Washing and Constant Cleaning, an Obsessive-compulsive Disorder (OCD)
Washing and constant cleaning, an obsessive-compulsive disorder (OCD). OCD often goes
undiagnosed. Patients obsessively wash, check something or hoard things to relieve themselves of an overwhelming anxiety, and are fully aware their behavior is abnormal. This research studies a 23-year-old married woman who sought treatment for a severe washing and cleaning problem and how the patient was treated. I will discuss how the patient was diagnosed, and treated with a form of cognitive behavioral psychotherapy or CBT (exposure and response treatment) and what medications can be used for treatment.
Vickie, a 23 year-old married woman arrived with the company of her husband. Vickie had
a problem with severe had washing and cleaning. She would wash her hands up to 30 times a day for at least 5 minutes each time. She always had the feeling that her hands were not really clean, she might touch the side of the sink after she rinsed her hands and then think they were dirty again. She also took two showers a day for up to 50 minutes or until all the hot water was gone. Other things she did to make herself feel clean is use alcohol to wipe things down that she would come into contact with, like her car seat before she set in it. She has been unable to seek employment as a Licensed Practical Nurse (LPN) due to her symptoms. I conducted four initial sessions, session one and two were to seek information about the history of her symptoms, obsessional content, including external and internal fears cues, beliefs about consequences, and information about passive avoidance patterns and types of rituals (Levenkron, 1991). I also requested Vickie before our next session to record all washing and cleaning that she did,
including wiping things with alcohol. She recorded every time she washed, how long she
washed, what made her wash, and how anxious she was before she washed. This kind of record
will help us identify any sources of contamination she may have gotten and we can also use it to
measure her progress during treatment; the third session was devoted to personal and family
history; the fourth session was devoted to treatment planning. During the first three therapy
sessions Vickie talked about her experiences of recurrent and persistent ideas, thought, impulses,
images that were intrusive and senseless. One example; her repeated impulses to wash her hands
or wipe down everything she came into contact with using alcohol for no apparent reason
(Levenkron, 1991). Vickie recognized that the obsession was the product of her mind.
After taking all the information gathered in the three initial therapy sessions and referring to
diagnostic and statistical manual of mental disorders (DSM-IV-TR) which states Obsessions:
recurrent and persistent thoughts, impulses, or images that are experienced, at some time during
the disturbance, as...