Fear of poison

What is the fear of poison

A fear of poison is one of many fears that can be central to Contamination OCD. An individual experiencing fear of poison often worries that they may have accidentally poisoned someone by making their food, bringing an item into the home, or using chemicals such as household cleaners. They may also fear being exposed to poisonous substances themselves, whether by touching an object, feeling or tasting something unexpected, or doubting the safety of food or drink. Let’s consider an example. After having cleaned the kitchen counter with bleach, Sherry then moves on to make herself lunch. However, while putting her lunch together, she starts wondering if she accidentally might have gotten bleach into her soup. She worries that any amount of bleach could be harmful, so she throws all of her soup away and wipes every surface in the kitchen to get rid of any trace of bleach. She feels better for a bit, but finds that she doesn’t feel safe eating at home, and only eats takeout meals for a week, often skipping meals for days at a time.  We can consider another example: Tyler is cooking a whole batch of cookies for someone he really cares about. While everything is in the mixing bowl, he remembers that one of the eggs in the carton was cracked when he bought it. What if they were tampered with? He disposes of the dough and decides to get store-bought cookies instead. He feels a bit better, but later that day the worry returns, and Tyler checks the expiration date on every item in his kitchen.

Common obsessions

• What if I mixed up the boxes and accidentally put poison into this?
• What if I accidentally poison my loved one while making their meal?
• What if I accidentally poison myself?
• What if I touch a dangerous substance and I die?
• What if this box was mislabeled and I put the wrong thing in?
• What if I accidentally give someone an allergic reaction?
• What if I accidentally poison my pet? Is their food safe for them?
• What if my food was tampered with?
• This food tastes a bit “off.” What if an ingredient went bad?
• Could someone have laced my drink with a drug?

Common triggers

People with Contamination OCD centered on a fear of poison may be triggered by situations involving unfamiliar sensations or tastes, prepared food, cleaning, or cooking. These situations can arise at home or in public places, and someone may even be triggered by hearing stories of individuals having been poisoned, either purposely or by accident.

Common triggers for people with fear of poison include:

• Making a meal for themselves or someone else
• Seeing a substance such as a powder of unknown origin
• Seeing something that looks like poison
• Tasting or smelling something unfamiliar
• Experiencing stomach upset or nausea
• Using household cleaning products
• Hearing about situations in which someone was accidentally poisoned
• Reading about household items that can potentially be dangerous and poisonous to either humans or pets

How can I tell if it’s OCD or a real threat of poison? 

It is very common for an individual experiencing a fear of poison to feel unsure if their fear is related to OCD or not.

As with all areas of life, there is a level of uncertainty regarding food and drink safety. In most areas of life, you are likely able to function with confidence and comfort, despite this uncertainty. With OCD, however, it can feel like your brain fixates on certain uncertainties, no matter how improbable, and tells you that you aren’t able to tolerate the slightest doubt as you do in other areas of your life.

This causes a cycle of fear or doubt, intense anxiety or distress that comes as a result, and an urge to find certainty or relief through safety-seeking behaviors called compulsions. If you feel an intense desire or need to feel 100% certain about your safety from poison, that’s a red flag that OCD may be involved.

Common compulsions

When people with Contamination OCD with a focus on fear of poison experience intrusive thoughts about safety from poison, they may engage in compulsions in an attempt to reduce their anxiety or prevent feared outcomes. For instance, they may want to throw away food that they fear is unsafe, or completely avoid making food for themselves or others, including pets, for fear of poisoning those they care about. They may become so fearful that they start eating only prepackaged food that they have deemed safe because it was sealed.

Common compulsions performed mentally or physically by people with fear of poison in Contamination OCD include:

• Avoidance of anything that causes doubt about safety
• Only ordering take out or only eating food that others make
• Giving themselves reassurance
• Asking for reassurance from others (“Do you think I accidentally dropped something in there?”)
• Google searching for common symptoms of poisoning
• Checking and rechecking while preparing food
• Saying a certain phrase while preparing food
• Excessively cleaning surfaces, dishes, and implements
• Throwing away food that causes any doubt
• Excessively smelling items to see if they smell correct
• Limiting food intake to items that feel “safe”

How to treat fear of poison

Fear of poison in Contamination OCD can be debilitating, but it is highly treatable. Exposure and response prevention (ERP) therapy with a trained ERP therapist is the gold standard for OCD treatment, and 80% of patients benefit significantly from treatment. ERP has been validated by decades of clinical research proving its effectiveness in disrupting the OCD cycle for lasting results.  The first step in treating Contamination OCD with a focus on fear of poison with ERP is to establish a hierarchy specific to one’s symptoms. This is done through a collaborative approach where a therapist and therapy member identify their fears, their compulsions, and their triggers to build exercises called exposures. In ERP, an individual gradually approaches feared situations and resists the urge to engage in compulsions. Repeatedly being exposed to anxiety-provoking scenarios while resisting compulsions disrupts the vicious cycle of OCD and also increases one’s tolerance of uncertainty and distress in general.

Examples of possible exposures done to treat a fear of poison in Contamination OCD include: 

• Having a homemade snack without asking for reassurance
• Baking cookies for a loved one 
• Feeding your pet without excessively after only rinsing the bowl

If you’re struggling with OCD, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

We look forward to working with you.