When Fear Isn’t About Germs: Understanding Emotional Contamination OCD

“I’m afraid that I’ll ‘get them on me’ and they’ll be with me forever. I cannot let that happen,” my client whispered. Hand washing, avoiding showering and personal hygiene, using alcohol wipes to clean items and their hands to lessen time spent in compulsive cleaning were all hourly occurrences. They could use alcohol wipes and be “clean enough” in 15 minutes but if they had to wash with water it might take 1-2 hours. For years this client had been diagnosed with OCD but all providers, having seen what looked like contamination-related compulsions, assumed that the client was afraid of contamination due to germs or getting sick. Due to this lack of understanding of their particular subtype of OCD, they were not able to progress effectively as a result.

In the first few days of  treatment, we discovered they had a great fear of becoming like a family member with whom they had experienced negative memories. The OCD brain told them that if they did not protect themselves by compulsively washing their hands and avoiding contact with the places this family member had lived, they would be “dirty forever.” Furthermore, we learned that their brain threatened them with the loss of enjoyment of their hobbies and passions which would result in a lifetime of unhappiness, with them dying by suicide as the only eventual outcome. Was this fear of contamination by germs? No chance! This client was silently suffering from a lesser known subtype of OCD called emotional contamination and had no idea.

Emotional contamination is a type of OCD in which the individual fears being contaminated by people, places, and things. Emotional contamination does not typically share fear of physical sickness and/or death as its more well-known cousin, contamination OCD, does. Some clients have shared fears of spending time with friends and family who have been divorced or struggled in relationships, fearing that they will become like those people and subsequently lose relationships. Another client experienced intense fear around feeling sad or “off,” a fear of emotion itself.

One client was very afraid of becoming like someone his brain labeled as “gross” and so, in an attempt to avoid her as much as possible, he paradoxically became over aware of her every move and felt like he couldn’t help but follow her around. In this state of hyper awareness, his brain fed him intrusive images of having touched/brushed up against her, and so he felt the urge to make physical contact by shaking her hand or giving her a high-five as a way of “giving it back.”

Anecdotally, I have found that avoidance of triggers tends to be the most common compulsions for sufferers of emotional contamination. Hyper-vigilance in consumption of media (TV, movies, books, podcasts, videos, or social media content), avoiding social gatherings/interacting with certain people, and compulsively checking in with one’s own emotional state can all be common responses to emotional contamination fears. Other compulsions can include reassurance seeking, self-reassurance, problem solving how to avoid becoming contaminated, neutralizing negative or contaminated thoughts, and self-isolation.

Emotional contamination can be very distressing and can make one feel “weird” or crazy - if you have experienced these fears or worries, you are *not* alone. Emotional contamination is quite common although it can be tricky to recognize and diagnose. Exposure and response prevention (ERP), a practice in which we purposely expose ourselves to feared triggers and then resist doing anything to make ourselves feel better, is the gold standard treatment for OCD and the way we learn that our thoughts and anxieties are not the problem but rather our desperate attempts to solve our discomfort. At CalmOCD we specialize in recognizing and treating OCD, mapping out your fears and working side-by-side to help you face them head on. If you have found yourself caught in a cycle of fear around people, places, or things and you would like help in knowing how to respond helpfully, we are here for you.