OCD vs. Phobia Problem?

By Kristina Randle, Ph.D., LCSW


Hello, please help! I am a 48 year old male, married with kids. I have always had some degree of anxiety (a worrier), usually very minor but with all the stressors I’ve endured lately (double job loss, part time business failure), I believe it has accelerated to an OCD condition – I have a fear of hazardous material, and in particular asbestos and the diseases it causes. My fear is heightened when I think my family may be exposed as well. I’ve had this fear (to a much lesser extent) for quite some time since learning the horrors of contracting mesothelioma, but it has seemed to peak – I can take the thoughts to the extreme as described below.

I feel compelled to check every old / antique thing we own for it and everywhere I go, and have taken several samples from our home into a lab to get checked (drywall mud, paint, ceiling texture, etc.), although our home was built well after asbestos was banned for those uses. I also have had articles from the yard tested (old cooler insulation, concrete fireplace, antique painted fencing and lawn furniture, etc.). Everything has tested “no asbestos”. It seems that as soon as I get the good news of a negative test, my anxiety drops for a bit, but I soon find something else to obsess over. I even get paranoid in older buildings – is there asbestos above the drop ceiling? Have they remodeled recently, releasing fibers into the air? Is that sprayed on stuff on the ceiling support asbestos? I called the school system about the school where my wife works to ask about some vinyl tile, the city to ask about dust being raised from the dump by the road, and I email experts often when I have anxiety about certain objects or substances. My wife only knows a fraction of my activity for fear of her thinking I am completely nuts.

I always go through several layers of “what if”, and it is maddening. I feel that I need to find a way to retire from being the “asbestos police” – I know the odds of an illness are very remote, and exposure and illness are essentially out of my control. I feel that this may be my main issue – I have such a current lack of control over my life, I must need to control something. I have seen a therapist several times and it has helped to bring down my overall anxiety level, but the obsession to check for asbestos everywhere remains. I do have moments of clarity, when I see my obsession as a problem and have very low anxiety, but they are fleeting. Do I fit the description as having OCD, or am I just phobic and overly “cautious”? I really want to be back to my old self, virtually without a thought about asbestos.

A. Though I cannot provide a diagnosis over the Internet, your symptoms seem indicative of obsessive-compulsive disorder (OCD). OCD is an anxiety disorder that is characterized by unwanted, reoccurring thoughts and repetitive behaviors.

Among OCD sufferers, specifically among those with health-related anxieties such as yours, often no amount of reassurance is enough. In fact, the act of seeking reassurance can make OCD worse. It temporarily decreases anxiety but it reinforces the “seeking reassurance” behavior.

OCD sufferers should resist the urge to seek reassurance and instead endure their anxiety. If an individual habitually seeks reassurance when they feel anxious, then not doing so will increase their anxiety, possibly to very intense levels.

Those levels cannot be sustained. Anxiety always decreases. In that way, anxiety can be likened to the law of gravity: what goes up must come down. Individuals with OCD are unwilling to endure their anxiety. They do everything in their power to escape it. That is a mistake. Anxiety avoided in the short run is only intensified in the long run.

As you stated, “I know the odds of an illness are very remote, and exposure and illness are essentially out of my control.” It is generally believed that individuals with OCD, through their rituals, are attempting to establish control over events and situations that in reality they cannot control.

You can reduce or eliminate your anxiety by focusing on reality. If you force yourself to believe in reality, then your anxiety will diminish.

Beginning therapy was a very wise choice. I would strongly urge you to continue. Therapy can help you to understand and to be comfortable with things that are beyond your control. This wisdom has been shared by mankind since the beginning of recorded history and perhaps before. It is exemplified in the Serenity Prayer, (adopted by Alcoholics Anonymous) “God, grant us the Serenity to accept things we cannot change, Courage to change the things we can, and the Wisdom to know the difference…”

OCD tends to be a progressive disorder but this is not true for everyone. Symptoms may occur on certain occasions or on all, decrease over time or increase. There are effective treatments for OCD including cognitive-behavioral therapy and relaxation training. A specific form of cognitive-behavioral therapy, known as exposure and prevention response, has been shown to be a very effective treatment. Medication can help as well.

I wish you the best of luck. Please take care.

Dr. Kristina Randle

Photo

 

 

Last reviewed: By John M. Grohol, Psy.D. on 13 Apr 2012

APA Reference
Randle, K. (2012). OCD vs. Phobia Problem?. Psych Central. Retrieved on November 25, 2014, from http://psychcentral.com/ask-the-therapist/2012/04/13/ocd-vs-phobia-problem/