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Some people like to ask when does washing your hands stop being good hygiene and start being ocd? Well, let's chat about that. I'm Dr. Patrick McGrath, I'm the Chief Clinical Officer for NOCD. If you're looking for help for OCD or related conditions, check us out@nocd.com that's n o c d dot com. We know that social media is full of all sorts of content about hygiene. Don't wear outside clothes inside or touch your your bed or, or you have to take your shoes off when you come in the house or you have to wash your hands and do all sorts of things. Maybe the hygiene Olympics or something like that. This is something I guess on social media, this is my maybe being older and lack of things but people are doing things like showcasing the excessive multi step cleaning that they're doing or bathroom routines like everything, showers, washing raw chicken and to extraordinary levels disinfecting hotel rooms, using different towels for different parts of the body after you shower or even multiple tools for one task to prove superior cleanliness. Most of this content I think is presented in an attempt to sound reasonable and to be healthy. But we know this, for people with ocd this can be very, very confusing because OCD will focus only on the worst case scenario. So you know, if someone with OCD sees one of these videos and says, oh, look at all that they did about the chicken. That's the new standard now of how I handle chicken, right? And it must be that way and every restaurant I go to must do it that way and everyone's home or else I'm not going to eat it, I'm not going to touch it, right? OCD latches onto these things that we care about that are important to us and finds what's the worst case scenario in any of those related things and then jumps into what if that were to happen? If I were involved in that, what if I were to do this? And you might not be surprised to learn that contamination and health related fears are very common symptoms of ocd. And all we need is to talk about COVID and flu season and RSV and other things and boy that just can intensify a lot of these concerns. And maybe, you know, some people have been sick over this season and well, the line between what's a reasonable cleanliness and OCD can really blur for a lot of people. So, so here's the deal. I don't want people to be unhygienic, right? Hygiene serves a very practical purpose. It reduces risk of illness to a Reasonable degree. I want people at the restaurant I'm going to to use good hygiene, right? I want them to follow the rules and regulations. That's the things that are set up. And you know, restaurants get graded on these types of things. And that's the stuff that I want to see. I, I like the fact that we have rules that say have to use the bathroom and you're working at this restaurant. Wash your hands. Employees must wash hands. That's ok. Wonderful. That's good stuff. However, what if we take it to the nth level? What if we go above and beyond right? Compulsions serve an emotional purpose for us. It reduces anxiety. It achieves this sense of everything feeling just right. And so what I want you to think about is, are you doing things the way that are suggested, or are you going above and beyond to serve what OCD says is the right thing to do? And let's face it, let's be glad that OCD is not in charge of society, because if it was, we would not be here within six months. Let me give you a quick example of that before I go back into hygiene things. Just imagine if OCD was in charge. Nobody would drive anymore because we'd be afraid of running people over with our car. Which means there's no more delivery of gasoline, there's no more delivery of food. So now we have to walk everywhere that we want to go. Right now in doing that, well, guess what? The grocery store is going to be cleared out within a couple of days. And there are people who aren't going to be able to get to work, who work at the water plant, the power plant, the gas plant, all those types of things. And the people who do get there don't want to work them anymore because what if they don't do the water the right way in terms of filtering it and somebody gets sick so no one filters water anymore. What if we don't run the power plant anymore because we're afraid? What if we cause a surge so there's no power anymore? What if we don't run the gas plant anymore because what if there's a gas surge so we don't have gas anymore, so within a couple of days all utilities are shut down? And now there's no more food at the grocery stores, there's no utilities, nobody's driving anywhere. So now we're forced to just live off the food that we have in our homes. And how do we heat it? Well, we start cutting down all the trees and everything in order to have firewood. But maybe we're also afraid of all the carbon that's putting in the air with the fire. So who knows if we even have fires anymore or not. And as you can see, society just collapses if we just do what OCD wants. So I