Don’t you know when you have a friend over, and that friend absentmindedly puts her drink on the ground, except the ground is filthy, so the cup becomes filthy? And you don’t say anything in the moment, choosing to carry on with conversation, but vigilant in monitoring the fate of that cup? (Where will it go next? What tables or surfaces might she move it to? What’s your game plan if she asks for a refill? How do you best handle the cup once she’s done?) And you have to have this 30-minute inner monologue take place in about 2.4 seconds? And isn’t it a total gas how you fight the urge to cause a scene and start frothing at the mouth, or banish your friend from your house, shatter the glass in the trash, and sob as you scrub your skin until it’s red in the shower, but the scene does quickly play out in your mind?
If none of this sounds even slightly familiar, then congratulations, you probably don’t have contamination obsessive-compulsive disorder! When I’m come into contact with something I deem dirty, I carry on, but I’m constantly aware that I’ll need to decontaminate as soon as possible. But until I’m in a space to do that, everything else I cross paths with is, or becomes, unclean as well. However, when I know I’m in a position to act upon my odder behaviors, I take full advantage. (I’m no stranger to a hands-free heel stretch when it comes to a urinal handle, which works perfectly, unless someone else is in the bathroom…then I have to flush with my bare hands, and let me tell you, I would rather drink horse glue.) Just this week, I dropped underwear and a pair socks on the ground while doing laundry and thought, “You know what? It’s fine, I can still use these!” As it turns out, that was a lie, I absolutely could not, and I put both right back in the dirty laundry where they belonged! I move through the world always considering any number of potential situations that will expose me to dirt, grime, filth, germs, and so forth. My brain is hardwired to view life through a lens of cleanliness, so when that lens gets so much as a speck of dust on it, the impulse is to tailspin. My OCD is heavy on the obsessive, light on the compulsive, contamination-centered, and subclinical. Let’s unpack.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) thoroughly breaks down the most basic criteria for OCD. Obsessions can be defined as undesired, persistent thoughts that cause marked stress and/or anxiety, that are either ignored, in theory, or neutralized via compulsions. (My brand of obsession mainly focuses on my personal ecosystem being compromised by any number of pollutants.) A compulsion is a ritualized behavior, or mental act that seeks to diminish the negative effects of the obsession, but has no true effect on reality. (My most utilized compulsion uses cleaning as a form of relief.) Obsessions and/or compulsions should take up an hour or more of your time each day, or impair daily function in some way. Here’s where things get interesting.
I knew I was pretty hyper-vigilant about my germ sensitivity and general cleanliness, especially when compared to other people. I had my little quirks that made me stand out, but I wasn’t wasting one of my 24 hours on crazy thoughts… maybe 57 minutes, but a whole hour? Absolutely not, I was totally fine. Right??? Wrong. That’s the “subclinical” part of the diagnosis: a lack of functional impairments. My brain doesn’t totally short-circuit when I feel myself fixating on a specific obsession, but I’m still cognizant of how much of my attention it’s taking up. I think of it a lot like a computer. When needed, my obsessions are able to be minimized, but they’re never fully closed. At least, not until I deal with them. I may have other documents or webpages open, but that contamination application is always just out of sight. It could take a few seconds, days, or even weeks to be addressed, and I continue to live my life in that time, but the piper always receives his due.
It’s never been a secret that germs were a huge part of my life, but I’d failed to really considered them a part of any sort of diagnosable issue, especially since I was able to navigate without having regular meltdowns. I’d looked up OCD very generally in the past, and while I found some resonance with the description, my OCD being nefariously subclinical is what threw me off the scent. After doing my research and arriving at this conclusion, everything seemed to click. The behaviors I wasn’t even batting an eye at as I took part in them weren’t normal for other people. (Although, I challenge you to find a logical flaw in washing your hands 5 times before, during, and after showering as you get ready for bed.) For me, OCD isn’t a monster under my bed, forever haunting me like some terrifying ghoul. However, he is a little gremlin that sleeps in my guest room, who occasionally forgets to respond to my texts. In either case, I’m glad I’ve been able to name him. I explained this revelation to some friends a few weeks ago, and although they were incredibly supportive and thoughtful, once the fifth minute of me talking rolled around, I realized how genuinely unwell I sound. But that’s the name of the game.
When I’ve been exposed, my worst case scenario is inherently linked to death. If I open my door to retrieve a package, my brain just tells me that if I don’t effectively wash my hands, I’ll get sick. And then I’ll die. If I trip, and my knee manages to graze the ground, I can’t help but lose sleep when I think about the fact that if I can’t change my dirty pants quickly, then the germs will overtake my body to the point that I’m ill. And then I’ll die. Back in my junior year of college, I entered my bedroom and had a moment of enlightenment that I’m fairly certain would guarantee my canonization. As the door swung closed behind me, I heard a voice (my own) clear as day ask why on earth I was wearing shoes indoor. If my room was grime free, clean as a whistle, maintained by regular cleanings, how could I drag the filth of “the outside” into that space? It was a fair question that prompted me to start leaving my dirty shoes at the front door. Things took a turn after that, the piper’s payments becoming bigger and more frequent.
In the years to come, I would grow to obsess over germs with increasing intensity. I would wonder how contaminated my dog’s food cup and water dish were, every time I fed or watered him. I would think about what might be resting on the surface of the bathroom counter at my home, or which specific particles were 100% infecting the buttons on the office water cooler. By the time I moved into my own place, I already knew what I could expect to combat just going into work. The madness was as follows:
Grab my dirty car keys and make sure to lock my dirty front door before opening my dirty car door, driving with my dirty steering wheel, turning on the dirty radio, touching one, two, three dirty office doors, get to my clean desk and immediately sanitize my hands to high heaven. Then, open the dirty office fridge using the dirty handle and put my clean lunch away, before I use the dirty kitchen machinery needed to make my tea and grab some water, go back to my clean desk, and sanitize again. Rinse and repeat as needed throughout the day.
