Obsessive compulsive disorder - OCD treatment and therapy from NOCD

What is Emotional Contamination OCD and How Do You Treat It?

By Stacy Quick, LPC

Jan 28, 20229 minute read

Reviewed byPatrick McGrath, PhD

Emotional contamination in OCD can be difficult to recognize. It involves a fear that certain people, places, or objects are contaminated, which leads the person affected to believe that they must be avoided or that rituals are needed to avoid negative outcomes. These individuals are not necessarily perceiving “contamination” in a traditional, physical sense, but rather as an inward emotional or mental contamination. 

For example, they may not have had contact with a physical external contaminant, but rather a taboo thought or one involving what they believe is a moral impurity. They may believe that having these thoughts will contaminate what’s around them. This can also lead them to feel “dirty” or “evil” and to attribute this feeling to an object, situation, or even a person. 

How emotional contamination manifests

Though the feelings are internal, someone who is experiencing emotional contamination fears may try to physically “wash away” these intrusive thoughts. They may feel that if they do not wash outwardly, there’s a chance that the thoughts may be true. Their need for uncertainty keeps the OCD cycle going, and can lead to hours of hand-washing, chapped hands, endless showers, and rewashing laundry. It leaves the person with OCD trapped in a cycle of compulsions that only strengthen the idea that there was a real danger. 

Others may instead attempt to deal with emotional contamination by spending countless hours in prayer and confession, trying to feel “clean.” They may seek constant reassurance that they are not a bad person. The relief that they feel from any reassurance they receive is short-lived, though, and only reinforces the idea that they cannot rely on their own sense of self or feelings, because they doubt on a deep level who they are and what they are capable of. 

OCD can be extremely creative. Sometimes the meaning or feeling that emotional contamination creates is attached to a characteristic or a situation. An example of this would be a person who has come into contact with someone who has cheated on their partner, then later has an intrusive thought that they too could cheat on their own partner. They become tormented by these intrusive and unwanted thoughts. As a result, they begin avoiding any possible contact with anyone who has ever cheated on their partner. They may even avoid watching all TV shows that depict cheating or unfaithfulness. 

Attaching feelings of contamination to objects, people, places, and more 

Emotional contamination can make a person feel internally “unclean” which results in distress and can cause them to attach this feeling to items, colors, numbers, or really anything at all.  Several years ago, I worked with Allie* who struggled with intrusive thoughts she considered to be morally wrong. This affected her most while she was eating – if she had a thought she considered “impure,” she began to feel that what she was eating would then become contaminated. She could no longer finish it because in her mind, it was now “dirty.”

For Allie, things like foods that were red were a problem. She believed the color red could mean blood was present in her food, which caused her to have intrusive thoughts that she had harmed someone in her past. This led her to feel so ashamed and sickened that she could no longer eat red foods, despite rationally knowing there was no blood. Just the possibility of eating the food could make it somehow true that she had harmed someone, and this caused her enough anxiety that she felt she had to avoid it.

Logically, Allie knew her food was not actually contaminated, but due to the anxiety that OCD made her feel, she felt she could not be certain. As a result, she wouldn’t eat any of the foods she associated with those thoughts. This would happen repeatedly until eventually almost every time she would eat, the thoughts would be present and before she knew it, she was imprisoned and unable to eat or enjoy most foods.

Another person I treated, John*, had a fear that one of his loved ones would die in a car accident, and this thought would specifically enter his mind any time he was getting dressed. He would then immediately change his clothes in an attempt to prevent this, and he would avoid any of the clothing he had been wearing each time he had those thoughts. He would never wear them again. Before he knew it, John had very few items of clothing that felt safe to wear. 

People with emotional contamination may understand that there is no tangible relationship between the clothing they wear and whether someone will get into a car accident, or that a mental thought won’t physically contaminate their food. But the familiar whisper of OCD that says “just in case” or “but what if” becomes the driving force, creating doubt and fear that lead to compulsions and sometimes extreme avoidance. 

Engaging in rituals or compulsions to try and neutralize these thoughts may feel good in the moment, but that feeling doesn’t last for long. The thoughts will keep coming back until they are faced head-on. To combat these unwanted thoughts, the individual with OCD must decide that they will not engage in the compulsion and see what will happen. That’s the only way that the brain can learn that there is no real danger or real connection between the feared thought and the resulting behavior. 

