Misophobia

An uncontrollable fear that arises as a mental reaction to a certain, quite safe object or situation is called a phobia. It subjugates a person for some time, it is impossible to resist. The body releases adrenaline and activates the instinct of self-preservation - the reaction is inadequate in strength to the irritant. Some people experience uncontrollable horror at the mere thought of coming into contact with pollution. There are many of them. Such an obsessive condition is called mysophobia (from the Greek mysos - dirt, filth, as well as filth and vileness).

Basically, mysophobes are people who frequently wash their hands, trying to avoid tactile contact with people and objects out of fear of infection and subsequent illness. Initially, this term was introduced by psychiatrist W.A. Hammond, who observed a patient who constantly washed his hands. He interpreted his behavior as a direct desire to wash his hands. Psychologist G.S. Sullivan supplemented the picture of obsessive fear of getting dirty by the fact that it is based on the fear of getting infected and getting sick. Such obsessions (compulsions) led to the development of cleansing rituals - endless hand washing, wiping surfaces with antiseptics, avoiding tactile contact, etc. Specific cases of fear of microorganisms, and not just visually noticeable dirt, received very specific names (verminophobia - from the English vermin, parasite; germophobia - from the English germ, microbe; bacteriophobia, etc.).

In 1924, a study was published that examined the phenomenon of so-called moral mysophobia. The author, based on his observations, claimed that the above-mentioned rituals of purification are caused by obsessive thoughts of unacceptable content, when a person feels morally defiled. [ 1 ]

One way or another, this unhealthy reaction can be a symptom of serious mental pathologies, including obsessive-compulsive disorder and even schizophrenia.

Epidemiology

There are no statistics on phobias, however, the studies conducted allow us to conclude that every tenth inhabitant of our planet has some kind of phobia. It is unknown how many people suffer from mysophobia, but it is quite common in the civilized world. In terms of strange behavior, you may not notice it right away, because washing your hands is considered a completely ordinary action, the need for which is not regulated, but determined by the desire of the person himself.

Causes misophobia

Persistent, strongly expressed irrational fear of contamination and rituals associated with cleansing and avoiding getting dirty can be one of the manifestations of obsessive neurosis, anxiety-phobic or obsessive-compulsive disorder, schizoid psychopathy, schizophrenia. In such patients, mysophobia will not be the only symptom.

Often phobias are present in people who are completely normal in all other respects, but who have certain personality traits - a predisposition to suggestion, increased sensitivity and impressionability, suspiciousness or, on the contrary, an inflated self-esteem, a tendency to self-admiration (narcissists, perfectionists), for whom dirt is incompatible with their self-perception. Such qualities are usually hereditary.

Risk factors

Risk factors for developing mysophobia include:

• family traditions, when personal hygiene was given hypertrophied attention, and almost every episode of its non-observance was accompanied by comments about the dangers of infection with terrible and deadly diseases;
• a negative event in the life of a mysophobe or a person close to him, for example, associated with an infectious disease that led to serious complications;
• advertising of antimicrobial hygiene products and household chemicals that exaggerate the danger of contamination and the microbes hidden in dirt.

As a result of the impact of traumatic factors on a susceptible personality, the pathogenesis of mysophobia develops - a persistent, uncontrollable fear of getting dirty, coming into contact with ubiquitous microbes appears, which is manifested by behavioral features, physiological and emotional symptoms. The main motivator of such changes is anxiety.

Moral mysophobia is a separate psychological phenomenon, when the desire to "wash oneself" and "cleanse" arises due to reasons of an emotional nature. Patients feel themselves soiled with "moral dirt", but this causes them to perform symbolic cleansing rituals similar to washing away real dirt (shower, bath, washing hands that have touched an object that is "unclean" in moral terms). This phenomenon has yet to be studied. Insufficient cases of moral mysophobia have been described to draw a conclusion. However, the authors have already put forward several hypotheses about its origin. The most well-known concept is that compulsive symbolic cleansing is based on the emotion of disgust caused by a feeling of one's own wrongness, guilt, and irresponsible behavior. The main character trait of such people is called hypertrophied responsibility. Which, in general, is also considered a risk factor for the development of most types of obsessive-compulsive disorder.

Some authors consider the basis of moral mysophobia to be the rejection of an immoral act (one's own or someone else's) that the patient had to deal with. Neuroimaging performed by the patient during the study of this phenomenon shows functional and structural disturbances in the parts of the brain that form the feeling of disgust.

