160. You Can’t Touch It!: Contamination OCD
Welcome to the Themes and Treatments for OCD series!
In this segment, Carrie breaks down contamination OCD and shows why it’s not simply about fearing germs.
Learn how ICBT can offer you a way out of the compulsive behaviors and bring true relief from contamination obsessions.
Episode Highlights:
- The complexities of contamination OCD and how it goes beyond a simple fear of germs.
- How contamination OCD can manifest through fears about illness, bodily fluids, or even specific diseases.
- The importance of understanding your personal story behind OCD to help break the cycle.
- The power of ICBT (Inference-Based Cognitive Behavioral Therapy) in addressing compulsions and obsessional doubts.
Episode Summary:
Welcome to the first segment of Themes and Treatments for OCD series!
Today, we’re diving into contamination OCD, one of the most common yet often misunderstood themes. You’ve probably seen it in movies—people constantly sanitizing or avoiding germs—but it’s much more complex than just a fear of getting sick.
Contamination OCD can show up in many forms, such as fears about germs, diseases, bodily fluids, food spoilage, or even allergies. It can also involve the intense worry that you’ll pass contamination onto someone else. The compulsions—like excessive hand washing, cleaning, or avoiding specific places or foods—can become ritualistic and deeply ingrained over time.
What makes contamination OCD tricky is the emotional reasoning behind these compulsions. Sometimes it feels like there’s a “right” way to clean or protect yourself, and if it’s not done exactly right, you just don’t feel safe. That’s where ICBT (Inference-Based Cognitive Behavioral Therapy) comes in. Unlike traditional approaches, ICBT helps uncover the reasons behind your obsessions and compulsions, digging into the personal stories that fuel your fears, not just the behaviors.
Changing old habits isn’t easy, especially when it feels like these routines are keeping you safe. But with time and practice, it gets easier. Whether traditional ERP has worked for you or not, ICBT could be a great alternative. Learn more about it at icbt.online or check out past podcast episodes for more insights. If you’re looking for a Christian perspective, join the waitlist at carriebock.com/training. You’re not alone—there’s always hope!
Tune in to the full episode for more on managing contamination OCD with ICBT and overcoming it!
Explore Related Episode:
Accordion Heading
This is the first segment in our Themes and Treatments for OCD series. When I was coming up with podcast ideas for this year, I thought we really should break down the different themes and maybe do a podcast episode on each theme. So today we are talking about contamination OCD. This is probably the most well known OCD theme.
It’s the one that gets portrayed in all the movies and TV shows. It’s the monk type person. You know, I can’t touch something or I need a sanitizing wipe. I need my hand sanitizer with me all the time, and now I’ve gotta wash my hands. Even though it’s portrayed a lot, I feel like most people don’t fully understand it.
They just see it kind of as a, oh, you have a fear of germs, you’re a germaphobe, and you don’t wanna get sick, so you don’t wanna touch anything. It’s more complicated than that, and there’s a wide variety even within the contamination OCD theme. So, you can have obsessions about germs, getting sick, and that may be you, or it may be someone else.
Maybe you’re afraid that your child is going to get sick, or your spouse is going to get sick, that you are going to somehow pass that on to someone else. Sometimes that can be more distressing than actually being sick yourself. You can have fears surrounding catching certain diseases, like HIV, or hepatitis.
Maybe you’re concerned about being contaminated by certain bodily fluids such as urine, feces, blood, or semen. This may lead to concerns about becoming pregnant or you causing someone else to be pregnant. There may be concerns surrounding food, specifically food spoiling, going bad, concerns that certain foods you’ll all of a sudden become allergic to or won’t be able to eat, and these concerns specifically don’t have anything to do with concerns about weight or body image.
Common compulsions for the contamination theme include hand washing, Excessive hygiene where you’re just in the shower for two hours, cleaning, avoiding, that could be avoiding using public restrooms, avoiding. Eating certain foods, avoiding going to certain restaurants you believe are contaminated, may involve using gloves or lots of sanitizer, and the challenge is that with contamination OCD that the routines tend to be very ritualistic.
So I have a certain way that I get ready in the morning or I have a certain way that I need to take the trash out or a certain way that I need to respond after I pump gas. The other challenge with hand washing and other compulsions is that there can be a little bit of just so mixed in, like I can’t really stop because it has to feel a certain way.
