OCD and Showering

When my son Dan was in the throes of severe obsessive-compulsive disorder in 2008, he would sit in his “safe chair” for eight hours at a time. He was literally “stuck.” While I didn’t realize it at the time, getting stuck, or more accurately, becoming a slave to OCD’s demands, is part of what severe OCD is all about. Never-ending compulsions take over your life as you try to achieve certainty that all is well.

I’ve always found it particularly heartbreaking when OCD latches on to our most basic needs such as loving relationships, eating, and physically caring for ourselves. One of the more common compulsions that is often used as an “example of OCD” is hand washing, which can indeed be so severe that scarring, bleeding, or infections occur. The person with OCD cannot stop washing until their doubt and anxiety subside.

What perhaps is less known to people who are not directly affected by OCD is that showering is also a common compulsion. While those with obsessive-compulsive disorder might believe they are just trying to get clean, showering as a compulsion serves the same purpose as all compulsions — to reduce anxiety and uncertainty. Some people will insist on using scalding hot water, while others will have rituals that need to be done in a certain manner. If something is done “incorrectly,” the person with OCD feels the need to start all over again. At the very least it is tiring and draining, and in the worst-case scenarios it is completely debilitating. I personally know of a young woman who got “stuck” in the shower for ten hours and had to be physically removed. As I said — heartbreaking. A basic activity of daily living turned into a nightmare.

What leads to this nightmare? How and why do things get that bad? Well, as with all types of OCD, it starts with an obsession. In those with shower compulsions, obsessions typically include contamination fears or germ phobias, but that isn’t always the case. OCD has an impressive imagination and can latch on to anything. For example, someone with OCD might fear harm coming to someone they love if they don’t wash each body part ten times in the shower. While the person with OCD typically realizes this makes no sense, there is always that doubt, and the compulsions are then carried out. Unfortunately, that’s never the end of it. The reassurance that compulsions provide is addictive and just as with drugs, tolerance rises and more and more compulsions are needed to feel that sense of relief. Before you know it, you’re in the shower, unable to get yourself out.

I know that even with this explanation, it is hard for those of us without obsessive-compulsive disorder to understand. Why can’t our loved ones just get out of the shower? Shut the water and get out!? It is difficult for us to comprehend the level of fear and anxiety they are dealing with.

But there truly is good news. Obsessive-compulsive disorder, no matter how severe, is treatable. The frontline psychological therapy for the treatment of the disorder is exposure and response prevention (ERP) therapy, and it works. Remember the young woman who was stuck in the shower for ten hours? After two months of intensive ERP therapy, she now easily takes fifteen-minute showers. She is in charge of her showers, and her life, now. Not OCD.

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