Engaging in magical thinking 

Many people with emotional contamination fears also engage in magical thinking. Magical thinking is the belief that one’s internal thoughts, beliefs, actions, wishes, or words can influence what happens externally in the world around them. It can also include superstitious beliefs. Magical thinking is very prevalent in people with OCD, particularly in children with OCD. 

This can be seen when a child has to say things in a certain manner or repeat a particular prayer or phrase before bed each night to keep their loved ones safe. The child will have a need to say certain words or prayers the same way each time, or they may say it a specific number of times or repeatedly until it feels “just right.” They may say it in their head, but because OCD causes doubt, they’ll question themselves. This will often lead them to restart the whole process again, which can result in endless amounts of time being spent on this compulsion. 

Magical thinking OCD may also look like a child saying to their parents “wear your seatbelt” every time they leave the house because they believe that if they do not say it even once, something bad will happen to their mom or dad. These situations can also happen with adults.

For an adult, magical thinking OCD may also look like tapping the light switch four times every time they go to turn the lights on or off to ensure that they’ll be safe from a fire. There doesn’t need to be any direct correlation between the two things (the thought and the compulsion); sometimes there is and sometimes there isn’t. 

The impact is substantial

The severe effects of emotional contamination OCD and the associated intrusive thoughts on the person experiencing them cannot be understated. Compulsions can range from subtle to extreme. I am reminded of Jane*, a young adult in her early twenties I worked with. 

Jane had been away on spring break when her best friend was sexually assaulted. After the assault, she began to attach her fears to her friend’s clothing and began to see them as contaminated. They shared a dorm room, so this quickly became a problem. Jane was careful not to let her laundry touch her friend’s. She worried that if their clothing touched that maybe that meant that she could sexually abuse someone herself in the future. 

Jane was experiencing emotional contamination, where she had intrusive thoughts that she could become like the person who attacked her best friend. She may have known this was illogical, but the anxiety was so great, and the sense of urgency so intense, that even the slightest possibility that it could be true led her to take extreme measures. 

It wasn’t long before keeping the laundry separate wasn’t enough. Jane then started to think that silverware and dishes that her friend used could also possibly be contaminated. She believed that if she used something her friend used, then maybe it would mean that she could be capable of sexual assault. Things began to spiral out of control. 

She wanted to be supportive of her friend and to be there for her in her time of need. However, before she knew it, she found herself avoiding her friend, even rearranging her schedule so that she wouldn’t have to have contact with her. She was unaware of why this was happening, but she was full of guilt and shame, believing herself to be a terrible friend. 

By the time Jane entered treatment, she had begun making plans to move out. She had decided that her fear and the potential of harming someone else was too great of a risk and that it would be easier to isolate herself. Thankfully, she was able to start OCD treatment before she took that drastic step and began practicing exposure and response prevention (ERP) with me. 

Soon, Jane began to recognize that these were just thoughts and that she didn’t need to avoid her loved ones or do compulsions to feel safe. She was able to be present with her friend again. Treatment helped her to learn to manage the symptoms of OCD and enabled her to regain her life.

Finding the right treatment

Like Jane, it’s possible for you to conquer OCD, with the right treatment. The key to addressing emotional contamination fears and treating OCD effectively is by seeing a licensed therapist who specializes in OCD and is specialty-trained in ERP.

ERP can teach you how to stop engaging with the thoughts causing your distress. You will learn how to sit with uncomfortable feelings and resist the urge to do compulsions, such as avoidance. You will see that anxiety, like any other feeling, eventually passes, and you don’t have to do anything to make this happen.

It’s important to see a specialist because they’re trained to help you prevent avoidance and other compulsions. A specialist will teach you how to accept the uncertainty behind OCD fears and will give you the tools and knowledge needed to learn how to manage OCD. 

At NOCD, we have licensed therapists that are specialty-trained in treating OCD with ERP, As an OCD specialist, I’ve used ERP to help many people regain their lives from OCD. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment. with our team to get matched with one and get started with OCD treatment. You can also join our Contamination OCD community and get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered. 

* Names and personal details have been changed.

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