Maintaining hygiene and taking care of neatness is the norm for a civilized person, but only until it becomes a pathological addiction. Mysophobia arises from fear of pollution or infection, increased attention to cleanliness.
What it is
The concept of "mysophobia" was introduced by scientist William A. Hammond in 1879, when he researched and described this condition. By his definition, this is an obsessive state of morbid fear of dirt, which is manifested by constant hand washing. This action gives a person suffering from mysophobia a feeling of control over the situation, it calms and brings temporary relief. While doing this, he only thinks about the need to have clean hands. Pathological disgust with dirty and, in the opinion of patients, dangerous objects and places leads to inadequate precautions.
Fear of germs is another type of phobia - germophobia. With it, even knowledge about the benefits of certain types of microorganisms does not reduce the state of anxiety and restlessness. This variant of phobic disorder forms a pathological connection between a feeling of insecurity, loss of control, and the need to protect one’s health and life from the impending threat of infection.
The development of mysophobia has a direct connection with the social life of a person and society. In the changes that come with the development of technology, science, germophobes and mysophobes are finding new sources of threat.
In the early 20s of the last century, people were afraid of bacteria, which claimed millions of lives. Constant cleansing and disinfection of hands, rituals for treating the body, household items, clothing, wearing gloves, certain patterns of movement around the home to avoid contact with furniture and objects, withdrawal from the environment, and as a result, loss from normal life. These manifestations of the disease deprive a person of the opportunity to become happy.
With the invention of penicillin, when most diseases caused by bacteria became curable, a new fear of viruses emerged. HIV, hepatitis, bird flu - these diseases caused by viruses frighten every person, but in people prone to anxiety, this fear takes the form of a phobia. In this case, the emphasis shifts to ways of transmitting the disease.
Possible infection through blood, saliva or sexual contact forces a person suffering from germophobia to scan risk groups (drug addicts and antisocial elements) and avoid places that pose a potential threat of infection. Thus, there is a constant search for risk factors and ways to avoid or overcome them.
A simple diagram of the development of a phobia looks like a chain of interconnected factors. Against the background of stress and the anxiety and worry associated with it, there is a desire to find a source of discomfort and danger in the external environment. Growing neurosis significantly changes a person’s behavior, up to the loss of work, friends, and final self-isolation from the outside world.
Other types of environmental fears make people afraid of technical objects and materials.
Germophobia and mysophobia, like other phobias, can seriously change your life and lead to serious consequences, which are more difficult to correct than to prevent.
Causes
There is a reason for the appearance of any phobic disorders. First of all, it is a genetic predisposition to anxiety and depression. If similar cases have been observed in the family, they may also appear in relatives.
More often, germophobia and mysophobia develop in adolescence, when hormonal levels are unstable. At the same time, the natural sensitivity, suspiciousness, indecisiveness, conscientiousness, pedantry and emotionality of a teenager become especially aggravated, receive hyper-manifestations, and when combined with stress, provoke the emergence of obsessive-compulsive disorder and its particular forms - the disorders in question.
Manifestations similar to mysophobia may be a consequence of low-grade schizophrenia, epilepsy or traumatic brain injury.
Other reasons:
- childhood traumatic circumstances associated with illness;
- acquired imitative behavior;
- media information about infections and their spread;
- wider introduction of hygiene products and obsessive promotion of new and improved cleaning and disinfection products.
Often the cult of a healthy lifestyle is perceived by suggestible and anxious individuals as a need for action to achieve the image of an ideal person imposed by society. Against this background, other phobias may arise, for example, hypochondria - over-concern about one's health.
