Tyler Tran, MSW, ACSW, of the OCD Center of Los Angeles, shares his personal experience navigating contamination OCD, the weight of cultural shame and stigma, and acceptance in a community where mental health is typically misunderstood.
I vividly remember being dragged out of the shower when I was 19 years old by my stepdad as I screamed at him to let me finish cleansing my body. I begged and pleaded as I assured him my body was contaminated. I could still feel the grime and germs across my body as I desperately scrubbed myself down. I was scratching and cutting my skin up due to my fear of being “contaminated.” If my father had not pulled me out, I was sure to have stayed another hour or so perfecting my shower routine to cleanse my body of being “contaminated.”
My life with this disorder has been an arduous, painful, long, and lonely journey. I felt trapped in a cycle of obsessions and compulsions that seemed foreign to others; not even my loved ones and family members could comprehend the shame, guilt, and pain I experienced. The stigma I suffered as an Asian American male struggling with Obsessive-Compulsive Disorder (OCD), made it all the more difficult to seek treatment and help. I’ve felt trapped in a cycle of intrusive thoughts and compulsive behaviors that I couldn’t explain to anyone—not even my closest family members. The stigma surrounding mental health in Asian American communities, especially for men, has made it all the more difficult to seek help.
OCD has many ugly faces; there are a plethora of themes and topics that the disorder latches onto. A common and highly stigmatizing theme is contamination. This was the theme I struggled with most. OCD is characterized by obsessions which are unwanted thoughts, feelings, or images, and compulsions; ritualistic behavior that reinforces the obsessions. My obsession with being “clean” showed up as washing my hands for hours on end, hyper fixating on the color red, due to a fear of blood, avoiding sticks because they looked like used syringes, and abusing bleach and antiseptic cleaning products that burned my skin due to overuse. I compulsively washed, scrubbed, and cleansed my body and personal belongings to feel a temporary sense of relief.
At my lowest, there was a part of me that realized this wasn’t about hygiene anymore, it was about an uncontrollable fear and uncertainty of what would happen if I contracted these germs. As I scrubbed and washed, the intrusive thoughts bombarded me. “What if I have germs still on my hands and I get AIDS?” “What if these germs get others sick and you’re responsible for their death?” It was all too much for me. I tried to hide my compulsions from everyone, secluding myself in my room for weeks on end. But the more I tried to keep it a secret, the more I felt alone, scared, misunderstood, and helpless. Fighting my OCD was exhausting enough, but coming from an Asian American household, there was another set of battles waiting for me.
Growing up in an Asian American household, my family didn’t believe in mental health issues. I would always hear them say “if you’re strong enough you’ll get through it,” or “if you’re strong mentally there is nothing to worry about.” Overcoming this hurdle was another bump in the road on top of my crippling OCD.
OCD is a debilitating disorder and on average takes about 7.5 years for individuals to receive treatment, which causes significant impairment in their family, social, and work functioning (Stewart et al., 2018). Furthermore, research indicates that only about 25% of those receiving treatment for OCD, are considered effective. Language and financial barriers are a concern as many minorities have limited culturally competent resources and therapy is expensive (Kolvenbach et al., 2018; Stewart et al., 2018). Stigma and shame were prevalent amongst minority individuals seeking resources for their mental health (Stewart et al., 2018). I wasn’t dealing with just my OCD, I was also trying to live up to the expectations placed on me by my culture and family.
In an Asian American household, there are unspoken rules about what a “successful young man” should look like. You went to college, received a studious degree, kept your emotions in check, worked hard, and never showed weakness. Showing vulnerability was unheard of, and mental illnesses simply were unacknowledged and trivialized. I love my parents to death but at the beginning of my OCD, they were like two deer facing an oncoming truck with blaring headlights. They simply did not know what to do, froze, and succumbed to worn out phrases such as “don’t think about those thoughts and they will go away” and “just think good thoughts.” My parents tried their best, but it was clear mental health issues were unheard of. Vietnamese culture values emotional restraint, and expressing negative emotions such as anger, sadness, or frustration is seen as a lack of control or face (Do et al., 2020). My parents are from an older generation that lived through the Vietnam War. They were raised in an environment where the only thing that mattered was survival and emotions were to be suppressed. After seeing me suffer with OCD and feeling helpless, my parents finally turned to therapists specializing in OCD.
I began Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP), which is the gold standard for the treatment of OCD. This treatment helped me slowly reclaim my life and confront my fears. I learned how to live with uncertainty and feel less controlled by my obsessions and compulsions. Treatment for me was gradually exposing myself to objects and situations that caused me anxiety. The treatment plan was individualized, and I began picking up sticks and straws covered in red paint which to me resembled needles dipped in blood, touching the bottom of my shoe and refraining from washing my hands, writing down imaginal exposures where I contracted HIV/AIDS, and attending shows and events that I deemed “contaminated.”
At first it was agonizing, but over time with each exposure, I learned my fears were not as bad as I deemed them to be, and over time my anxiety naturally decreased. I learned I was much stronger and braver than I imagined, and realized ERP was effective in overcoming my OCD. In addition to CBT and ERP, mindfulness practiced helped in my OCD recovery tremendously. Incorporating mindfulness into my life taught me to not worry about controlling my anxiety, but instead to accept its presence and allow my intrusive thoughts to come and go. With these tools and techniques, I was able to reclaim my life and live a life based on my values.
On the road to recovery, my parents and family finally acknowledged the efficacy of therapy and mental health issues. At first, my parents were hesitant about me going to therapy for my OCD, as mental health was foreign to them. But once they were able to speak and collaborate with a clinician who specialized in OCD, they saw the importance of therapy. My therapist explained how ERP and CBT worked to manage my thoughts and behaviors, shared progress with my family, and provided resources to help educate and bring awareness to them. We were finally able to have open conversations and over time, these efforts increased their support and awareness. This made therapy feel like something we were tackling together as a family, not just on my own.
Throughout my journey with OCD, I learned to rely on support networks, both professional and personal. Family and friends played a crucial role in providing compassion, patience, and support. Furthermore, finding a therapist specializing in OCD was paramount and instilled hope in me, and motivates me to give back to the community. I learned managing OCD is not an overnight fix, it requires courage, resilience, tenacity, and a willingness to confront the uncertainty head-on.
References
Stewart, E., Grunthal, B., Collins, L., & Coles, M. (2018). Public recognition and perceptions of obsessive compulsive disorder. Community Mental Health Journal, 55(1), 74–82. https://doi.org/10.1007/s10597-018-0323-z
Kolvenbach, S., Fernández de la Cruz, L., Mataix‐Cols, D., Patel, N., & Jassi, A. (2018). Perceived treatment barriers and experiences in the use of services for obsessive–compulsive disorder across different ethnic groups: a thematic analysis. Child and Adolescent Mental Health, 23(2), 99–106. https://doi.org/10.1111/camh.12197
Do, M., McCleary, J., Nguyen, D., & Winfrey, K. (2020). Mental illness public stigma and generational differences among Vietnamese Americans. Community Mental Health Journal, 56(5), 839–853. https://doi.org/10.1007/s10597-019-00545-y
•Tyler Tran, MSW, ACSW, is a psychotherapist at the OCD Center of Los Angeles, a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related anxiety based conditions. In addition to individual therapy, the center offers eight weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment. To contact the OCD Center of Los Angeles, click here.
