“I always imagined it as a plague that was spreading everywhere. It started with my mom and then it went to my dad and then to everything around the house. At that time, we didn't understand it at all; we didn't know what was wrong.”
Note: Noah is a pseudonym to protect the identity of the subject
After Emilie Zhou’s mother pet a dog in 2015, her brother, Noah, (then 11) began to see his mom as dirty. His behavior changed drastically and he became obsessed with cleaning everything.
“I always imagined it as a plague that was spreading everywhere,” Emilie said. “It started with my mom and then it went to my dad and then to everything around the house. At that time, we didn't understand it at all; we didn't know what was wrong.”
Noah began washing his hands multiple times per hour, forced Emilie’s mother to do laundry at least once per day, and didn’t let anyone walk on the carpet without socks or sit on it without first laying down a fabric square. He refused to touch the passenger seat in the car, door handles, countertops and appliances without first disinfecting them. During meals, Emilie and Noah would either stand or wrap the dining room chairs with saran wrap before sitting down.
Emilie’s family initially thought Noah was simply going through a childhood phase that he would soon grow out of, so they complied with his orders. However, Noah’s fears gradually worsened. Because his parents sometimes refused to wash their hands when he ordered them to or touched household objects without using a paper towel, they became vectors of contamination, from which he had to protect himself and Emilie against.
“I became the only person he trusted,” Emilie said. “He was trying to protect himself and me and I let him control me. I was the only one he could depend on because I didn't have the guts to say no to him.”
Since Emilie was the only person in their family Noah saw as clean, she took on the responsibility of caring for him, including helping him with his schoolwork and comforting him when others couldn't understand him. During that time, she became much closer with her brother and learned how to easily read what he was feeling from his facial expressions and body language.
Emilie said that the hardest order Noah gave her was to not touch her mom.
“I couldn't touch her. I couldn't hug her. I couldn't have any sort of physical interaction with my mom when my brother was in the room,” she said. “I had to avoid being in close proximity with my parents whenever they were around.”
For about a year, Emilie’s family avoided inviting guests over, going over to friend’s houses, and taking Noah to stores and restaurants, as they never knew what might trigger his fears.
But after about 6 months during which Noah’s fears intensified, Emilie’s family realized that his behavior wasn’t a part of a typical phase that a child would go through.
“His commands were pretty absurd and it was really tiring and frustrating to have to
listen to him without really understanding,” Emilie said. “At the time, everything he told us and everything he believed seemed so irrational. There was a point where we just couldn't handle it anymore.”
As a family, they went to see a psychiatrist, who diagnosed Noah with Obsessive-Compulsive Disorder. She recommended exposure therapy, which involves gradually exposing the patient to the source of his/her anxiety.
Having a better understanding of Noah’s condition, Emilie and her parents stopped giving in to Noah’s demands, often purposefully disobeying him by sitting in places he considered dirty or refusing to wash their hands excessively. Even though Emilie wanted to live a normal life and help her brother, she hated going against his wishes. She struggled with finding a balance between showing him that she cared about him and following the doctor’s recommendations.
“It was so hard to see the pain that [his OCD] caused him,” Emilie said. “Whenever I
didn't listen to him, he would scream and cry and I didn't want to put him through that.”
As part of the exposure therapy, Emilie’s father decluttered the house, moving around furniture and rearranging household items. He threw away the paper towels and the tissues their family used to touch items, which distressed Noah.
Emilie and Noah on a neighborhood walk in 2015 (left) and at the San Diego Zoo in 2016 (right)
“It was like his worst fears were coming true even though those fears were all irrational and completely absurd to most people,” Emilie said. “I think that he might have felt that we betrayed him and that something terrible would happen to us now that we were touching things he believed were dirty.”
Noah continued attending therapy multiple times a week. Over a few months, his condition eased and he became less obsessed with cleaning everything. Although he is still nervous around animals and refuses to pet them, he no longer sees everyday objects as dirty.
Emilie said that because she was there for Noah while he struggled with OCD, she developed a much deeper relationship with him.
“He couldn't help what his fears were doing to him,” she said. “Learning more about what he was going through definitely made me more sensitive and aware of what he might be feeling.”
Helping her brother overcome his fears also helped Emilie understand mental illnesses on a much more personal level.
“Because I was so close to my brother and ] I was there with him, I got an inside look on like what it really is like to deal with a mental illness and I became more aware of the feelings of the people around me. It made me be more patient and empathetic towards those around me.”