Hi all. I’m new to this forum. My sister has Schizophrenia which was diagnosed about 18 years ago and has been taken Denzapine (a generic brand of Clozapine, I think) for many years now. She also suffers with OCD which is said to be a side effect of that medication. She takes Prozac to treat the OCD but it is getting worse recently. She truly believes that coming into contact with products (like for example cleaning products or cosmetics) affect her mind. As a result she spends most of her day washing her hands. It’s not a hygiene concern but more so a belief that if she doesn’t wash her hands for long enough, the product she has come into contact with will affect her mind. She describes it as though she feels like she is going crazy. And can only prevent it from hand washing. I’m here wondering if anyone else has family or friends with similar thoughts or if someone can offer a solution on how to improve this for her. Thank you.
Our skin is a pretty tight barrier for most things, barring a cut or tear. Were it not we would all swell up like sponges in the shower. However, transdermal “contamination” can occur when the molecules of the product are made small enough. As usual is a bit of truth in every delusion. And I have met supposedly mentally healthy folks who get a bit worked up over transdermal transfer of chemicals. Rather than trying to convince her she is wrong, could you find a product that is not so rough on the hands? Like they use in the medical field?
I think you’re alluding to the idea that she suspects multiple different types of substances are harmful to her.
True that keeping skin clean is important, but as @thereisalwayshope said, skin is a pretty effective barrier. Usually, skin will react to a substance before it gets into the rest of the system.
Also agreeing with @thereisalwayshope that accepting the fact that your DX’d sister doesn’t like certain products or chemicals to touch her skin and being open to helping her find alternatives she is comfortable with might be a better use of your time and energy than trying to convince her otherwise.
Personal example,
My DX’d brother became suspicious of municipal water from the tap.
He was aware that it may have started from a delusional line of thinking, but there might actually be some sense to it.
I told him I have a filter that I use for drinking water only, even though I cook with unfiltered tap water. I prefer the taste after filtration.
He said that he is concerned mostly about the fungus spores and contamination from pipes that have probably never been serviced since installation. I googled some things and realized, he does have a good point.
So, we worked up a budget to estimate how much extra money it would cost to buy bottled water. It turned out his preferred brand was relatively cheap and he could afford buying a case of bottles a week.
Easy, non-crazy solutions.
I have to say @wreklus, you have the patience of a saint. You’re a good brother. This illness is so hard, but you seem to be able to see through the trees.
Thanks for the suggestions. She has chosen products which she is happy to use.
I’ve never tried to question her belief because I’m not living in her mind or living her experiences. I have my own experiences with OCD, depression and anxiety and even though I can relate to being in a bad state of mind, I still can’t find a way to make this any better for her.
I am really more concerned about the amount of time she spends hand washing to prevent it. She certainly doesn’t enjoy having to do it and she hasn’t always done this. It only began a couple of years ago. Because she dedicates most of her day to this, she is not doing the things she always done and enjoyed. I can see her getting more stressed and unhappy about how her life is and having to carry out this routine hand washing. I want to help but really don’t know how.
Sometimes as @wreklus has said a conversation about alternatives will work or distract. Ask her what she thinks she could do differently. Is she opposed to wearing gloves? Or doing several tasks that may contaminate her together then washing her hands? Agree there is contamination but talk about how thick the skin barrier is and the length of time she has. If she says there is nothing the sad truth is there is nothing you can do. My son did benefit some from CBT in terms of learning to examine his delusions. They don’t go away. But many days he can put them on the back burner for evaluation later.
We tend to think people with off the wall ideas are crazy because they express themselves differently and over think situations. My son moved into an old mobile home and HAD to have whole house filter installed for reasons similar to what your brother said. He did not like the bottled water solution because of the amount of plastic we “in Egypt” throw away. I understand what my son is saying with his odd language because I have asked for the references sometimes. And they will make me chuckle at his links on occasion, but bottom line, he often has a valid point.
Thanks again for the advice. Regarding the gloves, the unusual thing is that sometimes what she comes into contact with is not through her hands. For example she asks that we don’t spray hair spray or deodorant in the bathroom. So we don’t. We use them in our bedrooms and she is ok with that. If she thought we had used a product in the bathroom, she would feel the need to wash her hands even more excessively. Even though, something like a deodorant will be in air, she is not afraid of breathing that air. It is more a case of washing her hands to prevent it from affecting her. I know it’ sounds kind of complex and confusing.
