What is the name of the fear of worms. Scoleciphobia: the causes of the fear of worms. Scoleciphobia and other similar phobias

Psychopathology of the "unclean"

In Shakespeare's Macbeth, after Lady Macbeth helps kill King Duncan, she laments that no matter how hard she tries, she will never be able to wash her hands. Like Lady Macbeth, many patients come with a similar symptom - a constant feeling of dirty hands, even when it would seem that there is nothing to dirty them with. We often encounter patients who have an obsessive desire to wash their hands as often as possible.

For most people, it is considered quite natural to be disgusted with certain objects that are considered dirty. For example, it could be a toilet. But if this is not just disgust, but real fear, then this is already a mental illness called a phobia. In this case, helmintophobia takes place. At the same time, the value remains unchanged, a person is panicky afraid of all kinds of worms.

The behavior of helminthophobes is such that it exceeds reasonable limits, and there is no trace of rationality. It is not enough for them to confine themselves to a preference for clean space in the place where a person resides. Such patients need to tirelessly fight for cleanliness. environment. They must personally control everything in order to protect themselves from the hated and ubiquitous worms. Throughout the day, they are busy actively avoiding risky situations.

As a syndrome of scoleciphobia and its variant - helminthophobia can be present in diseases of a different register: alcoholism, psychosis (MDD and schizophrenia), various diseases neurotic spectrum (including obsessive-compulsive disorder and hypochondriacal disorder) and by-effect taking certain medications (MAO inhibitors, methylphenidate).

Who is at risk for imaginary helminthiases?

1. Persons who have had a history of helminthic invasion, but are currently healthy. Such people are convinced that they are still sick and require a second course of treatment without sufficient grounds, or they themselves are treated with various drugs of official and / or unofficial medicine.

2. Persons with a developed imagination (artists, performers and other people of creative specialties).

3. Patients with alcoholism, both during binge and in the period of withdrawal.

4. Persons who use certain drugs for a long time medications(MAO inhibitors, methylphenidate, etc.).

5. Patients with endogenous depression.

6. Patients with neurosis (often obsessive-compulsive disorder).

7. Lonely people in a state of emotional deprivation.

8. Persons with a guilt complex, possibly of a sexual nature.

The course of helminthophobia.

Helmintophobia can manifest as illusions, shared illusions, and hallucinations.

Illusions of helminthiases. People with helminthophobia can be well educated: have a higher or secondary specialized education. Usually they read all the scientific and popular science literature on the issue of interest to them. With a lack of knowledge, they often turn to acquaintances, friends, less often to doctors.

When contacting medical institution patients try to convince the doctor that they have a certain helminthiasis, which was "subtracted" in advance. They can bring jars with pieces of feces, remnants of undigested food, pieces of wool, hair, dust, lumps of mucus, earth, allegedly containing "helminths". We observed such a patient who many times brought various jars. This symptom is called the “jars” symptom or the “matchbox” symptom.

Helminthophobes can visit a large number of doctors, but usually do not find mutual understanding. Often these are primary care physicians (district physicians, infectious disease physicians), who usually refer them to an infectious disease specialist, a dermatologist and, much rarely, a psychiatrist. A case is known in the literature when a patient and her daughter visited 103 doctors and one veterinarian for 6 months about the presence of helminths.

No laboratory tests change their minds. Moreover, patients become even more entrenched in the idea of ​​a "terminally ill" disease that doctors cannot diagnose or hide for whatever reason. They usually write detailed complaints on many sheets of paper about the "inattentive" attitude of doctors towards them, who do not take them seriously and try to convince them that they are crazy. A feature of these complaints is a sharp transition from one topic to another without any connection, "forgetting" endings and even words.

Shared illusions ("induced psychosis"). Induced psychosis is a pathological state of the psyche in which a mentally ill person inspires his illusions in others. Very often husbands and wives "infect" their other half. IN scientific literature An indicative case is when a husband “infected” not only his wife, but also three more relatives (mother, brother and sister-in-law). In some cases, relatives and neighbors try to "infect" them with helminths through unwashed vegetables and fruits, milk, meat and other products that are benign only at first glance.

Causing fear in a person is a typical trick of scammers. Frequent helminthophobes are people with impaired eating behavior (such as raw foodists or pure lovers), lovers of "computer diagnostics" (). Helminths, allegedly, are found by the frequency of their electromagnetic oscillations))) Also, sellers of various kinds of additives and herbs often scare helminths.

