Contamination OCD and The Senses

Let’s talk about trusting the senses in Contamination OCD. Contamination OCD comes down to not trusting our 5 senses in some situations and not trusting our common sense in others (or not trusting both). For the sake of this post, we are going to talk about physical contamination (and not emotional contamination which we will address in a future post).

"The Invisible"

First - let’s talk about how we interact with the invisible in our day to day lives.

When it comes to invisible things (bacteria, viruses, chemicals, pollutants, gases, etc), we have to imagine them in order to interact with them appropriately. When someone is vomiting or bleeding, we know not to touch it because it could contain dangerous germs. We know not to mix certain chemicals together because it can create hazardous gases. These things are invisible - but we still can anticipate their danger.

This is all due to one thing: CONTEXT

Context is Important in Contamination OCD

Since we have to use our imaginations to interact with invisible things to begin with, we have to use context to help us know when we need to worry and when we don’t.

We do NOT rely on possibility alone when dealing with the invisible. We use our common sense and 5 senses in the context of the present moment to tell us if a possibility is relevant (if it is something we need to act upon in this moment in time).

Examples of Reasonable Doubt and The Invisible

Carbon Monoxide is invisible.

It’s possible it could be in any room you are in. That’s possible - BUT - do we need to be concerned? Not without direct evidence in that context.

If the carbon monoxide detector beeps- now we have direct evidence from our senses (hearing) which makes the possibility relevant in that context. “Maybe there is carbon monoxide present” is now a Reasonable Doubt.

But if the carbon monoxide detector wasn’t beeping, then we don’t have direct evidence in that context. The doubt would be Obsessional Doubt.

Getting rabies is not a good thing.

It’s possible that an animal could carry the rabies virus BUT - do we need to avoid all animals? Only in contexts where our common sense and 5 senses tell us that the possibility is relevant.

If you are bitten by certain wild animals- “Maybe I could have been exposed to rabies” is now a Reasonable Doubt. But if it is by a dog who has been vaccinated against rabies without fail every time they are due for their next dose, the doubt would be Obsessional.

Common sense lets us know we are protected in that context.

Contexts in Which the Invisible is Supported By the Senses

In what contexts, do we need to take actions in regards to invisible germs?
Here are a few:
We are surgeons prepping for surgery.
We see mold or smell rotting food.
The person next to us is sneezing and coughing.
Someone in our home is vomiting.
We handle blood samples/needles and were exposed.
We see visible urine or feces on our hands.

In what contexts, do we need to take actions about chemicals/gases/carcinogens?
Here are a few:
We work in a chemical lab and the ventilation hood stops working.
We are contractors working where asbestos is known to be present.
We smell cigarette smoke.
We see labels warning us that something is hazardous if inhaled or touches skin.
We are told by our housing inspector that radon gas is present in most homes in the area.

Physical Senses, Common Sense, and Context

Our physical sense can be helpful to a point. We can see or smell things that science has told us are more likely to contain dangerous invisible things (blood or feces for example).

Our common sense helps us find contexts where dangerous invisible things are relevant as well. When our physical senses alert us to a context that has a possible contaminant, we can follow up with common sense to see if that fits the current context to the point of action.

For example: Your child (who is not ill) vomits due to motion sickness. Your eyes see vomit, but your common sense can notice that the vomit is not due to norovirus. You are using context to determine the vomit isn’t harboring a highly infectious virus.

Here's another example where our physical senses and common sense help us identify contexts in which the invisble danger isn’t relevant:

Your work has signs that state that there is contained asbestos in the building. The signs have been there for years. There is no on-going construction or holes in the ceiling or walls. The flooring is all new.

Your eyes have alerted you to a situation in which a dangerous substance in on the premises. But your common sense helps show you that in this context, you don’t need to take action. Asbestos contained in walls is not a danger.

It Seems Like We Have to Rely on Our Imaginations, But We Don't

Contamination OCD can be awful to live with.

We are taught to wash our hands because germs are invisible. We are taught to use detectors in our homes because dangerous gases can be invisible. Experts seem to tell us to imagine the invisible and then act on it. But that isn’t what they are saying.

They are saying to act on it when the senses show that a certain context lends itself to danger in regards to the invisible. A way out of contamination OCD’s clutches is to consider the invisible as irrelevant until your senses alert you to a context in which it is now relevant.

Remember:
Direct Sense Data + Context = Relevant Possibility No Direct Sense Data/Out-of-Context Info = Irrelevant Possibility Possibility alone is NOT enough to act upon.

The evidence cannot come from what you IMAGINE to be there - it needs to come from your physical senses/common sense IN CONTEXT.

Source:

Adapted by OCD Training School from: O’Connor, K., & Aardema, F. (2012). Clinician’s handbook for obsessive compulsive disorder: Inference-based therapy. Chichester: Wiley-Blackwell.