Obsessive-Compulsive Disorder – Case Example

Jay: a Case Example

Jay is a 27-year-old man who lives on his own and works as a consultant in a software marketing company. He is the youngest of 3 brothers who live in the same town as Jay. Jay describes his relationship within his family as “very good”. Like his older brother, Jay describes himself as a worrier. Especially, he says, he worries about catching a life-threatening disease like AIDS or SARS. Two years ago, while in a romantic relationship with a woman, he had unprotected sex with her. Ever since then, he has been haunted by thoughts of contracting AIDS and other diseases. Jay was tested for AIDS twice, just to be on the safe side. Both tests came back negative, but Jay went on worrying and obsessing about being contaminated. At some point he started feeling as if his hands were dirty and contaminated all the time. He started imagining the germs creeping all over him and penetrating his body, contaminating his blood, liver and heart. These thoughts caused enormous anxiety in Jay and he found himself washing his hands over and over during the day. Not only had he been repeatedly washing his hands, but he also spent about 20 minutes scrubbing, rinsing and scrubbing again. He would only use paper towels to wipe his hands off, because he believes that cloth towels are “full of germs”. He would not use public washroom air blowers if he was required to push a button to turn the hand dryer on. Jay also takes an excessive length of time to shower. On weekdays, he showers twice a day, once in the morning before going to work, and once in the evening before going to bed. On weekends, he usually showers three or more times a day. He takes about an hour to an hour and a half each time because, he says, he “doesn’t feel thoroughly clean if he does not scrub every part of his body thoroughly and repeatedly.”

Jay’s washing has become so frequent recently that it has started to disrupt his functioning at work, because it takes him so much time. He has felt very anxious when he has the urge to wash his hands during an important meeting. He has even left a couple of meetings in the middle to go wash his hands. He could not stop himself from washing, even though he knew that his boss and colleagues were wondering why he was taking so long. He felt caught up in a double bind. If he does not leave the meeting to wash, he gets extremely anxious and if he did get out of the meeting he feels anxious about the others’ reactions and possible repercussions. Last week, he was late for work because he could not stop showering for almost 2 hours. He felt particularly dirty and contaminated that morning. When he finally got to work, a colleague told him that their boss had been wondering if everything was OK with Jay, and commented that recently it had seemed that Jay was “losing it”. That afternoon, Jay decided to consult his family physician, who referred him to a psychologist. Jay was diagnosed with Obsessive-Compulsive Disorder.