I have OCD myself so I can relate to the irrational fear element. And even though I was compelled to carry out various tasks to prevent bad things from happening, I always knew deep down that my doing so would not have an effect either way. I used CBT & Lexapro to overcome my OCD and have been lucky enough to now have it relatively well managed. But she has tried similar through CBT and Prozac and unfortunately it just seems to be getting worse. I’m not sure of perhaps it is because it is a delusion as part of her Schizophrenia or if it is her OCD or a bit of both. She insists it is not her OCD at all but feels that all of these products affect her mind because of the medication she take. (Denzapine). Thanks again. It is nice to share with people who have similar experiences
@wreklus 's story reminded me of something from my past. I used to work at a disaster restoration company where we had an ultrasonic cleaning machine for removing soot from small household items. We use to put our hands in it just to watch the dead skin cells float off—such fun!
Our machine was huge, but I know they make small versions. Perhaps your sister would consider one of these an acceptable time saver.
Sounds like an idea. Might be worth mentioning to her and see if she is open to it. 
Whoa … maybe that’s not a good idea at all.
I’ve just been looking around online and there are some sites that say not to put your hands in one of those machines while it’s running.
Probably should run it past a doctor before trying it.
Same. Just looked them up online to see what kind of products are available and there seems to be a lot info advising not to put hands in. Will have a rethink and see if there’s any other options. The skin on her hands is very broken and chapped too because of all washing. But she won’t use products like moisturiser or hand cream or creams for eczema because she says these also affect her. It’s a difficult one to remedy.
@Elf
That does sound like a challenge. Considering the skin on her hands is being harmed by frequent washing, maybe a visit to a dermatologist is a good option.
It is possible that having the full on medical explanation directly from a specialist might help her to feel differently about washing, especially if she uses abrasive or harsh products.
I personally believe that therapy, medication and a long-term treatment plan are the most important.
But seeing a dermatologist as well might provide a lot of valuable insight to the physical impact her habits are causing, as well as some useful information on options to prevent more harm.
I know I am the type to ignore other people’s advice regarding things like health, only to be told the same by a doctor and finally see the logic behind it.
Sometimes, “This works.” Isn’t good enough.
Sometimes I have to hear the big words from someone with an acronym after their last name. Your sister could possibly be the same in this circumstance.
Yeah that might be worth a try. And she is due to make an appointment with dermatologist soon to get mole mapping done. She had melanoma about 10 years ago and had this mole removed and it luckily hadn’t spread anywhere else so she has to get regular checks now to keep an eye on existing moles. It might be worth her while speaking to them about the condition of her hands too.
That sounds painful, Elf. I hope you find a solution to her problem.
It sounds like a delusion in that she has linked her meds to an adverse affect to certain chemicals. That idea is not too far fetched but the manner in which she sees the contamination occurring is not reasonable…none in air although the molecules of the chemical are there and only skin on hand contact. The problem with delusions is when they become fixed. It seems you have a work around that is satisfactory to some extent, but if you are worried and she is stressing about this, perhaps a call to her doctor is needed. Best of luck.
I sometimes can get a little bit like this at times when I use certain cleaners… if the label says, wash hands after use, I feel like I have to wash my hands multiple times, maybe excessively… maybe a little bit of a phobia of strong chemicals… but not thinking it will affect my mind…
I was going to make soap once as a project for grandkids. Then I started reading about the process. Many of those chemical names are a bit scary but mostly what I discovered is cleansers tend to be on the caustic side…which makes sense you want them to remove dirt residue and germs. Even baking soda and vinegar --“natural” products will dry out skin to the point of cracking. Maybe not so much a phobia, but practical!
Yeah it’s quite unusual because she will use some products for example she uses Dove Bar of Soap but not liquid soap from a bottle. She will also use Dove Shampoo and Conditioner but wouldn’t use hair spray or fake tan or moisturiser etc. She also wears make up everyday. Foundation, eyeshadow and mascara.
She is okay with using Fairy Liquid but not cleaning products like kitchen cleaner. Such as cream cleaners or spray cleaners or floor cleaning products. She will also get my mam to put washing powder or dishwasher tabs in the machine. She doesn’t want to touch them.
I can’t stand being around hair spray. It gives me a soar throat, at least the old fashioned kind. If my mother would visit, years ago, I would make her use it outside.