The ideas of moral mysophobia, according to researchers, take hold of the patients' consciousness to such an extent that they resemble delusional ones, but the presence of compulsions (cleansing rituals) correspond to their obsessive origin. The degree of maladaptation of the observed patients with moral mysophobia, the development of a noticeable intellectual deficit in them, as well as resistance to treatment allowed some authors to draw a parallel with schizophreniform disorders.

In studies of OCD patients, references to moral mysophobia are extremely rare.

Symptoms misophobia

Not every fear qualifies as a phobia. The level of anxiety corresponding to mental pathology leads to a person losing control over their fear and doing everything to avoid a traumatic situation. And if encounters with heights, crowds, spiders and even dogs can be avoided, then microbes and dirt are omnipresent. It is not at all necessary to get visibly dirty, it is enough to ride in a minibus, offer a hand to greet, count money in a wallet. Objects that cause their avoidance and the desire to wash themselves, as a rule, are dust and dirt; blood, saliva, feces, urine, other physiological fluids perceived as a source of infections; people and animals from which you can get infected; objects and places of common use; various chemicals used in everyday life.

Externally, the first signs look like behavioral deviations, eccentricities. A person washes his hands too often, constantly wipes his things with antiseptics, rewashes them unnecessarily, constantly cleans the house and workplace, tries to avoid tactile contacts. In advanced cases, the patient tries not to leave his sterile home and not to invite anyone to his place, during the period of expected epidemics he puts on a mask on his face and treats his nasal passages if there is a need to go to a crowded place, etc.

Developed mysophobia causes great inconvenience in everyday life. In addition, the need to go to work, travel by transport, contact with other people causes mental instability and mood disorders. A person becomes restless, irritable and absent-minded. He sleeps poorly, is often visited by anxious thoughts, as a result - the mood tends to zero and a depressive disorder can develop.

The situation is also aggravated by somatic manifestations - tremors of the limbs, increased heart rate, arrhythmia, shortness of breath, hyperhidrosis, nausea up to the development of gastric neurosis. In severe cases, if it is impossible to immediately cleanse oneself from dirt or avoid contamination, a panic attack may begin.

Moral mysophobia manifests itself as a feeling of defilement, internal impurity, arising regardless of the presence of visual pollution. Such sensations appear after various events: accusations or reproaches thrown at the patient, offensive actions or phrases, they are associated with individual unpleasant memories that run counter to the religious-cultural or moral-ethical ideas of the patient. The appearance of obsessive thoughts and images causes a desire to wash oneself, to cleanse oneself of moral pollution or to cleanse objects or premises that have been in contact with something “unclean” from filth.

Complications and consequences

Frequent hand washing is not yet a phobia. A pathology is a condition that prevents a person from performing everyday functions and even just leaving the house. These are the dangers that await mysophobes with an advanced stage of the disease.

In addition to the moral suffering that the mysophobe himself experiences, his hypertrophied passion for cleanliness becomes noticeable to others and begins to irritate them. Such people have difficulties with socialization; society considers them, at the very least, harmless eccentrics. It is difficult for them to create a family and save the one they already have. A rare partner is ready to endure constant reproaches for uncleanliness and to fulfill ridiculous demands for sanitary conditions - sterile cleanliness in the house, gloves and shoe covers, endless treatment of things and objects with antiseptics. In addition, the tactics of avoiding a disturbing situation, to which people suffering from phobias resort, leads to the fact that they find themselves in voluntary-forced isolation, feel unnecessary and lonely, and this is the path to depression.

Uncontrolled fear can result in panic attacks, development of neurosis, increases the likelihood of somatic health disorders. As is known: "all diseases come from nerves."

Some people follow hygiene rules more conscientiously and wash their hands more often. This is not a phobia, but if fear arises even at the thought of contamination and it is impossible to get rid of it, vegetative symptoms appear and the mood deteriorates, then it is worth analyzing your behavior and going to a consultation with a psychologist. Any phobia in the initial stage is easily corrected.

Moral mysophobia usually does not affect other people, but brings a lot of suffering to the patient and, according to research, is difficult to treat. In the final stage, even some intellectual deficit develops, in which experts see similarities with schizophrenia. Therefore, with the desire to "wash off" moral dirt, it is also better to seek advice immediately, as soon as it begins to periodically obsessively bother.

