consult with a mental health professional who can provide a proper diagnosis and work with you to develop a treatment plan tailored to your needs.

In the meantime, here are some strategies that might help you cope with your current feelings:
1. Mindfulness and Grounding Techniques: Practicing mindfulness can help you stay present and reduce the intensity of your obsessive thoughts. Techniques such as deep breathing, meditation, or grounding exercises can be beneficial.

2. Limit Reassurance Seeking: Try to reduce the frequency of asking others for reassurance. Set a limit for yourself on how many times you will ask for reassurance in a day.

3. Journaling: Writing down your thoughts can help you process them and may provide some relief. It can also help you identify patterns in your thinking.

4. Engage in Activities: Distracting yourself with activities you enjoy can help take your mind off the obsessive thoughts.

5. Seek Professional Help: As mentioned earlier, reaching out to a mental health professional is crucial. They can provide you with the support and tools you need to manage your symptoms effectively.

Remember, you are not alone in this, and help is available. Taking the first step to seek treatment can lead to significant improvements in your quality of life.

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