Probably a million articles.

There is no more sadness in the world

He penetrated both bodies and souls,

He is inside, he is outside.

He sits in every organ.

And if suddenly the brains freeze,

And my head hurt

Let's put aside unnecessary words

And let go of bad thoughts.

And yonder tail sticks out.

Worms, flukes, amoebas,

Plasmodium and Echinococcus

Fungi and other microbes...

Not even a hundred lines are enough

To list these reptiles.

There are so many of them in the world

They are always, they are everywhere

In food, in air, in water.

Scoleciphobia is a neurological mental disorder that manifests itself in a pathological fear of worms, as well as the diseases they cause. This phobia also extends to leeches, caterpillar slugs and other creatures that somehow look like worms.

Many people experience fear and disgust for worms, there is nothing special about this. Because of their appearance, these creatures are unlikely to cause someone to smile tenderly. However, some people panic at the very sight of them, or are afraid to touch them, or even think that worms can live somewhere in the house or garden. In this case, we can say that a person is sick with scoleciphobia - a disease that must be fought.

What is the reason for the development of scoleciphobia?

This disease is not inherent in young children. Children preschool age in a sense fearless, they know the world, analyze and draw a conclusion about certain things. A naive perception of the world "protects" kids from far-fetched fears and phobias. Children often collect worms after rain, examine and study them. From this behavior of the mother, most likely, they are in shock, they ask the child to throw out this muck, wash their hands with soap and never touch the worms again.

A small child feels mother's disgust for these creatures and adopts her behavior model. It is from this moment that the first signs of the disease begin to emerge. There are other events that strengthen the fear of worms in the mind of the child - the baby can be bitten by a leech or scared by a big green caterpillar.

Mothers often scare babies with worms, telling them not to walk with dirty hands, dig in the ground or drink dirty water. People with worms are especially susceptible to scoleciphobia.

Scoleciphobia is very often associated with the fear of death. The sight of a rotting corpse, teeming with worms, inspires simply terrible fear. People with a rich imagination, seeing such a spectacle on TV, begin to associate worms with death.

Depending on the cause, several types of diseases are distinguished:

• Scoleciphobia- fear of worms and everything that has a shape similar to a worm.
• Verminophobia. This is not a fear of worms, but rather a fear of all those diseases that can be contracted from them. A person is afraid to die from cadaveric poison, get irritation or warts on the skin.
• Teniophobia- Fear of getting worms.

Each person has his own reason to be afraid of worms, most often it is society that inspires a person with disgust for these creatures, and then his own fantasy is already connected. Scoleciphobia is often accompanied by other mental and nervous disorders.

What are the symptoms of this disease?

The mild form of the disease is almost asymptomatic. It is impossible to distinguish a person suffering from scoleciphobia from a person experiencing a slight degree of disgust towards worms.

Scoleciphobia in a mild form does not prevent a person from living a full life, the worst thing that can happen is a feeling of disgust at the sight of worms. Without encountering these creatures, a person does not notice his illness at all.

In severe scoleciphobia, the following symptoms may occur:

• Panic, unconscious fear at the mention of worms in a simple conversation with someone.
• Fear of touching objects in which worms can live. Some people are even afraid to eat fruit or drink water.
• Confused breathing (attacks of suffocation, or rapid breathing).
• Confused heartbeat and pressure jumps.
• Nausea and vomiting.
• Stomach upset.
• Tremor of the limbs

A severe form of the disease must be urgently treated, otherwise a person simply will not be able to fully live.

How to diagnose scoleciphobia?

Diagnosis of this disease, like any phobias, is a rather difficult process. It is very difficult to diagnose a mild form of scoleciphobia, because it is quite logical that even healthy people experience unpleasant feelings when confronted with worms. Many do not like these creatures, but this does not mean that a person is sick. Only an experienced psychoanalyst can recognize the disease in a mild form.

The severe form of scoleciphobia is much easier to diagnose. A patient without psychoanalysis can say about himself: "I'm afraid of worms to the point of trembling in my knees."

Who and how will cure scoleciphobia?

The first step to treatment is the realization that the disease really exists. If a person is aware of the problem, he is mentally ready to get rid of it. Often, diseases such as phobias (especially in their severe manifestation) are not treated on their own. From this follows the second step - to realize that in order to fight the disease it is necessary to seek help.