Diagnostics misophobia

The diagnosis of any phobia is made based on the patient's complaints. There are no other methods. A detailed interview with a list of sensations and somatic symptoms makes it possible to distinguish between natural and even somewhat exaggerated fear from phobia. Since simply frequent hand washing rather reflects a commitment to personal hygiene, mysophobes usually seek medical attention in advanced conditions, when the patient already has somatic complaints, panic attacks, neurosis-like disorders that significantly complicate his life.

There are many questionnaires on the Internet for independent determination of whether a person's fear reaches the level of a phobia, and which of them he is predisposed to. It is difficult to say how much one can trust the results of such testing. If the problem exists and bothers you, it is better to contact specialists.

The most reliable and authoritative test for mysophobia is the ZARS – Zung Anxiety Rating Scale. It is used by psychology professionals in different countries to measure the severity of anxiety disorders: panic attacks, phobias, neurasthenia, etc. According to experts, this questionnaire is quite effective as a preliminary diagnosis. It is about fear of any nature, not just fear of dirt. The object of fear is not very important. After instruction, the patient assigns a certain number of points to the pathological signs he has, and the severity of the anxiety disorder is determined by the total number.

Differential diagnosis

Differential diagnostics may be required if there is a suspicion of a serious mental disorder or somatic disease. In this case, to confirm or exclude a suspicion of, for example, schizophrenia or obsessive-compulsive disorder, various types of examinations may be prescribed at the discretion of the doctor. More specific differentiation, for example, germophobia and mysophobia, that is, fear of germs or any kind of dirt (including moral) is not of great importance in determining the treatment tactics. The choice of treatment methods is based on the severity of the disorder, the presence of somatic symptoms, concomitant diseases, and the response to the therapy.

Treatment misophobia

It is almost impossible to overcome fear in the clinical form of phobia on your own. It does not respond to logical persuasion, it is almost impossible to get rid of it through auto-training and mastering the technique of breathing exercises. Most patients require the help of specialists in the field of psychotherapy, in some cases hypnosis helps. Additionally, drug therapy is used to relieve concomitant and life-threatening symptoms.

According to the World Health Organization, the most effective psychotherapeutic method for getting rid of phobic disorder is cognitive behavioral therapy, as a result of which the patient should completely get rid of negative thoughts about the objects of his fear.

This method is based on the assertion that poor health after getting into an alarming situation is caused by the patient's own thoughts about how troubles can no longer be avoided. In our case, dirt and the microbes swarming in it will certainly lead to a serious illness. In the process of cognitive behavioral therapy, the patient, under the supervision of a psychotherapist who directs his thoughts in the right direction, gradually gets rid of negative thoughts and replaces them with positive ones, immersing himself in the situation that worries him, facing his fears. In the process of therapy, the patient learns to control his fear, he develops habits of impartially reacting to situations that previously caused uncontrollable anxiety.

Hypnosis is also used. In addition, the patient is recommended to conduct auto-training at home - repetition of verbal formulas that reinforce a positive attitude in the subconscious.

The doctor may prescribe medications to relieve the symptoms associated with the phobic disorder - sleeping pills, anti-anxiety medications. Most often, these are psychotropic drugs. They cannot eliminate the phobia on their own, they will only help reduce the physical manifestations of anxiety. The medications perform an auxiliary function, they are taken strictly according to the doctor's instructions.

Prevention

People prone to developing phobias have certain personality traits – increased suggestibility and anxiety. It is the individual characteristics of the psyche that experts call the main risk factor. Fears that develop into phobias arise in them in the absence of sufficient information necessary for a correct assessment of the situation and establishing control over it. Prevention of the emergence of unfounded fears is the formation of rational thinking from childhood, based on knowledge of the surrounding world.

In addition, it is recommended to watch less TV, leave the room during commercials, and re-evaluate your fears of pollution, parasites, and germs based on readily available scientific information about them.

There is a lot of literature on how to overcome your fear, anxiety, how to cope with a phobia. For example, the book series "Pocket Psychotherapist". Such books about mysophobia, and not only about it, help people learn to use their psyche and cope with serious problems.

Mysophobia is quite widespread, so there are films in which the heroes suffer from this disease. These are not films about mysophobia, they raise other topics, but this feature is played up in them.

Forecast

Uncontrolled fear can significantly reduce a person's quality of life. However, mysophobia is curable. The help of a qualified specialist and the desire of the patient himself are necessary, then everything will work out.