Mysophobia, or fear of pollution, is one of the most common types of obsessive-compulsive disorder (OCD) [23, 26], characterized by a feeling of disgust towards certain substances and associated with fear of their negative effects on the body, as well as the formation of protective and avoidant behavior in the form cleansing rituals and changes in entire lifestyle to prevent contact with sources of pollution. Substances or objects that cause disgust and/or fear in most cases include dirt, physiological secretions of humans and animals, blood (as a source of infections), animals (as carriers of certain diseases), and all kinds of chemicals, especially those used in everyday human life. (for example, household chemicals). However, cleansing rituals and the avoidance behavior typical of mysophobia can be caused by atypical triggers - intrusive thoughts of an unpleasant nature: blasphemous ideas or images, unacceptable sexual sensations or thoughts, ideas of "contamination" by evil forces, thoughts of one's own sinfulness, ideas of guilt. In these cases they speak of “moral pollution.”
Attention to this phenomenon is paid mainly in the psychological literature. The first detailed description of such obsessions was given in 1924 in the work of S. Rachman “Pollution of the mind” [24]. Moral pollution is described as a feeling of internal uncleanness, which usually occurs regardless of the presence of external, visible dirt. Both the source and the location of the pollution are uncertain, which partly explains the failure to cleanse moral pollution in the usual way. Contamination can be induced by accusations, reproaches, humiliation, insults, as well as unpleasant memories or intrusive thoughts and images. Moral pollution is specific to each person in its own way and is not transmitted from person to person, as is the case with “ordinary” dirt. As a rule, the patient considers himself to be the only one who is susceptible to it [24, 25].
S. Rachman [24] proposes to consider moral mysophobia as one of the variants of contamination (related to contamination - pollution, contamination) obsessions, since common behavioral mechanisms are involved in the formation of pollution obsessions and moral mysophobia. He associates the more persistent ritualized behavior of patients with moral mysophobia with the indirect, symbolized nature of rituals, i.e. Unlike cases when patients wash themselves away from the dirt that frightens them, with moral mysophobia they “wash themselves off” from something that, according to universal human understanding, is impossible to wash away from. To confirm that the feeling of pollution can arise without physical contact, a series of psychological experiments were conducted: subjects were asked to imagine an unpleasant event from a moral and ethical point of view, and then their need for washing and the subjective feeling of internal pollution were examined [11, 12, 20, 35].
Currently, there are several psychological concepts that explain the phenomenon of moral mysophobia. The most common of them is the idea that the basis of compulsive purging is the emotion of disgust [9, 18, 22, 33], provoked by a feeling of guilt [17]. However, according to other researchers [31], “fear of guilt from one’s own irresponsible behavior” is one of the factors in the development of most types of obsessive-compulsive behavior, and not just cleansing rituals. J. Cougle et al. [10] believe that an increased sense of responsibility (one of the factors in the cognitive model of OCD) predisposes to the development of moral mysophobia [28, 29].
Some researchers [14, 35] consider the phenomenon of moral mysophobia from a cultural and religious point of view. According to them, disgust is an emotion that can be experienced in both physical and moral aspects. Initially, “disgust” was considered a taste sensation, evolutionarily associated with avoidance of eating potentially dangerous food. Over time, the concept expanded to take on social and cultural meaning and began to include rejection of anything immoral. This is supported by data from neuroimaging studies showing that the brain regions responsible for feelings of disgust are structurally and functionally “overlapping” [19, 30].
Clinical studies devoted to the problem of obsessive-compulsive disorders contain only isolated references to moral misophobia [2, 7, 27].
S.A. Sukhanov in 1905 [7], when describing psychosis ideo-obsessiva, mentions that along with a severe fear of contamination, a situation may occur when the patient considers dangerous not only a thing that was in contact with something unclean, but also an object that was with him at a time when obsessive thoughts of unpleasant content came to mind. The author draws attention to the fact that in this situation there may be rituals of a special kind, for example, sprinkling surrounding things or water consecrated in the church accidentally falling into his room, and suggests that in this case there is a delusional element that cannot be separated from what relates to actually an obsessive idea.
