I was dating a gentleman for six months. He took two showers a day, disinfected his sink before he shaved, wouldn't use a towel on his clean body if it touched the floor accidentally, had to take a shower after he had a bowel movement, washed his dishes before he put them in the dishwasher, and walked around with his hands up so he wouldn't touch anything. This was a good relationship, but I ended it because of this type of behavior. Is this an illness that could be cured with medication?

Valerie

It would be inappropriate for me to diagnose someone I haven't fully assessed, much less someone I haven't even met. But I must say that the behaviors you describe your ex-boyfriend engaging in sound much like obsessive-compulsive disorder (OCD), a condition that can be successfully treated with medication or with psychotherapy.

The Jack Nicholson character in the movie "As Good As It Gets" has OCD -- along with an obnoxious personality, which not everyone with OCD has. In the movie, Nicholson starts taking his medication after his attraction to the Helen Hunt character motivates him to change. (As Nicholson tells Hunt, "You make me want to be a better man.") Antiobsessional medication includes the drugs Luvox and Anafranil as well as the antidepressants Prozac, Zoloft and Paxil.

There's only a brief mention of psychotherapy in the movie, when Nicholson bursts into his former therapist's office wanting to be seen again after having dropped out of treatment a year or two before. That omission is unfortunate, because most OCD patients (90 percent) relapse when they stop taking antiobsessional medication.

Behavioral therapy, with a success rate of up to 80 percent, is actually more effective for OCD than medication alone. Therapists encourage OCD sufferers to expose themselves to situations that trigger the obsessive behavior, but to gradually lengthen the time they can refrain from engaging in the compulsion. (This strategy is called "exposure plus response prevention.") Eventually, the obsessions and compulsions subside.

Such behavioral therapy actually changes the brain's chemistry, as demonstrated in positron-emission tomography (PET) scans of OCD patients before and after 10 weeks of behavior therapy without medication. (You can read more about that study, and the brain's activity in OCD, in a June 1996 Discover magazine article titled "The Chemistry of Obsession.") Such studies are a wonderful example of how even psychotherapy or behavioral treatment alone can cause long-lasting changes in brain chemistry and brain functioning.

One last note: In mentioning "As Good As It Gets" and the Nicholson-Hunt romance, I am NOT suggesting that you should start dating your ex-boyfriend again in order to motivate him to get treatment for what might be OCD. However, if you're still in contact with him and you think he would be receptive to seeking psychological consultation -- if, for instance, HE'S distressed by his behavior -- you could suggest that to him and let him know that help is available. Good luck.