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OCD question

Postby koki » Tue Aug 23, 2016 6:09 pm

Hello, I am not sure where to post this. This is really long but I am trying to provide as much info as possible.

I do not have OCD but am in a relationship and my boyfriend has contamination OCD. I had no exp with OCD until I met him. He was not up front about his OCD, ie the extent of it, at the beginning. Initially he told me he has it, and he doesn't like trash, things that are dirty and sitting on the floor. Well, as our relationship progressed and I fell in love with him I discovered the following as these OCD incidents happened along the way - and I do not know on the spectrum of OCD if this is "normal" OCD or severe OCD. He is 49, not on any meds, and last therapy he did was 23 years ago. I asked him if there was even 10 minutes during the day when he was not worried about being contaminated, or getting contaminated, I asked him if he ever got relief from thinking about contamination. He said no, the only time he gets relief is when he is unconscious, otherwise contamination/being contaminated/wondering if he touched something and got contaminated is on his mind continually.

It would help me to know - on the spectrum of OCD - whether this is typical. I have no idea how to help at this point and no way to know how much help would be needed since I do not know if the following is "severe" or "moderate" (if it is possible to say even). He says that it is not severe. He says that 23 years ago he could not even use a toilet and had to wait until night time and go outside; and he would purposely not drink anything during the day to avoid going to the toilet. He will use a toilet now; however he pauses every time he enters the bathroom. If he has a bowel movement he has to take a shower for 15 minutes and do a certain ritual, i.e. first the face, then ears, then arms etc and if he makes a mistake he starts all over. He absolutely has to take a shower after having a bowel movement.

These are some of the behaviors I have experienced (It is in no particular order, just examples of what has gone on in our relationship re his OCD)

1. If I throw something in the trash, even if my hand is far away from the trash can, my hand becomes contaminated; if I touch my face or hair, or anything I touch after throwing something away - that becomes contaminated. I found out about the throwing something away issue when I threw something away and approached him and he jumped up and hid behind the chair, looked terrified and told me he had to protect himself from me.

After I throw something away he will not let me touch him until I wash my hands, and if I touched my hair, I have to wash my hair. If I sleep in the bed without washing my hair the bed becomes contaminated. The contamination spreads all over.

2. Toilet paper is contaminated (even the new toilet paper in the store). He will avoid the aisle with the toilet paper. If I touch a roll of toilet paper I cannot touch him until I wash my hands.

3. Toilet cleaning supplies are contaminated

4. Washing machines and dirty laundry are contaminated. I found out about this when I did laundry and he came over and he asked me what I had been doing and I told him and he got very anxious and asked me if I had showered, washed my hair and changed clothes because if I did not he would have to leave because I was "dirty". (When I would do something that contaminated me he would tell me- "you're dirty right now - my mind thinks you are dirty"). He will avoid the aisle at Home Depot and Lowes where the washing machines are

5. The floor is contaminated; the ground is contaminated, feet are contaminated

6. Toilets are contaminated - he avoids the aisles at Home Depot and Lowes where the toilets are

7. All trash cans are contaminated - anything with trash is contaminated

8. Grocery carts are contaminated, he will not use one

9. Shoes are contaminated; the area from the knee down on anybody's pantleg is contaminated

10. He will not have any food in his kitchen - he does this to avoid creating trash so he won't have to throw anything away.

11. When he saw a pile of laundry on the floor he got extremely anxious and had to walk back and forth by it about 10 times. Even though he was a good 2 feet away from it, he said he was not sure if he touched it or not and had to keep walking back and forth staring at the pile of clothes

12. When I opened the door under the sink to throw something away - he was across the room but I had to open and close the door for him about 8 times so he could be sure he didn't touch the trash can

13. I set my purse on the ground while I did something and and put it in the passenger seat when I went to my car. He saw this and said, "I wish you didn't do that. You contaminated the seat." Consequently - he has not ridden in my car for 9 months because the seat is contaminated.

14. The climate control panel in his apartment was contaminated by a maintenance man 4 years ago, so he uses a pencil to adjust the setting rather than touch it himself.

15. When I was at his apartment I walked across the room and stood - not realizing the big trash bag had dirty laundry in it - I was about three feet away from it but he told me he would just assume that whole side of my body was contaminated since he was not sure if I touched it - even though I was quite a distance away from it

16. He takes tons of Immodium to block himself up in order to time his bowel movements so he can be at home where he can shower afterward

17. I used a napkin to pick something up off the floor at a meeting and threw it away. He would not sit next to me at the meeting. He sat one chair away because he told me he needed to stay safe since I had picked something up from the floor. I told him that I used a napkin and my hand did not touch the floor. He said it did not matter.

18. He told me that there had been many times he drove home from my house without his shirt on- because I had contaminated it and he did not want it to contaminate the seat belt so he would take it off, because for many things "once contaminated, always contaminated"

19. His dad is contaminated - this is so severe - in my opinion anyway. The entire office complex where his dad works is contaminated, any place his dad goes becomes permanently contaminated; the entire chain of grocery stores where his dad shops is contaminated - since he shops at one - all are contaminated; the same with restaurant chains - if his dad has eaten at one, they all are contaminated; anyone who has been around his dad is contaminated and remains so until they shower. The clothes I wore and jewelry I wore when I met his dad are permanently contaminated; his brothers are permanently contaminated because they have stayed with the dad; the brothers' families are contaminated'; his brothers and dad cannot even give him anything or send him anything in the mail because it will be contaminated and it will contaminate the mailbox. When his uncle visited, he walked underneath a tree and contaminated the leaves because his uncle stayed with his dad so his uncle is contaminated. However, he will talk to his dad on the phone, and exchange emails. I am not sure if this is difficult for him or not. This does not seem to be. He told me that if his dad ever came to my place that he could never come over again and it would probably doom our relationship.

