Exposure and Response Prevention (ERP) Therapy For Contamination Fears

Fear of contamination is a very common OCD symptom. The treatment for this type of fear involves exposing yourself to the things that make you feel contaminated without allowing yourself to engage in any compulsions such as washing, using hand sanitizer, changing clothes, or de-contaminating in any way.

Depending on the severity of your contamination fears, you may need to do the exposure and/or response prevention gradually. In doing exposure, you may be able to touch something “germy” directly or if this is too difficult, you may need to touch it “indirectly” by touching something like a tissue to it and then touching the tissue. In this way, you can work up to touching the contaminated item very lightly and quickly with one finger, and then work up to full contact. Similarly, washing may be cut out altogether for a while for a more aggressive approach or it can be cut back gradually, perhaps from several washings to one…to an incomplete wash…to just hand sanitizer…to eventually no wash at all.

Since sooner or later you will need to wash, it is recommended that you “spread” the contamination. This means touching as many things as possible that you come into contact with on a regular basis. Right after touching something dirty or germy, make sure you touch your clothes, hair, face, and items in your immediate environment such as your bed, pillow, hair brush, etc. Even try eating something with your fingers. The more spreading you do, the better.

Accepting uncertainty is another important way to combat contamination fears. Although it may feel like certain things are “clean” (and, therefore, can be touched) and other things are “dirty” (and cannot be touched), it is important to remember we really have no idea generally how clean or dirty things really are. Some things that are perceived as clean, if inspected under a microscope, may be full of dirt and germs. The reality is, it’s likely you come into contact with all the dirt and germs you are trying to avoid. Therefore, doing the exposure is really nothing new. Remembering this can help you negotiate with yourself to touch things you would rather avoid and eventually free yourself from the fear.

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Kristen mulcahy

Being able to tolerate our uncomfortable feelings allows us to move through them until they pass…

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1 Comment

  1. Sharon M.

    Thank you for your explanation and tips on doing exposure and response prevention. I have severe contamination ocd have just begun CBT. I happened upon your article as i was researching advice for doing ERP. You really gave me clarity and courage to be steadfast as i go forward with my therapist.
    i’m sure you are a tremendous help to others like me!:)


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