H. Rumke [27] noted that mysophobia may represent a fear of contamination by “moral filth.” According to the author, obsessions of this kind take over the patient’s consciousness so much that they often resemble delirium, but the rituals accompanying obsessions indicate the obsessive nature of such ideas. He draws a parallel with the schizophrenic process both in terms of the degree of maladaptation of patients and in terms of the formation of severe deficit changes.
Yu.B. Zagorodnova [2], in a study on the comorbid relationship between obsessive-compulsive disorder and manifestations of the hallucinatory-delusional register, also cites several clinical cases of mysophobia, manifested by fear of moral pollution. In all observations studied by the author, contamination obsessions appear together with paranoid phenomena.
The unfavorable course of disorders with phenomena of moral mysophobia is indirectly evidenced by the data of a number of authors [8, 10], who suggest that the presence of an unrecognized moral component within the framework of contamination obsessive-compulsive disorder causes a high level of resistance to treatment.
Thus, the problem of moral misophobia, covered to a greater extent in the psychological literature, has been little studied in the psychopathological aspect, and therefore its clinical and psychopathological development is very relevant.
Material and methods
The study included 16 patients who were treated in the Department for the Study of Borderline Mental States and Psychosomatic Disorders (headed by Academician of the Russian Academy of Medical Sciences A.B. Smulevich) of the Scientific Center for Mental Health of the Russian Academy of Medical Sciences (director - Academician of the Russian Academy of Medical Sciences A.S. Tiganov) during the period from 2008 to 2011
In all cases, the clinical picture was dominated by obsessive-compulsive disorders with phenomena of moral misophobia. Moral mysophobia included obsessive-compulsive disorders that occur with a predominance of compulsive purification, used by patients as a symbolic defense to combat impulses other than the feeling of ordinary, psychologically understandable pollution.
Among those examined there were 3 women and 13 men (gender distribution was 1:4). The age of the subjects ranged from 18 to 53 years (average - 33.6±10.5 years). The average age of patients at the onset of the disease was 12.9 years (from 6 to 16 years), and the average age at the time of manifestation of moral mysophobia was 22.7 ± 9.4 years. Thus, on average, the duration of the phenomenon of moral mysophobia at the time of the study was about 11 years.
The examined patients had a fairly low level of social adaptation, only 2 (13%) of them worked, 3 (19%) patients were students, the rest (68%) did not have permanent employment; 5 (31%) patients had group II disability due to mental illness, 6 (38%) were dependent on relatives. 3 (19%) patients had ever been married, but at the time of the examination they were divorced.
All patients were hospitalized with a diagnosis of schizophrenia, obsessive-compulsive syndrome; in 7 (44%) cases, a “malignant disease of obsessions” was additionally stated.
According to the ICD-10 classification, 6 (38%) patients were diagnosed with sluggish neurosis-like schizophrenia (F21.3), 2 (12%) - paranoid (F20.0), 6 (38%) - undifferentiated (F20.3) , 2 (12%) had schizophrenia, childhood type (F20.8xx3). Along with paranoid schizophrenia diagnosed in 2 patients, the diagnosis of 7 patients included an indication of the presence of paranoid phenomena (phenomena of mental automatism, incomplete Kandinsky-Clerambault syndrome).
Among 10 patients with a diagnosis corresponding to the F20 rubric (F20, F20.8 and F20.3), 8 patients had a continuous, and 2 had an episodic type of course with a stable defect. The stability of the process over a long period of time (more than 12 months) and the non-development of identified psychotic disorders when indicating clear psychotic episodes in the anamnesis allowed 8 (50%) patients to change the diagnosis to residual schizophrenia (F20.5).
At the initial stage of sluggish schizophrenia, various neurosis-like manifestations dominated in our patients: along with obsessive-compulsive symptoms (contrasting obsessions, obsessive doubts, motor rituals), body dysmorphic disorders, anorexia nervosa, socio- and agoraphobia were identified.
The study did not include patients with organic lesions of the central nervous system; severe somatic diseases; signs of addiction to psychoactive substances and alcoholism.
