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Got Anxiety: Compulsive washing and ‘mental pollution’ (part 3 of 4)

Barry C. Barmann, Ph.D.
Mary B. Barmann, MFT

Editor’s note

This is the third in a 4-part series about obsessive hand-washing.

Click here to read Part 1.

Click here to read Part 2.

Nick is a 43-year-old man who, unlike many people with a diagnosis of Contamination Obsessive-Compulsive Disorder (OCD), did not fear contracting a disease, nor becoming physically ill from any particular contaminate.

Rather, he reported fears of being contaminated by his Alma mater, the University of Washington (sorry Husky fans, no offense).

He stated that shortly after graduating, and leaving the campus, he began to think that the University, and everything associated with it, was contaminated in some way.



His belief resulted in several forms of avoidance. For example, he was unable to go to the campus during a class reunion, nor could he visit the state of Washington, where his parents still resided.

If he saw someone wearing a T-shirt from that University, looked at or held his diploma, or saw a bumper sticker on a car, he would immediately have to go home and shower for more than 1 hour, followed by changing his clothing.



This same ritual would take place during basketball or football season whenever he heard someone talking about an upcoming game involving the University of Washington, or walked past a TV broadcasting the game.

When we first began treating Nick (who has given permission to present this information, using a fictitious name, along with slight variations regarding the details of his case), we initiated a gradual and systematic exposure strategy that involved having him look at pictures of the University of Washington on the internet.

During the course of these exposure sessions, Nick became extremely anxious and stated that he FELT he had just become contaminated.

When asked what his most feared consequence was, as the result of experiencing this sensation, he replied, “nothing bad will happen to me or anyone I know. I wouldn’t get sick or anything, I’d just feel really contaminated, icky, and would need to compulsively wash my hands and/or shower.”

MENTAL POLLUTION

Nick does not fit the typical contamination OCD patient who presents with this clinical condition. He does not fear becoming ill, nor does he believe he is capable of spreading contaminants, which could result in others becoming seriously ill.

Nick never says he has been directly contaminated by anything related to his Alma mater — he simply FEELS that he is in a state of contamination (no pun intended).

In Nick’s case, he is describing a rare form of contamination OCD, referred to as “Mental Pollution”; a condition in which a person experiences “feelings of dirtiness,” void of any form of direct physical contact with an object or person believed to contain contaminants, or other substance which could cause illness or disease.

CAUSES OF MENTAL POLLUTION

Several research studies investigating the phenomenon of Mental Pollution indicate that the primary cause of this condition appears to be triggered by the occurrence of past sexual abuse.

These findings were supported by hundreds of interviews, in addition to the administration of well validated questionnaires, presented to individuals with this diagnosis — “Contamination OCD; Mental Pollution Type.”

In addition, a recent study published in the journal “Behaviour Research & Therapy” tested the hypothesis that feelings of mental pollution can be INDUCED in those who do NOT have this clinical diagnosis, nor a history of sexual abuse.

A sample of 121 female university undergraduates were asked to imagine (for a duration of 15 minutes) experiencing non-consensual sex with a family member, as described on an audiotape, vs. imagining having consensual sex with their current partner, also described on a comparable 15-minute audiotape.

Results demonstrated that participants in the non-consensual condition reported significant feelings of mental pollution, as well as the need to engage in compulsive washing, in order to counteract their feelings of mental pollution.

These findings are consistent with reports from studies that INCLUDED victims of sexual assault. Studies of this nature contained case descriptions regarding the onset of mental pollution and OCD, subsequent to sexual trauma.

Following the deliberate provocation to recall, in great detail, one’s history of sexual assault, during the course of a 30-minute discussion concerning this topic, over 90% of these individuals described feelings of mental pollution, both during this conversation, as well as up to one month after the conclusion of their involvement in these studies.

In addition to reporting feelings of dirtiness, all of these subjects also reported having engaged in compulsive washing, changing their clothes several times each day, and performing various types of cleaning rituals for as long as 3-4 weeks FOLLOWING their participation in these studies.

Thus, results from several research investigations strongly suggest that feelings of mental pollution may be prominent in victims of past sexual assault.

Barry C. Barmann, Ph.D., is a Licensed Clinical Psychologist in Nevada and California. His wife, Mary B. Barmann, MFT, is a licensed Marriage and Family Therapist in California. Visit anxietytreatmentinclinevillage.com to learn more.


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