Dealing with a Partner's Severe Obsessive Cleanliness: Seeking Help

Q: Dealing with a Partner's Severe Obsessive Cleanliness: Seeking Help

Hello, online friend： Your boyfriend lives every day with great caution, paying attention to various details to keep himself safe, which likely indicates he feels insecure. <br>Typically, such repetitive thoughts and excessive cleaning behaviors are classified as obsessive-compul

My boyfriend has severe obsessive-compulsive tendencies but lacks insight into his condition. He insists that I adopt his cleanliness standards and is unwilling to seek medical help?

Hello Doctor: My boyfriend has a phobia of microorganisms and practices strict hygiene, believing that any contact between objects can transmit bacteria.
Here are some examples of his behavior: 1.
When going out to eat, he only uses one hand, keeping his clean left hand for touching himself, his mask, and his phone.
2.
When shopping at convenience stores, he absolutely avoids touching any surfaces that the cashier has touched.
3.
Items that have touched the floor cannot "cross over" the area above new paper slippers, as he believes bacteria will fall onto the slippers.
4.
When staying at hotels, he avoids letting his head touch the headboard, as he thinks it is never cleaned; if it does, he feels he must wash his hair.
5.
He dislikes carpets, curtains, and other items that are rarely cleaned.
6.
He insists on showering before going out, and once he has showered, no one can touch him; if someone does, it affects his work efficiency.
7.
He spends four to five hours daily showering and disinfecting.
8.
He dislikes leather products, believing they harbor "other people's microbiomes." 9.
The only bacteria he is not afraid of are mine, as he considers me part of him; however, if I touch something dirty, he cannot tolerate it and forces me to wash my hair and hands, etc.
— In these various situations, if I go against his wishes, he may lightly advise me or, in severe cases, lose control and yell, showing no reason.
I consider myself a clean person, but over the past couple of years, due to the pneumonia pandemic, he has become even more convinced that his behavior is correct and safe, blaming others for being dirty.
If I mention that bacteria are naturally present in the air, that the human body has immunity, or that most bacteria are harmless, he counters with the infectious nature of pneumonia.
Yet, he is very enthusiastic about staying in hotels rather than at home (which I believe have been occupied by many people and harbor more bacteria).
Additionally, I have observed significant Asperger's tendencies in his behavior (various fixated behaviors, misunderstanding idioms, etc., which are classic symptoms found online), and he is very adamant about prohibiting me from eating any food he considers unhealthy (not even a single marshmallow).
I would like to ask: 1.
Is there any way to guide him toward accepting treatment for this condition? 2.
If the chances of treatment are low, will his obsessive cleanliness worsen? He spends too much time showering and disinfecting, and it is distressing to see his life consumed by these activities.
Thank you very much for taking the time to read this lengthy question.
Thank you.

Māomī, 20~29 year old female. Ask Date: 2021/11/22

Dr. Liao Dinglie reply Psychiatry

Hello, online friend: Your boyfriend lives every day with great caution, paying attention to various details to keep himself safe, which likely indicates he feels insecure.
Typically, such repetitive thoughts and excessive cleaning behaviors are classified as obsessive-compulsive symptoms in psychiatry, and medication can be helpful.
In my practice, I have patients who seek help because their family members feel distressed (for example, taking too long in the bathroom) or because they themselves are troubled (like needing to wash clothes nine times).
The most common obsessive thoughts revolve around themes like "dirt," "death," and "safety," and these patients are often quite anxious.
You may feel tense due to your boyfriend's habits, but he is likely feeling the same way.
It would be beneficial to discuss methods for relieving stress together and encourage him to explore ways to interact with others.
You might not need to argue with him about "excessive cleanliness," but rather discuss how being emotionally tense can lead to mistakes and make it difficult to interact with others calmly.
It would be advisable for him to consult a mental health professional to discuss emotional regulation, which can help prevent long-term physical and mental health issues.
I wish you success in persuading your boyfriend to step out of his anxious lifestyle.
Dr.
Liao Ding-Lie

Reply Date: 2021/11/22

More Info

Dealing with a partner who exhibits severe obsessive cleanliness and compulsive behaviors can be incredibly challenging, both for the individual and their loved ones. Based on the details you've provided, it appears that your boyfriend may be struggling with a form of obsessive-compulsive disorder (OCD) that manifests as extreme cleanliness and fear of contamination. This condition can significantly impact his quality of life and your relationship. Here are some insights and suggestions on how to approach this situation.

Understanding the Condition
1. Obsessive-Compulsive Disorder (OCD): OCD is characterized by unwanted, intrusive thoughts (obsessions) that lead to repetitive behaviors (compulsions). In your boyfriend's case, his fear of germs and the need to maintain cleanliness are likely driven by obsessive thoughts about contamination. This can lead to compulsive behaviors, such as excessive handwashing, showering, and avoiding contact with surfaces he perceives as dirty.

2. Cognitive Behavioral Therapy (CBT): One of the most effective treatments for OCD is cognitive-behavioral therapy, particularly a specific type called Exposure and Response Prevention (ERP). This therapy involves gradually exposing the individual to their fears (in this case, germs and contamination) and helping them learn to resist the compulsive behaviors that follow.

3. Medication: In some cases, medications such as selective serotonin reuptake inhibitors (SSRIs) can be prescribed to help manage the symptoms of OCD. These medications can help reduce the intensity of obsessive thoughts and compulsive behaviors.

Approaching the Situation
1. Open Communication: It’s essential to approach your boyfriend with empathy and understanding. Instead of framing the conversation around his behaviors as problematic, express your concern for his well-being. You might say something like, "I've noticed that you're spending a lot of time on cleaning and washing, and I worry that it might be affecting your happiness and health."
2. Educate Together: Encourage him to learn more about OCD and its treatment options. You could suggest reading articles or watching videos together that explain the condition and how it can be managed. This might help him see that he is not alone and that there are effective ways to cope with his fears.

3. Suggest Professional Help: Gently suggest that he consider speaking with a mental health professional. You could frame it as a way to improve his quality of life rather than as a treatment for a "problem." For example, "Talking to someone who understands these feelings might help you feel more at ease and enjoy life more."
4. Set Boundaries: While it’s important to support him, it’s also crucial to set boundaries for your own mental health. If his behaviors are impacting your well-being, communicate this to him. You might say, "I care about you, but I also need to take care of myself. It’s hard for me when you react strongly to things that seem minor."

Potential Outcomes
1. Treatment Acceptance: If he is open to seeking help, this could lead to significant improvements in his quality of life. With the right therapy and possibly medication, he may learn to manage his compulsions and reduce the time spent on cleaning rituals.

2. Continued Struggles: If he is resistant to treatment, it’s essential to recognize that his condition may worsen over time. OCD can be progressive, and without intervention, the compulsive behaviors may become more entrenched, leading to increased distress and impairment in daily functioning.

3. Your Well-Being: Regardless of his willingness to seek help, prioritize your own mental health. Engage in self-care practices, seek support from friends or a therapist, and consider whether the relationship is sustainable if his behaviors continue to escalate.

Conclusion
Dealing with a partner's severe obsessive cleanliness is undoubtedly challenging, but with patience, understanding, and the right approach, there is hope for improvement. Encourage open dialogue, educate yourselves about OCD, and gently suggest professional help. Remember to take care of your own mental health throughout this process, as it is crucial for both your well-being and the health of your relationship.

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