Invisible Trauma - Obsessive Handwashing (2)

Miss Marywood, dressed much younger than her usual self, greeted me with her usual warmth. She naturally started sharing her experiences from the past week: "Since our last meeting, my anxiety has somewhat eased, but within a few days, it began to creep back. Starting from the day before yesterday, every time I pass by sterilized alcohol at a store, I compulsively rub my hands, almost every five minutes. Now, my hands are dry, and my family is worried that I might be suffering from obsessive-compulsive disorder."

"Have you experienced this kind of compulsive hand rubbing before? Has it ever disrupted your daily life?"

"I feel compelled to rub my hands. If I don't, I fear getting infected, and I dread the thought of transmitting the disease to my family. My thoughts constantly circle back to what would happen if my mom, who is 73, falls ill. It terrifies me, and I feel utterly helpless. The thought alone is enough to make me break down."

Instead of answering my question directly, she shifted the focus to her mother's illness. This time, I chose not to intervene but to go along with her narrative.

"It appears you understand that this hand rubbing is illogical, but emotionally, you're unable to stop."

"Yes, I keep rubbing, as if trying to make it through the action."

"To make it through rubbing?"

"Yes, to rub until I'm convinced there are no viruses."

"Is that really possible?"

"Of course not! How can I ever be sure there are no viruses? But still, I feel compelled to continue..."

"I see, it's like endlessly searching without finding any answers."

"Precisely! The less I find, the more desperate I become to search."

"It's the feeling of being trapped without an exit."

"Exactly."

"Then why aren't you rubbing your hands now?" I hoped to provide a contrasting situation to make her realize that there are moments when she doesn't engage in the behavior.

She pondered.

"I feel safe here, there are no germs."

As she spoke, I sensed an inconsistency. She had initially been talking about viruses, and now suddenly, the conversation turned to germs. This shift, though seemingly minor, sparked my curiosity. I asked, "I'm wondering if there's a deeper significance to this. You've always expressed a fear of viruses, so why mention germs now? Did you notice that you've changed what you're saying?"

"Have I? Oh... Yes, that's something my mother often said to me."

"She often said that?"

"Yes, quite frequently."

Miss Marywood seemed to trivialize this frequent saying by her mother. Her tone shifted, becoming somewhat childlike, prompting me to delve deeper: "Is there a particular reason for that?"

She pondered deeply.

"I wouldn't have thought much about it if you hadn't mentioned it, but it's been this way for a long time."

"Hmm..."

I sensed the unfolding of a deeper narrative.

"I was a premature born, and my mother told me I was kept in an isolation box to prevent bacterial infection. She would often visit and say from outside the box, 'Baby, I'm so sorry you have to endure this. You're safe here, there are no germs.'"

A shiver ran through me as I realized that this phrase had been echoing in Miss Marywood's mind for over forty years.

The youthful attire, the isolation box, her mother's reassuring words—all too familiar. Forgive my imagination, but I felt as if I were in an isolation box myself.

Mary's physical memory of surviving in a sterile state is a vivid recollection of the intense panic she experienced as a newborn, before she even understood emotions. This emotional memory continues to live on in her mind.

Our conversation about this statement revealed its profound impact on many aspects of her life...

This was how Miss Marywood was being guided by her emotions, trapped in a cycle that originated long before she could comprehend it.

The journey of understanding and healing is often like this: You can only leave after you truly arrive.

Disclaimer: This simulated case is a composite based on many such cases from my clinical practice over the years. There may be an apparent resemblance to any one individual since the situation depicted in this vignette is relatively common. However, any such resemblance is accidental. The names are manufactured and do not refer to any one actual person.

#selfharm #ocd #depression #selfcutting #psychotherapy #healing #anxiety #washinghands

Image from www.pexels.com edited by #professionalkarmamaker