The term “Misophobia” in translation from the ancient Greek language means an obsessive fear of infection ( μύσος – dirt, pollution, defilement). With mysophobia, a person tries by all means to avoid contact with any objects, the sterility of which he is not sure.
Each of us is aware that the world in which we live is filled with various microbes. In the air, on the surface of the body, furniture or food, there are many microorganisms: bacteria, viruses, fungi. Even the human body (skin, gastrointestinal tract, oral cavity, nasopharynx) is a habitat for a large number of bacteria that are not only not harmful, but also necessary for normal functioning.
The vast majority of people, of course, tend to avoid contact with potentially infectious objects, adhering to generally accepted hygiene standards: wash their hands before eating and after going to the toilet, use wet or disinfectant wipes if there is no access to water and soap, control the expiration dates and storage conditions of food products, carefully process them, avoid contact with people with infectious diseases, etc. But these actions are reasonable and justified.
People suffering from mysophobia significantly exaggerate the threat from contact with microbes, their fear of infection many times exceeds natural anxiety and grows to the level of a phobia.
Of course, this obsessive fear should not be confused with a person’s natural fear of contracting, for example, leptospirosis in questionable water bodies, infectious diseases in Africa and South America, not to mention the current coronavirus epidemic.
Misophobia can be a symptom of obsessive – compulsive disorder (OCD) or one of the manifestations of hypochondriacal disorder (pathological anxiety about the risk of getting sick). However, mysophobia can also be an independent disorder related to isolated (rare) phobias. In this article, mysophobia is considered precisely as a separate disorder.
In psychiatry, a phobia is considered to be a significantly pronounced fear, which is caused not only by direct contact with an object or phenomenon, but also by the thought of the possibility of such contact. At the same time, the fear felt by a person is not explained logically and therefore is irrational. A phobic disorder can lead to a decrease in the quality of life, social maladaptation, and even disability due to the patient’s attempts to avoid frightening situations.
Manifestations of mysophobia
Since the pathological fear of infection is one of the variants of the phobic disorder, the manifestations of mysophobia are similar to the symptoms that are observed in other variants of phobias. Upon contact with objects that, according to the misophobe , can be potentially dangerous, a hormonal storm begins in his body. Cortisol and adrenaline are released into the blood, and the autonomic nervous system is activated. A person feels dizzy or derealized , breathing becomes shallow and rapid, nausea, trembling of the limbs, an acceleration of the pulse and an increase in blood pressure may occur. There is often increased sweating, and problems with urination and defecation control may occur.
In some cases, anxiety in mysophobia can be so pronounced that it reaches the level of a panic attack.
With mysophobia, a person may be fully aware of the irrationality of his fear, but, nevertheless, he experiences this state very hard . Very often, even the thought that he will have to touch any object that may contain germs causes a feeling of anxiety.
A patient with mysophobia makes every effort to avoid situations in which he may be exposed to germs; his behavior becomes unreasonable and his actions obsessive. Although overuse of soaps and disinfectants can make a person more susceptible to infection by destroying the skin’s natural protective barrier, the mysophobe repeatedly washes and re-scrubs their hands. A person suffering from mysophobia often uses detergents to clean food, avoids public pools, toilets, and baths. He carefully separates his personal belongings from the general ones, does not use other people’s dishes, cannot eat in cafes or restaurants, live in hotels, etc. Mizofob maintains maximum order in his apartment, uses disinfectants for washing floors and dishes and for washing clothes, disinfects surfaces, scalds food, etc.
With the development of this disorder, the life of a person with mysophobia becomes more complicated. He becomes afraid to ride public transport, use the elevator, go to stores, because, in his opinion, there he can meet dangerous microbes. Mizofob avoids social events due to fear of large crowds of people, does not come into contact with pets, as he considers them extremely dangerous in terms of infection. He cannot shake hands with interlocutors, cannot stand welcoming hugs or kisses. A person with mysophobia has to resort to various tricks in order not to come into contact with objects that, in his opinion, pose a risk of infection: he uses napkins so as not to touch door handles and handrails in transport, wears gloves, repeatedly disinfects all objects in his workplace etc.
