Amid coronavirus, when we’re told to ‘stay alert’ and stay home to avoid a looming, invisible threat, it makes sense that a simmering fear of germs, dirt, and contamination may boil over.
That fear, mysophobia, is often experienced by those with obsessive compulsive disorder (OCD) – although it’s important to note that OCD comes in many forms and is not always about germs and cleanliness – but one expert says that she’s seen many people newly experiencing the terror as a result of the pandemic.
Dr Martina Paglia, a psychologist at The International Psychology Clinic, tells Metro.co.uk: ‘Mysophobia, a fear of germs in general, usually begins in late childhood or early adolescence.
‘Since the pandemic, some of my clients with OCD have developed specific fear for catching Covid-19 germs.
‘I have clients who have had OCD for 10+ years, and since the pandemic the fear has shifted from generic germs to catching Covid-19.’
Martina gives an example of Rita, someone struggling with mysophobia as part of OCD.
‘Rita came into contact with dirt while cleaning her house,’ Martina explains. ;She start to think: “What if I fall ill or get an infection? What if I make someone else ill?”. As a result, she gets worried about getting sick or making others sick.
‘She starts to display compulsive behaviours, which act to neutralise intrusive thoughts, such as washing her hands several times and other routines such as checking that environments are completely clean in the future.’
It’s those compulsions that show when a phobia has trickled into obsessive compulsive disorder.
The difficulty in recognising and treating this during coronavirus lies in the idea that our compulsions might actually be the ‘correct’ thing to do – excessive hand-washing, refusing to leave the house, and avoiding contact with others are all praised behaviours amid a pandemic.
Add in the soothing effect of these compulsions, and it’s all too easy for these to become the go-to for coping with overwhelming and distressing obsessive thoughts.
‘Obsessive Compulsive Disorder (also known as OCD) is a mental health condition characterised by obsessive and/or compulsive symptoms that cause intense anxiety and fear,’ says Martina. ‘Obsessions can be defined as recurrent, repetitive and persistent thoughts, impulses or images, experienced as intrusive and unwanted.
‘Often those affected by obsessions try to ignore or suppress such thoughts or attempt to neutralise them with other thoughts or actions, without however succeeding. Obsessive thoughts are unpleasant. They can cause fear, anxiety, tension or even disgust.
‘Compulsions can be defined as repetitive behaviours or actions that the individual feels obliged to implement in response to obsession(s) or according to rules that must be applied rigidly. Compulsions can be seen as actions that are aimed at preventing or reducing anxiety.
‘However, these behaviours or actions are not realistically connected with what they are designed to neutralise or prevent, or are clearly excessive.
‘[In the case of Rita], dirt was the precipitating factor that led Rita to experience feelings of anxiety.
‘To reduce this anxiety Rita began to wash her hands repeatedly until she felt calmer. This compulsive/safety behaviour is a perpetuating factor, as Rita will continue to do this in the future, as she has learned that this is an effective way of reducing her anxiety.
‘However, this is blocking her from learning that no-one will become sick as a result of dirt in the environment, or that if they did become ill that this would be minimal.’
A fear or worry about germs is normal and to be expected, especially with all the messaging around coronavirus and the reality of the virus’ devastating effects.
But when that fear becomes overwhelming and is affecting your everyday life, that’s a sign there’s a problem.
So, how can you deal with it?
‘CBT (cognitive behavioural therapy) is the best therapy for OCD,’ says Martina. ‘Exposure therapy is undergone where the client is forced to fight the obsessive thoughts and not to act upon them. It requires some time but it is a process of learning. CBT teaches the client to face the fears because it forces them to face the same situation every time but with better handling. Brainspotting and EMDR therapy can also help treating OCD.
‘It would be helpful for Rita to be exposed to dirt so that she learns that these situations are manageable and that nothing awful happens as a result.
‘Rita would also need to engage in response prevention, which means that she would not engage in her compulsive behaviour. Engagement in compulsive behaviours during exposure work is counterproductive, as this would lead Rita to believe that her rituals are keeping her safe. By preventing herself from engaging in compulsive behaviours Rita learns other ways to manage her anxiety and realizes that it is not the compulsive behaviour that is protecting her.’
It’s crucial that anyone struggling reaches out for help rather than trying to battle through OCD or an overwhelming phobia alone.
It’s still possible to access therapy in lockdown, often in the form of online or over-the-phone appointments, and medication can also help to treat OCD.
Get in touch with your GP or approach a private therapist if you’re finding a fear of germs is becoming overwhelming.
Try to fact-check those intrusive thoughts that tell you disease is all around by remembering that germs are not all bad and the worst-case scenario is rarely the most likely one.
We spoke to microbiologist Nicky Milner earlier in the pandemic, and she had this hope for life during the pandemic and long after it: ‘I would like to see greater public awareness of the invisible world of microorganisms and recognition that not all microorganisms cause infection – in fact, we cannot survive without the good microorganisms, such as those which help us digest our food, for example.’
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