The study was conducted using follow-up data (duration of at least 1 year), as well as a retrospective analysis of medical documentation.
results
The study of trigger factors for moral misophobia showed their heterogeneity. The impulse to perform purification rituals in different patients was caused by ideas of guilt and/or sinfulness - in 5, blasphemous thoughts - in 5, a feeling of negative influence from others - in 3, hostility towards individuals or groups of people - in 6 patients; Some experienced more than one of these triggers. At the same time, the rituals performed by patients practically did not differ from those characteristic of mysophobia in general: cleansing activities and actions aimed at minimizing possible contact with frightening objects dominated.
The vector of symbolized pollution had different directions - outward, when the patient was afraid to pollute (defile) others with his touch, and inward, when the patient believed that they were polluting (desecrating) him. In cases where mysophobia is associated with ideas of guilt and sinfulness, the vector of symbolized pollution was directed outward. Ideas of guilt and sinfulness have different contents, they can develop gradually, gradually, but more often they arise through the mechanism of “the sudden appearance of a microsymptom - an idea that arose as an “insight” (according to Yu.V. Kannabikh [3]). However, in all cases they are persistent and dominate the patient’s consciousness.
Considering themselves sinful, guilty, and “morally unclean,” patients avoid pollution and desecration of surrounding people and objects, often objects of religious paraphernalia. In most cases, patients experience massive ritualized behavior that completely covers all areas of life. Each action is surrounded by a series of rituals to prevent the spread of special “moral dirt”. Any object touched by the patient is considered contaminated, and from then on carries the same risk of contaminating others as he does himself. Rituals are for the most part aimed at preventing the spread of “dirt,” which is achieved by sharply reducing all kinds of contacts and washing objects that, in the patient’s opinion, bear traces of his touch, sometimes even questionable to him.
Blasphemous thoughts that occurred in 5 patients were represented by blasphemous thoughts and images of predominantly religious content - insults to saints and clergy, praise of the devil. Often, such obsessions arise in patients associated with the sight of religious objects or church utensils. Sometimes they are accompanied by overwhelming ideas of their own blasphemous actions, obscene scenes, images of evil spirits, etc. In two cases, such obsessions were noted along with ideas of sinfulness. Against the background of persistent “blasphemous thoughts,” persistent ideas of self-accusation and self-deprecation are formed. Blasphemous thoughts and blasphemous ideas begin to be perceived by patients as a consequence of their low moral principles, insincere faith, as retribution for their sins. Such obsessive phenomena lose their intrusive character, which is accompanied by a refusal to confront them. Psychopathologically, this can be regarded as a decrease in the level of criticism and the transition of obsessions to a more severe register of disorders. Often, obsessions of this kind begin to be perceived by patients as “imposed from the outside,” “sent from the outside,” and interpreted as a consequence of the influence of demonic forces [4]. Patients are characterized by a particularly ambivalent attitude towards existing disorders. On the one hand, it is recognized that obsessive thoughts are a product of one’s own consciousness (which is an indicator of the obsessive-compulsive nature of these formations); on the other hand, the possibility of influence from the outside is assumed, i.e. We are talking about mental automatisms. Swear words and curses that appear against one's will take on the character of spoken phrases pronounced in the voice of either the patient himself or another person.
The vector of pollution in moral mysophobia associated with blasphemous thoughts can be directed both at the patient himself and at others if ideas of sinfulness are attached. In the presence of blasphemous thoughts, cleansing rituals are aimed at getting rid of bad ideas that are unpleasant for the patient, which is most symbolically represented in one of the patients, whose rituals mainly consisted of washing the mouth with which he once spoke (or could say without noticing ) bad words. But more often there is a situation when the patient considers his entire body “dirty”; rituals are aimed at constantly cleansing it and preventing “contamination” of others by limiting contacts. Often there is washing with water blessed in the church or sprinkling it on objects with which the patient has been in contact.
