Q. I have had an Obsessive-Compulsive Disorder for years. I use paper plates because I think dishes are “contaminated.” I am fearful of touching my children’s clothing if they have been outside. If I touch “contaminated” things, I have to wash my hands 20 times or more. I have no health insurance. What can I do on my own to resolve this problem?
A. The most effective treatment for OCD is called Exposure Response Prevention (ERP). Exposure means confronting those items such as “contaminated” dishes or clothing that make you anxious. Response Prevention means remaining in the situation and not engaging in ritualistic behaviors to lessen the anxiety. Start your ERP exercises by eating from a dish that you perceive as “contaminated.” Then don’t wash your hands or engage in any other ritual. Your anxiety level will rise immediately because you will feel contaminated; however, you should stay with the anxiety until it subsides.
After you have conquered one of your fears, you will feel empowered to take on more difficult assignments. Wear or hold a jacket or shirt that one of your children wore outside. Your anxiety level will rise. Stay with it without performing rituals, and your anxiety will gradually subside. Continue this activity until you no longer avoid touching your children’s clothing or anything else that you feel may be contaminated.
Exposure Response Prevention can be moderately easy or extremely difficult depending on the severity of your OCD and your willingness to work an ERP program. There are many excellent self-help books and workbooks on OCD. You can do a search on-line for these or go to one of the many OCD websites.
Q. My daughter, who is 15, worries about going to hell. She has been saved and baptized, but she continues to have fears. Every few days she will ask me, “do you think I’m going to hell.” I try to reassure her that she is fine, but she is getting worse. I think she may have a serious problem since this is all she thinks about.
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A. Your daughter seems to be suffering from a form of OCD called “scrupulosity.” People with this disorder have recurring religious obsessions that cause anxiety. Regardless of how much your daughter attempts to control her thoughts, the obsessions persist. Because these worries become intertwined with her religious beliefs, it is difficult for her to understand that this is a mental health condition and not a religious failing.
Some of the other “scrupulosity” symptoms she may experience are excessive praying or reading scriptures, repeating Biblical passages over and over, or making pacts with God or Jesus. These actions may seem normal at first, but they may become out of control as her stress levels and fears increase. I treated a patient who was forced to quit her job as a school principal because she prayed over 6 hours a day.
The more reassurance you give your daughter, the more she will need. Although we like to reassure those who are distressed, it increases obsessive thinking in someone with OCD. As her fears become more pronounced, she could begin asking you several times a day to reassure her that she is not going to go to hell.
Some ministers are trained in recognizing religious scrupulosity. If your minister does not have the training, find a counselor who understands OCD. Additionally, many anti-depressants are effective for treating scrupulosity, so I suggest that your daughter have an evaluation by her physician or a psychiatrist. The combination of therapy and medication can often alleviate these obsessions in a short period of time.
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Nancy Ryburn holds a doctorate degree in psychology. She teaches psychology at Southeast Arkansas College and maintains a limited private practice in Pine Bluff. If you have questions pertaining to mental health, e-mail them to drnryburn@gmail.com. The questions will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.