“You think, ‘If 20 seconds is good, then 40 seconds is better.’ It’s a slippery slope.”
体育投注网址It’s impossible to watch the news, listen to the radio, or be online without encountering various public service announcements about the importance of “hand hygiene” (regular handwashing for at least 20 seconds).
体育投注网址These are well-intentioned and important reminders, but for some people with obsessive-compulsive disorder (OCD) — particularly those who have “contamination OCD” — it can be extremely triggering.
Dr. Chad Brandt, a clinical psychologist at the McLean OCD Institute in Houston, explains why.
体育投注网址“The ‘O’ in OCD stands for obsession. That’s essentially an unwanted thought that gives us feelings we don’t like and want to get rid of. So when someone with OCD has those unwanted feelings, they want to do something to make it go away. That leads to a compulsion, which is the ‘C’ of OCD,” he says.
“The strongest underlying mechanism of obsessive-compulsive disorder is the inability to tolerate uncertainty,” says Anna Prudovski, clinical psychologist and director of in Ontario, Canada, which specializes in treatment for OCD and anxiety.
Uncertainty is a challenge for all of us, Prudovski says, but in people with OCD, it’s “very, very pronounced.”
体育投注网址Compulsive behaviors like excessive handwashing, she notes, are a cyclical effort to reduce uncertainty, which only exacerbates the existing anxiety.
体育投注网址Both Brandt and Prudovski stress that not everyone with OCD has “contamination OCD,” where the compulsion involves handwashing or cleaning, but many do. (Research has shown that up to of people with OCD have cleaning or contamination compulsions.)
But even people with OCD who don’t typically have cleaning compulsions may be compulsively handwashing, Prudovski says.
体育投注网址“Some people with OCD have an overinflated sense of responsibility,” Prudovski adds.
“That can be very triggering right now, because there’s so much talk about protecting vulnerable people. Combined with the need to be 100 percent certain, this overinflated sense of responsibility is also a driver behind increased compulsion,” she says.
When vulnerable people need to be protected from a highly transmissible virus, that overinflated sense of responsibility might lead someone to not just practice responsible handwashing, but go above and beyond — all in an effort to increase the certainty that they won’t pass the virus to someone.
In that sense, this global environment can be activating for people with obsessive-compulsive tendencies.
体育投注网址One of the most effective therapies for treating OCD can be a little harder to do during a pandemic, too.
Dr. Patrick McGrath, a psychologist and head of clinical services for NOCD, a telehealth platform for treating OCD, explains, “The whole goal of ERP [exposure and response prevention] is exposing people to things that make them uncomfortable and then stopping them from doing their typical coping strategy,” McGrath says.
“Because we know that those coping strategies are often what keep people stuck. We want to encourage people to sit with the thoughts that make them uncomfortable without immediately trying to make it go away,” he adds.
体育投注网址For someone who has contamination or harm OCD, McGrath says, “I might say, for the next 24 hours, don’t wash your hands.”
But, of course, that would have been McGrath’s suggestion before the pandemic.
体育投注网址“Things are a little bit different now. If the person is staying inside their house, that might be fine, but if they go out and come home, they should follow the CDC guidelines and wash their hands for 20 seconds,” he says.
But, McGrath warns, it’s important to keep it to 20 seconds.
“Beyond that, we’re looking at obsessive-compulsive disorder trying to sneak its way back in,” he says.
Imposing limits, either on the number or length of time a person can engage in the compulsive behavior, is extremely important for people with OCD, Prudovski says.
体育投注网址“OCD takes advantage of logic. You think, ‘If 20 seconds is good, then 40 seconds is better.’ It’s a slippery slope,” she says.
Last medically reviewed on May 28, 2020