In 6 patients, mysophobic rituals were associated with hostility towards individuals or groups of people on some basis other than the concept of “dirty” or “infectious”. This can be one person (usually from the immediate environment), or a group of people identified, for example, on ethnic or social grounds. Contact with a person from the group identified by the patient (often even indirect, without physical contact, for example, conversation, being in the same room) is considered a polluting event, which is certainly followed by a developed set of cleansing rituals.
It should be noted that in all the cases studied, there was no formation of any developed concept explaining exactly what potential harm is caused by persons causing fear and disgust. Ideas are being expressed about the spread of special “moral dirt”, which, when transmitted to the patient, will bring certain changes to him, making him “similar” to them. In some cases, the formation of unstable persecutory ideas was observed - patients report that they observe an increased concentration of people who frighten them around them, and see signs of increased interest on their part. However, there were no ideas of deliberate harm; it was assumed that “moral dirt” was spread accidentally, just like any street dirt.
In 3 observations, a different variant of hostility towards others was noted: one well-known person (a close relative or neighbor) acted as the source of contamination. The pollution emanating from it was perceived as the influence of some negative “energy” at the level of sensations. In the presence of a “source of pollution,” patients experienced severe weakness, various bodily sensations, confusion of thoughts, and causeless depression. These psychopathological manifestations, which are syndromic incomplete (according to Yu.B. Zagorodnova [2]) delusions of influence, are inextricably linked with the defensive behavior characteristic of mysophobia. To get rid of negative energy, patients perform a set of cleansing measures: blowing off and shaking off energy pollution from the surface of the body, avoiding any (even visual) contact with its source. The complex of protective ritual actions also includes all the standard rituals for mysophobia with the same principles of transmitting pollution (in this case, “negative energy”). The feeling of influence often turns out to be situational; it occurs directly when communicating with the “source of influence”, or when coming into contact with his things or household items.
Impact ideas (as in the cases described above) do not assume that the source of negative influence will intentionally cause harm. It is suggested that the object of avoidance has a special energy and its own increased sensitivity to negative influences.
In all the studied cases, the phenomenon of moral mysophobia is registered within the framework of schizophrenia, occurring with obsessive-compulsive disorders. The picture of the disease with a predominance of moral mysophobia in the mental status appears in most patients an average of 10 years after the onset of the disease. In most cases, the disease manifests itself in adolescence and is accompanied by a fairly rapid increase in negative symptoms and thinking disorders.
Thus, manifestations of moral mysophobia are formed against the background of already pronounced negative changes, mainly of the type of pseudo-organic defect with a drop in mental activity, intellectual decline, and elements of apato-abulic symptoms. It should also be noted that the phenomenon of moral mysophobia is inextricably linked with a feeling of constant causeless anxiety and tension - “pan-anxiety” according to P. Hoch and P. Polatin [15].
The dynamics of the studied disorders are characterized by a persistent course with periods of temporary relief of obsessive-compulsive symptoms, alternating with exacerbations, in which the main role is played by increased anxiety, accompanied by an increased need to perform rituals. At the same time, the phenomenon of moral mysophobia, having arisen for the first time, persists throughout the entire course of the disease, and has no tendency to either reverse development or become more complex.
Discussion
Although the present study was carried out on small clinical material (16 observations), its results allowed us to draw a certain conclusion about the features of the psychopathological structure of moral misophobia.
It was found that this phenomenon is a complex formation, the formation of which involves violations of various psychopathological registers. In the cases studied, we are talking about the interaction of obsessive-compulsive and delusional symptoms.
