What is Contamination OCD?


– Carolyn Moriarty, LCPC


Contamination OCD is among the many subtypes of Obsessive-Compulsive Disorder (OCD). Before looking more closely at this particular subtype, let’s do a quick review of OCD.

OCD is characterized by the presence of disturbing thoughts or images (obsessions) that are intrusive and unwanted. As a result, people with OCD feel driven to engage in repetitive mental or behavioral acts (compulsions) that help them to feel that they are preventing a feared outcome.

These compulsions are effective in the short-term because they can immediately extinguish intense guilt, shame and anxiety. However, the relationship between obsessions and compulsions is cyclical, with one only serving to reinforce and perpetuate the other.


What is Contamination OCD?


Contamination OCD is characterized by intrusive and distressing thoughts and obsessions related to contamination (i.e. fear of germs/ bacteria or feeling “unclean”) and a compulsive need to engage in cleaning, washing, or other rituals to reduce anxiety associated with perceived contamination.


Contamination OCD vs. Mysophobia 

Contamination OCD and mysophobia both involve concerns about contamination and cleanliness but they are not the same.

  • Mysophobia is specific phobia that involves an intense fear of germs or dirt without the presence of obsessive thoughts or compulsive behaviors. 
  • People with mysophobia still experience distress, but the distress is related to the germs and bacteria themselves.  They chose to avoid dirt and engage in cleaning because it brings them peace of mind.
  • People with contamination OCD have intrusive, distressing and unwanted thoughts about being contaminated. These intrusive thoughts cause great anguish and torment.
    • For example, they may obsessively worry about getting sick and causing harm to themselves or others, which would make them “bad” or “immoral”. An idea like this can turn into non-stop obsessions that can fill individuals with confusion, fear, and dread.
    •  They believe the only way to prevent their feared outcome is to engage in compulsive cleaning rituals–not because they want to, but because they feel like they have to.


In summary, contamination OCD is characterized by intrusive thoughts and compulsions related to contamination and cleanliness. Mysophobia, on the other hand, is a specific phobia that involves an intense fear of germs or dirt without the presence of obsessive thoughts or compulsive behaviors.




Let’s look at some examples of obsessions and compulsions involved in the contamination OCD subtype.



People with contamination OCD may fear not being perfectly clean, being permanently contaminated, contracting a disease from touching a contaminated object or unintentionally passing along a disease or virus to someone else.

Obsessions such as these can manifest in various ways, such as:

  • fear of touching objects or surfaces: individuals may fear touching doorknobs, public restrooms, money, or other items they perceive as dirty or contaminated.
  • fear of bodily fluids or waste such as saliva, urine, or feces, leading to avoidance of situations or objects associated with them.
  • excessive worries about contracting diseases or illnesses from everyday objects or interactions, even when the risk is minimal.
  • intrusive thoughts or mental images related to contamination, which can be distressing and difficult to control.



To neutralize the anxiety and distress caused by these obsessions, individuals with contamination OCD typically engage in compulsive behaviors or rituals.  However, these behaviors provide only temporary relief and only serve perpetuate the cycle of obsessive thoughts in the long run.

Compulsions may include:

  • excessive cleaning or washing: individuals may engage in repetitive and lengthy cleaning or washing routines, often using specific techniques or products to remove perceived contamination.
  • avoidance behaviors: people with contamination OCD may avoid situations or places they believe to be contaminated or avoid social gatherings in order to safeguard against transmitting sickness to someone else.
  • rituals to prevent contamination: people may develop complex rituals or rules to prevent contamination, such as avoiding certain colors, numbers, or patterns.




Treatment for Contamination OCD usually involves:


Exposure and Response Prevention (ERP)

  • ERP exposes a person to a stimulus (i.e. person, person, thought or memory) that produces anxiety or discomfort. Throughout the exposure process, the individual is encouraged to actively resist engaging in their typical response to that trigger. This allows people to learn that their feelings of discomfort and doubts naturally subside on their own without them doing anything about it.

Acceptance and Commitment Therapy (ACT)

  • ACT is an additional treatment modality that can be incorporated into OCD presentation. The intolerance of uncertainty is very common for people struggling with OCD, and acceptance can be an integral part of treatment by learning how to tolerate feelings and thoughts that may have once seemed unmanageable. Instead of trying to fight off compulsions with rituals, ACT helps guide the person towards acceptance of thoughts and feelings as part of the experience of life. ACT works to help teach the individual that these compulsions can come and go rather than getting stuck.


  • Medications like selective serotonin reuptake inhibitors (SSRIs) may be prescribed to help manage anxiety and obsessive thoughts.


Seeking Mental Health Support

It is important to not feel silenced by your OCD. Although the disorder can feel isolating, it is more common than you would think. Many people who struggle to cope with OCD symptoms often feel too ashamed to speak about them. This is unfortunate, since speaking up about an overwhelming feeling or fear can strip away the power it has over you. You might want to consider scheduling an appointment with Chicago Counseling Center to meet with our therapists who specialize in treating OCD.  Meet our team to learn more!

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