Dear Sir, My mother is 54 years old she is suffering from physiological disorder. She washes any cloth or any substance 4-5 times. She became uncomfortable when any one enters with shoes and sandal she suspects some dirty things come with shoes. She believes everywhere dirty thing speeded and she is feeling very uncomfortable and she can?t touch anything. She is tells when I suspects some dirty thing my heart starts paining and brain do not works that time. Two or three years back one gynecologist doctor practicing outside my home that time she has seen some unwanted thing she believes that dirty spread everywhere from that time this symptom is increasing day by day. And she has no trust in medicine cure. Her heart starts paining that?s why she is doing nothing avoiding cooking food also. Please Please help me guide me and tell what is the treatment because situation becoming worst day by day. Sometime she is going on depression mode and start cry she is thinking there is no possibility of cure and always thinking how she will survive. Sometimes suicide feeling also comes because there is no hope of survive.

Dr. Saul PereiraPsychologist46yrs exp

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Meet with a counselor first and then if that person recommends a psychiatrist to deal with this issue, do visit one as soon as possible. There may be some developmental issues that may have contributed to this condition. This is a fear-based condition and for some reason, she has not been dealing with childhood fear which has now developed into these repetitive adaptations to seem to need it for normal functioning. The behavior will then become based on magical thinking and certain rituals will become necessary to do normal things making her believe that either the frequency or the ritual is important to its success. This, of course, is a fallacy but there will come a time that even if told the truth, she will believe such things as will defy any logic and she will continue behaving like that even if it cripples her in your daily routines she cannot but help herself. It only appears as though some other force is behind these behaviors and that she is compelled to act in this fashion. That is obviously not true but no one can convince her of anything different. The obsession is a repeating thought pattern with no meaningful outcome; and the compulsiveness is the need to act on those obsessions also in a repeated behavior pattern as though she just cannot help herself, like the excessive washing. There are certain behavioral techniques to be implemented and if they work she may get out of this condition rather easily. If that does not work as desired, then medication has to be introduced, and in combination with counseling much work can be achieved. 

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