In some cases, the formation of a complex symptom complex occurs with the participation of contrasting obsessions (mainly blasphemous thoughts and overwhelming ideas of blasphemous content), which are complicated by the addition of delusional disorders. It should be noted that indications of the possibility of the formation of comorbid connections between contrasting obsessions and delusional disorders are contained in previously performed studies. So, S.Yu. Stas [6] suggests that the formation of persistent comorbid connections between contrasting obsessions such as blasphemous thoughts and delusions is realized through the “amalgamation” mechanism [5, 34]. Blasphemous obsessions are included in the structure of the delusional plot (“delusional motivating factor” in the terminology of E. Kretschmer) and in most cases become more intense. According to the opinion of S.Yu. Stas [6], we are talking about comorbid relationships with the formation of “common symptoms” within a single symptom complex.
The data obtained in the present study confirm that contrasting obsessions (in particular, blasphemous thoughts) can be aggravated at some stages of the dynamics due to the congruent delusions of self-blame and sinfulness. However, the study mentioned above [6] does not provide data on the possibility of developing purification rituals in these cases. In the work of Yu.B. Zagorodnova [2] mentions the possibility of the development of mysophobia together with paranoid formations, in the formation of which contrasting obsessions are involved. Mental automatisms in the cases studied by the author are fully realized within the complex of contrasting obsessions, arise exclusively during periods of exacerbation of obsessions and have no tendency to further develop. The author, proposing to qualify these complex symptom complexes within the framework of obsessive hallucinations, points out that the latter are formed in the process of expanding the obsessive syndrome due to the addition of mental automatisms, i.e. are secondary psychopathological formations in relation to obsessive syndrome.
An analysis of the dynamics of obsessive-compulsive disorders in the studied sample showed that the development of moral misophobia is preceded by a fairly long stage, during which the formation of pronounced negative disorders is observed. This circumstance, as a working hypothesis, allowed us to assume that one of the conditions for the formation of moral mysophobia is a relatively stable stage of the endogenous process, as well as the presence of pronounced negative changes.
In some cases, the phenomena of moral mysophobia are noted without direct connection with contrasting obsessions. Purification rituals have a greater share and correlate with even more pronounced negative personality changes. Defensive-ritual behavior, characteristic of mysophobia, is noted in connection with the reduced Kandinsky-Clerambault syndrome, which includes undeveloped delusions of influence with mental automatisms or elements of persecutory delusions. The pathological observed in these cases, associated with a delusional belief in the need to perform rituals, accompanied by the patients’ refusal to resist them, was described by P. Janet [1] in the framework of fixed ideas (beliefs).
Currently, disorders of this kind are considered within the framework of obsessions with low insight [13, 16, 21, 32]. A. O'Dwyer and I. Marks [21], giving characteristics of undeveloped hallucinatory-delusional phenomena, especially emphasize their close connection not only with the obsessive plot, but also with the features of the rituals that dominate the clinical picture. It is indicated that the absurd content of obsessions and the pretentiousness of the rituals accompanying them, as a rule, are combined with insufficient criticism and are a predictor of the development of erased psychotic disorders.
Thus, the phenomenon of moral mysophobia is a symptom complex formed as a result of the interaction of obsessive-compulsive symptoms with deceptions of perception, delusions of sinfulness (with the dominance of contrasting obsessions in the clinical picture) and reduced Kandinsky-Clerambault syndrome.
In conclusion, it is necessary to note the clinical significance of this psychopathological phenomenon. Moral mysophobia is a stable psychopathological formation, without a tendency to complicate and modify delusional symptoms (towards its expansion or systematization), the formation of which correlates with negative changes of the pseudo-organic type.
Symptoms of the disease
Germophobia and mysophobia in mild form are manifested by a feeling of tension and anxiety in a person who is in places with, in his opinion, an increased degree of pollution and threat of infection, for example, in hospitals or public toilets.
More pronounced symptoms include sweating, tachycardia, weakness, dizziness, the urge to run, to urgently do something, even panic attacks. Even awareness of the problem cannot cope with it. The feeling of being surrounded by microbes and of impending danger becomes too strong, beyond control and internal convictions about the inadequacy of the threat assessment.
Often people try to minimize symptoms or hide them from others, while others turn to specialists for help.