Need to see a psychotherapist, it is he who will help you choose the most effective individual methods of dealing with fear.

The doctor will help to understand what exactly the person is afraid of and what caused the development of the disease. Next, you need to convince the patient that worms are not monsters, but creatures created by nature and necessary for this world. The psychotherapist will help the patient look at his fear from a different angle (rationalization method).

Often used in the treatment of disease cognitive method. The essence of it is to face your fear. Under the supervision of a doctor, the patient comes into contact with worms and caterpillars. At first, this is a great stress for a sick person, however, his body eventually begins to adapt and get used to things that cause fear. The protective mechanism of the psyche is triggered - after a while nervous system the patient simply stops responding to the source of fear.

The method helps a lot. art therapy. The patient draws in detail on paper his most terrible fantasy associated with worms. It could be a giant worm monster, a graveyard infested with worms, troupes, worm food, and more. These fantasies are then discussed with a psychotherapist and a "ritual destruction" of the drawing is carried out. The picture is the personification of the fear of scoleciphobe, and its destruction will be associated in the patient with getting rid of his fear. You need to destroy the picture as emotionally as possible, throwing out everything that has accumulated inside, only then the effect of therapy will be positive.

The treatment of scoleciphobia is a long process, and you will have to contact a psychotherapist more than once. It is very important that the whole family supports the patient, but even more important is the person’s desire to be cured, a positive attitude and self-confidence.

If other methods fail, the patient is subjected to hypnosis. Under hypnosis, a person is told that worms should not be feared.

Drug therapy in this case is undesirable and is used only as a last resort. The severe form of the phobia is treated with tranquilizers or sleeping pills. You should not take them on your own - these drugs are addictive. Only a doctor can prescribe a tranquilizer. It should be taken as little as possible and only in the prescribed dosage.

Prevention of scoleciphobia

The best prevention of this disease is the absence of contact with worms, caterpillars and other fear-inducing creatures. People who are suspicious and have a great imagination should not watch horror films or documentaries with a corresponding plot. You need to avoid what seems unpleasant and squeamish and, of course, try to control your fantasy.

A type of mental disorder on the neurotic spectrum, manifested in a pathological fear of worms and the ailments they cause, is scoleciphobia. Less often, a phobia is considered as a symptom of fear of helminthiases and worms of various etiologies, often not only neurotic. According to the Diagnostic and Statistical Manual of Mental Disorders, family members of a patient with severe scoleciphobia have an increased risk of developing the disease.

Varieties and causes

According to psychiatric research, this disease is inherent in older people. In childhood, many show interest in knowing the world, studying the surrounding plants and animal world. Direct perception of the surrounding world protects children from imaginary fears. Toddlers often collect worms of interest to them after the rain, examine, study. Parents, as a rule, ask the child to remove this muck and, having thoroughly washed their hands with soap, never touch them again.

Feeling mother's disgust and fear towards worms, the child adopts the basic behavior patterns.

From this moment, the first signs of the disease may appear. Also, the cause of the onset of the disease can be any strong emotional shock. For example, from an unexpected tactile sensation of a slippery body or an accidentally seen picture of crushed caterpillars. Less often, scientists suggest a direct connection with the collective unconscious. In ancient times, worms had a negative response in a variety of legends and myths.

There are the following types of scoleciphobia:

The sight of the object of a phobia or something similar outwardly to a worm causes severe anxiety in patients. The patient in most cases realizes that his fear is unreasonable and excessive. However, fear violates the habitual way of life, causes an asthenic effect. The asthenic effect manifests itself in the form of a painful condition, leading to increased fatigue and exhaustion of the body.

A characteristic feature of scoleciphobia - the so-called fear of worms - is the desire to avoid contact with a possible irritant as soon as possible.

The range of emotional reactions ranges from mild nervousness in response to the actual presence of a worm to panic attacks provoked by a simple graphic image.

To the physiological symptoms of fear of worms (phobia) include:

1. bouts of dizziness and headache;
2. digestive tract disorders: nausea, diarrhea, vomiting;
3. horse racing blood pressure and palpitations;
4. dilated pupils or darkening of the eyes;
5. noise in the head;
6. tremor of the limbs;
7. choking, shortness of breath;
8. increased sweating, especially in the area of ​​​​the palms.

