Compulsive hand-washing

Dear Ragu,

This question is very straightforward. Most problems in the psychotherapy field can be relieved by counseling or talk therapy itself. Some issues are best dealt with by a combination of counseling and medication. However, some problems are really almost exclusively biochemical and can only be relieved by medication. Your problem of being compelled to wash your hands for an hour and a half after going to the toilet is mainly a chemical problem. This difficulty is primarily a chemical disorder and usually there is a hereditary base to the problem. You might want to take a good look at your family and see if you can find anyone within the last three generations who have experienced similar symptoms.

The problem you suffer from is called Obsessive Compulsive Disorder or OCD. This is a disorder in the chemistry of the brain that compels a person to have repetitive thoughts or perform repetitive actions to relieve anxiety. Usually a person realizes that the thoughts and/or behavior is rather senseless and has no real basis in reality, but still cannot get themselves to stop the cycle. It is probably quite apparent to you that washing your hands once would be sufficient to be clean after using the toilet, but cannot get yourself to stop. It makes a person feel out of control and lowers their self-esteem. No amount of logic seems to be effective and often secondary depression results.

I would suggest that you search your community for a reputable psychiatrist who is knowledgeable about Obsessive Compulsive Disorder. He or she will very likely prescribe an anti-depressant such as Luvox or Anafranil. These anti-depressants tend to be especially effective for obsessions and compulsions. The side effects are usually mild and temporary. These can include weight gain, headaches, anxiety, dry mouth, nausea, and sexual inhibition. It is not rare for these medications to be needed on a life long basis, but the benefits are significant.

I do not mean to suggest that there is no benefit from counseling for this problem. It is very helpful to seek out a counselor to add support and direction to deal with the self-esteem that invariably gets lowered from this disorder. They can also educate you and your family about the condition. There is also usually a need for behavioral strategies that can be effective in alleviating this distressing problem.

I hope this has been helpful and wish you all the best.

Jef Gazley