20. My home is pretty much all contaminated; he is uncomfortable sitting at the dining table, sitting on the couch, being in the kitchen

21. He did not take home the Christmas present I got him. For a long time he told me he wanted to make a place for it at his apt. It was a sculpture - but later on I found out it was because it was in a box, in a gift bag in a larger bag and I had set it on the washing machine (before I knew washing machines were contaminated) and because I did this - the entire gift was contaminated.

22. He wears tight t-shirts in his apartment because he said he is worried that if he walks down the hall and is not paying attention his t-shirt might brush against the wall and get contaminated because there are parts of his walls that are contaminated.

Is this a typical case of contamination OCD, or would this be considered a more severe case? :?:
Thank you
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Re: OCD question

Postby Snaga » Tue Aug 23, 2016 10:35 pm

I think that has to be the most extreme story of contamination OCD I've ever heard, even here in Psych Forums.
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Re: OCD question

Postby koki » Tue Aug 23, 2016 10:59 pm

Thank you for your opinion Snaga. This is helpful since I have no previous experience with this; I figured the folks on here would know much more than I re: the OCD spectrum.
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Re: OCD question

Postby Bert the Turtle » Wed Aug 24, 2016 3:31 am

I agree with Snaga, and this is coming from someone who's got a pretty severe case of contamination OCD himself. (My best friend is contaminated, and has been for about six years to give you an idea.) The level of complexity, and the sheer destructiveness of his OCD is impressive by any standard.

Seeking Help ---

If he is capable of seeking some kind of help it would be a very good thing. But as you are, by your own admission, new to the world of OCD I feel I should warn you that most treatments for OCD either have limited effects in isolation (meds) or can be extremely painful to undergo (CBT). As such many people who have lived with chronic OCD develop an strong knee-jerk emotional reaction to being told to seek help ... so it's a subject I'd advise you to approach carefully, if you want to at all.

If you do want to talk to him about it, and he's open to it, there are some obvious practical concerns. That is, how can he cultivate a relationship with a therapist when he might permanently contaminate them at any moment? CBT therapists routinely challenge their clients as a part of therapy, so it's very likely to happen.

CBT ---

Skype therapy might be good a solution. Unfortunately, it's still difficult to find a skilled CBT therapist who advertises using the technology. Your best bet to get quality care is probably to avoid the online services, and instead have him approach a well-reviewed therapist in your area and ask if they'd make an exception for him, even temporarily, because of his circumstances. It might take a few tries, but I bet you'd find someone willing to work with you.

Also, make sure you do some research, as CBT therapists vary *widely* in quality. The best way to find a good one in your area is usually to ask another therapist you know personally for their recommendation, but failing that a local hospital, research center, or in-patient institution may be able to provide you with a list of names. Then it's on to Google.

Meds ---

A psychiatrist is trickier. I doubt you'd find one comfortable prescribing medication at a distance. But since psychiatrist appointments are more infrequent and less challenging it might not even be an issue. Studies show that meds and CBT work best together, so if he wants to go for it I'd recommend that kind of two-pronged approach.

Do-It-Yourself ---

There are also some, very limited, things you can do on your own. OCD is associated with certain vitamin deficiencies, like D and B12. So if he tests positive for either of those supplementation is a good option. I've found a healthy diet makes a big difference for me, and studies show that regular aerobic exercise or running can also go a surprisingly long way in alleviating symptoms.

In Patient ---

This, of course, is all assuming your boyfriend wants to avoid entering a rigorous in-patient program. Speaking frankly, and as an obsessive-compulsive, these programs scare me $#%@less because of the intense ERP involved, so I'm not the person to ask. But the option is always out there.

PANS/PANDAS ---

The final option for treatment is the seeing one of the specialists who are now treating OCD as being related to the immune system. You might want to see if you can get him in to see a PANS/PANDAS specialized immunologist or neurologist to see if there's anything they can do for him. It's a very new approach, so you'd have to look into online to see if there's anyone even working the PANS/PANDAS angle in your area. And as I believe PANS/PANDAS OCD is currently thought to be quite rare it probably won't apply to your boyfriend's case. But one the off chance it does, you might strike gold for further treatment options.

---

You can find more info in the sticky thread on this forum, or elsewhere online. Recovery from OCD is often a long and difficult process, but it is true that some lucky ducks see significant improvements within months. That said, it can be a rough road, and I'd encourage you to be sympathetic toward any fears or difficulties your boyfriend might have regarding therapy, but the only way to know is to find out.

All that aside, I'm honestly amazed and impressed your boyfriend is able to function well enough to have a life and a girlfriend, considering his symptoms. However deep in the OCD hole he must be, just the fact that it hasn't completely destroyed him shows he must have some impressive qualities. Same to you that you love him enough to stick this out. I wish you both the best of luck.
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Re: OCD question

Postby koki » Wed Aug 24, 2016 3:50 am

Thank you so much for the helpful suggestions - I appreciate all the information you provided; perhaps these treatment options will help him, thanks!
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