Washing and Constant Cleaning, an Obsessive-compulsive Disorder (OCD)

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Washing and Constant Cleaning, an Obsessive-compulsive Disorder (OCD)


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.

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, ...

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... to obtain anti-obsessional effects. Studies done to date suggest that the following dosages may be necessary: Luvox (up to 300 mg/day), Prozac (40-80 mg/day), Zoloft (up to 200 mg/day), Paxil (40-60 mg/day), Celexa (up to 60 mg/day), and Anafranil (up to 250 mg/day), (Jenike, 1999b).


American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author

Engler, J. & Goleman, D. (1992). The authoritative guide for making informed choices about all types of psychotherapy. The Consumer’s Guide to Psychotherapy. New York, NY: Simon & Schuster/Fireside

Levenkron, S. (1991). Treating & Understanding Crippling Habits. Obsessive-Compulsive Disorders. New York, NY: Warner Books.

Jenike, J. (1999a). How to select a Behavior Therapist. Obsessive-Compulsive Foundation.


Jenike, J. (1999b). OCD medication: Adults. Obsessive-Compulsive Foundation. Retrieved

November 18, 2001, from

Obsessive-Compulsive Foundation: How is OCD treated. Retrieved November 14, 2001, from
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