Exposure Therapy for Germ Phobia
As part of CBT or used alone, exposure therapy, as the name implies, exposes you to what you fear. Exposure therapy is based upon the behavioral concept of habituation where behavioral and sensory responses diminish after repeated exposure to a particular stimulus.
The stimulus in exposure therapy for mysophobics is germs. With time and gradually increasing levels of intensity, habituation occurs and fear and anxiety eventually lessen. For mysophobics, therapy may begin by looking at images of germs through a microscopic. Then, you may be exposed to germs in controlled situations. These sessions build up to exposure to germs in real-life situations.
In each session, the therapist will guide you in experiencing the fear and anxiety until habituation occurs and theses feelings subside over time. Additional techniques, such as progressive muscle relaxation or deep breathing, are taught to lessen anxiety and promote relaxation.
Extinguishing fear through habituation undoes what has been learned through classical conditioning, in which individuals become afraid of neutral stimuli due to the paired association between neutral, conditioned stimulus (CS) and fear-inducing stimuli (UCS). To reduce or eliminate the fear, you need to unlearn the association between the CS and UCS. As a mysophobic, for instance, you may have learned an association between fear and door handles (CS). In exposure therapy, you would touch door handles again and again until habituation occurs. The association between the CS and fear eventually breaks, and your fear lessens or disappears over time. With ongoing practice, you learn that touching a door handle will not result in terrible consequences.
Response prevention is a second component of exposure therapy and may be used if you carry out ritualized, repetitive behavior, such as frequently washing your hands to neutralize your anxiety. Based on the principle of operant conditioning, response prevention works on the theory that behavior becomes extinct, or gradually stops, when it is no longer rewarded. Washing your hands after touching a door handle, for example, negates the effect of touching it. Since washing your hands reinforces and allows you to avoid or escape contact with possible germs, the behavior cannot stop unless it is prevented. The combination of exposure to germs, along with the prevention of constant hand washing, leads to the most effective treatment for mysophobia.
Germ phobia treatment requires patience and commitment. These effective therapies work if you confront your fear instead of avoiding it. You may often feel as if you are getting worse long before you get better. Continuing treatment, though, will help you conquer your fears.