Contamination obsessions and poor self grooming

[maliee]

My son has severe contamination issues, but I can't understand why he is not showering, brushing his teeth or cut his nails. It's a real struggle, but he wouldn't explain.

He smells and looks like a homeless person, but washes his hand constantly.

I just want to understand it from his point of view, it breaks my heart...

[MomWithOCDSon]

My son has severe contamination issues, but I can't understand why he is not showering, brushing his teeth or cut his nails. It's a real struggle, but he wouldn't explain.

He smells and looks like a homeless person, but washes his hand constantly.

I just want to understand it from his point of view, it breaks my heart...

 

Maliee --

 

In short, the explanation is this: OCD is not rational. It doesn't follow any rational train of thought. Therefore, the person with severe contamination issues will, like your son, wash his hands until they bleed, but he will refuse to shower. Unfortunately, it will sometimes extend to such completely absurd behaviors/thoughts as fearing eating food at home prepared by a family member because that family member will contaminate the food, but being perfectly willing to graze at a buffet bar-style restaurant where the food is not only prepared but also "picked over" by half the human race.

 

The nastiest, most insidious characteristic of OCD is that, because it wants to control the whole person, it will often render those things closest, safest, most "ordinary" and routine, as the things that should be most feared and/or avoided. So, sometimes family members themselves become "contaminated" as can ordinary, everyday places and tasks such as showering, sleeping, etc.

 

When my son was at his sickest, showering was a horrifying process. Because our son had an OCD diagnosis a full 6 years before we discovered that PANDAS was behind his behavior, we had been fully trained and ensconced in the "world of OCD." So his therapists had taught us not to negotiate with the OCD, not to allow it to overtake him, his time, his life completely. So showering was a non-negotiable; we put our feet down and insisted it had to take place. But it was at times just short of a knock-down, drag-out brawl.

 

My DS didn't want to shower because of the rituals that were required of him by the OCD during the process. So, once he was in the shower, he felt compelled to do things in just the "right" way, the "right" order. And, inevitably, it would somehow go "wrong" for him in some way, and then he would have to start all over again. And again. And again. At his sickest, he never felt he got the showering ritual "right," so his dad would eventually have to turn off the water and drag him out, physically, ending the process. On top of the drama and trauma of the rituals and the forced intervention of the ritual by us, my DS found it absolutely exhausting.

 

So, he hated it. He feared it. And he loathed it. I'm betting your DS is going through something similar, and this lies behind his choices.

 

If you don't already have an ERP therapist on board for your DS, I would suggest you try to find one. The therapy process will not only help him, but it will help you and the whole family in terms of contending with the OCD and supporting your DS rather than inadvertently aiding and abetting the OCD. There are also a number of very good books available, such as those by Dr. Aureen Wagner that can help you understand and give you tools and techniques for helping your DS at home.

[911RN]

Nancy,

 

I just wanted to say that I admire your posts. You have the knack of always saying the right thing to the right person... likely at the right time!! It is clear you have walked the walk, thus can talk the talk. You understand the OCD behavior, mindset and treatment. Your DS is lucky to have you as his Mom! It is obvious you have done your homework to help him and it has paid off. You provide such sound advice to those in need of understanding these irrational behaviors.

 

While my DS12 has never suffered with OCD to this degree (thankfully). Had I posted this question---I would have found this post to be so insightful and helpful!

 

My son's OCD is more quirky and noticed really only by those close to him. Mom mainly, Not debilitating or life altering in the grand scheme of things. We have more ticcy issues... for which, I have yet to find the magic bullet

 

Just wanted to extend a shout out for such a concise yet revealing post into the mindset of OCD behaviors. You ARE THE BOMB, MOMwithOCDson

[MomWithOCDSon]

:wub:

 

Back at you, 911RN!

 

I am so grateful to you and everyone else who's helped us over the years, I'm rewarded to think that maybe I'm able to help someone in return.

 

Your kind words are making me feel all warm and fuzzy! Thanks!

[CeeKay]

My 16 y.o. son has always had to be badgered to take a shower, but it was only a couple of months ago - at the beginning of this terrible flare-up that we only just found out is likely PANDAS or PANS, that we realized that he wasn't showering or brushing his teeth at all anymore. He would go in the bathroom and stay in there for a while, but when he came out he was dry, and looked and smelled the same as before he went in. His toothbrush was untouched. He also stopped washing his hands. When I realized what was going on, I went into the bathroom with him and pointed out the bar of soap, and shampoo, and he recoiled in horror at the sight of the bar of soap, saying "IT'S DIRTY!!!" I was so shocked, I didn't know what to make of it. He's suffered with anxiety and depression for years since his sudden onset episode at age 9, which we now realize was PANDAS, and he's had sensory issues as well, so we assumed he hated showering because he didn't like the feel of the soap and water. Now I don't know what to think as he won't touch water in any way or wash his hands. I also recently noticed that he'll only drink out of one cup and if it's not clean, he will not wash it but will badger me to wash it.

 

Speaking of sensory issues, as I said, he's had sensory issues for years that wax and wane, but lately, just the sight of food I've cooked, or other normal household sights, sounds and smells can put him in a defensive position. He saw me putting ketchup on my food tonight and he backed away from the table and averted his eyes and covered his ears in such a violent reaction to the squeaky noise of the ketchup bottle being squeezed. Last week I made chili, a food he used to love, and when he came to the table and saw the bowl sitting on the table, he let out a scream at the sight of it! I can attest that it looked the way chili is supposed to look!

