Friday, September 28, 2012

Public bathrooms and contamination OCD

There are things I don’t want to touch. There are places I don’t want to go. There are things I don’t want to see.
I have contamination OCD.
Over the years, it has morphed from an obsession with germs on my hands that led me to compulsively wash them to an obsession with bathrooms.
Over the years, the length of time it takes me to clean the bathroom has become a lot shorter.
But one obsession has remained, and that is one about public bathrooms.
I hate to use them. I hate to even go into them because of what I might see.
I used to wonder what it was that I was so afraid of about public bathrooms. I didn’t have the same fear I used to have about hand washing, that I’d pass along germs to others and make them sick. I wasn’t afraid of getting sick myself. So what was it?
Months ago my therapist mentioned that I could be afraid of feeling disgust. But I didn’t really relate that to OCD.
Then I read what Jonathan Grayson wrote about contamination OCD in his book Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty.
Grayson wrote, “Most obsessions have consequences that you are afraid of” (p. 29). Considering contamination OCD involving bodily fluids like saliva sweat and blood, he named “four different feared consequences that can appear singly or in combination: (1) harm to oneself; (2) harm to others; (3) finding the idea of contact with bodily fluids overwhelmingly disgusting; and/or (4) feeling that having thoughts of contamination is too awful to contemplate” (p. 29).
Numbers three and four fit my contamination OCD. I don’t want to touch or see anything disgusting. I don’t want to even think of anything disgusting.
And there can be plenty of disgusting things to see in a public bathroom.
I’m not talking about things that I imagine are contaminated. I’m talking about stains and smears that I can see.
I’m having a problem with the public bathroom in the building where I work. It’s on the first floor of a building that houses several businesses and gets a lot of traffic. The bathroom is not cleaned often enough.
That’s not just my opinion. Other women in my office also find the bathroom unclean.
But sometimes I have to use it. I have to spend hours at work without leaving sometimes.
When I do go into the bathroom, I try not to look directly at anything. I glance around and try to quickly measure which is the cleanest stall. I cover everything in toilet paper and don’t touch anything barehanded except the water faucet to wash my hands.
I dread going to the bathroom. I get anxious about it. I avoid it when I can.
And I sometimes make plans about going somewhere based on whether or not I’ll have to use a public bathroom.
I know I should do some kind of exposure.
At this point, I am not willing to go into a public bathroom and touch a stain or smear that someone else has left behind. It makes me want to throw up just writing it. I’m not going down that exposure road.
But since I’m trying to avoid feeling disgusted, would it help to put myself deliberately in positions of seeing something I find disgusting? To not turn away, but to stare at it?
I’m frustrated with myself and wonder if I’m not willing to do enough to overcome this obsession.

How can I deal with this aspect of contamination OCD? Any suggestions?

22 comments:

  1. Oh man public restrooms. I think this one may be harder because of the reality of how gross public restrooms can be. Maybe you can look at something that you think is disgusting at home. For instance I used to have to clean hair out of the bathtub drain and that was pretty disgusting. At first, I would gag as I did it. Is it only disgusting things in public restrooms or disgusting things in general?

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    1. It's any disgusting thing (and that's subjective), but I guess I have more control over things at home. And the only disgusting things I have nightmares about are public bathrooms. I dream that I'm going from bathroom to bathroom looking for a clean one.

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  2. Sorry.. I don't have any suggestions for you.

    My public restroom phobias are crazy! I've come a long way but they are still crazy. Yesterday, for instance, I had to go home and take a shower and wash my clothes because I accidentally touched something. Maybe I'll blog about it when it doesn't make me so anxious. Right now, with it having happened just yesterday, I'm still going over and over the incident in my mind.

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    1. Elizabeth, I'm sorry you had a bad incident. An OCD incident like that tends to stick in my mind for a while too.

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  3. Well, this is very interesting to me because I never thought of my contamination issues in this way. I never think of contamination bringing harm to myself or others, like the likely hood of it making anyone sick is probably low but I just don't want to be or feel dirty and I definitely think I could spread the dirty to other places (like bring it home) or to other people. But mainly I am worried about myself, which I also feel guilty about because it sounds selfish. So, I would go with #3 and #4 too. I hate public restrooms for the reason you stated, and because I am going to have anxiety in there means I will probably wash my hands longer and the last thing I need is somebody else coming in and then I feel I have the wash my hands quicker as to appear normal and my hands don't feel clean afterwards.
    My answer to your question is ironically from another of Grayson's book's where he says to do exactly the opposite of what your OCD is telling you to do. I am the Queen of not looking too, so I know what that is like but by not looking I am giving the OCD thought validation, which like performing a compulsion, strengthens it. (I could not actually touch a smear or stain either without washing my hands - I am light years away from ever doing that one.)

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    1. Krystal Lynn, it was very interesting to me, too, to figure out the reason behind my contamination OCD over public bathrooms. Thank you for the suggestion of doing the opposite. I'm going to try that.

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  4. Hi Tina, I'm reluctant to write anything because I don't really know what you should do and I'm so new at all of this. But one thing that stood out to me that I connected to something my psychologist and I talked about a couple of times: using extreme words to describe a huge range of possibilities.

    For example, when I've had a difficult time with an obsessive topic, I might describe that I was overwhelmed in my house because it's "filthy, repulsive, and disgusting" because of something I did/didn't do. (Also adding, I didn't connect very well with ERP and so maybe this is more of a CBT action, I'm guessing.)

    "Filthy, repulsive, and disgusting" describes the feeling and degree of anxiety, not the reality of what I'm looking at. So I guess what I'm saying, is would it be helpful to assess what the actual contamination issues are/could be in that bathroom before you choose your erp? So you know what your true "disgusting" is?

    (Sorry if I have gone the wrong path to helpful. :) Maybe this is the opposite of erp? or what you're actually working out? I started erp in late July and when I returned the following week, we both agreed that I hadn't connected with it-- at least in relation to a very specific thing we were working on-- and went back to cbt.)

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    1. Reconcile This, thank you for bringing this up--that my word choices probably fit my anxiety and not always what I'm actually seeing. What you say is so true--I should know what I'm really dealing with before deciding on a ERP. Thank you!

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  5. What a great topic to explore! Public restrooms are a hot topic for people who don't have the level of contamination issues that you describe.

    I like the idea of exposure therapy, but maybe with a gentler approach. Part of my exposure therapy involves a lot of visualization, getting comfortable with the imaginary scenario first before actually going into the restroom. Back in the day, I couldn't go into a grocery store on a Saturday afternoon (too crowded, too much stimulation). I started imagining the trip and waited until I calmed down from that before taking it any further. Then I drove to the store and sat in the parking lot but didn't go in -- and waited until I was calm before doing any more.

    I also have a "safe place" that I go to in my mind when I'm feeling threatened, and this could be useful for you. Mine is a grotto filled with roses, and some relatives and animals who have passed on come to me in this visualization. I find it comforting and useful when I can't physically leave a place that aggravates anxiety.

    Most importantly, I would suggest taking the pressure off of yourself. You are always enough and you are always doing enough. Seems like the harder we are on ourselves, the harder it is to overcome these obstacles. Be gentle and compassionate with that part of you that's wounded, and you'll overcome it when you're ready. You've accomplished so much, and you're helping so many others with your blog...it's okay to not have it all figured out yet.

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    1. Thank you, Nadine, for your wisdom! I love the idea of visualization. I think that would help me, too. I also have a "safe place" I go to sometimes in my mind when the reality around me is heightening my anxiety. It helps.

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  6. This is such an interesting topic, as I feel the same way about public bathrooms and I don't have OCD. Really, who likes hanging out in public bathrooms? I don't often avoid them, though on occasion I've walked in and walked out immediately, if it was just too filthy. Of course I know I don't have anywhere near the level of anxiety with these issues that comes with OCD.I agree with Nadine, that you shouldn't be so hard on yourself and when you are ready, there are plenty of exposures waiting for you...

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    1. Thank you, Janet. It's so easy to feel like I'm not doing enough! I tend to want to be over obstacles right now. Patience is not a strength of mine. Thank you for reminding me that I can go slower.

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  7. I have the world's smallest bladder, so I wouldn't survive if I couldn't use public restrooms! Just today when I was setting up for a yard sale I probably went to the bathroom in the church 5 or 6 times, LOL.

    Sorry it's so hard for you - I hope it eventually becomes easier.

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    1. Lisa, For all my complaining, public restrooms do come in handy, don't they! :-)

      I think it will eventually become easier. One step at a time. Thank you!

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  8. Tina I don't like using public toilets either but suffering with IBS I tend to have to use the public toilets a lot if I am out. Toilet paper on the toilet seat is what I do to. I guess for me the consequence of not using the toilet would be worse so I although I hate it I use them anyway and try ignore the mess if there is one and use the cleanest looking toilet etc as well.

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    1. Behind the Smile, I'm sorry you have IBS. I suffer from that, too. It comes in spells. Thank goodness for public bathrooms when we need them!

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  9. Hi Tina!

    As one who can't say that I understand, or even can attempt to understand. I do understand how anxiety can swell up at the thought of something that is just plain hard for us, no matter what it may be.
    I hope that in time this very thing will become easier for you. But, this has got to be so very hard for you, for even I will walk out of a bathroom just because of the smell that comes at the opening of the door even with out seeing what condition it is. In fact just last week I was so offended (yes, a strong word here) at our beautiful library down town -it is very beautiful, with a coffee shop and all, that they are leaving their bathrooms to smell so badly!! -so, I turned right around, daughter with me, and said I just can't go in there -it may hurt my bladder but I will have to drive home first before using the bathroom!!!
    Blessing:)

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    1. Deanna, thank you for your kind comment. I, too, have had to just walk away from the public bathroom sometimes.

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  10. Oh boy, you're not going to like what I'm going to say!! Yep, in order to get over the disgust, you need to expose yourself to it. One of the things my doc suggested was going to YouTube and searching for "disgusting bathroom," "dirty bathroom," stuff like that and just watching the videos over and over again. I still struggle with disgust, but I am much better than I used to be. It is really hard though. I definitely feel your pain on this one. It is one of my biggest struggles of all time.

    Hang in there!!!

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    1. Thanks, Sunny! There are videos on YouTube of this stuff? That amazes me. Maybe someday I'll give it a go.

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  11. I have the same OCD's about it.

    I was forced into dealing with it when I had children. Specifically when I had a child who was potty training. It didn't help that I potty trained my first right as I was heading into a sever bout of depression/anxiety, had an 18 month old and a new born baby. It was a crash course in dealing with my fears. I'm not going to lie. I failed...for a long LONG time. A lot of panic, yelling, crying, screaming, making my son feel ashamed for having to go to the bathroom (sad to say). I still have issues with it....I always will. But now with three potty trained children, all boys, I have had to live my this phrase, "what I don't know can't kill me." In other words, as they enter the bathroom I remind them, "stand, don't touch anything, and wash your hands....VERY WELL." Then they come out, "did you wash? With soap? Good....here's some hand sanitizer." Ha ha ha...it's still a little obsessive...but it's what keep me sane (or as sane as can be).

    I'm not sure what would work for YOU. Maybe you could borrow my kids for a while? :)

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    1. Melanie, you have had to face your fears out of necessity. I feel for you and admire your strength to get through it! I like the phrase "what I don't know can't kill me." I'll have to remember that.

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