Psychological signs include:

1. feeling of anxiety and tension;
2. anticipation of the development of negative events;
3. increased sensitivity to ambient noise;
4. loss of concentration;
5. obsessive ideas about an unpleasant future.

Classic Syndrome

As a syndrome, scoleciphobia and its common variant, helminthophobia, can be present in the development of diseases of various industries: psychosis and schizophrenia, alcoholism, hypochondriacal personality disorders, a side effect of long-term use of MAO inhibitors or methylphenidate.

Often there is a development of a phobia in patients already cured of real helminthiasis.

If the phobia violates the usual way of life, then the patient should seek qualified help from specialists. In the treatment of a person use:

1. Hypnotherapy. The doctor inspires the subconscious of the patient with positive thinking and the perception of his fears. This the most complicated technique with many nuances. The success of the session depends solely on the experience and professionalism of the hypnotherapist.
2. Medical treatment. It is used in cases of advanced states of anxiety, panic and depression. By prescription of a psychiatrist, a drug of the benzodiazepine group may be prescribed. The main effect in this case is obtained from the process of inhibition of nervous excitation.
3. Phytotherapy. sedative effect, needed by people in the treatment of fears, it is achieved through a balanced intake of alcoholic infusions and decoctions of dill, lemon balm, hawthorn, peonies and valerian.
4. Behavioristic technique of "rapprochement". Cognitive psychology involves achieving maximum efficiency from doctor-controlled contacts with the object of a phobia. As a result, new psychological reactions to the stimulus should be formed.
5. Art therapy. The patient is invited to make a detailed drawing of the object of anxiety or the worst fantasy associated with it. After detailed analysis and discussions with a psychotherapist, a "ritual" destruction of the image is carried out. Clear associations are formed with the destruction of the patient's fears.

At all times, people treated diseases with fear. Once they were accepted as a punishment for sins, sometimes our distant ancestors saw in them the curses of heaven, or the intrigues of a witch neighbor. Now everything has changed, and already studying at school, children will learn how the human body works and how infection occurs. various diseases. But, nevertheless, the fear of illness has not become weaker, and the phobias of this series continue to flourish and multiply. Someone is afraid of heart attacks, others are afraid of sexually transmitted diseases, scabies, and other health problems. There is also a phobic fear called teniophobia. A person suffering from this disorder is terribly afraid of being infected with worms.

Of course, the phenomenon, to put it mildly, is unpleasant. But everyone knows that this is a disease that is being treated, modern medicine has a large number of special drugs that successfully solve this problem. In addition, children are mainly affected by helminthic invasion, as well as the population living in countryside where the farm contains domestic animals, livestock, poultry. Again, modern rural life is significantly different from the village life of our great-grandmothers, and any sane owner of a rural estate takes measures to ensure that all his living creatures are healthy. However, it is impossible to convince a teniophobe with such facts. His thoughts are constantly occupied with this topic, and the number one task is to keep his hands sterile and not to touch objects unnecessarily.

Of course, a person suffering from tenophobia creates many difficulties for himself, involving those around him. Fearing infection with worms, he constantly disinfects the floors in the apartment so as not to accidentally bring worm eggs on shoes from the street, washes his hands many times, trying to touch objects outside the house as little as possible, zealously monitors the household, forcing them to take medicine for worms every month. Of course, he does all this himself, showing good example. In addition, the teniophobic constantly goes to the laboratory, taking blood and stool tests to make sure that he is healthy, but constantly doubts the results, and is sure that doctors could simply "look through" the infection.

As a rule, teniophobia is associated with personality disorders. These are prolonged depressions, anxiety for any insignificant reason, suspicion. A patient suffering from teniophobia is constantly trying to identify in himself the signs that occur in a person with helminthic invasion. He is worried about the seeming nausea, then he is sure that diarrhea is caused precisely by the presence of worms of various types and sizes in his body. Signs of gastritis, or any other disease, are unequivocally regarded by such an individual as infection with worms. The slightest deviation in the work of the intestines causes a real panic, and teniophobe again rushes to the laboratory to take tests.

There are many factors that can cause the development of teniophobia. In some cases, such fear can even be justified, and to a certain extent understandable. It is not surprising if a child has had a helminthic infection, and his parents are afraid that this may happen again, because kids often take toys in their mouths that they played in the sandbox in the yard. And it is known that such places on playgrounds are very fond of visiting all the cats living in the vicinity. Therefore, the logical chain is understandable to anyone, and in this case, there really is a reason for fearing that the child will get any infection.

