Obsessive-Compulsive Disorder - I Can't Stop Washing

I Can't Stop 1

Running Head: I CAN'T STOP WASHING

I Can't Stop Washing and Cleaning

Jeriel L. Music

ST. Martin's College

Psychology 345

I Can't Stop 2

Abstract

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.

I Can't Stop 3

I Can't Stop Washing and Cleaning

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.

I Can't Stop 4

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 intrusive and inappropriate and that cause marked anxiety or distress.

Compulsion: repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g.,

praying counting, repeating words silently) that the person feels driven to perform in response to

an obsession, or according to rules that must be applied rigidly as a definition for obsessive-

compulsive disorder (DSM-IV-TR, 2000, p. 462). Now with the disorder defined, during the

fourth session the patient and myself compose a treatment plan, and a commitment to follow my

instructions is secured. My first step in treating her for OCD was educating her and her family

about OCD and its treatment as a medical illness. This is crucial in helping Vickie and her

family learn how best to manage OCD and prevent its complications.