Jana Mettwali

ENG 210

Professor Zayas

Final Draft-Research Paper

May 4,2025

The Hidden Burden of Cleaning OCD as a Neurological and Psychological Affliction

OCD in pop culture is usually simplified to being just about loving cleanliness or perfection, but in truth, it’s an excruciating and misinterpreted illness. It’s marked by ongoing intrusive thoughts (obsessions) and actions (compulsions) that repeatedly happen. One of the most prevalent—and mischaracterized—is cleanliness OCD in which the fear of germs, dirt, or contamination is overwhelming. The reactions extend way beyond just being neat, though. They involve excessive washing of the hands, public avoidance, as well as lengthy, exhausting cleaning rituals. These actions aren’t choices—they’re measures of control over searing anxiety and an overwhelming need for safety.

This work looks at cleanliness-oriented OCD from the perspective of neuroscience, psychology, and developing treatments. It cuts through the stereotypes on the surface to reveal the biological and emotional underpinnings of the disorder. Based on scientific research and human experience, the aim is to aid in reframing our perceptions of the condition—not as a punchline or character foible, but as an authentic, isolating affliction worthy of compassion, knowledge, and improved solutions.

Neural Basis of Obsessive-

Cleanliness OCD is not only about patterns of behaviour – it’s also a feature of the brain. Several decades of neuroscience have mapped areas of the brain in relation to OCD, primarily the orbitofrontal cortex, anterior cingulate cortex, and striatum, which mediate the activities of decision-making, controlling impulses, as well as emotion regulation. With overactive functions in these regions, the brain can’t suppress obsessive thoughts, resulting in compulsive behaviours such as excessive cleaning (Fineberg et al., 2013).

One of the main chemicals in the brain used in OCD is serotonin, which controls mood. Abnormalities in serotonin signaling are thought to cause obsessive thought patterns and compulsive actions (Pauls et al., 2014). Individuals with cleanliness OCD are aware their fears are unreasonable, but the brain’s miswiring makes the urge impossible to overcome. More current work from De Joode et al. (2023) employed imaging of the brain to demonstrate how the symptoms of OCD physically impact both structure as well as chemistry in the brain, affirming once again that the disorder is not “in someone’s head” in an oversimplification sense—it’s neurologically present and quantifiable.

Emotional and Psychological Aspects

Although biology describes the mechanisms, psychology makes known the emotional weight of cleanliness OCD. It is not being afraid of dirt as much as having a profound sense of being morally or emotionally “unclean.” According to one study, in which Reuven, Liberman, and Dar (2014) participated, individuals with OCD tend to have guilt or shame associated with their obsessions, and cleaning serves as an attempt to alleviate that pain. These actions provide temporary catharsis, but in the long run, they reinforce the cycle of OCD and make it increasingly difficult to overcome.

Living in such a society where cleanliness or moral purity is stressed may exacerbate these patterns further. Cleaning starts being an emotional consolation, albeit temporarily. With time, avoidance of discomfort turns out to be a lifestyle. Fortunatelaly, therapies such as Cognitive Behavioral Therapy (CBT) can help with the same. CBT helps train the individual in recognizing thought patterns that are not rational and cope with anxiety without succumbing to compulsions. Stephenson et al. (2021) have found that even online CBT (e-CBT) alleviated symptoms as well as improved cognitive function, indicating the might of psychological treatments in mending mind-body.

Current and Emerging Treatments

While no permanent remedy treatment for OCD exists, several treatments have proven effective in reducing symptoms. The combination of Exposure and Response Prevention (ERP) therapy with Selective Serotonin Reuptake Inhibitors (SSRIs) is the most prevalent treatment. ERP encourages patients not to do their routine rituals when in feared situations, allowing their brains to learn that the feared consequence will not materialize. Stein et al. (2019) assert that ERP is the gold standard in the treatment of OCD.

Selective serotonin reuptake inhibitors such as Prozac and Zoloft boost serotonin in the brain and can alleviate obsessive thoughts as well as compulsive actions. Unfortunately, roughly one-third of individuals with OCD resist standard treatments, prompting the search for novel options. These include Transcranial Magnetic Stimulation (TMS), which sends magnetic pulses through regions in the brain, and Deep Brain Stimulation (DBS), in which electrodes are permanently implanted to modify activity in the brain. Although DBS is usually reserved for serious cases that are resistant to treatment, both techniques hold hope for those not finding relief in therapy or medication.

