Specialist CBT Treatment for Contamination OCD

Continuous scanning for contamination triggers, excessive worry about germs or other feared substances and compulsive cleaning, control  or avoidance behaviours, may be linked to Contamination Obsessive Compulsive Disorder. If you or a family member are struggling with Contamination OCD, you can talk to a member of our specialist OCD therapy team. You can organise a brief informal call via our contact form , or email This email address is being protected from spambots. You need JavaScript enabled to view it.

Firstly hypervigilance and selective attention to the fear of contamination, infection,  pollution, uncleanliness or mental corruption. Secondly, obsessional worry, over-analysis, rumination,  magical thinking and catastrophising about contamination risks. Thirdly, compulsive decontamination behaviours including repetitive and ritualistic cleaning, sanitisation, restrictive control, cordoning off work or living areas and avoidance behaviours. 

Individuals struggling with Contamination OCD become consumed by the need to prevent, control, avoid and decontaminate their environment. This can also involve high levels of control and restrictions placed on family, friends and colleagues.

How is Contamination OCD Maintained?

`Consistent with other OCD subtypes, Contamination OCD involves a three-step cycle including the trigger / intrusion, the contamination obsession and the decontamination compulsion. 

Triggers / Intrusions 

This involves hypervigilant scanning and selective attention to perceived contamination cues. This causes normal doubts about human interactions or contact, sticky or slimy substances, raw food, smells, certain colours,  upsetting thoughts, names of illnesses or disabilities and  certain places such as doctors surgeries to be automatically interpreted as potential contamination dangers. 

Over time and reinforced through the implied need for cleaning, control and avoidance behaviours, these normal daily interactions become synonymous with a wide range of contamination agents. This can include automatic association with germs, STDs, Covid, toxic chemicals, led poisoning, asbestos,  sweat, faeces, urine, blood and disgusting substances. Individuals struggling with Contamination OCD see every contact or interaction as a risk of being physically or mentally infected, polluted, soiled, debased or tainted by contamination. 

Research also suggests that these primary contamination doubts can be underpinned by early formed maladaptive beliefs and experiences. Beliefs about vulnerability, physical weakness or susceptibility, disgust and dirtiness have been linked to excessive parental criticism,  high  levels of perfectionistic control, perfectionistic fears  or excessive cleaning behaviours modelled by parents. 

Contamination Obsessions 

Once the initial contamination doubt has been triggered, this leads to intensive obsessional fixation, worry, rumination and catastrophic thinking. Individuals struggling with Contamination OCD frequently describe a chain of complex worries involving contact and cross-contamination between people, objects, situations and interactions. These obsessional worries can persist over long periods of time, creating vivid fears and “no go” zones. 

Contamination obsessions can also involve worry about mental contamination. This might include being morally corrupted or psychologically affected in some way. The obsessional worry and over-analysis leads to increased levels of distress including anxiety, fear and disgust. 

Contamination obsessions can typically include:

•  Contracting viral or bacterial infections including Covid, STDs, HIV or intractable  diseases. 
•  Being chemically infected or damaged by toxins, dust, radiation or polluted air. 
•  Being tainted by bodily fluids such as urine, saliva, blood or traces of faeces. 
•  Feeling unclean or unable to remove the sensation of being dirty or soiled. 
•  Mental contamination by disability, names of illnesses, morally corrupt or undesirable people.

If you are struggling with Contamination obsessions you can organise a informal and confidential call with a member of our team by completing the contact form or emailing This email address is being protected from spambots. You need JavaScript enabled to view it.

Contamination Compulsions

Compulsive, avoidance or safety  behaviours are used in an attempt to pre-empt, decontaminate, clean, control and neutralise contamination related worry and distress. Compulsive behaviours can include:

•  Excessive and ritualised hand washing. 
•  Sterilising and disinfecting objects, surfaces and furniture. 
•  Washing or throwing  clean clothing away. Frequent showering and sanitising with anti-bacterial gel or spray. 
•  Avoiding Places and public transport. 
•  Avoiding touching door handles, seats or external objects. 
•  Seeking reassurance and asking others to check that things are clean. 
•  Making lists of past contamination fears to stay in control. 
•  Excessive praying or mental ritualising. 
•  Conducting excessive internet searches and Googling evidence of contamination. 
•  Creating “Clean” and “Dirty” areas and “No Go” zones, to compartmentalise life and cope between home and work or the outside world.
  

The contamination compulsions provide a temporary form of relief or escapism from the obsessional worry and fear. This relief is transient, requires increased frequency over time and reinforces the association between the trigger and need to decontaminate. 

Contamination OCD leads to profound disruption to work and personal commitments and can contribute to significant relationship difficulties.

How Is Contamination OCD Treated?

The gold standard psychological treatment for Contamination OCD is Cognitive Behavioural Psychotherapy. In particular, a combination of cognitive, meta-cognitive and behavioural strategies drawn from mainstream CBT, Acceptance and Commitment Therapy (ACT) and Inference Based Therapy (IBT), have been found to be highly effective in the treatment of Contamination OCD. 

In the UK, Exposure and Response Prevention (ERP), is normally integrated into the behavioural component of the CBT treatment process. Whilst some therapy providers recommend ERP as a stand-alone treatment, this provides limited access to other evidence based cognitive change and defusion strategies. 

We strongly support the assertion that other forms of talking therapy including interpersonal, psychodynamic and psychoanalytic therapy, are ineffective in the treatment of Obsessive Compulsive Disorder. The research demonstrates that Cognitive Behavioural Therapy is the preferred treatment of choice for all forms of OCD.

Sometimes the term “Refractory” OCD is used to describe particularly complex and treatment resistant forms of OCD. 

At GoodCBT.com we therefore recognise that effective treatment always involves a combination of cognitive and behavioural strategies, where the research demonstrates that there are good treatment outcomes. This can sometimes involve schema based CBT to identify and alter the individual’s relationship with early formed maladaptive beliefs that act as precursors for contamination OCD.

How Many Therapy Sessions are Required to Treat Contamination OCD? 

Whilst it’s always difficult to state precisely how many sessions of Cognitive Behavioural Therapy will be required to address Contamination OCD, the process typically involves as few as eight sessions and can involve up to twenty. The number of therapy sessions will always follow a full psychological assessment of the problem and the production of a therapy plan. At GoodCBT.com we always write to our clients following the first session, with a full psychological assessment and treatment plan. Every session is followed by detailed session notes, summarising the key learning points and the agreed actions. 

All sessions are 60 minutes long, rather than the 50 minutes or less offered by most other private providers. This means that our clients can spend more time engaging in the therapy process, without being distracted by time constraints or detailed note taking. Sessions may also be recorded for future reference where the client wishes. 

To talk to us about specialist Cognitive Behavioural Psychotherapy for Contamination OCD, complete our contact form or email This email address is being protected from spambots. You need JavaScript enabled to view it.

Always ensure that you work with a fully qualified and professionally accredited CBT specialist. BABCP accreditation is the UK recognised standard of excellence for Cognitive Behavioural Therapy. Anything less could be wasting your time and money.