All these actions and attempts to avoid frightening situations lead to the restriction of social contacts and travel space . It becomes difficult for a misofob to communicate with other people, not only because he is afraid of infection, but also because acquaintances and colleagues do not understand his actions. Others perceive the misophobe’s attempts to evade contact and constant disinfection as an eccentricity, which causes alienation. In some cases, the behavior of a person with mysophobia appears hostile and sometimes paranoid, leading to social isolation.
Reasons for the development of mysophobia
As in the case of other mental disorders, some authors attribute the causes of the development of mysophobia to the interaction of several factors, including: hereditary predisposition, prenatal developmental disorders, certain conditions of upbringing ( overprotection or excessive control), and psychotraumatic situations. The impetus for the formation of mysophobia can be a negative life experience associated with an infectious disease, which occurred both with the person himself and with one of his acquaintances. In the presence of a genetic predisposition to the formation of a phobic disorder, mysophobia can occur after reading a negative story from a literary work or movie.
Paradoxical as it may sound, the increase in general literacy, including in matters of medicine, plays its negative role in the spread of mysophobia. In the 21st century, information about the infectious nature of a large number of diseases has become public and common knowledge; people are more aware of the need to adhere to hygiene rules. There is an opinion that a significant factor in the increase in the number of patients with mysophobia was the spread of such a disease as acquired immunodeficiency syndrome, which occurred in the 20th century. At the moment, due to the coronavirus pandemic in 2020, an increase in the risk of developing mysophobia in a large number of people with a genetic predisposition to developing phobias is predicted.
Aggressive advertisements for disinfectants such as antibacterial soaps, special seat belts that prevent handrails on public transport, and similar publications can fuel mysophobia in people with a hereditary tendency to form phobic disorders.
Treatment of mysophobia
The general principles of therapy for phobic disorders also apply to the treatment of mysophobia . In the event that the severity of the disease reaches such a level that the quality of life decreases, it is rational to use an integrated approach to the treatment of mysophobia – a combination of drugs and psychotherapy.
Medical treatment of mysophobia
To reduce anxiety, sedatives are used as a medical treatment for mysophobia, including anxiolytics , as well as antidepressants. These drugs are prescribed by a psychiatrist in the case of a diagnosis of mysophobia individually, depending on the course of the disorder and the severity of the symptoms. In parallel with taking medication, the patient undergoes a course of psychotherapy.
Psychotherapy for mysophobia
Psychotherapy for mysophobia is an important aspect in overcoming this disorder. Cognitive behavioral therapy is recognized as the most effective treatment for phobias. First of all, psychotherapy for mysophobia is aimed at ensuring that the patient realizes, comprehends and rationalizes his actions. In addition, techniques such as implosion therapy and systematic desensitization are used.
Implosion therapy for mysophobia
One of the psychotherapeutic methods of treatment is implosive therapy for mysophobia. The essence of this technique lies in the deliberate immersion of the patient in a traumatic situation; in the case of mysophobia, it is the opportunity to come into contact with objects contaminated with microbes. First, a person with mysophobia imagines such circumstances, then they are modeled, later they become reality, and the duration of contact increases. The patient, under the supervision of a specialist, experiences the emotions caused by fear and, as it were, gets used to them. With sufficient persistence, over time, the severity of negative reactions decreases.
Systematic desensitization
The first stage of psychotherapy for mysophobia in this case is teaching the patient methods of deep relaxation. Then, as in the case of implosive therapy, the person is placed in conditions that cause him to react with fear. Gradually, the reaction of anxiety is replaced by developed reactions antagonistic to fear. Systematic desensitization (desensitization) is a fairly effective technique for overcoming mysophobia.
The combination of drug treatment prescribed by a psychiatrist and psychotherapy reduces the severity of mysophobia until complete recovery and returns the patient to normal functioning without debilitating fears.