Overcoming Obsessive Cleanliness: A Personal Struggle with Hygiene

Wiping after using the toilet has become a daily challenge?

1.
The issue of whether I clean myself properly after using the restroom has been bothering me for several years.

2.
I once consulted a psychiatrist about whether my behavior could be classified as obsessive-compulsive disorder.
The doctor responded, "It's a cleanliness obsession, but try to shorten the time."
3.
I can spend 15 to 30 minutes using wet wipes.
I have also searched online to see if others share similar concerns.
One person, a student from National Taiwan University, mentioned that since using wet wipes, their cleaning time has decreased from one hour to half an hour.
I thought to myself, "Wow, that's too long; if you were working in a clinical setting, you'd get criticized."
4.
A doctor online elaborated on her views regarding cleaning oneself, stating that as long as there are only faint marks left, it's acceptable.
However, I cannot accept any residual matter.

5.
My habit involves wiping the skin around the anal folds, and I even extend a bit inside for circular wiping.
Sometimes, if there is a small amount of fecal matter left in the rectum (before the urge to defecate kicks in), I might end up wiping it.
At that moment, I think to myself, "Yes, it’s not clean." I am aware of the concept of "anal itching and excessive cleaning," but if a doctor were to tell me to only wipe the outer skin (the skin around the anus) without going slightly inside, I might struggle to accept and adapt quickly.
I feel that when I sit down or squat, the external anal sphincter might inadvertently open and soil my underwear.

6.
I know I am what they call a perfectionist, but with only one month left until a major exam, I must admit that this behavior frustrates me and makes me want to cry.
Moreover, sometimes I encounter certain doctors who do not consider the practical aspects and simply tell people like me to make an appointment.
But honestly, in internal and surgical medicine, you must genuinely have a condition, like IBS or hemorrhoids, for them to address your concerns.
Sometimes, it’s uncertain whether they will even provide advice...
It all depends on the doctor's mood.

Gao Yi Guo Kao Sheng, 20~29 year old female. Ask Date: 2020/12/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

The gastroenterology department may no longer be able to provide assistance (other than suggesting the use of a toilet designed for hemorrhoid relief).
If you are open to it, you may consider discussing this with a psychiatrist.

Reply Date: 2020/12/30

More Info

Your struggle with obsessive cleanliness and the compulsive behaviors surrounding hygiene is indeed a challenging situation that many individuals face. Based on your description, it appears that you may be experiencing symptoms consistent with Obsessive-Compulsive Disorder (OCD), particularly in relation to cleanliness and hygiene. OCD is characterized by intrusive thoughts (obsessions) that lead to repetitive behaviors (compulsions) aimed at reducing the anxiety associated with those thoughts.

Your concern about cleanliness, especially regarding wiping after using the restroom, is a common manifestation of OCD. The excessive time spent on this behavior—15 to 30 minutes—indicates a level of distress and impairment that can significantly affect your daily life. It’s important to recognize that while cleanliness is generally a positive trait, when it becomes a source of anxiety and takes up a considerable amount of time, it can be classified as a disorder.

The fact that you have sought help from a mental health professional is a positive step. However, it’s crucial to find a therapist or psychiatrist who specializes in OCD and understands the nuances of this condition. Treatment for OCD often includes Cognitive Behavioral Therapy (CBT), particularly a specific type called Exposure and Response Prevention (ERP). This therapy involves gradually exposing you to the sources of your anxiety (in this case, the fear of not being clean) and helping you learn to resist the compulsive behaviors that follow.

Your mention of a physician suggesting to "shorten the time" spent on cleaning is a common approach, but it may not address the underlying issues effectively. It’s essential to work with a professional who can help you understand the cognitive distortions that fuel your compulsive behaviors and develop healthier coping mechanisms.

Additionally, medication can be an effective part of treatment for OCD. Selective Serotonin Reuptake Inhibitors (SSRIs) are often prescribed to help manage the symptoms. These medications can help balance the neurotransmitters in the brain that may be contributing to your obsessive thoughts and compulsive actions.

It’s also worth noting that your feelings of frustration and sadness regarding your situation are valid. Many individuals with OCD experience a sense of isolation and despair due to their compulsions. It’s important to communicate these feelings to your therapist, as they can help you process these emotions and develop strategies to cope with them.

In terms of practical advice, consider setting small, achievable goals for yourself regarding your hygiene routine. For example, you might aim to reduce the time spent on wiping by a few minutes each week. Celebrate your successes, no matter how small, and be gentle with yourself during this process. Remember that recovery from OCD is often not linear; there will be good days and bad days.

Lastly, connecting with support groups, either in-person or online, can provide you with a sense of community and understanding. Hearing from others who share similar experiences can be incredibly validating and may offer new strategies for coping.

In conclusion, your experience with obsessive cleanliness is likely tied to OCD, and seeking specialized treatment is crucial. With the right support and strategies, you can work towards managing your symptoms and improving your quality of life. Remember, you are not alone in this struggle, and help is available.

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