17 June 2017

The Fish Tank Compulsion

Many people associate hand washing with OCD. The person obsesses over hand cleanliness, so they create a ritual around washing their hands properly to alleviate the anxiety. Sometimes the ritual is scrubbing a certain number of times. Sometimes it is a certain manner of washing to get rid of all the dirt and germs. Regardless, continually washing ones hands all day does not actually accomplish anything positive. Even I have dealt with compulsions in the form of rituals to achieve the necessary level of cleanliness.

Before college, I had a fish tank. Cleaning that fish tank brought up a lot of contamination issues. I put towels down everywhere so no stray drop could get through. Once the dirty water was out and the clean water in, it was time for decontamination. Everything had to be done in a very specific order to prevent contaminating anything. First my clothes went into a pile in the bathroom. I carefully piled them such that no wet spots touched the floor. Then I washed my hands and arms three times, as three was number necessary to get rid of any yucky fish water. If I didn't feel like I sufficiently scrubbed myself, it become four or five times. Next, I wrapped myself in a clean towel and went back to my room to change. All the towels and clothes were carefully carried downstairs and straight into the washer. Just in care, I washed my hands again between carrying the pile and turning on the washer. No sense in getting fish water on the washer controls. Finally, I sprayed down everything with antibacterial cleaner. The outside of the fish tank, all nearby hard surfaces, the bathroom sink. Everything. After waiting a few minutes for the cleaner to work, all the surfaces were wiped down with paper towels. The paper towels went straight into the trash. Finally, I washed my hands another three times. Contamination from the fish water was my obsession and this ridiculous cleaning strategy was my compulsion.

What happened if something went awry in my plan? Disaster. One time I ran out of antibacterial cleaner. I needed a new bottle from under the kitchen sink. I tried to open the door with my foot, but the childproof lock kept me out. I asked my dad to open the cabinet for me. He refused, saying I should open it myself. In desperation to finish my cleaning, I eventually opened it myself while in a teary mess. My life-preserving decontaminating ritual was ruined.

For years, I refused to touch that part of the cabinet. No amount of scrubbing or chemicals could disinfect that area sufficiently, as the fish water penetrated the wood. In fact, I never touched it again. It wasn't until the cabinet was replaced that I opened the door under the sink normally.

Such a rigorous cleaning regiment is clearly not necessary to prevent fish water from ruining my life. Fish water isn't even that horrible compared to other possible contaminants. Somewhere in my brain I always knew this wasn't logical. And yet I continued for years, as performing the compulsion was infinitely better than not doing it.

After years of cognitive behavioral therapy, I now know how harmful it is to keep performing the compulsion. Instead, through countless hours of exposure and response prevention (ERP), it is possible to overcome the compulsion. Exposing yourself to an obsession and sitting through the anxiety instead of performing the compulsion is incredibly hard by itself. A therapist or ERP coach makes it mind-numbingly painful by constantly reminding you about how horrible the situation is and not letting you cheat. Eventually, the ERP makes it possible to function without performing the specific compulsion. Sometimes the compulsion goes away completely. Other times, the desire to compulse remains, but is bearable. Either way, it's better than living with horrible, time-consuming ritual.

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