Another very common reason for the appearance of teniophobia is a person's excessive interest in medicine, based on the study of various "home healers" and collections of folk healing. For example, the authors of some publications claim that the human body is literally crammed with worms of various types and sizes, and it is extremely difficult to get rid of them. Unable to adequately perceive the information received from various means mass media, such people turn their lives, and the lives of their loved ones, into an endless and relentless struggle against a helminthic infection.

In most cases, this disease is not considered a separate problem, but is an addition, or a consequence of certain mental disorders, so it does not matter which method of treatment the doctor chooses in this case. In addition, patients with teniophobia often suffer depressive disorders. It has also been proven that somatic symptoms occur much more often in such patients. These include sensations of pain of various origins, as well as phenomena such as dizziness, chest discomfort, shortness of breath, hand tremors, and increased sweating.

If a depressive state is treated at the same time, and the signs of depression go away, then somatic complaints also become less. To rid the patient of teniophobia, psychotherapists use a number of special techniques, both traditional and copyrighted. Each treatment is effective in its own way. In the first stages, the doctor establishes a trusting relationship with the patient, carefully listens to all his complaints, and descriptions of symptoms, even if they sound ridiculous. The main thing is that the doctor must reassure the patient, and prevent possible uncontrolled self-treatment from an imaginary helminthic infection.

The fear of microbes greatly complicates the life of a person. Such a phobia can turn into a real paranoia if you do not start to fight it. People concerned about cleanliness own body, wash their hands several times a day and not only. In their opinion, this is the only way to get rid of germs and dirt that could get on the skin in the process of communicating with another person or interacting with any object. Paranoid thoughts prevent them from focusing on really important events, which is why the quality of life of misophobes greatly deteriorates.

A person with mysophobia tries to wash his hands at every opportunity.

Fear of germs is called one of the varieties of zoophobia. It can be found in the ICD-10 under the code F40. To know exactly what this disorder is called, you need to refer to reference books. In medicine given state called bacteriophobia or mysophobia. Verminophobia is also included in this category of fears. People who are very afraid of worms suffer from it.

Man with mental disorder She tries to wash her hands every chance she gets. Such actions do not alleviate his condition, because after a few minutes he again has a need to cleanse his body of non-existent pollution. In severe cases of the disorder, the patient can wash their hands at least 600 times a day. Because of this, his skin suffers greatly. Due to cleansers, it becomes excessively dry and cracked.

The patient always carries hand sanitizer with him. As a rule, he is characterized by such character traits as pedantry and cleanliness.

People with mysophobia often realize that not all bacteria and germs are life threatening. But they can't help their own fear.

Causes

According to the results scientific research, are most susceptible to phobias that are associated with germs, worms and dirt, people who have unresolved issues psychological nature. In this case, we can talk about constant coercion to something or the frequent invasion of other persons into personal space.

Bacteriophobia often worries people whose profession is associated with constant contact with pathogens. The person who died due to infection is afraid of bacteria close relative or a friend.

A mental disorder may be the result of an incorrect definition of boundaries in a residential area. This applies to people who have to share their home with another family.

Rapid weight gain, pregnancy or abortion are also factors that contribute to the development of mysophobia.

It is very important to define true reason fear of germs. The choice of treatment for a person with this disorder depends on this.

Every year, the number of people suffering from a fear of germs is only increasing. Experts have found an explanation for this phenomenon. In their opinion, such fears are born in a person’s head due to the fact that he lives in a potentially dangerous environment. In addition, films about infections with various pathogens are now popular. Such films leave a negative imprint on impressionable viewers.

Symptoms

People who suffer from mysophobia feel that everything around them is teeming with germs.

Verminophobia, like the fear of microbes, is characterized by pronounced symptoms. It is noticeable to most people who are surrounded by a patient with a mental disorder. People with mysophobia cause bewilderment in others, sometimes they can frighten with their unnatural behavior.

You can recognize a person with a fear of germs by the following symptoms:

1. Constant rejection of handshakes and hugs.
2. Preference for using disposable tableware.
3. Refusal to move to public transport.
4. Isolation from other people, even friends and relatives.
5. Disdainful attitude towards street and domestic animals.
6. Need for handwashing a large number of once.
7. Fear of touching any sources on the street that can lead to infection.