I have to feel clean. So what’s interesting about even something like hand washing, if you were to look at a traditional behavioral exposure and response prevention approach, they would say Do something and then don’t wash your hands or you’re only allowed to wash your hands if they visibly look dirty You’re about to eat.
You’ve just used the bathroom like in those settings you could wash your hands one time the cool thing that I love about inference based cognitive behavioral therapy or hereby referred to as ICBT So we actually care about the story and the reasons of how did you come to believe that washing your hands is the solution?
What obsessional doubt are we trying to resolve by doing this? It’s very different for different people. So you may say, well, I’m washing my hands this way because I used to work in a hospital and I saw someone who contracted MRSA, and I know how bad that can be. Or you may say, I wash my hands so much because I’m a single mother and there’s no one else to take care of my children if I go down and get sick.
You might say, I wash my hands so much because how can I be really sure that they’re clean? I don’t see dirt on them, right? But there may be germs because germs are invisible and how would I know when they’re all off my hands? By really uncovering the reasonings behind your obsessional doubt, which ICB tells us that there are reasons that OCD uses to support these doubts.
Sometimes they make more sense to you than others. There are facts mixed in inside the inferential confusion process. It is a fact that we should wash our hands in certain situations to prevent illnesses from spreading. We also all lived through COVID, which was a very scary time, where we were told repeatedly to wash our hands, make sure you’re washing them for 20 seconds.
There was a lot of fear, a lot of uncertainty, and for some people, that has carried over. That fear has never gone away. The long term goal in ICBT would be to look at the arguments that OCD is making, the story that it’s drawing you into, and convincing you that these compulsions are absolutely necessary in your life in order for you to maintain a sense of safety.
Once we know more about that story and understand it a little bit better, then we can start to find cracks in OCDs. reasoning process. Not to argue back with it. I think that’s a big misnomer about ICBT is people say you’re arguing with the OCD. No, we’re finding cracks in the OCD reasoning process. We’re identifying inferential confusion so that we can retrain the brain to notice these obsessions as irrelevant To our present sense data, the goal is to be able to trust your senses that your hands are clean or trust your internal sense that you’re not a dirty, awful person.
I want my clients to be able to have a certain sense of confidence that they would be able to handle situations if they did get sick or if their loved ones did get sick. And they may have gone through some things in the past where somebody was sick or they were sick and they felt like they couldn’t handle it or they didn’t handle it very well.
There may have been some medical trauma in the family history. These are the types of things that a very traditional behavioral approach, I feel like, doesn’t take into consideration. Being trauma informed is very important when it comes to OCD. So I would encourage you, if you’re dealing with contamination, look at what is contributing to that story in your mind.
How do you or other people or objects become contaminated? How does that contamination spread from one person to another person? When you do that, you may be able to recognize that some of this defies common sense data. That’s another aspect that ICB talks about, is trusting in the senses, and one of those is not just your five senses, that you can see that something is clean, you can smell something is clean, you can know that you’ve taken the steps to clean something, but really trusting common sense data.
and internal sense data as well. What does it mean about you as a person if you are contaminated or get sick? This might help you identify what you would call the feared possible self or the vulnerable self. It’s not really you, but it’s who OCD says that you are. I’m excited one of my colleagues is going to come on and talk about this concept in more detail in a future episode, how this interplays with Christian faith, which is really exciting.
I know it can be super challenging and scary. to do something differently than OCD has told you that it always has to be done. For example, if you have a certain ritualistic compulsive routine after you use the bathroom and now you are trying to make changes to that, or eliminate aspects of that, just know that that’s going to be very challenging, especially in the beginning, but the more that you are able to gain a little bit of ground, the easier and easier that it’ll be.
The most important thing that I would want anyone to know is that there is hope regardless of the OCD theme that you are dealing with. Maybe you’ve been highly advised to do exposure and response prevention if you have contamination OCD. If that has worked well for you, awesome. We’re all for it. Love that.
If you felt like ERP just wasn’t for you, or you’re interested, I would encourage you to look into ICBT. There’s a good amount of information at icbt. online. You can also search the podcast for previous episodes on ICBT that we’ve done. And if you happen to be interested in learning all of this from a Christian perspective, you can join the waitlist by going to carriebock.com/training. I’ll add this part in after I talked about being concerned about HIV. You may have concerns about being in touch with bleach, other chemicals, some type of chemical or radioactive waste.