Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of Pooping: Is it OCD, Coprophobia, or Anxiety?

Feb 29, 20248 minute read

Fear of pooping involves extreme distress around defecating or feces, which can cause you to engage in highly inconvenient, time-consuming, or unhealthy compulsive rituals. As a licensed therapist who has worked with people struggling with this specific issue, I know how upsetting it can be. 

I’ll give you an example: Juanita lives with a type of obsessive-compulsive disorder (OCD) called contamination OCD. She had graduated from high school and was hoping to find a job over the summer, and go to college in the fall. Unfortunately, her OCD got so bad toward the end of the school year that she had to finish her studies online and could no longer leave her house. 

One of the things Juanita deals with is a fear of pooping. Her OCD wants her to engage in many rituals to feel 100% sure that she is clean. For example, every time she has a bowel movement, she goes through almost an entire roll of toilet paper. And Juanita often will sit on the toilet for hours because she knows that wiping so much will cause her immense pain and that she will probably bleed. After she finally completes wiping, she then moves on to other compulsions—like taking a shower that lasts at least 30 minutes, throwing away the soap she uses, rinsing so extensively that it causes chafing, and washing her clothes.

She hopes she won’t have to poop again for several days. At one point, she went for more than a week without having a bowel movement—and recently had to go to the emergency room because of a bowel impaction. Juanita also restricts her diet so she has to poop less, doesn’t leave her house for fear that she’ll need to poop in public, and is constantly seeking reassurance from her mother about the cleanliness of the bathroom in her home. When her family members use the bathroom, Juanita feels compelled to ask them if they’ve washed their hands and whether they did a thorough enough job. Needless to say, Juanita’s fear of pooping is causing a great deal of strain on her and her family. 

What is contamination OCD?

OCD is a mental health condition that consists of persistent, unwanted intrusive thoughts, images, urges, sensations, or feelings (or obsessions). Intrusive thoughts are ego-dystonic, meaning they don’t align with your values, morals, or beliefs. Everyone experiences intrusive thoughts, but if you have OCD, you’re unable to dismiss them as being out-of-alignment with who you are, and instead, you take them extremely seriously.

These obsessions can cause extreme distress, causing you to perform mental or physical actions (compulsions) to try to relieve your discomfort. 

Common obsessions related to a fear of pooping in contamination OCD include thoughts like:

  • Is there feces on my clothing? My hands?
  • Using a bathroom to poop will increase my risk of infection. 
  • If I poop in public, people will laugh at me or judge me.
  • If there is a trace of feces on my clothing, I may be judged.
  • It may hurt if I poop.
  • Someone didn’t wipe well enough and this bathroom is contaminated.
  • If I poop, I will never feel clean.
  • If I go out in public, I may have to poop and not be able to find a bathroom.
  • If I eat this, I could get diarrhea.

Common triggers of contamination OCD

If you have contamination OCD with a focus on fear of pooping, it could be triggered by any situation involving defecation, food, and bathrooms. For some, it may be any urge to use the bathroom, while others may fear coming into contact with poop through exposure to a child, walking their dog at a dog park, or spending time in a nursing home. Sometimes an intrusive thought will spark fear seemingly out of nowhere: What if I just pooped my pants and I can’t feel it? or What if I get diarrhea and can’t find the bathroom?

Here are some other common triggers:

  • Having the urge to poop while in public
  • Feeling gassy
  • Leaving the house
  • Having house guests
  • Stepping in dog poop
  • Smelling poop
  • Riding public transportation with no bathroom
  • Not knowing where a bathroom is located 

Other causes of a fear of pooping

A fear of pooping is common in contamination OCD, but it may be involved in other conditions, including a specific phobia called Coprophobia. While your symptoms could be a sign of various conditions, or several at the same time, here are some questions that could be helpful in assessing whether you may have OCD—specifically contamination OCD centered on a fear of pooping.

