My ocd evolved quite rapidly from one very specific concern to a spiderweb of relationships to other illnesses, people, places, objects, and experiences. While I wasn't relieving myself in bottles in a dark room like Howard Hughes at my worst, I'd still call it severe. Being housebound for six months qualifies, and I was.
Even eating got to be too challenging; there is always the risk for an unexpected exposure if something doesn't look right or appears to have been tampered with in some manner. For a period of time, I was sleeping on the floor with no blanket or pillow, eating nothing but bottled water, coffee, and snack crackers, and not even stepping out my front door to retrieve packages or mail. The wake-up call came when the "diet" ocd had imposed on me started making me retain fluid in my ankles and my kidneys started hurting all the time from constant dehydration. While I drank the bottled water, it wasn't much. Opening the caps was an exposure for me, and I avoided it until my thirst was so intense it was almost unbearable.
I utilized a broom to reach items placed on the wrong side of the door when mail packages arrived. Literally every single moment of my day consisted of cleaning and washing rituals, and even my sleep was invaded by contamination nightmares. If I came into contact with anything on myself which I believed to be an infection of any sort, a minimum of 4-8 hours of ritual body cleaning and disinfection of the area around me and the area around that would follow.
At my worst, I truly believed suicide was the only way out. I thought my life was over and I was left with an existence of suffering and watching like a ghost as my life, he one I once enjoyed so much, kept going on without me. This was before I experienced the results of response prevention.
If someone had told me five years ago that I'd be living that way, I would have laughed and said, "There's no way in hell I'd ever do that to myself." I completely understand why people have such difficulty imagining why we do the things ocd tells us to do. The worst of it, I think, it the fact that lessening the grip ocd has on me involves reacting to and doing things in such a way that it feels wildly counterintuitive. Common sense says wash if you feel dirty, and our biology has us programmed to react to fear in a certain way. I always say that reducing the ocd's power involves something akin to having a hungry, roaring lion in your living room and knowing that the only way to avoid being consumed is to ignore any urge to respond to the lion or fear the situation causes. Doing anything to placate the lion will only cause it to grow and become angrier. Mindf_ck.
But it is what it is.
I went to sleep last night without washing my hands at all. I didn't plan it that way, but I sat in the recliner feeling like I just needed a break for a moment, then I woke up hours later. I decided to skip the rituals I knew I'd need to go to my bed and sit with the fact that I hadn't washed my hands because it was still a step in the right direction. In all, I slept over 10 hours in the chair. After being awake for two straight days, I guess I needed it. I washed my hands when I got up, but for less than 5 minutes. Feelin' good. In the past, falling asleep with dirty hands might have worked briefly, but it would have been on the floor only and I would have had to spray the floor with disinfectant, change my clothes, and wash any uncovered part of my body as I cannot know what I touched in my sleep. None of that happened, and I don't really feel the need.