say all of that as we discuss hygiene to get you to recognize that using OCD as our barometer for what to do, not a great idea. Here's the things with hygiene, maybe you feel a bit uncomfortable, you can move on. Right. OCD says, though, no intense anxiety, dread, terrible, awful things are going to happen. So are you changing clothes after being outside because you prefer clean clothes when you're inside, or is it driven by this intense distress and fear of contaminating your safe space? Right. Okay. If. If you've been working out in the garden all day and your clothes have a lot of dust or pollen on them and you don't want that spread around your house, that's fine. Versus all right, I'm going to go in the garage, I'm going to strip naked, I'm going to put them in a bag and have to take that right in the laundry, run it three times in order to get all the pollen out, go take two showers to make sure that I'm clean and everything's fine. That's going above and beyond. Right. Are you doing behaviors that match what health authorities recommend? The CDC guidelines say using soap and water for 20 seconds when appropriate for washing your hands. Are you deciding that, well, that's a good start, but five minutes would be much better. Multiple different soaps and the water's going to be scalding hot and my skin's going to be raw. And that's when I know that I've actually taken a layer of skin off that's taken all the germs off with it, and then I'm clean at that point. That's when your skin starts to crack and peel and bad things start to happen. Right. And then what are you going to do? You're going to look at your hands and go, oh, cracked and peeling. Lots of germ potential to get in there. I better go wash my hands more. And the cycle starts all over again. Is this taking up a lot of your life? Right. Is this causing a ton of time and distress and limiting your activities? Right. If you're doing things hygienically, they can be quick, automatic. They don't really disrupt your day much at all. But if it's for ocd, substantial amounts of time. Right. Causing a lot of distress, it can prevent you from doing Things that you'd otherwise do or it could lead you to miss things. Right. I don't want people coming over to the house until it's cleaned in a certain way, which means nobody actually comes over. I don't want to go to anyone else's home because I don't know if they clean things the right way. You're isolating more and more now all out of these fears of what if types of things. Right. So if you're spending 30 minutes showering, brushing your teeth and getting ready for the day and it takes a half hour for all those things versus a two hour shower, following all sorts of teeth brushing, types of things, following ways that you put your clothes on and the clothes can't touch the floor, maybe because the floor might be dirty. And then if it does, I have to start all over again. And now I've missed work and I've already had a warning at work that if I miss again, I'm going to get fired. And now it starts to affect my livelihood. These are things to really start to pay attention to. Right. Are you able to adjust the behavior if circumstances require it, or does it feel like you must do things in a certain way for hygiene? Yeah. Okay, you know what? Drop something on the floor. A lot of people play the old five second rule, like, okay, whatever kind of thing OCD says, nope, can't do that. Not allowed. You cannot change anything whatsoever. There's no adjustments that are allowed. There is a right way to do it. Everything else is the wrong way. And if you deviate from the right way, terrible, awful, horrible things will happen. So maybe you can normally wash your hands after you use the bathroom, but if you're camping, it might just be like some hand sanitizer or rinsing in the stream or something like that. Versus nope, I've got to go trek two miles over to where the bathroom is because I have to use soap and hot water in order to do this. So every time that I have to wash my hands, I'm going to look at maybe an hour trek there and back before I can rejoin all of my friends. Sorry. OCD can really get in the way and be a bit of a buzzkill on our day to day life. So if this relates to you, it's worth exploring whether OCD might be at play. Contamination OCD is treatable with exposure and response prevention therapy. And please note that at nocd, all of our therapists are really trained in ERP and we have people waiting to chat with you right now on our intake team. Who are there to assist you and get you hooked up with one of our well trained therapists. They will understand the nuances of ocd. They're not there to judge, they're there to assist. If this sounds like something that would be helpful to you, go to nocd.com that's no c d dot com. We'd love to book a time with you with one of our intake specialists who can help you get set up with one of our therapists so you can start life changing exposure and response prevention therapy. We hope to hear from you soon.