[On compulsive hand-washing--psychopathology of "touching"].
Compulsive hand-washing has been well known to the psychiatrists, since Legrand du Saulle described this disorder by the name of "délire du toucher" (1866), which refers to mysophobia or contact-phobia. But its clinical significance seems to have been not fully examined, except from the psychoanalytical point of view, that has observed the repression of sexuality in its pathology. This report presents four cases of compulsive hand-washing, and explores why they exclusively wash their hands. In order to elucidate the reason for their hand-washing and its significance, this report aims to study the relation of following three elements; "Sexuality", "hand" and "touching". As the idioms using "hand" often represent the various modes of sexual life in Japanese language as well as in English, so the "touching by hand" is reasonably considered to evoke the sexual impulsions, which the hand-washers fear and wish to avoid. On the other hand, "touching" is, necessarily in nature, to be touched by the touched object. For example, one who touches the lover's hand is inevitably to be touched by hers. That is; one is forced to be an object of one's object, which becomes to be a subject. In this sense, the act of "touching" means to lose one's "being subject" and to melt oneself into the situation where the structural distinction of subject and object can disappear. So one's act of "touching" or vivid contact with the other can cause anxiety by means of losing one's ego, which may be also a critical point to introduce to create something new. A compulsive hand-washer fears and avoids this critical moment that can make him lose his "being subject", so he "washes his hands of (cuts off relation with)" the situation that can undermine his ego. This avoidance of having contact can be compared to "the lose of vivid contact with the reality (la perte du contact avec la réalité (Minkowski)" observed in schizophrenia. In their ways of life, many hand-washers are not less autistic than the schizophrenics.om
Matsumoto
M
M
College of Medical Technology, Kyoto University.
D000328:Adult; D003192:Compulsive Behavior / Q000523:psychology*; D005260:Female; D006235:Hand Disinfection; D006801:Humans; D012559:Schizophrenia; D012723:Sex; D014110:Touch