Chair contamination

Author: KW

Created: 10/09/2021 Last Modified: 27/09/2021

Adult / CYP: Children and Young people

Categories: OCD

Experience Narrative:

Practitioner and client sat in therapy room. Client touching the chair both palms and then rubbing this on her phone and clothing and back onto the chair. We plotted on a graph how much discomfort they were feeling (SUDS) out of 10 - being most. Leaving the therapy room and when returning home, sitting on several family chairs or sofas with same clothing, repeating touches.

Belief to be tested:

If I touch the chair then I will be contaminated, I will get sick or my family will get sick and may die, it would be my fault.I may also infect others who use the chair after me. If I go home and touch things with my clothes or hands, I will spread the germs and family members will get sick or die. Responsible and a bad person

Alternative Perspective:

If I touch the chair covering, then no one will get sick and no one will die. When I get home, I can sit and touch areas and no one will get sick from this. Nothing will be my fault. I am a good person

Safety Behaviours to drop:

Neutralising by hand washing or wiping down hands or clothing, or changing clothing after the ERP. Asking others to avoid sitting in the places you have or wiping things down for you. Scrunching up hands avoiding palms touching areas.

Client reflections:

Client noticed the urge to neutralise, discomfort in hands, felt one hand was more contaminated than the other. Noticed lots of intrusive thoughts with the OCD was telling her not to put hands flat, that she still needed to keep safe.

Practitioner reflections:

Good to use a name for the OCD 'Karen' and to ask what Karen was up to, how did she make you feel, what thoughts and physical symptoms were going on. Also linked this ERP back to theory and and theory b. The formulation was also in view.

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