I map out my day according to how much contact I’ll probably have with things I consider “unclean”. Even with the luxury of working from home for close to a year, my sanctuary isn’t free of contamination. I still let the mail sit on the floor, toeing through it with my shoes, only picking up what I need to open, because, you guessed it, mail is contaminated. I still do a total disinfecting every time I grab my UberEats, since I have to flick my one dirty light switch to go downstairs, touch two dirty doorhandles and a dirty lock, twice. Whenever I drop something on the floor, which is often, I retrieve and/or disinfect as needed, and continue on.
Another part of OCD is “magical thinking”, which is a symptom I totally assumed I was exempt from when, in actuality, I’m absolutely not. In short, those impacted by this belief are convinced that their thoughts, actions, desires, and so forth, have the power to bend circumstances to their will. As someone who’s not at all STEM-minded, the most fascinating part of my journey has been convincing myself that I’ve legitimately transformed into an immunologist. (Fauci wants what I have.) For example, let’s say I go on a two-week trip and then return home. Now, my luggage is thoroughly contaminated (obviously), so I normally grab the essentials that I genuinely cannot live without, and then just leave everything else in my suitcase. I don’t know the exact timeline, but my brain tells me that, after a few weeks have passed, it’s “safe” for me to retrieve the rest of my things. Why? Oh, because my “good/clean” house germs have overtaken the “bad/dirty” outside contagions. Picking and choosing what and when things are dirty is both reflexive, and highly illogical. Some of my decisions are pretty rational and firmly rooted in practicality, but portions of it make no sense whatsoever. The bath mat I step onto every time I exit the shower is also directly in front of my toilet… so by my own logic this should make it a war zone. I take my body, at its absolute cleanest, and allow it to come in contact with contamination? Yes, because I proceed to get into bed with socks (I’m one of “those people”, I poor circulation, stop wincing!), which trap and contain any possible germs from invading my sterile space.
The true differentiating factor between small things that might bother me and full-blown obsessive-compulsive behavior is whether or not I have no choice but to act on the stimuli. In a dream scenario, I would install a self-cleaning floor in my entire house, and put my toilet in another room altogether, or on my roof. (I can think of few things worse than barely starting my day before even slightly grazing the commode as I brush my teeth or something. I have to change now, it’s truly the I my way I’ll know peace.) As a self-proclaimed microbiologist, somehow, it makes sense to me that germs on my hardwood and carpeted floors are eternal until I clean them, even if I haven’t left my house in a month, but the one rug I have is comparatively clean(ish), which is why I can walk on them with my socks on, rather than the slippers necessary for any other surface.
You might be wondering, “Well Jesse, where do you go from here?” and if you are, that’s a shame, because I was about to ask you the same thing. I know exposure therapy is the most common way to treat OCD, but given how the very thought of intentionally confronting the gross things that haunt me is nauseating, I think I’d opt for more nontraditional methods. But that’s assuming I eventually feel the need for treatment at all. While my day-to-day routine certainly has different pitfalls than other people’s, I don’t feel like it stops me from living. I’ve never turned down a hangout with friends, cancelled a date, etc., because I knew I’d have to battle a cavalcade of treacherous doorknobs, or drink from a glass that I wasn’t able to witness being washed with my own two eyes. And that’s not to say that I haven’t thought about those things, among a host of others. I just mean that I’m able to quiet my mind enough to know that, as much fun as I’ll have, some part of me will always have to submit to the suffering that accompanies these encounters. There’s a scene in Sharp Objects (#Justice4AmyAdams) when Camille articulately explains, saying, “My demons are not remotely tackled. They’re just mildly concussed.” Although my brain continues to try and sabotage me on a regular basis, each compulsion a transaction that I struggle to pay, I know just enough to keep myself in check. I may not be tackling my issues with the most gusto per se, but I’m working to be more mindful of them. There’s a chance that my neuroses could run rampant forever, and if that’s my lot in life, so be it. All I ask, for now, is that they gallivant in tighter formation.
For those of you thinking, “Hey Jesse, how bad has your OCD gotten with COVID-19 at large?” First of all, thank you so much for asking, it’s greatly appreciated. Second of all, I haven’t noticed much of a difference to be honest. In a situation where something like a virus is wreaking catastrophic destruction on a global scale, it’s actually more likely that folks with contamination OCD will adapt because, if nothing else, we’ve been training for this. Now I have a reason to which my nonsensical behavior can be anchored. In normal times, my specific actions would be peculiar, but now, many of them are habits that people have or should’ve developed in the past year. While some OCD sufferers run the risk of going from subclinical to clinical categories during a pandemic, for others, coronavirus hasn’t prompted the manifestation or exacerbation of symptoms, because they were already there.
I’m still learning how to best excavate the inner workings of this disorder. What are my triggers? Where do they come from? How can I negate them, if at all? I’m open to seeing a therapist and doing my own research to figure out better coping mechanisms, but I’ll start with working to be more mindful when I can feel my brain impulsively going into overdrive. Not because I believe you can will away something like this, but because I’ve already noticed a difference in the minuscule efforts I’ve made to take note of my more baseless fears. It’s a cross that I find myself carrying every day, but I’m praying that it gets easy to shoulder, and my body learns to keep less of a score. Who knows, maybe one day that old piper will give me a discount.