Such a person is instantly annoyed when someone else touches him. personal belongings. In particular severe cases on the hands of the patient, you can notice severe damage to the skin. They arise from the fact that he makes too much effort while washing a potentially infected part of the body.

If the patient is in a state of panic, which is caused by the inability to cleanse his body with available methods, then he begins to experience a lack of air. A person vomits, the skin turns pale and the pulse quickens. In this case, he needs urgent health care. He is not capable of overcoming a phobia on his own at the activation stage.

Diagnostics

Mysophobia is diagnosed by psychotherapists. Based on the patient's symptoms, they can tell what exactly is bothering him. According to experts, this pathology does not present any particular problems. It responds well to treatment if the person himself becomes interested in his recovery.

In the process of diagnosing a fear called mysophobia, it is important to distinguish this disorder from other, more serious pathologies. Fear of germs can be confused with the following disease states:

• Neurosis-like form of schizophrenia.
• schizotypal disorder.
• paranoid schizophrenia.

These pathologies are associated with delusional and obsessive states which have nothing to do with phobias.

How is the treatment carried out?

Since mysophobia operates on a subconscious level, professional psychotherapist hypnosis is one of the oldest, fastest and most effective forms of psychotherapeutic work.

Fear of worms, germs and bacteria may require treatment, which is carried out by various methods.

Therapy is used if mysophobia causes a person severe discomfort and prevents him from living a normal life.

If a person wants to get rid of a phobia, he first of all needs to set such a goal for himself and gradually move towards it with the help of an experienced psychotherapist.

Professional help

Verminophobia and fear of germs do not go away on their own. A person with a mental disorder, which is caused by a fear of infection, requires psychocorrection.

Prices for consultations with a qualified psychotherapist start at 600 rubles per session.

If a patient comes to an appointment with a specialist and says, "I'm afraid of germs," ​​the doctor begins to select an individual course of therapy for him, aimed at suppressing the main fear.

Many misophobes are constantly in a state of increased anxiety. To calm the patient, the specialist will suggest that he take certain medications:

• Antipsychotics.
• Tranquilizers.
• Antidepressants.

They relieve the main symptoms of a mental disorder. Hypnosis sessions help to eliminate the problem itself. In the subconscious, all those factors that contribute to the development of the disease are hidden. The person himself may not know about them. And only through hypnosis can information about negative experiences from the past be brought to the surface.

Hypnotherapy gives a lasting effect. But to achieve it, you have to go through several long sessions. As a result of such treatment, the following changes will be noticeable:

1. The patient begins to understand that microbes are an integral part of his life.
2. He learns to correctly assess the threat to life that microorganisms can carry.
3. A person becomes interested in communicating with other people.
4. In society, he feels safe.
5. He is no longer haunted by anxiety.

Another way to treat the fear of germs is psychotherapy. To get rid of fear, a person must learn to perform actions that can lead to infection. It's about about shaking hands, riding public transport, or petting someone else's pet. This therapy gives a good result if the patient does not refuse to fulfill the tasks of the psychotherapist. It works best when the disorder is on initial stage of its development.

People with mysophobia benefit from meditation

A phobia can be corrected without the intervention of a specialist. If the manifestations of the disorder are mild or moderate, then the person can cope with the deviation on his own. To achieve this goal, he will need to master a number of meditative techniques and autogenic training that help to fully relax and get rid of feelings of anxiety.

People with this mental disorder benefit from breathing exercises and meditation. They help relieve tension, anxiety and restore balance. The most important thing in such a situation is not to try to run away from fear, but to start fighting it with radical methods.

Recovery is achieved gradually. To avoid severe panic attacks in the future, the patient should learn to perform elementary actions that do not threaten his life:

1. You need to pet your dog or cat.
2. You should learn to take a shower no more than 2 times a day.
3. Do not refuse to shake hands when a familiar person holds out a hand during a greeting.

In an attempt to recover as soon as possible, some misophobes completely abandon water procedures. This is wrong behavior that will only make things worse. A person must see a clear line between the painful desire to constantly be in a sterile environment, and also avoid contamination of the body, and ordinary cleanliness. If he is unable to distinguish between these things, then he definitely needs medical attention. The sooner it is provided, the sooner the patient can return to normal life without fear of germs.