 

I guess I have lot to learn. Despite my son being in therapy for four years now, no one ever said "OCD" to me. I heard about anxiety, depression, Asperger's, and many other things, but I had always associated OCD with handwashing or lining up hand towels. I have a lot of catching up to do in figuring this all out. I agree that Nancy has been most helpful in her posts and appreciate everyone who takes time to explain things to newbies like me.

 

Carol

 

My son has severe contamination issues, but I can't understand why he is not showering, brushing his teeth or cut his nails. It's a real struggle, but he wouldn't explain.

He smells and looks like a homeless person, but washes his hand constantly.

I just want to understand it from his point of view, it breaks my heart...

 

Maliee --

 

In short, the explanation is this: OCD is not rational. It doesn't follow any rational train of thought. Therefore, the person with severe contamination issues will, like your son, wash his hands until they bleed, but he will refuse to shower. Unfortunately, it will sometimes extend to such completely absurd behaviors/thoughts as fearing eating food at home prepared by a family member because that family member will contaminate the food, but being perfectly willing to graze at a buffet bar-style restaurant where the food is not only prepared but also "picked over" by half the human race.

 

The nastiest, most insidious characteristic of OCD is that, because it wants to control the whole person, it will often render those things closest, safest, most "ordinary" and routine, as the things that should be most feared and/or avoided. So, sometimes family members themselves become "contaminated" as can ordinary, everyday places and tasks such as showering, sleeping, etc.

 

When my son was at his sickest, showering was a horrifying process. Because our son had an OCD diagnosis a full 6 years before we discovered that PANDAS was behind his behavior, we had been fully trained and ensconced in the "world of OCD." So his therapists had taught us not to negotiate with the OCD, not to allow it to overtake him, his time, his life completely. So showering was a non-negotiable; we put our feet down and insisted it had to take place. But it was at times just short of a knock-down, drag-out brawl.

 

My DS didn't want to shower because of the rituals that were required of him by the OCD during the process. So, once he was in the shower, he felt compelled to do things in just the "right" way, the "right" order. And, inevitably, it would somehow go "wrong" for him in some way, and then he would have to start all over again. And again. And again. At his sickest, he never felt he got the showering ritual "right," so his dad would eventually have to turn off the water and drag him out, physically, ending the process. On top of the drama and trauma of the rituals and the forced intervention of the ritual by us, my DS found it absolutely exhausting.

 

So, he hated it. He feared it. And he loathed it. I'm betting your DS is going through something similar, and this lies behind his choices.

 

If you don't already have an ERP therapist on board for your DS, I would suggest you try to find one. The therapy process will not only help him, but it will help you and the whole family in terms of contending with the OCD and supporting your DS rather than inadvertently aiding and abetting the OCD. There are also a number of very good books available, such as those by Dr. Aureen Wagner that can help you understand and give you tools and techniques for helping your DS at home.

[Brese]

My daughter would also refuse to shower and constantly washed her hands. OCD does not make any sense an can't be made logical. One day she finally told me that she was afraid of the chemicals in the body wash and hair soap and it ran down her whole body and she could never get it all off. I was afraid to ask her why the hand soap was different because I did not want her thinking about it too much. She was also afraid of the soap the dishes were washed in and laundry detergent.

 

At one point she had so many different OCD issues I thought I was loosing my mind that I could not help her. One Christmas morning was the worst after she opened her gifts she started sobbing that she could not play with any of them because she touched them and they were contaminated. I went to hug her and she was afraid she would contaminate me. She ripped off all her clothes ran outside and laid in the snow naked. She said there is nowhere she can be that is not contaminated and where she felt ok. Everyday I would have to buy her new clothes because we could not wash them and after a few hours they were contaminated again. Shirts, pants, underwear, socks, shoes, jackets. These are things that many people can't understand and even if they say they do they can't really. The good thing is everyone hear has a better understanding of the confusion, anger, sadness, triumph, fight, dedication and energy it takes to see this through.

 

On the upside the CBT helps and we reinforced it at home. Her friends knew she had PANDAS OCD and also worked at helping her. She also took SSRI. We were lucky that the IVIG seems to have cured all her symptoms for almost 2 years.

 

It takes time and effort but it does get better. There are really tough days and then days you can see glimmers of your child again. Hang in there!

[3bmom]

Nancy you do have a wonderful ability to explain how irrational this disorder is.

 

My DS looked like a homeless person too and he chose to go to school because he wanted to see his friends so much. Just thinking about it makes my stomach hurt. He also chose not to eat because he didn't want to grow taller. Lost 30lbs in 2 months. When he was at one of the top hospitals and they told me we had parenting issues I asked if he had showered in the 4 days under their watch....They hadn't even noticed he had not taken a shower or taken his hat off where he hid a rats nest of hair. They also failed to notice he only ate ice cream because everything else tasted weird, which I later learned was just food with protein in it to "Make him big and strong",so he avoided it. Talk about irrational.

 

Later after 3 infections were addressed with abx and antivirals, along with diet, he cut his hair and started a new chapter in his life.

 

An earlier flare we had no Dr. and did CBT. It is amazing too.

 

I think the combo is a great step to healing.