  • Do you experience repeated, unwanted thoughts, urges, or images related to fear of pooping or contamination from feces? 
  • How persistent are your fears around contamination and pooping? Are thoughts popping up often? Are the thoughts distressing or disturbing? 
  • Are you trying to ignore the thoughts? Do you try to push the thoughts away? 
  • Do you engage in any behaviors in an attempt to neutralize those thoughts or fears or prevent a feared outcome, such as repetitive cleaning, seeking reassurance, avoidance, or checking? 
  • Do these worries or behaviors take up a significant amount of time? Do they take up more than one hour of your day?
  • Do your thoughts and behaviors interfere with your daily life—like your family, social activities, or work?

If the answer to some or all of these questions is yes, you may be living with OCD, rather than another condition like anxiety or Coprophobia. Being assessed by a trained OCD specialist can confirm whether you are experiencing OCD, and help you find the best course of treatment.

When people with a fear of pooping experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in compulsions in an attempt to eliminate the fear and anxiety resulting from their intrusive thoughts or prevent a feared outcome. 

Common compulsions performed mentally or physically by people with a fear of pooping in contamination OCD include:

  • Avoiding using the bathroom or avoiding bowel movements for as long as possible
  • Excessive washing rituals after pooping
  • Excessive wiping to be sure no trace of feces is left behind
  • Seeking reassurance from family members that the bathroom isn’t contaminated
  • Monitoring the bathroom habits of family members or loved ones
  • Avoiding public restrooms
  • Avoiding places where there might not be a bathroom
  • Checking clothing for poop
  • Throwing away objects that are or could be contaminated
  • Mentally reviewing areas or situations where someone may have come into contact with feces

Get your life back from OCD

How to overcome the fear of pooping

Contamination OCD with a focus on fear of pooping can be debilitating, but it is highly treatable. The most successful treatment for OCD is a form of behavioral therapy called exposure and response prevention (ERP). Unlike traditional talk therapy, which can backfire and make OCD worse, ERP—which was developed specifically to treat OCD—is clinically proven to be highly effective in the majority of people.

Here’s how it works: A trained therapist who specializes in OCD will take the time to understand your symptoms and create a custom ERP therapy plan specifically for you. Then, you’ll work together to rank your fears or triggers based on how stressful they seem. To begin with, your therapist will typically prompt you to face a fear that brings on only a mild amount of distress. For example, your therapist might simply show you a photo of a public restroom. The fear thoughts will likely come up, but instead of responding with a compulsion, you’ll learn to tolerate the discomfort. By making this conscious choice and seeing that nothing bad occurs, or realizing that you handled the discomfort better than you thought you could, your brain gets the message that there was nothing to fear in the first place.

As your therapy progresses, you’ll tackle triggers that elicit a bit more distress, to conquer bigger fears. With an ERP therapist guiding you, you’ll practice confronting your fears in your everyday life, too, instead of just the controlled setting of therapy. 

Most of the time something amazing happens as a result of this therapy: You won’t be riddled with distress from intrusive thoughts, images, or urges. Your need to engage in compulsions goes away. And the things that matter the most to you won’t feel like they’re at risk of slipping away. In essence, you’ll get to live a life that’s free from the grip of OCD.

Working with an OCD specialist to address the thoughts and situations that cause you distress is more accessible than ever thanks to virtual ERP therapy. In fact, peer reviewed research shows live teletherapy sessions of ERP can be more effective, delivering results in less time than traditional outpatient ERP therapy, often in as little as 12 weeks. 

Want to begin your ERP therapist search? We encourage you to browse the NOCD Therapist Directory. Every NOCD therapist is not only specialized in ERP but trained to deliver treatment online. Choose your therapist and we do the rest, including helping with scheduling and payment. Of course, if NOCD Therapists aren’t the right fit, you can also explore the International OCD Foundation Therapist Directory.

These are some examples of possible exposures for those with OCD and a fear of pooping:

  • Cutting back on wiping rituals. Using only 8 squares of toilet paper or a few sanitary wipes.
  • Not showering after pooping 
  • Washing hands after pooping for only 20 seconds
  • Using a public restroom to poop 
  • Changing a baby’s diaper
  • Watching videos where people lose control of their bowels in public
  • Using public transportation
  • Spending time somewhere that doesn’t have a bathroom
  • Watching a video or reading about diseases spread by feces

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. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. We’re here to help!

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