What is the fear of pooping?
| Fear of pooping involves fears that center around the topic of defecation or feces, as well as potential related negative health or social effects. Fear of pooping can cause a person extreme distress. A person who feels this distress may engage in highly inconvenient, time-consuming, or unhealthy compulsive rituals as a result of their OCD fears. Let’s consider an example: Juanita just graduated from high school and is hoping to find a job over the summer and go to college in the fall. Unfortunately, her Contamination OCD got so bad towards the end of the school year that she had to finish her studies online and can no longer leave her house. One of the things Juanita struggles with is a fear of pooping. She knows that when she poops, she will have to engage in many rituals to feel 100% sure that she is clean. She goes through almost an entire roll of toilet paper each time she has a bowel movement. She 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. These compulsions involve taking a shower that lasts at least 30 minutes, disposing of the soap she uses, extensive rinsing that causes chafing, and washing her clothes. She hopes she will not have to poop again for several days. At one point, she went over a week without having a bowel movement, and went to the emergency room recently because of bowel impaction. Juanita restricts her diet so she has to poop less, doesn’t leave her house for fear she will need to poop in public, and is constantly seeking reassurance from her mother about the bathroom’s cleanliness. When her family members use the bathroom, Juanita feels compelled to ask each family member if they have washed their hands and was it “good enough”? Juanita’s fear of pooping, contamination by feces, and other related behaviors is causing a great deal of strain on her and her family. |
Common obsessions experienced by people with a fear of pooping in Contamination OCD include:
- Is there feces on my clothing? My hands?
- Using a bathroom to poop increases 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
| People with Contamination OCD with a focus on fear of pooping may 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 trigger the 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?” |
Other common triggers for people with a fear of pooping in Contamination OCD include:
- 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
How can I tell if it’s a fear of pooping in Contamination OCD and not cleanliness, anxiety, or Coprophobia?
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 the thoughts and behaviors interfere with your functioning in one or more area of your life (i.e. family, social, work, academics)?
If the answer to some or all of these questions is yes, you may be suffering from OCD, rather than another condition like anxiety or Coprophobia. Being assessed by a trained OCD specialist can confirm whether you are experiencing OCD, and direct you toward 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 holding their bowels as long as possible
- Excessive washing rituals after pooping
- Excessive wiping and toilet paper checking to be sure no trace of feces is left behind
- Seeking reassurance from family members about things being contaminated
- Monitoring the bathroom habits of family members or loved ones
- Avoiding using public bathrooms
- Avoiding places where there might not be a bathroom
- Checking clothing for poop
- Throwing away objects that are or could be contaminated
- Mental review of contaminated areas or situations where someone may have come into contact with feces
How to overcome the fear of pooping
Contamination OCD with a focus on fear of pooping can be debilitating, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with a trained ERP therapist, individuals can find relief from the cycle of OCD. ERP is the gold standard of treatment for OCD, and it is backed by decades of clinical research. Most individuals who do ERP with a trained OCD therapist experience a decrease in OCD symptoms, reduced anxiety and distress, and increased confidence in their ability to face difficult situations.
People who struggle with a fear of pooping in Contamination OCD will work with their therapist to build an exposure hierarchy and begin working on one trigger at a time. Usually an ERP therapist will start with an exposure that is predicted to bring about a low level of fear and anxiety and work up to the harder exposures as confidence is built. When doing exposures, the goal is always response prevention: your therapist will guide you in resisting the urge to respond to fear and anxiety by doing compulsions. Over time, this allows you to tolerate anxiety about pooping and contamination, without relying on compulsions to feel better.
Examples of possible exposures done to treat Contamination OCD focused on fear of pooping include:
- 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
If you’re struggling with OCD and are interested in learning about ERP, you can schedule a free call with the NOCD Care Team to find out how treatment can help you. 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.
