We can all agree that washing your hands is totally rational. But refusing to touch a door handle afterward and freaking out that you’ll die of some terrible disease if you do? Not so much. It’s officially known as contamination OCD, but colloquially, we tend to call people who suffer from it germophobes. It leads to a worldview that the earth is a disgusting, non-navigable place, and it can be utterly debilitating.
We talked to a variety of people who deal with germs and germophobia to see if there’s any way to scrub yourself clean of the condition permanently.
Martin Hsia, anxiety therapist: Typically we associate fear of germs and contamination as a form of OCD rather than a phobia — that might not matter to the layperson, but there are some differences in how we treat it. Both, though, are in the anxiety disorder camp.
The fear of germs manifests with an inflated or irrational fear of, if I touch something dirty or contaminated, or if I don’t clean/wash/wipe, perhaps in some ritualistic way, a number of things could happen: I could get sick. I might die. And for some people, it’s not even that formulated, it’s just, “Eww that’s gross, that’s disgusting. Who’d ever eat something without washing?”
With contamination OCD, you’ll see some ritualistic behavior: “If I wash with soap seven times before I eat, only then will I feel safe.” But the problem is, even then, they want 100 percent certainty. Well, who’s to say if you washed seven times, maybe that last wash didn’t feel quite right, so you’ve gotta do it again. Or thinking that touching your shoe will get you sick, so you’re just gonna not touch your shoe. Or doorknobs. You’ll open doors with your elbow. Avoid shaking anyone’s hands. Covering the seat everywhere I’ll sit — bringing a garbage bag and covering it, even in a conference room at work.
These are real examples, by the way.
We use exposure therapy, in which we’re gonna ask you to confront something uncomfortable. It’s short-term pain but longer-term gain: Maybe I’ll ask you to purposely touch the bottom of your shoe with your hand and not immediately go and wash your hands. That’s just a small example. The goal is to do something that’s uncomfortable so that you see, “Oh, maybe this isn’t the worst thing, and I could handle it.” Once you have that experience — and you have it repeatedly — it starts to be corrective. Then you start to realize maybe you don’t need to keep avoiding this thing, and then the world starts to get bigger again.
Sometimes I’ll do an exposure with a client so they’ll see that I’m totally fine. I say, “Well, last week I ate a cracker off the carpet in my office. I don’t typically do that, but I like my odds.” I do it partly for shock value, but partly just to show them that I’m okay.
City of San Diego sewer worker: I sort of worry about germs. I definitely take precautions: When I get home I take off my clothes, my boots, my gloves — everything — right away. You don’t know what’s down there. It could be anything. I don’t even know what’s down there myself sometimes!
Elaine L. Larson, nursing and epidemiology professor and hand-washing expert, Columbia University: I use hygiene just like everybody else — I have my vaccinations, and I carry around some hand sanitizer in my purse. But people tend to have weird ideas about the relative risks of different things. People get really scared about touching things in public. Germs can last for a while on inanimate environments, but the chances of getting an infection from a door handle are a lot less than from a lot of other things. That said, certainly during flu season, if somebody’s coughing into their hand and then opening the door, if you’re going to open the door after them, you’d wanna clean your hands off afterward.
But I think what we touch at home is just as important.
I’m concerned about kitchens, because that’s one of the biggest places where you could get germs. Things like sponges shouldn’t be sitting around for a week, because those grow huge numbers of bacteria. Normally they don’t hurt us because we have good immune systems, but if there’s older people in the household, or kids, or somebody with immune problems, you should be careful. If you’re using the same dish cloth for days and days, you’re probably just spreading germs around the table when you wipe it up!
Gyms are the same way. If somebody in the shower has athlete’s foot, that’s the place you get athlete’s foot, in wet environments, because that’s where the fungus grows — in wet environments. So that just makes sense. And it makes sense not to share towels with some people, especially people you don’t live with. It’s true that most people who live together begin over time to share the same bacterial flora, so in households it’s frequent that kids and parents may share things, and in general that’s okay. But certainly if somebody’s sick in the family, I wouldn’t be sharing their towels, their handkerchiefs and their toothbrushes.
Most of it’s just logic.
Home/office cleaner, Super Bright Cleaning Service: I don’t worry about germs. Why? Because I have a good immune system. You know antibacterial soap is popular, right? Well, they say it’s a bad idea to buy it because your immune system always needs to be tested. It’s like the reason why people go to the gym is to get fit — well, it’s the same thing with the immune system. It needs to always be challenged, to always be fit. You don’t want to create an environment that’s so antiseptic that your immune system becomes lazy or uneducated.
Do you know anything about the immune system — biologically or physiologically? There’s certain specialized cells called B-cells, which are “teacher cells.” They have a repository memory of antigens in bacteria that have invaded your body in the past. So they’re the shortcut way of gearing up the immune system by storing memory of prior infections. This is why babies are susceptible to diseases, because they have no memory; their immune system is uneducated. It’s like when you go to Mexico you get Montezuma’s revenge, whereas the natives don’t because their immune systems have that repository memory of how to handle that particular bacteria.
Still, I do take precautions. We use antibacterial disinfectant in our degreasers, we use gloves, that sort of thing. But I wouldn’t be in the business if I were paranoid about germs.
My garbage man: Do I worry about germs? Nah. I’m used to it. It’s part of my job. Advice? I don’t know… Wash your hands I guess? It won’t kill you. [Drives off.]
Adam Elder
Adam Elder is a writer in San Diego. He's also written for Esquire and WIRED magazines, VICE, The New York Times, The Wall Street Journal, The Guardian, newyorker.com and elsewhere.
