Compulsions are also often known as safety-seeking behaviors. OCD makes us feel threatened or afraid, and we engage in compulsions in order to feel safe, if only for a short while until our obsessions return again.
The problem is that obsessions aren’t actually dangerous—by endlessly seeking safety that never comes, we can cause our world to shrink more and more over time. Sometimes, people can end up completely housebound, fearing the potential triggers they might encounter when away from home. Most often, these triggers and obsessions revolve around harm coming to themselves or others, self-control (urges), contamination, and other safety concerns.
Let’s look at some examples of people becoming housebound due to their OCD fears, and learn more about how people can overcome these debilitating experiences:
What if I harm someone?
People with OCD who feel unable to leave home are often consumed with fear or uncertainty that they may harm someone else, whether inadvertently or on purpose. They may become concerned that they could do something that they know is out of character or against their values, or develop false memory OCD themes, fearing that they may have hit someone with their car or that they may have erased memories of harming someone else. This can be an extremely scary experience—consider an example:
Drew has recently moved away from home to start college, and is finding it difficult to go out on his own. He has suffered from OCD for most of his life, but lately his intrusive thoughts have been about harming others.
Driving has become particularly difficult. He feels fine when someone else is with him, but if he has to go anywhere alone, he avoids going altogether. He is embarrassed to tell anyone, but he worries that he may murder or harm someone when he is on his own. When he hears about different things happening in the news in his area, he has intrusive thoughts: “What if I was involved in that and forgot?”
One day he heard that a woman who lived on campus was raped. Even though part of him knew he had never met this woman or even knew she existed, he had a thought that he may have done it. He had driven to the post office that day—what if he was the culprit and somehow forgot? He became so scared that he hasn’t left his dorm room in over a week, and his grades and health are declining.
If I leave my home I will be contaminated
People experiencing this form of OCD often know that their fears are illogical, but even the slightest chance of something bad happening can fill them with anxiety that feels impossible to tolerate. They may feel they must do everything within their power to protect themselves and others, because the slightest hint of risk is simply too high. Contamination OCD can be debilitating, as the anxiety people feel is very real, as if danger is imminent and inevitable. Let’s take a look at how these fears can even keep people from leaving their homes:
Lena has always been concerned about her health and regularly takes precautions to avoid getting sick. Even more important to her, though, is that she doesn’t get anyone else sick, especially her loved ones.
Her elderly grandmother lives with her family. She knows that she is more susceptible to sickness, and Lena worries that her grandmother could die if she came down with even a mild sickness. Lena feels highly responsible for her grandmother’s health and well-being, afraid that if she were ever to allow harm to come to her, her guilt would be overwhelming. Lena’s siblings often refer to her as the “germ police,” because she is constantly barking orders at them about how to handle things in the home.
Lately, Lena has been scared to leave the house, fearing that she will come into contact with someone else who is sick and bring an infection home to her grandmother. She is so overwhelmed by the thought that she could hurt her grandmother that she recently started refusing to attend school because she felt it was just too risky. Her parents know she needs help, but they don’t know where to start.
What makes OCD different from Agoraphobia or other phobias?
Symptoms of OCD are different from having a specific phobia or Agoraphobia, though these various conditions can all cause people to avoid leaving home.
Agoraphobia is a fear that is distinct from other phobias, these can involve strong fears surrounding using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, or being outside of the home alone.
Similar to OCD, Agoraphobia causes people to avoid public situations that invoke fear and anxiety. The main difference between these conditions is that people with Agoraphobia don’t typically experience the intrusive thoughts, feelings, urges, and images that characterize OCD. In Agoraphobia, people also don’t usually engage in ritualistic compulsions other than avoidance, while people with OCD may respond to their fears by avoiding their triggers, as well as other compulsions like reassurance-seeking, excessive researching, thought suppression, or even discarding potentially contaminated clothing.
On the other hand, specific phobias, while similar to Agoraphobia in many ways, differ in that they involve only one feared stimulus that triggers the feeling of fear. For example, someone who is afraid of being robbed while outside of the home without other fears would likely meet the criteria for a specific phobia. Someone who is more generally afraid of being in crowded areas, public spaces, or long lines of people would more likely be diagnosed with Agoraphobia.
Just like OCD, these conditions can significantly impact people’s lives. Their fears are often illogical or out of proportion to any actual threat, causing people to avoid situations that may trigger these feelings of anxiety and panic. This often means they will refuse to leave their house, or only leave under very strict circumstances.
Another distinguishing factor between these phobias and OCD is that people with OCD often report that their symptoms come and go over time. Those with OCD are also more likely to experience a variety of themes or fears, rather than one single obsession, while specific phobias and Agoraphobia usually remain consistent when left untreated.
How you can conquer your fear of leaving the house
Treatment may seem daunting for people experiencing these fears, whether they have OCD, Agoraphobia, or a specific phobia. The mere thought of leaving the house to find therapy can be too much, too soon. That is one of the amazing benefits of online OCD therapy. This type of therapy allows people to start the process of recovery from the comfort of their home, learning how to manage their condition without facing their greatest fears all at once. It is important that a person doesn’t feel flooded with anxiety, but rather that they are able to build up their tolerance for the feelings of discomfort.
By doing exposure and response prevention (ERP) therapy with a trained specialist, people with OCD, Agoraphobia, or a specific phobia can learn to tolerate their fears without relying on avoidance or compulsions. By facing their fears head-on and allowing uncomfortable feelings to be present, they learn that they can tolerate the anxiety and uncertainty associated with being away from home. Previously, by engaging in compulsions and avoiding triggers, they have not learned that they can manage uncertainty and anxiety, while still living the life they want to live.
