When a friend, family or loved one is struggling with contamination OCD, it can be difficult to know how to help them. Of course you want to support them, but how exactly?
Contamination OCD is characterized by obsessions and compulsions around fears of contamination or contracting a disease. Like all types of OCD, it can be tricky to spot. While some compulsive actions are visible, such as hand-washing or repeatedly scrubbing surfaces, others take place in the person’s mind, and are just as painful and distressing, even if you can’t see them.
In this article we’ll talk about some of the specific ways you can be supportive to someone with contamination OCD and what you should avoid when trying to help someone with this OCD subtype.
If you’re reading this, you’ve likely already started taking steps toward learning about the condition. This will help you support the person in your life who is struggling. The more you know about how OCD is treated, the more you can help your loved one cope. This is largely because much of contamination OCD, like all OCD subtypes, takes place in a person’s mind, and while some symptoms manifest as actions, this is likely the tip of the iceberg to what that person is experiencing internally. People with contamination OCD can act in ways that seem illogical to the people around them, or even to themselves, but understanding how the condition takes hold of someone’s mind will help you react in stressful situations.
Ways to Help
The best way for someone with OCD to manage their symptoms is by working with an OCD-trained therapist. If you notice a loved one struggling with OCD, recommending therapy can be an incredibly effective way to help someone with contamination OCD. The best treatment for someone with OCD is exposure and response prevention (ERP) therapy. This therapy differs from traditional talk therapy in that it uses behavioral therapy to target obsessions and compulsions. . Basically, a person with OCD works with a therapist to expose themselves to stimuli that trigger their obsessions, and then sits with the distressing feelings without acting on the compulsion. People complete exposures and engage in response prevention where they don’t engage in compulsions repeatedly which allows them to incorporate new learning. ERP works because it provides opportunities for new learning. Engaging in exposure and resisting compulsions teaches people with OCD that their fears will not come true, that they can handle their distress in the event they do occur, and they are able to tolerate uncertainty, anxiety, and other distress.
For example, someone with contamination OCD might avoidtouching a doorknob without covering their hands with their sleeve due to fear that they will contract a disease. An ERP therapist would encourage the patient to intentionally touch doorknobs without covering their hands, washing their hands immediately after, or engaging in other compulsions. Over time the individual might find that their practice gets easier and the uncomfortable feelings subside faster or that their feared outcome hasn’t come true. By learning into the discomfort and uncertainty, the person learns they don’t need their compulsions to cope.
As you can imagine, this type of therapy can be difficult, and even frightening, because it involves exposure to the specific triggers of a person’s obsessions to be effective. If someone in your life is starting therapy, you can support them by offering encouragement along the way. It takes an incredible amount of courage to start mental health treatment of any kind, and that’s especially the case for one that deals with direct exposure to your fears.
The good news is ERP therapy has been found to be 80% effective for those with OCD. Being there as a support system can mean a lot for the person who has OCD in your life..
Apart from therapy and providing support, there are other ways you can help someone in your life who is struggling with contamination OCD.
For someone who does not have OCD, it can feel disorienting and confusing to watch someone you love behave in seemingly irrational ways. A mother might watch her daughter spend hours scrubbing the bathroom floor and not know how to help her. Should she try to convince her to stop? Offer advice? Tell her the floor is clean? At a loss, she might assist her in cleaning the floor when she sees it’s the only thing that eases her anxiety.
When a family member or other support person helps the individual with OCD complete compulsions or starts to change their behaviors to prevent the person from ritualizing, this is called accommodation. Accommodation might be helpful in temporarily getting the person to stop with the compulsions they are stuck in. However, this will only reinforce the compulsion, and while it may help themr feel better in the moment, it will ultimately make it more difficult to step out of the obsessive-compulsive cycle in the long term. When people are seeking treatment for OCD, we encourage them to include their support system and discuss the role of accommodation in maintaining symptoms. We encourage you to have these conversations with your loved ones to help them work towards a life that is free from compulsions.
One common compulsion someone with OCD might engage in is reassurance seeking. They might ask repeated questions to decrease the uncertainty they are experiencing and neutralize their distressing intrusive thoughts. For instance, they might ask repeatedly whether you think this food is contaminated. How long has it been in the fridge? How many days? And though it might feel unnatural, it’s important not to provide reassurance to these questions. It will only reinforce the person’s need to rely on reassurance to stop the obsession, even if it provides relief in the short term.
Therapists who specialize in OCD say that the best way to respond to these kinds of questions is to be okay leaving them unanswered. That could look like saying:
- “I’m not sure. What do you think?”
- “Sorry, I can’t answer that for you.”
- “This sounds like reassurance-seeking. Is this really your OCD asking?”
Rather than perpetuating the obsession, these questions can be a useful source of support. Supporting someone with contamination OCD is a process, and the more you know about the condition, the more you can help the person in your life get better. Instead of feeling lost and confused, you both can learn to prepare, prevent and manage the effects of OCD.
If you’re interested in what kind of treatment options are available for someone in your life with contamination OCD, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment. You’ll be connected to a member of the NOCD care team and get started learning more about how treatment can help. You can also join our Contamination OCD community and get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered.