How to coach someone out of excessive showering

[0CDspouse]

My spouse has OCD and frequently showers for long periods of time, often 5-12 hours straight. His fear is of contaminating others with his bodily fluids - feces, urine, sperm. How do you coach someone with this fear through taking a normal shower? Once they're in the shower and stuck in a loop, how do you coach them out of it so they can finish their shower and get out? He showers every time he poops and frequently after urinating. He has a very specific way of wiping, and if it doesn't go exactly perfect, he ends up in the shower. How do you coach someone through this? To him, these are not only cleanliness issues, but there is a moral component in his mind, which is the strongest driver. Does anyone have experience in helping a loved one through this?

[MothFir]

Is he in therapy or taking medication for his disorder? ERP (Exposure and Response Prevention) is the proven therapy for OCD and can be especially effective for contamination concerns. You and he could attempt it through self-help materials but having his own OCD therapist would likely be more efficient, especially if his OCD is as severe as you describe.

I have contamination fears as well, and they often cause me to worry more about contaminating others than myself, just like your husband. ERP has helped me immensely, as has a moderate dose of SSRI medication (prozac in my case). Your husband needs a therapeutic approach that will help him reframe his fears and recognize that they are not based in reality. Once he fully recognizes that he is experiencing highly realistic and very urgent danger signals that are actually meaningless and do not reflect genuine significant concerns, he can begin working to reduce his compulsions gradually and eventually get to a place of normal behavior.

Once someone is "in a loop" of compulsions it is much, much harder for them to stop than it is for them to not start the loop to begin with. As I have worked toward recovery, I've had to recognize that doing "just a little compulsion" to relieve momentary anxiety often leads into long, panicked compulsive loops. ERP does not require stopping compulsions cold-turkey, but it does require a systematic approach to expecting anxiety around certain triggering activities and responding according to predefined rules (like limiting shower time). Again, it's easier to follow those rules if your husband gets into a mindset where he accepts his terrifying anxiety and guilt as byproducts of a mental disorder and not legitimate signals of contamination or wrongdoing.

It is not easy, but it is possible, and it is definitely preferably to a life of servitude to OCD!

[LuvSun]

Hi there! I can only relate to your situation from the viewpoint of someone with contamination OCD myself. I also worry about contaminating others through bodily fluids. I have never showered as long as your husband but I have always had a very ritualistic way in which I showered. It got to the point that I dreaded even having to take a shower. My husband actually got in the shower with me and tried to show me the “ normal” way to shower to cut down on the time and manner. It really helped me a lot ( even though I still am ritual about it but I have cut down on the amount of time and soap that I used to use.

[mmmmww in reply to LuvSun]

This is a good way of helping, by showing "normal" shower routines.I too am a contamination OCDer, I too have a "shower routine" but each time I have a shower, I try and eliminate one "step" of my routine at a time. For example, if part of my routine consists of using soap, scrubbing under my nails, and rinsing under my nails, after each body part wash, I try and eliminate one part of it, so will only rinse under my nails without the use of soap. I will do this a few times and then when confident/comfortable, move on to eliminate another step, like not cleaning under my nails after washing my arms, for example.

One little step at a time. It takes quite a while to do, but it does help in the long run.

And as the previous poster has mentioned, I also find it helps to think of how "normal" people do things. When I get a "washing compulsion" I try to stop and think "would my husband wash after doing/touching that" if the answer is "no" then I try to resist the washing urge, by thinking "my husband and other people don't wash after doing/touching that, and they are all fine, nothing bad has happened to them, so I will be fine too".

I am also on a low dose of Prozac, which I have found has helped. It doesn't get rid of the OCD completely, but it "quietens" it enough for me to concentrate and be able to work on exposures. So I recommend meds to aid in CBT.

As for you helping your husband/coaching, discuss the above comments (mine and others) give him tips and hints on what he can do to help himself ( such as the "step elimination" ). Encourage him but try not to push/force him, don't put pressure on him and let him do it at his own pace. It will take time, it will be difficult, but the best thing you can do for him is have understanding and patience. And since you are here asking for help/tips, I'd say you are already on the right path to helping him.

[pumpkinbard0503]

This is tricky, and I feel you. I agree with other responses that a therapist is key here, but a therapist isn't always going to be in the bathroom during his 5th hour in the shower. In those moments, when you're deep in a spiral, it can make one feel very powerless, even dehumanized. Whether it feels like an incredible real threat, or an incredibly strict moral responsibility, the weight can be crushing.

What I have found helpful in the past are two things: a calm outside opinion, and light distraction. Although awkward, I'll give examples of what my ex used to do.

Calm outside opinion: Your voice is calm (obviously). Don't use patronizing statements, think more devils argument; these are alternative perspectives that might crack through the "OCD logic." How long does it take for a body to get clean in the shower? When does further showering no longer make a difference? (Again, always trust a medical professional's advice; if they say this is the worst idea, listen to them over me :P)

Light distraction: These will either come across as very annoying (only when too pushy) or as a relief (I think the key is you have to feel calm). I've seen examples on tv and been coached through these moments in different ways. Engage the five senses (popular with crisis lines) or ask trivia questions. I knew someone who would find anything with writing on it and read everyword in a weird voice or mispronounced, doing so until I laughed. It means the world when coming from someone you love, I guarantee you.

[0CDspouse]

Thanks for the suggestions, everyone! He is currently on a low dose of Sertraline, although we've read that high doses of SSRI's are better at treating OCD. What is everyone's experience with meds? Having been suffering for over 10 years, he's literally tried every med possible, including ketamine.

Also, are there key phrases that your supportive person/coach says that help when trying to get you out of the loop? I struggle with calm assertiveness and giving concrete responses. Example: He drops the bar of soap in the shower and questions if he should reuse it. I say "yes, pick it up and use it again." Then, he starts to question, "What about......?" And I struggle at this point. I confesss, I have lacked consistency in my answers and have caved to his OCD compulsions, so in the long run it reduces my reliability and his trust in me to listen to my advice to go against what the OCD tells him to do. Any advice on specific phrases? One that I'm working on is instead of "You don't have to do that", saying "We don't do that. Here is what we do....."

Thanks again!

[pumpkinbard0503 in reply to 0CDspouse]

Having something to come back to is nice, something consistent that you can both return to. Reminding him to take a deep breath before doing anything else might be good (helps you relax too). Just allowing you both that moment to kind of regroup.

[MothFir in reply to 0CDspouse]

I take a medium (40mg) dose of Prozac a day, which makes ERP therapy easier for me (the obsessions feel less important and are easier to resist).

You have to be careful what sort of phrases you use for support. There's a fine line between supporting his recovery and enabling his OCD with reassurance. This is where a therapist or a good OCD workbook could help develop a systematic plan of what's allowed and what's not. Consistency is really important.

The OCD sufferer may indeed need some guidance about what is normal behavior, even if it seems obvious to you. Non-OCD people would think nothing of reusing a bar of soap that was dropped, but your spouse may perceive so much contamination that he genuinely doubts that it's safe. At first I think it's legitimate for you to say something like "No one can promise you that the soap is 100% safe to use, but a non-OCD person would assume that it is and use it without question." That answer doesn't allow for many follow-up ("what about...") questions, which you should avoid getting sucked into. OCD will "what if" until the sun burns out and you can never provide an answer that satisfies it for good. If he drops the soap in the future and asks for guidance again, you should remind him that you've already addressed this issue and not reassure him by answering a second time. He already knows the answer and he's only asking again because hearing you say it provides a quick relief from his anxiety, and that only perpetuates his OCD.

I am not a therapist and this advice just reflects what has helped me as a sufferer. The reality I have had to accept is the same reality that a non-OCD person accepts without thinking about it: doing an everyday task the "normal" way may in fact result in contamination that kills me or my family, but the chances of that are so minute that it doesn't warrant any attention. I might as well worry about being hit by a piece of falling aircraft. It only feels like a big risk because I have OCD, and OCD warps my perception of risk.

Deep down your spouse probably realizes that the daily reality of taking 5-hour showers after using the toilet is a bigger threat to the well-being of him and his loved ones than the incalculably small chance of spreading contamination by practicing normal hygiene. When he is calm and not in the throes of an OCD episode, you should both acknowledge this and agree on what you will and won't do when he is triggered. He needs to understand that the reason you will not offer reassurance is because you want him to get better and you don't want to keep giving his OCD what it wants. When he is "in a loop," you should of course be loving and supportive, but you should also be firm and stick to the plan, because he will have a very hard time sticking to the plan on his own. He will be experiencing incredible anxiety and the temptation to do a compulsion by washing or asking for reassurance will be incredibly strong. You'll have to be the "adult in the room" until his obsessions fade enough that he can follow the plan on his own. Good luck!

[Blue455]

I used to take three hours before I could even get into the shower doing mental rituals to prepare for my shower then my shower was a Huge ordeal. This was 40 years ago lasting for YEARS Finally I got on Clonazepam and my Dr told me walk straight into the shower and just take a shower. I was SO relieved not to do the three hours that the rest wasn’t so hard. My grandfather was a Psychiatrist and we believe he had OCD, my Mom had it and now I have it. Now I hate taking showers, but there not so bad. I find once you get a handle on something even major it transfers to something else, like now I wash my hands or wipe with baby wipes so many times a Day I couldn’t tell you. I feel Very discouraged. I feel how can I stop because of contamination, I Can’t believe after this Many years I’m in this place. Well it started with a Psychiatrist who put me on and off every med all the way down to MAO inhibitors for OCD because he couldn’t diagnose me. Then I lived overseas where we didn’t have access to therapist only Psychiatrist who loaded me up on meds for 20 years and now I have been home for twelve years so I guess I see why I’m still in this place. I’m six feet and have a high tolerance to meds and am on A Lot. Five or Six years ago they have discovered I’m bipolar as well. My point of all this is after ALL I have been through I would say you can Not do this on your own, you Need a therapist and a Good one and a Good Psychiatrist. Don’t overload on meds. Let him come on here, it might help him. I Feel his pain. It sounds Severe, I have Never heard of 12 hours that’s not something you can do alone. I don’t mean to be harsh or discourage you, but I want help for him. Please keep use posted. I’m just being honest because I want him to be helped. If anyone has any ideas with my hand and contamination I’d Love to hear it. I am presently working with a Really Good Psychiatrist and therapist but I Love this site and find it Very helpful. I applaud ALL of the spouses helping SO Very Much, my father didn’t get it and my husband was at first washing my hair then became Very unsupportive.

[LuvSun]

As far as medication I have been taking Prozac off and on for over 30+ yrs. It does help a bit but doesn’t take the OCD away.

[0CDspouse]

Has anyone heard of or been admitted to a residential treatment program that specializes in OCD? There aren't any in our area, but we'd be willing to travel for a quality program.

[DieHardMusicLover in reply to 0CDspouse]

Where are you based?

[Susiesweeney]

I have OCD and have been an inpatient for treatment . My OCD is rumination but can relate to the moral element of your husbands illness. For what you describe your husband sounds like he needs ERP as it is having such an impact on his life. ..My heart breaks for him to have to live been so tortured and it must be so upsetting for you. His he taking medication or attending any treatments . You will never coax him out of his compulsions, the aim of treatment is to get him to feel and accept the anxiety that comes if he resists the compulsions. It is so wired in the OCD brain that the cycle can be hard to break. Sincerely hope he gets the help he needs . OCD IS SUCH A HORRIBLE ILLESS.

[0CDspouse in reply to Susiesweeney]

If you are ok sharing, where did you go for inpatient? How long did you stay? Was it effective? We realize that the OCD won't be cured, but we need to break out of this cycle and reset his system. We are kind of just spinning our wheels trying to do it on our own at home.

[Susiesweeney in reply to 0CDspouse]

Hi I live in Ireland so attended a private Mental Health facility. I had 5 admission in total during my twenties and thirties all medication based that gave me our my family no understanding of my condition. It was only when i had my 2nd child at 40 after a relapse I finally meet the right Dr and got on an ERP programme and medication that i finally after years had a much deeper understanding of my condition. Your husbands behaviour sounds like a serious OCD cycle but there is HOPE and you are so good to support him because it is not easy. It is an absolutely HORRIFIC illness lived in silence illness and feeds on misunderstanding. I hope I didnt go on to much. One book I found really helpful for me was the IMP of the mind by a Dr Brear. It was the first book that helped me see that my OCD as not been who I am. Years of supportive therapy on and off also helped because of the pure trauma of living with it. If I could make a suggestion i would suggest your family Dr first anf if you have the tesources or health cover seek proper treatment. I hope this helped in some way. Give my regards to your husband life can get better.

[1Peter1]

Believe it or not a lot of the chemistry comes from the stomach so when you can terminate your blood in your skin with soap chlorine this makes it worse for the brain the mind they say OCD is from the environment and effects genetics having one in 50 people affected by this disorder it's very common most of thought patterns chemistry comes from the stomach less contamination the better you'd be surprised living off the grid with less water contamination and that's not an OCD view of opinion having this disorder myself to contamination of chlorine and soap affects the stomach greatly and that affects thought processes more so

[alexandraisobsessed IOCDF Advocate]

Hey OCDspouse,

I see you've gotten a lot of amazing support here. It's so nice to see a spouse willing to be supportive and caring. I really love that.

I just want to echo what has been said here about therapy. The best way to truly help your spouse is to gently encourage him to find an OCD therapist specializing in Exposure Response Prevention. Recovering from OCD requires us to learn a lot of tools to reframe and eventually change our thinking patterns and be able to tolerate uncertainty and distress. Those are tools he will need to learn from a qualified therapist.

I wish you and your husband the best,

Alex