“I feel like there’s something under my skin…it’s like a film of filth,” Sarah* often says in her therapy sessions. Her words capture the persistent and overwhelming sensation of internal contamination that has haunted her since a sexual assault five years ago. For Sarah, this feeling isn’t really about hygiene; it’s emblematic of a deeper sense of being tarnished and unworthy of connection.
Mental contamination (MC), a phenomenon often reported by trauma survivors, is a disturbing consequence of traumatic experiences. For individuals like Sarah, it manifests as an internal feeling of dirtiness without physical contact with a contaminant. Often triggered by memories, thoughts, or emotions linked to trauma, the “invisible pollution” of mental contamination can perpetuate turbulent cycles of shame and emotional distress amongst trauma survivors.
Understanding Mental Contamination
Mental contamination (MC) is distinct from other trauma-related symptoms like flashbacks or hypervigilance. It arises internally, originating from the survivor’s emotional and cognitive responses to trauma. Ojalehto and Abramowitz (2024) define MC as “an internal feeling of dirtiness that is typically experienced in the absence of contact with a physical contaminant” (Ojalehto & Abramowitz, 2024, p. 661). Survivors often describe it as an emotional or moral stain tethered to their trauma.
Often triggered by memories, thoughts, or emotions linked to trauma, the “invisible pollution” of mental contamination can perpetuate turbulent cycles of shame and emotional distress amongst trauma survivors.
Marcus,* a 45-year-old veteran, endured chronic abuse by a relative throughout his childhood, leaving him with deep-seated feelings of uncleanliness. Marcus believes that his perpetrator’s immorality “rubbed off on him” and that he is permanently contaminated because of it. The emotional legacy of his trauma is directly tied to his abuser’s actions, continuing to shape his self-view and coping strategies. As a result, Marcus avoids intimate relationships and drinks regularly to cope with his trauma symptoms.
Research highlights strong connections between MC and posttraumatic stress disorder (PTSD). Ojalehto and Abramowitz note in their paper, “Quantitative studies showed strong evidence for a link between sexual assault and MC. There was also strong support for a relationship between MC and posttraumatic stress symptoms” (Ojalehto & Abramowitz, 2024, p. 661).
“I feel like there’s something under my skin…it’s like a film of filth.”
The Long-Term Impact of Mental Contamination
For many survivors, mental contamination becomes a lens through which they view themselves in the world. This subjective experience can shape every aspect of their lives, leading to:
- Distorted Self-Perception: Survivors often internalize feelings of contamination, believing they are inherently “dirty,” immoral, or unworthy. For Marcus, this manifests as a deep sense of moral failure. He feels irreparably adulterated by his trauma, which leaves him hesitant to form close relationships.
- Compounding Pathologies: MC can co-occur with PTSD, depression, and substance misuse. Marcus, for example, frequently relies on alcohol as a form of experiential avoidance to suppress intrusive memories and emotions tied to MC. While survivors may use substances to manage distress arising from MC, these behaviors can paradoxically increase the intensity of mental contamination over time.
- Social Withdrawal and Isolation: Many survivors withdraw from relationships out of fear of judgment. For example, Sarah’s avoidance of social situations is fueled by the belief that others can sense her internal “pollution.” She feels disconnected from her loved ones and describes herself as “disgusting and unworthy of love.”
Photo by John Salvino on Unsplash
Breaking the Cycle
Addressing mental contamination in therapy requires an approach that integrates cognitive, emotional, and somatic strategies. As a therapist, I use EMDR (Eye Movement Desensitization and Reprocessing) as a primary modality to help clients work through these challenges. During an EMDR session, the client focuses on specific aspects of a disturbing memory (e.g., image, beliefs, emotions, and sensations). At the same time, the therapist provides “bilateral stimulation,” using eye movements, alternating sounds, or hand-held pulsars. The combination of bilateral stimulation with the therapist’s guidance facilitates an updated, adaptive integration of the memory. A successful treatment demonstrates a reduction in emotional distress, revised negative beliefs about the self, and neutralized physiological discomfort previously associated with the memory.
To address the pervasive impacts of mental contamination, EMDR provides a targeted and effective approach. Below are three key areas where EMDR proves particularly beneficial for clients struggling with MC.
1. Restructuring distorted beliefs
At the heart of MC are distorted beliefs about self-worth. Survivors often view themselves as tainted, leading to shame and self-loathing. Through EMDR, I guide clients in addressing these beliefs from the etiological root. By targeting specific memories that contribute to these distortions, clients can reprocess their experiences and adopt more adaptive narratives.
2. Addressing avoidance
Avoidance behaviors are common coping mechanisms for survivors of MC, and they can be self-perpetuating. EMDR provides a structured approach to address these patterns. During sessions, clients focus on distressing memories while engaging in bilateral stimulation, which helps the brain process and integrate the memories adaptively. The byproduct of this process is a reduction of avoidance in the face of trauma-related triggers.
3. Processing emotions and strengthening self-compassion
Shame, guilt, and disgust are pervasive in MC, and EMDR offers a pathway to resolve these intense emotions. By processing the memories fueling these feelings in EMDR, clients often find relief and arrive to a compassionate self-view.
Rebuilding Lives Beyond Contamination
Mental contamination is heavy burden for trauma survivors that shapes how they view themselves and their relationships. As therapists, our role is to help survivors untangle these deeply entrenched beliefs and patterns. By addressing cognitive distortions, emotional and physiological distress, we can help survivors break the cycle of mental contamination and experience emotional repair.
Reference:
Ojalehto, H. J., & Abramowitz, J. S. (2024). Mental contamination among trauma survivors: A scoping review. Traumatology, 30(4), 661–676. https://doi.org/10.1037/trm0000492
*The examples discussed in this article are composites of clinical experiences and are not based on any one individual. They have been constructed to ensure confidentiality.
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