What is Contamination OCD?

Bacteria, viruses and germs are all around us. That can make life with contamination OCD difficult to navigate. Take the case of a young woman named Sophie. Her severe obsessive-compulsive disorder manifested when she was 18. One of her fixations was preventing bacteria from getting into her nose. Sophie would sit for hours making lists of the clothes she could and could not wear, based on whether they would contaminate her nose. There were times that she felt she couldn’t wear clothes at all.

There are many contamination OCD stories like Sophie’s. Of the 2.2 million adults in the United States who have OCD, about half experience contamination OCD. But what is it all about, and how does it differ from regular OCD? Clinician Dr. Roxanna Rosen uses Sophie’s story to shine a light on this particular form of OCD. It’s a mental health condition that can disrupt a person’s daily life if not properly managed.

Understanding the OCD Fear of Contamination

With OCD, thoughts, images or feelings become irrational obsessions that seem uncontrollable. These obsessive thoughts become ingrained in a person’s mind and compulsive behaviors or rituals rise as a kind of coping mechanism, Rosen said

The obsessions in contamination OCD revolve around exposure to potentially harmful substances, Rosen said. This can include disease-causing germs, bodily fluids, chemicals, trash, environmental toxins, dead animals, and even dirt. Some people fear that these substances may cause harm or even death. For others, contamination OCD’s roots are in disgust at the prospect of touching harmful materials and becoming infected or dirtied by them. These are considered contact contamination and mental contamination, respectively. 

Emotional contamination is another version of this disorder. Someone with this mental health condition avoids particular people or places that are thought to be contaminating. Perhaps the fear is that a location brings bad luck or poses physical risk. Some people with emotional contamination OCD may see someone who is homeless and worry that they will somehow become homeless, too. This type of OCD favors superstitious feelings over rational thought. 


Sophie’s OCD progressed to a state where she couldn’t wear clothes due to a fear of bacteria getting into her nose. Dr. Roxanna Rosen, Psy.D. analyzes the complexities of obsessive compulsive disorder and how to overcome them, including OCD at a young age, making lists, contamination disorder, giving in to irrational thoughts, obsessing over arranging objects, recurrences, and hospitalization.

Common Contamination Compulsions

The obsessive thoughts, feelings, or mental images behind contamination OCD turn into compulsions that take many forms, Rosen said. Some of the most common:

  • Repetitive cleaning of surfaces or rooms, even if they’re already tidy
  • Compulsive washing of the hands or body
  • Throwing away anything that’s perceived as dirty
  • Staying away from places that pose contamination risk
  • Performing rituals to rid a room of contaminants
  • Asking people not to touch surfaces or objects, or enter spaces, because they will contaminate them
  • Questioning whether something is clean or safe, even after being reassured there’s no contamination risk

As was the case with Sophie, people with an OCD fear of contamination feel the effect of the disorder in almost every area of their lives. It can cause disruptions at work, home or school. People may stay home or limit relationships to prevent contact with perceived risks. Even their bodies suffer the toll when constant hand or body washing damages the skin. In the worst case, someone may become a recluse, shutting out people for fear they might poison the environment. 

This form of OCD may sound dire, but there is help, and hope, out there. 

How to Overcome Contamination OCD

As with other types of OCD, contamination OCD isn’t curable, but it is treatable. People can take steps to make the condition more manageable so that it doesn’t get in the way of their normal daily activities. Rosen said Sophie came up with an ingenious solution: She used her cat as a role model. She saw her cat didn’t pay attention to its nose, so she learned to not pay attention to her nose, either, and ignore her negative thoughts.

It’s a form of treatment called Exposure and Response Prevention, Rosen said. While someone will avoid the thing that triggers their OCD, Exposure and Response Prevention requires the fear to be faced head on. For instance, a person may try to avoid going into a large store because they’re afraid of contamination. Instead, they’ll go into the store. The second part of this method calls for the person to not engage in their typical ritual. So if the person usually goes home to shower and change clothes to “cleanse” themselves after being in the store, they would resist that behavior for as long as possible, with the gap between the exposure and response prevention widening each time. The goal is to strip away the power of the obsession over time, Rosen said

Exposure and Response Prevention is an effective tool for managing contamination OCD. A trained therapist with experience in this cognitive behavioral therapy technique can educate their patients and teach them how to use this tool when they encounter challenging situations in their lives. Medication may also be helpful for more severe cases. Group therapy for families can be beneficial, so they have the knowledge and sensitivity needed to support their loved ones with contamination OCD.

Sophie now has her OCD under control. She’s one of the many people sharing their mental health journeys on TAG. This mental health streaming service is an innovation in healing. It promotes greater understanding of mental health conditions through videos where real people discuss their stories, and professional clinicians share their input. There is no stigma around mental issues; TAG is a space designed to educate and empower. Visit TAG today to see Sophie’s story about overcoming OCD.

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