Shattering Myths and Eliminating Stigma

Even with advancements in medicine, OCD, notably cleanliness OCD, remains misunderstood and stigmatized. The media depicts it as an amusing preoccupation with orderliness, not acknowledging the pain it inflicts. Such misrepresentation helps to confuse the public as well as deter individuals from receiving help. Behind the Scenes: Unveiling the Misportrayal of Obsessive-Compulsive Disorder in Film and Television (2024) describes how film and television tend to oversimplify OCD as something comedic, omitting the pain and anxiety inherent in the disorder.

Education and awareness are key in combating this. Schools, healthcare providers, and the media must disseminate accurate knowledge about OCD. De-stigmatization of discussions about mental health can enable earlier diagnoses, increased support, and kinder treatment. Altering how society discusses OCD can minimize shame and make individuals feel secure enough to speak about the condition and obtain care.

Conclusion: A call for Understanding

OCD in relation to cleanliness is much more than mere tidiness preference—it’s an intricate illness forged from biology, emotion, and experience. The combination of broken brain pathways and intense emotional pain makes it exceedingly difficult to live with, yet in desperate need of attention and comprehension. With adequate treatments, increasing public awareness, and an abolishment of hurtful stereotypes, individuals with OCD can receive hope and healing.

Let’s finally stop mocking OCD and instead hear from the individuals who live with the disorder. They don’t need us judging them or laughing at them—they need our empathetic support, access to treatment, and faith that an end is within their reach. The weight they bear is invisible, but with our collaboration, the burden can be alleviated as we work together to view the disorder as what it is—and guide them through.

References

Abramowitz, J. S., Taylor, S., & McKay, D. (2009). Obsessive-compulsive disorder. The Lancet, 374(9688), 491–499. https://doi.org/10.1016/S0140-6736(09)60240-3

Behind the Scenes: Unveiling the Misportrayal of Obsessive-Compulsive Disorder in Film and Television. (2024). International Journal for Multidisciplinary Research, 6(5). https://doi.org/10.36948/ijfmr.2024.v06i05.29274

de Joode, N., van den Heuvel, O., Koster, M., Clarke, W., van Balkom, A., Schrantee, A., & Vriend, C. (2023). The Effect of OCD-Symptom Provocation on Neurometabolites in the Lateral Occipital Cortex and Their Relation to the BOLD Response. Biological Psychiatry, 93(9), S242–S243. https://doi.org/10.1016/j.biopsych.2023.02.608

Fineberg, N. A., Reghunandanan, S., Brown, A., & Pampaloni, I. (2013). Obsessive-compulsive disorder: The role of neuroimaging in diagnosis and treatment. Neuroscience & Biobehavioral Reviews, 37(10), 2256–2272. https://doi.org/10.1016/j.neubiorev.2013.02.014

Pauls, D. L., Abramovitch, A., Rauch, S. L., & Geller, D. A. (2014). Obsessive-compulsive disorder: An integrative genetic and neurobiological perspective. Nature Reviews Neuroscience, 15(6), 410–424. https://doi.org/10.1038/nrn3746

Reuven, O., Liberman, N., & Dar, R. (2014). The Effect of Physical Cleaning on Threatened Morality in Individuals With Obsessive-Compulsive Disorder. Clinical Psychological Science, 2(2), 224–229. https://doi.org/10.1177/2167702613485565

Stephenson, C., Malakouti, N., Nashed, J., & Francis, J. (2021). Efficacy of e-CBT on OCD symptoms and neural functioning. Journal of Cognitive Therapy, 34(3), 291–305. https://doi.org/10.1016/j.jct.2021.02.012Stein, D. J., Costa, D. L. C., Lochner, C., Miguel, E. C., Reddy, Y. C. J., Shavitt, R. G., van den Heuvel, O. A., & Simpson, H. B. (2019). Obsessive–compulsive disorder. Nature Reviews Disease Primers, 5(1), 52. https://doi.org/10.1038/s41572-019-0102-3