Overcoming Fear of Germs: Obsessive Cleanliness and Anxiety

Q: Overcoming Fear of Germs: Obsessive Cleanliness and Anxiety

Hello： Your symptoms may be indicative of obsessive-compulsive disorder (OCD), characterized by repetitive checking, a demand for perfection, and excessive worry about not doing things correctly. <br>In reality, the human body has a considerable resistance to dirt and germs; we d

Fear of feces or flatulence-related cleanliness obsession?

Hello, Doctor.
You might find my question amusing, but I can't help but ask.
I've always been a person who adheres to certain cleanliness habits, which may be a form of obsessive-compulsive disorder.
I hope you can help me alleviate my anxiety.
Since childhood, I have been extremely reliant on the feeling of "cleanliness." This has led me to have a cabinet specifically for my favorite shoes and clothes, and I require myself to wash my hands (using body wash or soap) before touching anything inside that cabinet.
I have also had a significant fear of feces since I was young, so after using the restroom, I always wash my hands with soap and have never failed to do so.
Now, I also take a shower after using the toilet (I have adjusted my routine to shower before using the toilet).
I have a habitual belief that fecal particles are a major concern, and I feel that soap and body wash are the enemies of fecal particles.
I hope someone can enlighten me on whether this belief is correct.
The incident occurred four days ago.
I was wearing jeans at work and passed gas, which had a strong odor.
After work, when I returned to my rented room and was about to take a shower, a piece of toilet paper accidentally fell into my jeans.
I was "unsure" if that piece of toilet paper had "touched" the area of my underwear near the anus where I had passed gas.
Therefore, I threw the toilet paper into the toilet and "strictly determined" that my hands had "indirectly" come into contact with the foul gas (which I equate to fecal particles).
I set aside the jeans that I believed were contaminated and planned to wash my hands thoroughly in the shower, intending to wash the jeans and the underwear the next day.
The next morning, I first tossed the jeans and underwear into the washing machine outside the bathroom with my "left hand," then used my "clean right hand" to add detergent and press the power button to wash them.
After that, I wanted to clean my contaminated left hand, so I used my "clean right hand" to apply body wash and began washing at the sink.
However, midway through rinsing, the water pressure was too strong, and I felt some water droplets (which I perceived might contain fecal particles) splash onto my chest and sleeves.
I thought to myself that I was done for; according to my strict rules, my clothes, including my sleeves and hands, were now contaminated.
So, I washed my hands again, carefully placed the new clothes in the bathroom, locked my room (I live in a rented room), and prepared to shower.
However, I nearly broke down again because, before leaving the room, my sleeves brushed against the door (fearing contamination from the door).
According to my rules, I planned to clean the door with alcohol after showering and changing into new clothes.
After finishing my shower, I happily returned to my room, completely forgetting to first wipe the door with alcohol.
I opened the door, dried my hair, and played with a pair of high-end shoes in my cabinet.
When I remembered that I hadn't wiped the door with alcohol, I felt very guilty, thinking that my negligence might have allowed fecal particles to indirectly come into contact with my expensive shoes.
I've been preoccupied with this thought for the past few days and can't find a way to let it go.
Anxiety One: I feel that I used to manage these things very well, so why did I fail this time (self-blame)?
Anxiety Two: The fecal particles from the foul gas "might" have indirectly transferred to my high-end shoes, which I cannot accept!
Doctor, please provide me with some insights or theories to help me find peace.
Although I studied science in school, I didn't take biology, and my chemistry was poor.
Thank you for taking the time to respond!

Mr. F, 30~39 year old female. Ask Date: 2017/11/23

Dr. Liang Sunyuan reply Psychiatry

Hello: Your symptoms may be indicative of obsessive-compulsive disorder (OCD), characterized by repetitive checking, a demand for perfection, and excessive worry about not doing things correctly.
In reality, the human body has a considerable resistance to dirt and germs; we do not need to live in an absolutely clean environment, as such a condition is impossible to achieve.
Most people do not have such stringent cleanliness standards and still lead healthy and comfortable lives, which serves as the best counterexample.
It is advisable to tell yourself that cleaning once is sufficient, and then focus on other matters.
OCD is a chronic condition that is not easy to overcome quickly; try to successfully break the original rules without triggering anxiety, as this is the principle for improvement.
If it continues to be a significant concern, seeking medical assistance is recommended.
Wishing you all the best.

Reply Date: 2017/11/23

More Info

Your concerns about cleanliness and the fear of germs are not uncommon, and they can significantly impact your daily life. It sounds like you may be experiencing symptoms consistent with obsessive-compulsive disorder (OCD), particularly related to cleanliness and contamination fears. Let's break down your situation and explore some strategies to help you manage these feelings.

Firstly, it’s important to understand that OCD often involves intrusive thoughts (obsessions) that lead to compulsive behaviors aimed at reducing anxiety. In your case, the fear of contamination from what you perceive as "germs" or "fecal particles" has led to a series of rituals, such as excessive handwashing and avoiding contact with items you believe to be contaminated. This cycle can be exhausting and can lead to increased anxiety when things don’t go as planned, as you've experienced.

Your reliance on cleanliness as a means of feeling safe is a common coping mechanism for individuals with OCD. However, this can create a paradox where the more you try to control your environment, the more anxious you become when things don’t go perfectly. The incident with your jeans and the fear of contamination from the bathroom is a classic example of how OCD can spiral out of control, leading to feelings of guilt and self-blame when you perceive that you have failed to maintain your standards.

Here are some strategies you might consider to help manage your anxiety and obsessive thoughts:
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for OCD. CBT focuses on changing the patterns of thinking that contribute to your anxiety. A specific type of CBT called Exposure and Response Prevention (ERP) can be particularly helpful. This involves gradually exposing yourself to the sources of your anxiety (like touching items you fear are contaminated) and learning to resist the urge to perform compulsive behaviors (like excessive washing).

2. Mindfulness and Acceptance: Practicing mindfulness can help you become more aware of your thoughts and feelings without judgment. This can help you recognize when you are engaging in obsessive thinking and allow you to let those thoughts pass without acting on them. Acceptance and Commitment Therapy (ACT) is another approach that encourages you to accept your thoughts and feelings rather than trying to control or eliminate them.

3. Limit Rituals: Gradually reduce the time you spend on cleaning rituals. For example, if you typically wash your hands for five minutes, try reducing it to four minutes, then three, and so on. This can help you break the cycle of compulsive behavior.

4. Challenge Your Thoughts: When you have intrusive thoughts about contamination, challenge them. Ask yourself: "What evidence do I have that this is true?" or "What would I tell a friend in this situation?" This can help you gain perspective and reduce the power of those thoughts.

5. Seek Professional Help: If you haven’t already, consider speaking with a mental health professional who specializes in OCD. They can provide you with tailored strategies and support to help you manage your symptoms effectively.

6. Educate Yourself: Understanding the science behind germs and cleanliness can help alleviate some of your fears. For instance, while it’s important to maintain hygiene, the human body has a robust immune system that can handle exposure to various bacteria and viruses. Most germs are harmless, and the fear of contamination can often be exaggerated.

7. Focus on Self-Compassion: Be kind to yourself. It’s easy to fall into a trap of self-criticism when you feel you’ve failed to meet your own standards. Remember that everyone makes mistakes, and it’s okay to have moments of imperfection.

In conclusion, overcoming the fear of germs and obsessive cleanliness is a process that takes time and effort. By employing these strategies and seeking professional help, you can begin to reclaim your life from the grips of OCD. Remember, you are not alone in this, and there is support available to help you navigate these challenges.

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