Psychology, Treatment & Care
Mysophobia, better known as germaphobia, is a “…pathological fear of germs, bacteria, microbes, contamination and infection” (Psychlopaedia). Many people use the term to mean an aversion to dirt or anything sticky, messy, yucky, or gross, but, like other phobias, germaphobia is a more serious psychological issue. Germaphobia is also know more specifically as verminophobia (fear of germs), bacillophobia or bacteriophobia (fear of bacteria), molysmophobia or rupophobia (fear of dirt, trash, or contamination), and rhypophobia (fear of feces).
Germaphobia and its variations are types of OCD, or obsessive-compulsive disorder. While OCD has a broad range of tics, symptoms, and triggers, germaphobia is specifically related to germs and infection. Germaphobia and OCD can both result in ritualistic behaviors, but germaphobia will specifically cause one to obsessively clean, decontaminate, or avoid situations in which they may encounter germs or bacteria.
A person with germaphobia can develop it after a traumatic event or trigger, or they may inherit it genetically. Trauma that links germs or dirt with negative emotional responses, regardless of how tenuous the link, can lead to germophobic behaviors. The trauma could be caused by a first- or second-hand experience, and the behaviors can be triggered by anything from images on tv or advertising to a recreation of some element from the traumatic event.
The WebMD feature “Cleanliness Rules Germaphobes’ Lives” explains the psychology of OCD a little better. “OCD is believed to be caused by an abnormality in the brain's circuitry. Brain scans show brain activity is different in people with OCD. There's probably a genetic component as well, especially when OCD begins in childhood” (WebMD). What specifically causes different types of OCD is not currently known, but all types of OCD are linked to anxiety. Rituals and avoidance behaviors are meant, however irrationally, to alleviate that anxiety. The person suffering from germaphobia may know and even admit that their behavior is irrational but cannot help themselves. This is the major difference between a normal aversion to being dirty, and a true case of germaphobia.
According to the article “Getting to Grips with Germaphobia”, by Professor Michael Kyrios Faps, “From studies in the US and other Western countries we known around one-quarter to one-third of people with OCD have contamination fears and associated decontamination rituals such as compulsive handwashing, washing and cleaning compulsions, and avoidance of potential contaminants” (Psychlopaedia).
Depending on severity, germaphobia can have a small or huge impact on daily life. Those who suffer may spend an exorbitant amount of time cleaning themselves and/or their surroundings. They may develop excessive grooming routines that include prolonged or repetitive teeth and hair brushing, hand washing, etc. These routines can result in more harm than good; breaking down enamel on teeth or nails, cracking or irritating the skin, and even bleeding or infection in severe situations.
In addition to cleaning, germaphobes take measures to avoid bacteria or germs. Some of the obvious places to avoid are playgrounds, social gatherings, and stores where merchandise is being touched by countless hands. But taken to an extreme, this can lead to isolation—avoiding leaving one’s house for any reason whatsoever. This can become a life-threatening issue if a germaphobe specifically avoids doctors’ offices and hospitals, regardless of their own health and wellness.
In less severe cases, avoidance may manifest in behaviors such as covering one’s hand with a sleeve or tissue when touching doors, wearing gloves at all times, “…pushing the heel of one shoe down with the other so as not to touch their shoes, [and] shopping online so as not to have to touch money” (Psychlopaedia). But even these smaller behaviors can cause a disturbance in the germaphobe’s life. They may refuse to touch the door to their office and get stuck waiting for someone else to let them in. They may not touch a gas pump and end up stranded with an empty tank. There are endless possibilities for disastrous situations caused by “simple” avoidance.
WebMD explains that the best treatment for germaphobia is a combination of therapies, including medication and “…a form of cognitive behavioral therapy called ‘response prevention’ or ‘exposure and response therapy’” (WebMD). Medication is typically an antidepressant but could also be antianxiety.
In response prevention, the aim is to first slow, then stop the patient from performing their ritual behavior. At first the therapist may allow the patient to wash their hands once but make them wait before washing again. Gradually, the therapist and patient work together to increase the waiting time until finally the patient does not need to repeat their behavior at all.
It’s important to do this with professional guidance as otherwise the patient may suffer from severe anxiety. Creating a change in behavior for a germaphobe requires a change in their psychology: “Successful treatment produces a change in brain activity and, for most patients, at least partial remission of the disease” (WebMD). Friends and family can assist with the process by reinforcing a therapists’ guidance at home. If they notice their loved one performing a ritual, they can lovingly guide them away and provide a distraction.
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