Symptoms of the disorder:
- excessive disgust towards dirt, fear of contact with contaminated objects;
- most activities during the day involve washing, cleaning and disinfecting the body and surrounding objects;
- cleansing rituals that take more than an hour;
- short-term calm after rituals and increasing anxiety after a short time;
- uncontrollable desire for cleanliness, even with full understanding of the exaggerated fear of pollution;
- a desire to avoid places perceived as containing too many germs;
- refusal to exchange personal belongings;
- avoiding physical contact with other persons or foreign objects;
- fear of infecting children;
- avoiding large crowds of people;
- limiting contact with animals.
Sometimes a person does not realize the destructiveness of his behavior, and perceives criticism from the outside as misunderstanding and rejection of him as an individual, which leads to a tougher attitude towards the people around him. In another case, a person suffering from mysophobia understands that something is happening differently from the majority. In these or other types of manifestations of phobias, the best solution is to consult a doctor. A correctly established diagnosis makes it possible to apply adequate treatment.
Therapy methods
Most often, the disease lasts several years and is perceived by others as character traits. At first, the desire for cleanliness, neatness, caution and disgust do not affect social relationships and do not spoil life. But the disease is dangerous because ignoring the first signs aggravates its development and leads to consequences that become difficult to ignore. They become a problem for the patient and his family.
If it is established that germophobia and mysophobia have developed as a form of neurosis, then individual cognitive behavioral psychotherapy becomes the main method of treatment. It is aimed at relieving or reducing nervous tension. To do this, the doctor may recommend to the patient:
- adjust your daily routine;
- make physical activity regular;
- use relaxation and meditation techniques;
- balance your diet by eliminating alcohol and caffeine;
- yoga and breathing practices;
- communication with people who have similar problems, sharing experiences of overcoming the disease.
To treat advanced and severe forms of the disease, antidepressants are prescribed. Their short-term use has no side effects, but is effective in the complex treatment of the disease. With such neuroses, organic changes occur in the brain that are associated with disruptions in its normal functioning. Antidepressants improve organic processes and make cognitive behavioral psychotherapy more effective.
Another method of treating mysophobia is exposure therapy. This is a treatment method that is based on the action of the irritant that causes symptoms.
Short sessions with mild stimuli are gradually replaced by stronger ones. When the highest tension from meeting his fear is reached, the patient understands the illusory nature of the danger and the level of anxiety gradually decreases.
Relaxation therapy, hypnotherapy and auto-training are also used to treat mysophobia. The selection of appointments for each individual patient may vary. It all depends on establishing an accurate diagnosis, the causes of the disease, the severity and individual reactions to therapy. The support of the attending physician is very important in it, who supports the patient and helps control his anxiety.
Treatment
It should be immediately noted that it will be impossible to get rid of the panic fear of germs without the help of a qualified specialist.
Treatment of phobias, especially advanced ones, requires more time and patience on the part of the psychotherapist, as well as a great desire to change on the part of the client. The most effective methods of psychotherapy for mysophobia include the cognitive-behavioral therapeutic model. During its course, a person is gradually taught to reconsider his attitude towards fear, and is also explained how to better control his own emotions. Schwartz’s “4 steps” technique is excellent for these purposes.
It consists of the following stages:
- correctly place the emphasis (realize that obsessive hand washing is caused not by real life-threatening microbes, but by a phantom fear of getting sick);
- find the root cause of the disease;
- learn to distract yourself from the current experience of fear of dirt and focus on positive thoughts;
- reevaluate your view of the fear of germs, and also look at your behavior from the outside.
Some psychotherapists successfully use hypnosis to treat this phobia in conjunction with teaching the client autogenic training skills.
Hypnotic practices relieve the severity of symptoms, and autogenic meditations, which the client conducts independently at home, increase his self-esteem and confidence in his abilities. However, if help is aimed only at eliminating the manifestations of the phobia, and not at its causes, then after some time the symptoms of mysophobia will definitely return.
